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79 Cards in this Set
- Front
- Back
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Describe the steps of Critical Thinking. (p.193)
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Recognizing that an issue (pt problem) exists,
Analyzing info about the issue (data about pt), Evaluating information (reviewing assumptions & evidence) Making conclusions (p.193) |
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Define Evidence-based knowledge. (p.193)
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Research based or clinical expertise
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Identify the concepts of a critical thinker. (p.194)
(re: Table 15-2) |
1. Truth-seeking
2. Open-mindedness. 3. Analyticity 4. Systematicity 5. Self-Confidence 6. Inquisitiveness 7. Maturity |
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Explain the critical thinking behavior: Truth-seeking.
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Seek the true meaning of a situation. Courageous, honest, and objective about asking questions.
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Explain the crit. thinking behavior: Open-mindedness.
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Be tolerant of different views; sensitive to the possibility of your own prejudices; respect the right of others to have different opinions.
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Explain the crit. thinking behavior: Analyticity
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Analyze potentially problematic situations; anticipate possible results or consequences; value reason; use evidence-based knowledge.
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Explain the crit. thinking behavior: Systematicity
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Be organized, focused; work hard in any inquiry.
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Explain the crit. thinking behavior: Self-confidence
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Trust in your own reasoning process.
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Explain the crit. thinking behavior: Inquisitiveness
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Be eager to acquire knowledge and learn explanations even when applications of the knowledge are not immediately clear. Value learning for learning's sake.
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Explain the crit. thinking behavior: Maturity
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Multiple solutions are acceptable. Reflect on your own judgments; have cognitive maturity.
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How many levels of Crit Thinking are there? Identify them.
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3.
Basic Complex Commitment |
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Describe the BASIC level of Crit Thinking.
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- Learners trusts experts' answers.
- Concrete and rule-based thinking - Insufficient experience to anticipate how to individualize a procedure - Answers to problems are either right or wrong |
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Describe the COMPLEX level of Crit Thinking.
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- Begin to separate yourself from experts.
- Independent analysis - Learns alternatives and/or conflicting solutions exist - You see how each solution has benefits and risks that you weigh before making a final decision - Creative and innovative - Consider diff options from routine procedures; learn a variety of different approaches for the same therapy |
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Describe the COMMITMENT level of Crit Thinking.
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- Person anticipates when to make choices without assistance from others
- Accepts accountability - Choose an action or belief based on the available alternatives and support it. - Choose to delay as a result of your experience and knowledge - You consider the results of your decision and determine whether it was appropriate. |
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The 3 Crit Thinking competencies are?
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1. General crit. thinking (i.e. scientific method, problem solving, decision making)
2. Specific crit. thinking (i.e. Diagnostic reasoning and inference, Clinical decision making) 3. The Nursing Process |
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Scientific method ?
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Systematic, ordered approach to gathering data and solving problems
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Problem solving?
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Obtain info and then use that info plus what you already know to find a solution.
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Decision making?
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Focuses on problem resolution
- when you face a problem or situation and need to choose a course of action from several options... |
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Diagnostic reasoning?
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Determining a pt's health status after you have assigned meaning to the behaviors and Sx presented
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Inference?
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Drawing conclusions from related pieces of evidence and previous experience with the evidence.
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Clinical decision making?
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Careful reasoning so the best options are chosen for the best outcomes
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Nursing Process?
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5-step clinical decision making approach
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5 Components of Critical Thinking
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1. Knowledge Base
2. Experience 3. Critical Thinking competencies 4. Attitudes 5. Standards |
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List the 11 Crit Thinking Attitudes.
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1. Confidence
2. Thinking Independently 3. Fairness 4. Responsibility and authority 5. Risk taking 6. Discipline 7. Perseverance 8. Creativity 9. Curiosity 10. Integrity 11. Humility |
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Application in Practice: CONFIDENCE
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Learn how to introduce yourself to a pt.
Speak with conviction when you begin a treatment or procedure. Do not lead a pt to think that you are unable to perform care safely. Always be well prepared before performing a nursing activity. Encourage a pt to ask questions. |
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Application in Practice: THINKING INDEPENDENTLY
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Read nursing lit., esp. when there are diff. views on the same subject. Talk with other nurses and share ideas about nursing interventions.
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Application in Practice: FAIRNESS
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Listen to both sides in any discussion. If a pt or fam member complains about a co-worker, listen to the story and then speak with the coworker as well. If a staff member labels a pt uncooperative, assume the care of that pt with openness and a desire to meet the pt's needs.
