Module 11

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Module 11
2011-10-30 15:01:07
N110 CH2

Test 6, Nursing Process: Critical Thinking and Assessment
Show Answers:

  1. What is Critical Thinking and Clinical decision-making and how they relate to nursing practice?
    • In nursing critical thinking for decision makingis the ability to thinkin a systematic and logical manner with openness to question and reflect on the reasoning process used to ensure safe nursing practice and quality care.
    • Critical thinking: reasoned action
    • Clinical decision-making: describe decision making as providing a basis for intervention utilising critical thinking as a framework in the search for alternatives through inferential (higher order) reasoning
  2. Critical -Thinking Skills?
    • Skills:in critical thinking refer to cognitive(intelectula processes used in complex thinking operations such as problem solving and decision making.
    • Objectively gathering information on a problem or issue
    • Recognizing the need for more information
    • Recognizing gaps in one's own knowledge
    • Listening carefully, reading thoughtfully
    • Separating relevant from irrelevant data, important from unimportant data
    • Organizing or grouping information in meaningful ways
    • Making inferences (tentative conclusions) about the meaning of the information
    • Integrating new information with prior knowledge
    • Visualizing potential solutions to a problem
    • Objectively evaluating the likelihood that each potential solution will work
    • Exploring the advantages, disadvantages, and consequences of each potential action
    • Evaluating the credibility and usefulness of sources of information
  3. what are Critical-Thinking Attitudes?
    • Attitudes: more like feelings and traits of mind.
    • Independent thinking. Critical thinkers do not believe everything they are told; they do not just go along with the crowd. They listen to what others think and they learn from new ideas. They do not accept or reject an idea before they understand it. Nurses should challenge actions and policies that have no logical support.

    Intellectual curiosity. Critical thinkers love to learn new things. They are naturally inquisitive and frequently think or ask, "What if . . . ?" "How could we do this differently?" and "How does this work?"

    Intellectual humility. Critical thinkers are aware that they do not know everything, and they are not embarrassed to ask for help when they don't know. They reevaluate their conclusions or chosen course of action in light of new information and are willing to admit when they are wrong. However, this trait does not imply ambivalence or apathy.

    Intellectual empathy. Critical thinkers try to understand the feelings and perceptions of others and expand perspective toward a worldview. They try to view a situation as another person sees it.

    Intellectual courage. Critical thinkers consider and examine their own values and beliefs, as well as viewpoints of others, even when this is uncomfortable. They are willing to rethink, and even reject, previously held beliefs that are not well justified. Without intellectual courage, people become resistant to change.

    Intellectual perseverance. Critical thinkers don't settle for the quick, obvious answer. They do not jump to conclusions. Important questions are usually complex; critical thinkers are willing to contemplate and consider alternate ideas. They investigate thoroughly, even when this takes a great deal of effort and time.

