Exam 1 Content Questions Flashcards
(76 cards)
1
Q
A nurse’s personal moral code is to assist all patients to the best of ones ability. What blended skill would the nurse use when seeking out special services for a homeless patient with a diabetic foot alert?
A
Ethical/legal
2
Q
Describe The Benner Model (8)
A
- Creates a climate for establishing a commitment to healing
- provides comfort measures and preserves personhood in the face of pain and extreme breakdown
- presencing
- maximizes patient participation and control in recovery
- interprets pain and selects strategies for pain management and control
- provides comfort and communication through touch
- provides emotional and informational support to patients/families
- guides patients through emotional and developmental changes
3
Q
Describe Swanson’s Caring Process
A
Five caring processes: knowing, being with, doing for, enabling, maintaining belief
4
Q
Define “knowing” in SCP
A
- Avoiding assumptions
- centering on the one cared for
- assessing thoroughly
- seeking cues
- Engaging the self of both
5
Q
Define “being with” in SCP
A
- Being there
- conveying ability
- sharing feelings
- not burdening
6
Q
Define “doing for” in SCP
A
- Comforting
- anticipating
- performing competently / skillfully
- protecting
- preserving dignity
7
Q
Define “enabling” in SCP
A
- Informing/explaining
- supporting / allowing
-Focusing - generating alternatives/thinking it through
- validating/giving feedback
8
Q
Define “maintaining belief “ in SCP
A
- Believing in/holding in esteem
- maintaining a hope filled attitude
- offering realistic optimism
- going the distance
9
Q
Describe Watsons Carative Factors (8)
A
- Humanistic altruistic system of values
- instillation of faith/hope
- sensitivity to self and others
- helping/trusting human care relationship
- expressing positive and negative feelings
- creates a problem-solving caring process
- transpersonal teaching/learning
- supportive, protective and/or corrective mental, physical, societal, and spiritual environment
10
Q
Define thoughtful practice
A
- practice that is considerate and compassionate
11
Q
Define reflective practice
A
- Occurs when the one caring has a profound awareness of self
-awareness of one’s own biases, prejudgments, prejudices, and assumptions - understands how these may affect the therapeutic relationship
12
Q
How is the awareness in reflective practice developed?
A
- Through the process of reflection, thinking back on what has occurred for the purpose of learning in order to improve
13
Q
Define critical thinking
A
The intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from observation, experience, reflection, reasoning, or communication, as a guide to belief and action
14
Q
How does a nurse develop the method of critical thinking?
A
Work methodically through five considerations:
1. The purpose of thinking
2. Adequacy of knowledge
3. Potential problems
4. Helpful resources
5. Critique of judgment/decesion
15
Q
Define critical-thinking indicators
A
Evidence-based descriptions of behaviors that demonstrate the knowledge, characteristics, and skills that promote critical thinking in clinical practice
16
Q
Define clinical reasoning
A
- The thought process that allow healthcare providers draw a conclusion
- The process you use to think about patient problems in the clinical setting
17
Q
When is clinical reasoning required?
A
- When providing thoughtful, person-centered care
- when engaging in quality improvement projects
- when integrating evidence-based practice
- when providing teaching
18
Q
Describe characteristics of clinical reasoning (uses, what it leads to, type of thinking, guidance, driven by, based upon, focuses, what it identifies) (9)
A
- Process used to think about patient problems in a clinical setting
- Leads to clinical judgement
- purposeful, informed, outcome-focused thinking
- guided by standards, policies, ethic codes, and laws
- driven by patient, family, and community needs
- based on principles of the nursing process, problem solving, and the scientific method
- focuses on safety, quality, reevaluating, and self correcting
- identifies key problems, issues, and risks
- uses logic, intuition, and creativity
19
Q
Steps of the clinical reasoning cycle (8)
A
1.) consider the patient situation (describe)
2.) collect cues and information (review, gather, recall)
3.) process information (interpret, discriminate, relate, infer, match, predict)
4.) identify problems (synthesize)
5.) establish goals (describe)
6.) take action (select)
7.) evaluate outcomes (evaluate)
8.) reflect on processes and new learning (contemplate)
20
Q
Define clinical judgment
A
- The result or observed outcome of critical thinking and decision making
21
Q
List models, frameworks, and theories related to clinical judgement (7)
A
- Tanner’s clinical judgement model
- Developing nurses thinking model
- California critical thinking disposition inventory
- National council of state boards of nursing
- Clinical judgement measurement model
- Clinical judgement action model
- Nursing process
22
Q
Tanner’s clinical judgement model definition of clinical judgement
A
- An interpretation or conclusion about a patient’s needs, concerns, health problems, and the decision to take action, use or modify standard approach, or improvise new ones as deemed appropriate by the patients response
23
Q
Define Tanners Clinical Judgment Model
A
A research-based model that accounts for:
1. The impact the nurse’s knowledge, experience, and values have on assessment and action in a situation
2. The importance of knowing our patient’s and considering their perspectives
3. The influence of context and culture on a situation
4. The recognition that nurses typically use more than one reasoning pattern
5. The importance of reflection to foster the development of clinical knowledge and improving clinical reasoning
24
Q
What are the core elements of TCJM
A
- Noticing
- Interpreting
- Responding
- Reflecting
25
Define Developing Nurses Thinking Model
Identifies 17 critical thinking processes including:
- Information seeking
- contextual perspective
- predicting
- discriminating
-Intuition/pattern recognition
- creativity
26
Why is the DNT model used?
