RNSG 1125 EXAM QUESTIONS AND ANSWERS A+
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Clinical Judgement
an interpretation or conclusion about a patient's needs, concerns, or health problems,
and/or the decision to take action (or not), use or modify standard approaches, or
improvise new ones as deemed appropriate by the patient's response
Clinical Judgment: Antecedents
- sound judgement skills
- analytical reasoning skills
- awareness of patient and self
- creativity/inquisitiveness
- sound knowledge base
- persistence
Clinical Judgement: Positive
- positive patient outcomes
- evidence-based nursing care
- effective patient education
- effective nurse-patient relationship
Clinical Judgment: Negative
- unsafe nursing care
- "failure to rescue" patient
- breach of professional boundaries
- ineffective communication with patient/family
- breakdown in clinical judgement
Tanner's Model: noticing
notice things about patient, looking for patterns (assessment)
Tanner's Model: Interpreting
process of assembling info to make sense of it (diagnose/analyze)
Tanner's Model: Responding
appropriate action/implementation of actions and interventions
(implementing/intervention)
Tanner's Model: Reflection
purposely thinking back or recalling a situation (evaluation)
Tanner's Model: Reflection examples
- "why did I say that or did this?" (anxiety)
- Did original plan of care achieve optimal client outcomes? if so, which interventions
were successful or unsuccessful?
What are 2 types of reflection?
- Reflection IN action
- Reflection ON action
Reflection IN action
happens in "real time" while care is occurring
Reflection ON action
, after the patient care occurs/improves future practice
Levels of critical thinking: Basic
nurse trusts experts/based on rules
Basic (critical thinking) example
client reports pain 1 hour after receiving pain meds, instead of reassessing nurse tells
patient he must wait 2 hours before he can receive another dose
Levels of critical thinking: Complex
nurse begins to express AUTONOMY, analyzing, examining data for best alternative
(results from experience, knowledge, intuition, and flexible attitudes)
Complex (critical thinking) example
patient doesn't ambulate as often as prescribed because of fear of missing daughters
phone call, nurse assures patient the staff will listen for call when she is out of the room
Nursing Process
- assessment
- diagnosis or analyze
- plan
- implementation
- evaluation
ADPIE
Assess
gathering of data (information) to define your patient's needs
What is subjective data?
data that only the patient can describe: pain dizziness
What is objective data?
vitals
- data the nurse can directly observe
What thee parts does a nursing diagnosis contain?
- problem
- etiology
- symptoms
Problem
a concise statement of the problem or focus based on the data
Etiology
the "related to" cause or contribution to the problem
Symptoms
the defining characteristics that exist that show the problem exists (as evidenced by)
(AEB)
Nursing diagnosis example
risk for constipation related to inadequate dietary fiber and fluid intake AEB patient
verbalizing irregular stooling of hard stool
Planning
to develop a goal or goals to address the diagnosis
- should be patient centered, measurable, and prioritized according Maslow
Implementation
the actual carrying out and implementation of goals set out to address the diagnosis
Evaluation
GRADED. Buy Quality Materials!
Clinical Judgement
an interpretation or conclusion about a patient's needs, concerns, or health problems,
and/or the decision to take action (or not), use or modify standard approaches, or
improvise new ones as deemed appropriate by the patient's response
Clinical Judgment: Antecedents
- sound judgement skills
- analytical reasoning skills
- awareness of patient and self
- creativity/inquisitiveness
- sound knowledge base
- persistence
Clinical Judgement: Positive
- positive patient outcomes
- evidence-based nursing care
- effective patient education
- effective nurse-patient relationship
Clinical Judgment: Negative
- unsafe nursing care
- "failure to rescue" patient
- breach of professional boundaries
- ineffective communication with patient/family
- breakdown in clinical judgement
Tanner's Model: noticing
notice things about patient, looking for patterns (assessment)
Tanner's Model: Interpreting
process of assembling info to make sense of it (diagnose/analyze)
Tanner's Model: Responding
appropriate action/implementation of actions and interventions
(implementing/intervention)
Tanner's Model: Reflection
purposely thinking back or recalling a situation (evaluation)
Tanner's Model: Reflection examples
- "why did I say that or did this?" (anxiety)
- Did original plan of care achieve optimal client outcomes? if so, which interventions
were successful or unsuccessful?
What are 2 types of reflection?
- Reflection IN action
- Reflection ON action
Reflection IN action
happens in "real time" while care is occurring
Reflection ON action
, after the patient care occurs/improves future practice
Levels of critical thinking: Basic
nurse trusts experts/based on rules
Basic (critical thinking) example
client reports pain 1 hour after receiving pain meds, instead of reassessing nurse tells
patient he must wait 2 hours before he can receive another dose
Levels of critical thinking: Complex
nurse begins to express AUTONOMY, analyzing, examining data for best alternative
(results from experience, knowledge, intuition, and flexible attitudes)
Complex (critical thinking) example
patient doesn't ambulate as often as prescribed because of fear of missing daughters
phone call, nurse assures patient the staff will listen for call when she is out of the room
Nursing Process
- assessment
- diagnosis or analyze
- plan
- implementation
- evaluation
ADPIE
Assess
gathering of data (information) to define your patient's needs
What is subjective data?
data that only the patient can describe: pain dizziness
What is objective data?
vitals
- data the nurse can directly observe
What thee parts does a nursing diagnosis contain?
- problem
- etiology
- symptoms
Problem
a concise statement of the problem or focus based on the data
Etiology
the "related to" cause or contribution to the problem
Symptoms
the defining characteristics that exist that show the problem exists (as evidenced by)
(AEB)
Nursing diagnosis example
risk for constipation related to inadequate dietary fiber and fluid intake AEB patient
verbalizing irregular stooling of hard stool
Planning
to develop a goal or goals to address the diagnosis
- should be patient centered, measurable, and prioritized according Maslow
Implementation
the actual carrying out and implementation of goals set out to address the diagnosis
Evaluation