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Application in Practice: RESPONSIBILITY & AUTHORITY
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Ask for help if you are uncertain about how to perform a nursing skill. Refer to a policy and procedure manual to review steps of a skill. Report any problems immediately. Follow standards of practice in your care.
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Application in Practice: RISK TAKING
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If your knowledge causes you to question a health care provider's order, do so. Be willing to recommend alternative approaches to nursing care when colleagues are having little success with pts.
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Application in Practice: DISCIPLINE
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Be thorough in whatever you do. Use known scientific and practice-based criteria for activities such as assessment and evaluation. Take time to be thorough and manage your time effectively.
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Application in Practice: PERSEVERANCE
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Be cautious of an easy answer. If co-workers give you information about a pt and some fact seems to be missing, clarify the info or talk to the pt directly. If problems of the same type continue tot occur on a nursing division, bring coworkers together, look for a pattern and find a solution.
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Application in Practice: CREATIVITY
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Look for different approaches if interventions are not working for a patient. e.g. different positioning, distraction technique
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Application in Practice: CURIOSITY
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Always ask Why. A clinical sign or Sx often indicates a variety of problems. Explore and learn more about the pt so as to make appropriate clinical judgments.
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Application in Practice: INTEGRITY
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Recognize when your opinions conflict with those of a patient; review your position, and decide how best to proceed to reach outcomes that will satisfy everyone. Do not compromise nursing standards or honesty in delivering nursing care.
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Application in Practice: HUMILITY
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Recognize when you need more information to make a decision. When you are new to a clinical division, ask for an orientation to the area. Ask RNs regularly assigned to the area for assistance with approaches to care.
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What are the Two standards in the Crit Thinking Model?
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Intellectual Standards (a guideline or principle for rational thought)
Professional Standards (ethical criteria for nursing judgments, evidence based criteria used for evaluation, and criteria for professional responsibility) |
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Explain the INTELLECTUAL STANDARDS of CRIT THINKING MODEL?
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Clear, Precise, Specific, Accurate, Relevant, Plausible, Consistent, Logical, Deep, Broad, Complete, Significant, Adequate (for purpose), Fair
(a guideline or principle for rational thought) |
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Explain the Professional Standards of Crit Thinking Model?
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ethical criteria for nursing judgments, evidence based criteria used for evaluation, and criteria for professional responsibility
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Reflective Journaling?
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Tool for developing critical thought and reflection by clarifying concepts; improves your observation and descriptive skills
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Concept Mapping?
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Visual representation of pt problems and interventions that shows their relationships to one another.
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Clinical decision making requires the nurse to?
1. Improve Pt's health 2. Standardize care for the pt. 3. Follow the health care provider's orders for pt care. 4. Establish and weigh criteria in deciding the best choice of therapy for a pt. |
- 4. Establish and weigh criteria in deciding the best choice of therapy for a pt.
Rational: Involves recognizing an issue exists, analyzing information, evaluating information, and making conclusions |
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Which of the following is not one of the 5 steps of the nursing process? Planning, Evaluation, Assessment, and Hypothesis Testing
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- Hypothesis Testing.
Rationale: The 5 steps are assessment, Nursing Dx, Planning, Implementing, and Evaluation. |
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Gathering, verifying, and communicating data about the patient to establish a database is an example of which component of the nursing process?
1. Planning 2. Eval 3. Asssessment 4. Implementation 5. Nursing Dx |
3. Assessment
Rational: Identifying a pt's health care needs |
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Completing a nursing actions necessary for accomplishing a care plan is an example of which component of the nursing process?
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Implementation
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Nursing Process?
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The FUNDAMENTAL BLUEPRINT of how to care for patients.
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Assessment?
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Collection, verification, and analysis of data
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Database?
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The pt's perceived needs, health problems, and responses.
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Cue?
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Info obtained via the senses
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Inference?
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Your judgment or interpretation of cures
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List Gordon's 11 functional health patterns.
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1. Health perception-health management pattern
2. Nutritional-metabolic pattern 3. Elimination patter 4. Activity-exercise pattern 5. Sleep-rest pattern 6. Cognitive-perceptual pattern 7. Self-perception-self-concept pattern 8. Role-relationship pattern 9. Sexuality-reproductive pattern 10. Coping-stress tolerance pattern 11. Value-belief pattern |
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Two primary sources of data?
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Subjective & Objective
Subjective - everything the pt says; pt's self-description of their health problems Objective - observations or measurements of a pt's health status e.g. BP, pulse |
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Identify the variety of sources where data can be obtained.