- Develop clinical reasoning prompts designed to assist student nurses in making clinical judgements on case studies (increased confidence)
- The value and necessity of threading clinical judgment models and frameworks into curriculum for students to have repeated opportunities to develop critical thinking, clinical reasoning, and clinical judgement
27
Describe the California Critical Thinking Disposition Inventory
- Measures the willingness of an adult learner to think critically
- describes the characteristics of an ideal critical thinker
28
What 7 attributes dues the CCTDI measure?
The disposition toward:
1. Truth seeking or bias
2. Open mindedness or intolerance
3. Anticipating possible consequences
4. Proceeding in a systematic/unsystematic way
5. Being confident in the powers of reasoning or mistrustful of thinking
6. Being inquisitive or resistant to learning
7. Mature and nuanced judgment or rigid simplistic thinking
29
Describe the National Council of State Boards of Nursing
- Independent n/p organization through which nursing regulatory bodies act and council together on matters of common interest and concerns affecting public health, safety, and welfare
30
Describe Clinical Judgment Measurement Model
-NCSBNs model
- works behind the scenes of the standardized test required for nursing licensure upcoming new version of the NCLEX
- layers 0-2 of the model emphasize how clinical judgement informs the clinical decisions made to address the clients needs
- layers 3-4 focus on expected behaviors of a student in a specific clinical or case scenario.
- related to core elements of the nursing process
31
Describe Clinical Judgment Action Model
- Developed by NCSBN
- aligns the six cognitive operations from layer 3 of the CJMM (recognize chef, analyze chef, prioritize hypotheses, generate solutions, take action, and evaluate outcomes) with specific situational factors from layer 4 (environmental, client observation, medical record, time pressure cues)
32
Describe the nursing process
- Outlines the way nurses think; represents the unique, shared languages of nurses
33
ADPIE
- Assessment
-Diagnosing/identifying actual or potential problems
-Planning
-Identifying interventions with rationales
-Evaluation
34
Define a mental model
- Organized way of thinking that assists in understanding complex aspects of a situation and guides assessments and behaviors
35
Define assessment
- Systematic and continuous collection, analysis, validation, and communication of patient data
36
What data is included in a assessment?
- How health functioning is enhanced by health promotion or compromised by illness/injury
- includes all the pertinent patient information collected by the nurse and other health care professionals
37
What critical thinking activities are linked to assessment?
- Assessing systematically and comprehensively to identify nursing and medical concerns
-Detecting bias and determining the credibility of information sources
-Distinguishing normal from abnormal findings and identifying the risks for abnormal findings
-Distinguish relevant from irrelevant data
- identify assumptions and inconsistencies, checking accuracy and reliability, and recognizing missing info
38
What are the steps for assessing?
1. Preparing for data collection
2. Collecting data
3. Identifying cues and making inferences
4. Validating data
5. Clustering related data and identifying patterns
6. Reporting and recording data
39
Name the types of nursing assessments (7)
1. Initial
2. Focused
3. Quick priority
4. Emergency
5. Time-lapsed
6. Triage
7. Patient - centered assessment method (PCAM)
40
What is performed during the initial assessment?
1. Performed after initial admission
2. Performed to establish a complete database for problem identification and care planning
3. Performed to collect info. On patient health
41
What is performed during the focused assessment?
