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N103 test 1 (GRCC)

N103 test 1 (GRCC) Nursing Process, Critical,teach, & Prof Roles

QuestionAnswer
The Nursing Process is..... patient Based on how they react to a situation.
A Decision-making approach that enhances critical thinking. Nursing Process
Is the focus of nursing care Nursing Process
The Nursing Process address what? The Response of the client to illness.
The primary purpose of the nursing care plan is? Communication with the health care team. (part of the nursing process)
ADPIE Acronym of the nursing process: Assess, diagnosis, plan, implementation, Evaluate.
Assessment is a method of data collection.
When doing an assessment, what sources do you the collect data? Client - usually more reliable, family and significant others, and medical records.
During the assessment process what should you look to first when collecting pt history? A) Charts/Medical records B) Client/Patient C) Family & Significant other Start with chart/medical records, then go to patient and have them fill in the gaps.
This process is pertinent to the diagnosis. Diagnosis and analysis (which is part of the nursing process)
During what phase interventions and outcomes are developed as well as discharge plans begin when client is first admitted? This is the Planning phase of the nursing process.
Carry out planned interventions with ongoing assessment. Implementation phase of the nursing process.
T or F. If something wasn't documented but verbally stated, then it is assumed that it was done. FALSE. Documentation is a legal requirement. If it was not documented, then it wasn't done.
Validating the effectiveness of the nursing care plan. Evaluation
Purposeful, outcome-directed thinking that aims to make judgments based on scientific evidence rather than tradition or guess work. Critical Thinking
Critical Thinking Self - directed thinking within
Nursing care is based on research and critical thinking. Evidence Based
T or F. We do things because it is Evidence Based thinking. True- research has been done and tells us this is the best way to do things.
Being able to think independently. Attitude and mental habit that affect critical thinking.
Intellectual courage Part of critical thinking where listening to and being fair in evaluation of others, ideas, and beliefs.
Intellectual Empathy Critical thinking attribute where being able to put yourself in the place of another to better understand that person.
Intellectual Sense of justice Critical thinking attribute where someone is fair-minded and considers viewpoints before making a decision.
Intellectual Humble Critical thinking attribute where one is constantly learning from others, don't be afraid you don't know something.
Critical Thinking Attribute Be creative and self confident.
Divergent Essential critical thinking skill that is having the ability to sort out relevant patient information. You pick out what is relevant to patient.
Reasoning Critical thinking skill having the ability to discriminate between facts and guesses. (i.e. head injury effects reasoning skills)
Clarifying Critical thinking skill is being able to define terms, note similarities and differences.
Reflections Critical thinking skills is being able to take the time to think about something. DOES NOT occur during emergency situations.
Assessment of clients willingness, goals and feelings (positive or negative) Learning readiness.
T or F? You can still teach a client who aren't ready to learn. False. Clients will not listen if they are not ready to learn.
T or F? Client who demonstrates avoidance or denies their illness can still learn. False. Clients must be accepting of dx and a need for teaching in order to learn.
T or F? Frustration can drive a desire for learning readiness. True. Frustration is a motivational principle in which patients desire to regain control of their lives enabling them to be ready to learn how to get better.
T or F? You assess and decide where to start teaching the patient. False. Assess what patient wants to know or be able to do himself and start from there.
Factors to consider when teaching a patient. Education level, socioeconomic level, type of support systems (i.e. caregivers), Age (depending on age, it may take longer to grasp concept), & culture.
Culture Teaching in terms related to a clients culture. For example, in some cultures, family takes care of home months after new mother brings home newborns. In the U.S. new mothers usually return to their usual routine after returning home from hospital.
T or F. If the client does not want to learn, you can still set goals with clients. False. Goals must be mutually established by client and nurse. If client doesn't want to learn, then there is no mutual collaboration.
Measurable learning goals client centered, time, specific and measurable learning goals. Example: The client will be able to verbalize....by d/c.
Patient can go home when pain is controlled by oral pain meds by d/c. Example of measurable learning goals.
Teaching techniques and strategies Establish rapport, set goals/boundaries, set priorities (want patient to be safe @ home).
Assess when people learn best is a teaching strategy. Not being able to learn when in pain, anxious, or post surgery.
T or F. The best teaching technique is to hand a pamphlet to the client to read. False. Clients learn better by demonstration, hands on warning, AV, etc.
T or F. It is important teaching technique to involve the significant other or caregiver. True. SO &/or caregivers help with pt rehabilitation and it is important they understand the pt care.(i.e. ted hose and deep breath/cough exercises)
Limit Distractions such as t.v. or radio. Teaching technique and strategy.
T or F. When considering learning techniques/strategies, all stroke patients have good reasoning skills. False. Reasoning skills may be affected due to stroke. It is important to put pt safety first when strategizing learning techniques.
T or F. Proceed from Complex to Simple when teaching a client FALSE. The best teaching technique is to proceed from simple to complex.
Giving praise, reviewing materials before learning new materials, and provide practice time are what? Teaching techniques and strategies.
Benefits of standard teaching plans Others can continue where you left off.
You don't have to document what has been taught. T or F False. document what has been taught to fill in missing gaps and someone else can finish whatever you started. (avoid duplication)
T or F. Insurance companies do not see the value in teaching. True. Teaching has not been documented in the past and there fore, insurance companies do not recognize the benefits.
Do you evaluate client interventions? No. It is not necessary to evaluate interventions (i.e. pt pain controlled by oral pain meds).
Goals/outcomes being met, are revisions necessary, is time frame realistic, and is client satisfied w/ the experience. These are questions one would ask in the evaluation of client learning during the planning, implementation process.
Responsibility to explain your actions Accountability
Accountability to patient/client Give safe and appropriate nursing care.
Accountability to hospital Follow policy, procedure and rules (HIPAA). Be honest, confidential, adhere to dress code and conduct.
Accountability to instructor Look up and research info on patient in a timely manner. Inform instructor when something is happening.
Accountability of policy/procedure manuals. Found at hospital intranet site.
Accountability of Level 2 nursing students Look at student handbook. (i.e. appropriate uniform).
Created by: Wends1984
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