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1. The Pt
2. Family & Significant Others 3. Health Care Team 4. Medical Records 5. Other records and the SciFi Lit 6. Nurse's Experience |
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A Pt-centered interview is an approach for?
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...for obtaining data to FOSTER a caring a nurse-pt relationship, adherence to interventions, and treatment effectiveness.
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The interview process involves four steps. They are...
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1. Setting the stage
2. Gathering information about the pt's chief concerns or problems and setting an agenda 3. Collect the assessment or Nursing health history 4. Terminating the interview |
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Define the "Setting the stage" of the interview.
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Greeting using full name, self-introduction with role explained, safety and privacy met, explain the reason for collecting health history. Reassure confidentiality.
Wkbk answer -- "This is the orientation phase of the interview." |
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Define the "Setting the Agenda" of the interview.
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Focus on the patient. Let the pt know your purpose and ask the pt for list of concerns/problems. This time allows the pt to feel comfortable with you and become an active partner in decisions about care.
Wkbk answer -- "Gather info about the pt's chief concerns or problems and set an agenda (patient's)." |
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Define the "Collect the Assessment or Nursing Health History" of the interview.
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Start with open-ended questions allowing pt to describe clearly their concerns and problems
Wkbk answer -- "Collect the assessment (nursing health history" (-_-) #Duh |
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Define the "Terminate the interview" of the interview process.
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Summarize your discussion with the pt and check for accuracy.
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Basic components of Health History are?
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Bio information
Reasons for seeking Health care Patient expectations Present illness/health concerns Health history Family history Environmental history Psychosocial history Spiritual history Review of systems |
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Biographical information?
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Factual demographic data about the pt.
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Reasons for seeking health care?
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Chief concerns or problems
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Patient Expectations?
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Patient's understanding of why he or she is seeking health care
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Present illness/health concerns?
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Essential and relevant data about the nature and onset of Sx
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Health history
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Health care experiences and current health habits and lifestyle patterns
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Family history
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To determine whether the pt is at risk for illnesses of a genetic or a familial nature
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Environmental history
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Pt's home and work, focusing on determining the patient's safety
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Psychosocial History
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Reveals the patient's support systems and coping mechanisms
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Spiritual history
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Represents the totality of one's being
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Review of systems
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Systematic approach for collecting the patients' self-reported data on all body systems
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Physical exam involves five techniques. List.
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Inspection
Palpation Percussion Auscultation Smell |
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Diagnostic and lab data provide??
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Further explanation of alterations or problems identified during the nursing health Hx and physical exam
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Data Validation related to assessment.
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The comparison of data with another source to determine data accuracy.
How? Asking pts; medical records; consulting with other HCPs; fam or friends |
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Data Analysis related to assessment.
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Involves recognizing patterns or trends in the clustered data, comparing them with standards, and then coming to a conclusion about the pt's responses to a health problem.
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Identify some common practices related to documentation, the last part of a complete assessment.
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Documentation should be timely, thorough, and accurate. Record all observations. Pay attn to facts and be descriptive. Record objective information in accurate terminology. Do not generalize or form judgments.
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Concept Map?
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A visual representation allowing you to graphically show the connections between a pt's many health problems.
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The interview technique that is most effective in strengthening the nurse-patient relationship by demonstrating the nurse's willingness to hear the pt's thoughts is:
1. Direct question 2. Problem solving 3. Problem seeking. 4. Open-ended questions |
4. Open Ended questions.
Allows pts to respond to questions in more than one or two words. |
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While obtaining a health Hx, the nurse asks Mr. Jones if he has noted any change in his activity tolerance. This is an example of which interview technique?
1. Direct question 2. Problem solving 3. Problem seeking 4. Open Ended question |
1. Direct question.
Only allows for one or two word response to a specific question for objective reasons. |
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Mr. Davis tells the nurse that he has been experiencing more frequent episodes of indigestion. The nurse asks if the indigestion is associated with meals or a reclining position and asks what relieves the indigestion. This is an example of which interview tech?
1. Direct Q 2. P. Solving 3. P. Seeking 4. Open-ended Q |
3. Problem solving
Takes info provided in the pt's story and then more fully describes and identifies specific problem areas. |
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The information obtained in a review of systems (ROS) is:
1. Objective 2. Subjective 3. Based on the nurse's perspective 4. Based on physical examination findings |
2. Subjective
Asking q's about the normal functioning of each system and the changes are usually subjective data perceived by the pt. |