1. May be performed during initial assessment or as routine ongoing data collection
2. Performed to gather data about a specific problem already identified, or to identify new or overlooked problems
3. Performed to collect information on a specific problem
42
What is a quick priority assessment?
1. Short and focused to gain important information first
2. Can flag existing problems and risks
43
What is an emergency assessment?
1. Performed when a physiologic or psychological crisis presents
2. Performed to identify life threatening problems
3. Gathers info about life threatening problems
44
Define a time-lapsed assessment
1. Compares current status with baseline behaviors
2. Reassess health status and makes revisions if needed
3. Collects out about current health status
45
Define a triage assessment
- Determines extent and severity of patient problems and follow-ups if needed
- completed on phone or in person
- nurses need clinical reasoning and judgement skills
46
Define a patient centered assessment method
1. Assess patient complexity using social determinants of health
2. Asks questions to gain understanding about patients health/wellbeing, social environment, health literacy and communication
47
Define objective data
Observable and measurable data that can be seen, heard, or felt by someone other than the person experiencing them.
Ex.) elevated temperature, skin moisture, vumiting
48
Define subjective data
Information perceived only by the affected person
Ex.) pain experience, feeling dizzy, feeling anxious
49
Sources of data
1. Patient
2. Family and significant others
3. Patient record
4. Medical history, physical examination, progress notes
5. Consultants
6. Reports of laboratory and diagnostic
7. Reports of therapies by other health care professionals
8. Nursing and other health care literature
50
List different assessment methods
1. Inspection
2. Palpation
3. Percussion
4. Auscultation
51
Define inspection
The process of performing deliberate, purposeful observations in a systematic manner
52
Palpation
The use of the sense of touch to assess skin temperature, turgor, texture, and moisture as well as vibrations within the body
53
Percussion
The act of striking one item against another to produce sound
54
Auscultation
The act of listening with a stethoscope to sounds produced within the body
55
OLD CARTS
1. Onset
2. Location
3. Duration
4. Characteristics
5. Alleviating and Aggressive
6. Relieving factors
7. Treatments
8. Severity
56
What is included in onset?
When did your symptoms begin
57
What is included in location?
Where is the symptom
58
What is included in duration?
Is it episodic? How long does it last?
59
What is included in characteristics?
How would you describe it?
60
What is included in alleviating and aggravations?
What makes it worse
61
What is included in relieving?
What makes it better
62
What is included in treatments?
Have you tried anything to make it better
63
What is included in severity?
On a scale of 1-10 how serious is the symptom
64
What are the purposes of the diagnosing step?
1. Identify how an individual, group, or community responds to actual or potential health and life processes
2. Identify factors that contribute to health problems
3. Identify resources or strengths on which the party can draw to prevent or resolve problems
65
What are problem statements?
Focus on unhealthy responses to health and illness; may change dry to day
66
Define medical diagnosis
- Identifies disease and describes problems for which the physical or advanced practice nurses directs the primary treatment remains the same
67
What are the types of nursing diagnoses?
1. Problem-focused
2. Risk
3. health promotion
68
What forms a nursing diagnosis?
1. Problem
2. Etiology
3. Signs and symptoms
69
Define etiology
Identifies factors maintaining the unhealthy state
70
What is the goal of the identification and planning step?
1. Establish priorities
2, identify patient outcomes
3. Select evidence-based nursing interventions
U. Communicate the nursing plan of care
71
What are the three elements of comprehensive planning?
1. Initial
2 ongoing
3. Discharge
72
What is included in maslow's hierarchy of human needs?
1. Physiologic needs
2. Safety needs
3. Love and belonging needs
4. Self-esteem needs
5. Self-actualization needs
73
What are the purposes of implementation?
1. Help patient achieve valued health outcomes
2. Promote health
3. Present disease and illness
4. Restore health
5. Facilitate coping with altered functioning
74
What are the focuses of the nursing implementation?
1. Scope of practice: who, what, where, when, and why
2. Nursing interventions taxonomy structure
3, care coordination and continuity
75
What are the different types of nursing interventions?
1. Those providing direct and indirect care
2. Independent and collaborative interventions
3. Protocols and standing orders
4. Care bundles
76
What are the five rights of delegation
1. Right task
2. Right circumstances
3. Right person
4 right directions and communication
5. Right supervision and evaluation
