Lecture 1

Question 1

Critical Thinking

Answer 1

Looking beyond the obvious, exploring patient responses and seeing what needed to benefit patient

Question 2

Characteristics of Critical Thinkers: 6

Answer 2

• Raise questions and anticipate questions
• Willingness to search for answers
• Are inquisitive
• Eager to acquire new knowledge
• Consider multiple perspectives
• Explore ideas in new ways
• Are open-minded

Question 3

Critical Thinking =

Answer 3

Character + Knowledge + Skills

Question 4

Critical Thinking requires the habit to…

Answer 4

Ask questions to be well informed, being honest in facing biases and to reconsider and think differently about issues

Question 5

Critical thinking is a…

Answer 5

Multidimensional Thinking process

Question 6

Critical Thinking Skills

Answer 6

1. Identify assumptions
2. Identify an organized and comprehensive approach to assessment
3. Validate
4. Normal vs Abnormal
5. Make interferences
6. Cluster related clues
7. Relevant vs Irrelevant
8. Recognize inconsistencies
9. Identify patterns
10. Missing information
11. Promote Health
12. Diagnosis actual/potential problems
13. Set Priorities
14. Identify patient- centred expected outcomes
15. Determine specific interventions
16. Evaluate/ revise your thinking
17. Determine a comprehensive plan

Question 7

Set Priorities

Answer 7

1st Level (ABCDS)

• Airway
• Breathing
• Circulations
• Deficit (losing consciousness)

2nd Level

• Acute pain
• Abnormal Lab Values

3rd Level
-Anything that doesn’t fit

Question 8

Nursing Process…

Answer 8

a thoughtful, informed, evidence-based, and ethical nursing practice

AD PIE
(DYNAMIC, MOVES BACK AND FOURTH, NOT LINEAR)

Question 9

Assessment

Answer 9

Collection of data relating to clients health status

a. Collect and verify Data
- Physical exams
- Family info
- Old charts
- Asking them
- Blood

b. Analyse the data
- think holistically

Question 10

Types of Data

Answer 10

Subjective
Objective
Constant
Variable Data

Create data cluster

Question 11

Subjective

Answer 11

Pt States (symptoms)

Question 12

Objective

Answer 12

Observations (signs)

• Vital signs
• What you observe

Question 13

Constant

Answer 13

Data that cannot change

• Name
• Gender

Question 14

Variable Data

Answer 14

Data that can Change

• Weight
• Pain

Question 15

Sources of Data

Answer 15

Primary source
-pt

Secondary Source
-Family, support people

Question 16

AOVD

Answer 16

Analyse

Organize (data cluster)

Validate (double check)

Document

Question 17

Nursing DIAGNOSIS

Answer 17

Clinical judgement about individual, family, or community responses to actual or potential health problems/ life processes.

Provides basis for selection of interventions to achieve outcomes for which the nurse is accountable

(NOT A MEDICAL DIAGNOSIS, relates to it but not the actual diagnosis)

Question 18

Nursing Diagnosis Types

Answer 18

1. Actual (existing problem)
2. Risk (Potential problem pt vulnerable to)
3. Health Promotion (focus on being healthy)
4. (based on group of S&S that occur together, provide clinical picture)

Question 19

PES (how to write nursing diagnosis)

Answer 19

Problem - Diagnosis Label

Etiology - Cause/ contributor to problem ( R/T)

(as evidenced by)
Symptoms

EXAMPLE:

P: Acute pain -> E: Abdominal discomfort -> S: Patient stating “this pain in my stomach is unbearable”

Question 20

Planning (with outcomes

Answer 20

Use priority setting - attend to the most important needs first

Combine goal with stated outcome and timeframe:

• goals = broad statements
• Outcomes = Specific, observable data

Can be as many outcomes as goals

Example: Patient will have decreased pain as evidenced by
Verbalization of pain rated less than 9/10 in 1 hour.

Question 21

SMART (goal setting)

Answer 21

Singular
Measurable
Attainable
Realistic
Timed (short or long-term)

Question 22

nursing Interventions

Answer 22

Used to achieve Client goals

Direct or in direct

• Independent: Initiated and carried out by nurses alone
• Dependent: Dependent on physician’s orders (giving meds)
• Collaborative: Carried out by working with other health care pro’s

Must indicate rationale: significance?

Question 23

Criteria when selecting interventions:

Answer 23

• Safe and appropriate
• Achievable considering available resources
• Congruent with values/beliefs/culture
• Congruent with other therapies
• Based on evidence/research
• Within our scope of practice

Question 24

Implementation (acting on Nursing interventions)

Answer 24

• Reassess the pt (review/revise)
• Determine need for assistance

(Prevent complications, safety and lack of knowledge)

• Organize Resources

Question 25

Evaluation (6)

Answer 25

1. Identify outcome criteria 2. Collect data and compare with desired outcomes 3. Interpret and summarize findings 4. Document findings 5. Continue/ revise/ terminate care plan 6. Document evaluation. Example: 19/09/14 Goal met: Pt states “I feel better now” after having a bowel movement.