    • Fair-mindedness. Critical thinkers try to make impartial judgments. They consider various viewpoints fairly, realizing that personal biases, customs, and social pressures can influence their thinking. They examine their own biases each time they make a decision.
  4. Individual differences
    uniquness of each client (e.g., type of illness, culture , and age) make it impossible to provide strict rules for all client care.
  5. Explain ways in which nurses use critical thinking
    • Nurses use critical thinking when dealing with uniquness of each client to evaluate and modify guidlines to be sure they are appropriate for each client pg. 28.
    • Nurses use complex critical think processe )e.g. problem sloving, decision making, and clinical reasoning) in every aspet of their work.
    • Assess the client's and family's cultural beliefs and adapt care so that it is clturally sensitive and responsive to their needs.
    • To determine why a nursing intervention was or was not successful
  6. 5 Major categories of critical thinking
    • Contextual awareness: An awareness of what's happein in the total situation, including values, cultural issues, interpersonal relationships and environemntal influences.
    • Inquiry: (based on credible sources) Applying standars of good reasoning to your thinknig when analyzinga situation and evaluating your actions
    • Considering alternatives: Exploring and imagining as many alternatives as you can think of for the situation
    • Analyzing assumptions: recognizing and analyzing assumptions you are making about the situation and examining the beliefs that underlie your choices.
    • Reflecting skeptically and deciding what to do: questioning, analyzing, and reflecting on the reationale for your decisions.
  7. Kinds of Nursing knowledge
    • Theoretical knowledge: info, facts, principles, and evidence-based theories in nursing and related disciplines. You will used it to describe your patients, understand health status, explain your reasoning for choosing interventions, and redict patient responses to interventions and treatments
    • Practical knowledge: knowing what to do and how to do it - consists of processes and procedures and is an aspect of nrusing expertise.
    • Self-knowledge: self-understanding. Be aware of your beliefes, values, and cultural and religious biases. helps you find errors in your thinking and enables you to "tune in" to your patients. You can gain self knowledge by developing personal awareness - by reflecting, "why did I dot that? or how did i come to think that.
    • Ethical knowledge: knowledge of obligation, or right and wrong.
  8. Nuring process
    • is a systematic problem-solving process that guides all nursing actions. It is they type of thinking and doing nurses used in their practice.
    • The purpose of the nursing process is to help the nurse provide goal-directed, cient-centered care. Involves thinking anddoing.
    • PRomotes collaboration
    • Is cost-efficient
    • Helps people understand what nurses do
  9. Explain how critical thinking is used in the nursing process?
    • read page 33 or power point slides
    • Assessment
    • Diagnosis
    • Planning (outcomes and interventions)
    • Implementation
    • Evaluation
    • pg. 36
    • Nurses use ritical thinkingin allsteps of the nursing proces. They also apply criticalthinkng to the four kinds of nursing knowledge, and when they are doingfor the patient. Caring motivates and facilitates the thinking and donig. The goal of all this is to have a positive effect on a patient's health otucomes.
  10. Discuss Full-spectrum nursing model
    • 4 Concepts(ideas):
    • Critical thinking
    • Nursing knowledge
    • Nursing process
    • Patient situation
    • Full-spectrum nursing - is a unique blend of thinking, doing, and caring. It is performed by nurses who fully develop and apply nursing knowledge, ricitical thinking and the nursing process to patient situations for the purpose of effective good outcomes.
    • Nurses use ritical thinkingin allsteps of the nursing proces. They also apply criticalthinkng to the four kinds of nursing knowledge, and when they are doingfor the patient. Caring motivates and facilitates the thinking and donig. The goal of all this is to have a positive effect on a patient's health otucomes.
  11. Assessment
    • the systemic gathering of information related to the physical, mental spiritual, socoeconomi and cultural status of an individual, group, or community.
    • Colleciton data
    • Using a systematin and ongoing process
    • Categorizing the data
    • Recodring the data.
  12. State the ANA position on delegating assessment
    • The nurse determines the appropriate delegation of tasks consistent with the nurse's obligatin to provide optimum patient care.
    • ANA has a guide on how to make decision on who is ultimately responsible and qualifed to collect assessment data.
  13. Subjective data
    symptoms, infom communicated to the nurse by the lient, famiy or community. thoughts, feelings, beliefs, sensations.
  14. Objective data
    signs, gathered through a physical assessment or from lab or diagnostic tests. Can be measured or observed.
  15. Primary Data and Secondary data
    • Primary data: subjective and objective data obtained from the client: what the client says or what you observe.
    • Secondary data: obtained"second had," ex, from medical record or from another caregiver.
  16. Identify the component of a nursing health history and explain he purpose of each
    • Biographical data. Provides basic information about the client. The person's responses to these questions reflect his mental status and ability to communicate.
    • Chief complaint/reason for seeking healthcare. This is the client's perception or reason for seeking medical or nursing advice. From this, you will be able to target your assessment to gather the most relevant and important data.
    • History of present illness. This provides details about the client's current health problem.
    • Client's perception of health status and expectations for care. This will give you insight into the client's view of his health problem and what he expects to be done for him.
    • Past health history. The past health (medical) history will help guide your assessment and help you to understand some of the data you obtain.
    • Family health history. This includes data on first-degree blood relatives such as mother, father, siblings, and maternal and paternal grandparents. It includes data about diseases relatives have had, their current state of health, whether they are alive, and cause if death if they are not. Risk factors for various illnesses and disorders (e.g., hypertension, allergies) are often tied to multigenerational problems.
    • Social history. This includes information about family and other relationships, economic status, occupations, exposure to toxic materials, home and neighborhood conditions, and ethnicity. It also includes data about tobacco, alcohol, and drug use as well as exercise habits.
    • Medication (nutritional supplements, herbs) history and medical device use. Current and past medication usage may uncover some medical history the client has forgotten to disclose. Current medications are of utmost importance because (1) they may interact with newly prescribed medications and (2) some may affect certain body symptoms, causing abnormalities in your assessment findings (e.g., skin color, laboratory values). Also inquire about vitamin and nutritional supplements and the use of alternative therapies, as they may interact with the allopathic treatment plan. A thorough health history includes use of medical devices, such as bracing, inhalers, home CPAP.
    • Complementary/alternative modalities. These therapies can support or interfere with conventional therapies.
    • Review of body systems and associated functional abilities. This is subjective data regarding body systems, as well as functional abilities. This review provides information on the client's concerns and the effect of illness on the client's life.