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Nursing Proc./Health
WWCC Nursing Process and Health and Wellness.
| Question | Answer |
|---|---|
| Describe the art & science of nursing. | Art:Intentional creative use of self based on skill and expertise. Science:Requires knowledge to deliever care |
| Describe the concepts/components of critical thinking & clinical decision making. | *Confidence *Contextual persepective *Creativity *Flexiblity *Inquisitive *Intellectual integrity *Intuition *Open-mindedness *Perserverance *Reflection |
| Describe how journal writing helps develop critical thinking. | Journaling inspires reflection. Thinking back and discover meaning or purpose. Allows to track what to continue or change. |
| Discuss Benner's model for skill acquisition. | (Bottom to top) Novice-Relies on rules, Advanced beginner-recognize common patterns, Competent-recognize own thinking/analizing problems. Proficient-intuitive thinking begins. Expert-Intuition becomes prominent |
| Explain how professional standards influence a nurse's clinical decidsion making. | Standards give structure where critical thinking takes place. They are a framework/blue print that guides. |
| Define the use of the nursing process in clinical practice. | A structure/guideline to promote critical thinking. |
| Explain the relationship between data collection and critical thinking. | Data collection is just the gathering of facts, and the critical thinking is the analyzing of the data you collected in order to make a plan. |
| List common techniques for data collection. | Observation, Interviewing and Examining. |
| Differentiate between subjective and objective data. | Subjective-What you are told. Objective- What you see or measureable data. Such as VS. |
| Describe data collection using client interview/nursing assessment. | Includes: Nursing health hx, physical exam, observation of client behavior, diagnostic & lab data |
| Compare vital signs values in health with those observed during illness. | Know what normal rages are and what illness will impact which vitals and how. |
| Discuss the purpose of obtaining a physical assessment. | Assists in identifying problems that need nursing interventions. Establish baseline patterns. Comparing status between then and now. |
| Compare and contrast a comprehensive physical assessment, a basic physical assessment and the focused assessment. | Comprehensive:Total body assessment, holistic Basic: Focused:Assessment focused on a specific area of concern. |
| Describe vital signs. PULSE | Pulse: adult norm 60-100, absent 0 weak/thready +1 normal +2 strong +3 bounding +4 |
| Describe vital signs. RESPIRATIONS | Resp: adult norm 12-20, regular/irregular/deep/shallow |
| Describe vital signs: BLOOD PRESSURE | BP: adult norm 120/80 Hypotensive 90/60, normotensive 120/80, prehypertension >120/80 Hypertension 140/90 |
| Describe vital signs: TEMPERATURE | Temp: adult norm 96.8-99.5 hypothermic <93.2, normothermic 96.8-99.5, hyperthermic/febrile >99.5, hyperpyerxia >105.8 |
| Sites for thermometers | Oral: mouth, Tympanic: ear, Temporal: across the forehead to ear, Axillary: Arm pit (1 degree below) Rectal: anus (1 degree above) |
| Pain Assessment | Pain scale of 0-10 |
| Identify normal asssessement finding in the adult | Normal ranges... |
| Describe possible rationale for varitations in the baseline assessment. | Changes in pt. status or body condition, error etc. |
| Develope a systematic framework for organizing assessment date. | |
| Describe rationale for data clustering | Organizing data into clusters to form meaningful patterns in order to reach diagnostic reasoning(critical analysis of the clustered data.) |
| Differentiate between a medical diagnosis and a nursing diagnosis | Medical:Focus on disease process Nursing:Focus on human response to health problems. |
| Identify the components of a nursing diagnosis | Types: Actual, Risk for, health promotion/wellness 3 part statement:diagnostic label(approved ND), Related factors("related to..." no med. diagnosis)Defining characteristics(conditions supporting diagnosis) |
| Identify sources of diagnostic error | Error in data collection(missing/gaps/inconsistencies), Error in interpretation of data, Error in data clustering(don't make diagnosis fit s/s) |
| Discuss criteria used in priority setting | High priority:Emergent(ABC) Intermdeidate:Non-life threatening Low:Not always directly related to illness but effects pt. future. |
