WWCC Nursing Process and Health and Wellness.
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| Describe the art & science of nursing. | Art:Intentional creative use of self based on skill and expertise.
Science:Requires knowledge to deliever care
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| Describe the concepts/components of critical thinking & clinical decision making. | *Confidence *Contextual persepective *Creativity *Flexiblity *Inquisitive *Intellectual integrity *Intuition *Open-mindedness *Perserverance *Reflection
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| 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.
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| 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
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| 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.
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| Define the use of the nursing process in clinical practice. | A structure/guideline to promote critical thinking.
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| 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.
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| List common techniques for data collection. | Observation, Interviewing and Examining.
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| Differentiate between subjective and objective data. | Subjective-What you are told.
Objective- What you see or measureable data. Such as VS.
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| Describe data collection using client interview/nursing assessment. | Includes: Nursing health hx, physical exam, observation of client behavior, diagnostic & lab data
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| 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.
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| 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.
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| 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.
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| Describe vital signs. PULSE | Pulse: adult norm 60-100, absent 0 weak/thready +1 normal +2 strong +3 bounding +4
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| Describe vital signs. RESPIRATIONS | Resp: adult norm 12-20, regular/irregular/deep/shallow
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| Describe vital signs: BLOOD PRESSURE | BP: adult norm 120/80
Hypotensive 90/60, normotensive 120/80, prehypertension >120/80 Hypertension 140/90
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| 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
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| Sites for thermometers | Oral: mouth, Tympanic: ear, Temporal: across the forehead to ear, Axillary: Arm pit (1 degree below) Rectal: anus (1 degree above)
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| Pain Assessment | Pain scale of 0-10
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| Identify normal asssessement finding in the adult | Normal ranges...
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| Describe possible rationale for varitations in the baseline assessment. | Changes in pt. status or body condition, error etc.
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| Develope a systematic framework for organizing assessment date. |
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| 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.)
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| Differentiate between a medical diagnosis and a nursing diagnosis | Medical:Focus on disease process
Nursing:Focus on human response to health problems.
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| 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)
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| 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)
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| 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.
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| Differentiate between goals and expected outcomes. |
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| 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
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| Describe the skills neccessary for implementing nursing care. |
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| 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.
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| 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
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| 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.
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| 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.
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| 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.
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| 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.
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| Describe the factors the influence health, wellness & illness. | Genetic/physiological, behaviors/lifestyles, physical/social/enviromental, age.
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| Describe the difference between primary, secondardy & tertiary prevention. | Primary:Before illness-education
Secondary:Early detection/treatment
Tertiary:Late illness/Irreversible-reach max function.
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| Differentiate between illness & disease. | Disease:Physiological alteration of the body.
Illness:Includes disease & impacts functioning/wellbeing of pt.
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| Differenctiate between acute & chronic. | Acute:Sudden onset, temp. less than 6mo.
Chronic:Long term,slow onset, greater than 6mo.
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| 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
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| 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.
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| Discuss factore affection adult development & health in oler adults. Physiological changes of aging: | Loss, Loneliness, living arrangements.
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| 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
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| 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.
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| 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.
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| 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
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| Stages of Change: | *Precontemplation:No thought/desire to change
*Contemplation:Thinking about change
*Preparation:
*Action:
*Maintenance:
*Termination:
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| SPICES | Sleep Disorders, Problems with eating, Incontinence, Confusion, Evidence of falls, Skin breakdown
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