| Differentiate between goals and expected outcomes. | |
| List guidelines for writing a client centered outcome statement. | Pt. centered, realistic, directly related to ND, specific measurable change in pt. status as result of intervention, outcomes drive intervention |
| Describe the skills neccessary for implementing nursing care. | |
| Identify types of nursing interventions and when each type is used: Nursing initiated, collaborative, physician-initiated. | Nurse:No MD orders needed, act independently on pt behalf, based on science MD:Orders needed, MD response to med diagnosis. Collaborative:Interdependent nursing interventions requiring mult. professionals. |
| Identitfy nursing interventions to meet established expected outcomes. | Direct:Intervintions through pt(meds, dressing change, IV, Ambulation) Indirect:Performed away from pt on pt behalf |
| Discuss rationales for selected nursing interventions. | 6 factors(ND charac, goals/expected outcomes, evidenced based interventions, feasiblity, acceptabilty to pt, personal competency) Not all interventions work the same on all pt. Individualize to pt. |
| Evaluate the client's progress toward meeting identified goals. | Assessments, Compare w/ baseline, Did it meet outcome?, What is problem status?, Cont/Mod/Term care plan. |
| Define heath, wellness and illness using WWCC concepts. | Heath is a process that varies w/ a person's PERCEPTION of well-being. Achieve mx potential. |
| Discuss the issues that impact an individual's view of health, wellness & illness. | Internal: interllectual, age/developement, spiritual, family/culture, perception. External:Family practices, socio-economic, culture. |
| Describe the factors the influence health, wellness & illness. | Genetic/physiological, behaviors/lifestyles, physical/social/enviromental, age. |
| Describe the difference between primary, secondardy & tertiary prevention. | Primary:Before illness-education Secondary:Early detection/treatment Tertiary:Late illness/Irreversible-reach max function. |
| Differentiate between illness & disease. | Disease:Physiological alteration of the body. Illness:Includes disease & impacts functioning/wellbeing of pt. |
| Differenctiate between acute & chronic. | Acute:Sudden onset, temp. less than 6mo. Chronic:Long term,slow onset, greater than 6mo. |
| Describe the nurse's role in health promotion & disease prevention. | Assessment:(Health Hx, Physical fitness assessment, Lifestyle assessment, Social support system-Gordon's)Diagnosis:ND Planning:resource person to improve health Implementation:"doing" Evaluation:ongoing |
| Discuss factore affection adult development & health in oler adults. Developmental tasks of older adults: | Integrity vs despair, physical changes, reduced income, loss, self-esteem, living arrangements, role changes, sense of purpose. |
| Discuss factore affection adult development & health in oler adults. Physiological changes of aging: | Loss, Loneliness, living arrangements. |
| Discuss factore affection adult development & health in oler adults. Psychosocial changes of aging: | Prevalence of ageism, body image, elder abuse, lack of transporation, inadequate safe housing, decreased access to healthcare, retirement, isolation |
| Describe modifications of the health history & phsical examination for older adults. | ENVIORMENT:quiet, low voice tone, good lighting, temp of room, no distractions. FUNCTIONAL ASSESS:ADLs, mobility, social interactions, problem solving. |
| Identify nursing interventions related to the physicological, psychosocial, cognitive changes of aging. | Education(lifestyle changes, med management, stop smoking, immunization, dental care, health visits, screening) Individual attention, Reality orientation, Validation theraphy, Reminiscence, Body-image interventions. |
| Identify nursing interventions related to the changes of aging. | *Education:lifestyle changes, med. management, stop smoking etc. *Individual Attention:therapeutic comm., *Reminiscence *Body-Image Interventions |
| Stages of Change: | *Precontemplation:No thought/desire to change *Contemplation:Thinking about change *Preparation: *Action: *Maintenance: *Termination: |
| SPICES | Sleep Disorders, Problems with eating, Incontinence, Confusion, Evidence of falls, Skin breakdown |
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