NUR 301 CT MIDTERM EXAM STUDY GUIDE.Week 1:
- **Definition of Nursing (ANA, 2015) Nursing is the:
o Protection, promotion, and optimization of health and abilities.
o Prevention of illness and injury.
o Facilitation
...
NUR 301 CT MIDTERM EXAM STUDY GUIDE.Week 1:
- **Definition of Nursing (ANA, 2015) Nursing is the:
o Protection, promotion, and optimization of health and abilities.
o Prevention of illness and injury.
o Facilitation of healing.
o Alleviation of suffering through the diagnosis and treatment of human response.
o Advocacy in the care of individuals, families, groups, communities, and populations.
- Human Responses
o Patients/families/communities reactions to actual or potential health problems, injuries, or
life processes.
o Human Responses include identification of the NDx/problem (label) and likely causes or
etiologies of the diagnosis/problem.
o Each NANDA dx has a definition, defining characteristics (or signs and symptoms) and related
factors (etiologies).
- Clinical Reasoning and the Nursing Process
o ADPIE
1
st: ASSESS: the situation and identify important cues or pt data.
2
nd : Generate multiple hypotheses: to describe the possible problem
3
rd : Make a CLINICAL JUDGMENT or a NURSING DIAGNOSIS: NDx are
HUMAN RESPONSES of a patient/family/community actual/potential health
problem
4
th: PLANNING: Identify OUTCOME GOALS and INTERVENTIONS:
5
th : IMPLEMENT plan: coordination of care, health teaching and promotion
6
th : EVALUATE: COMPARE the actual pt outcome to predetermined GOALS
Modify diagnosis, goals, and plans as indicated (if GOALS have been
achieved—continue the plan. If NOT achieved, REFLECT!
o Thinking errors in any phase of this process can lead to inaccurate diagnoses,
ineffective/harmful nursing interventions and poor patient outcomes.
- Nurses’ Judgments Impact Patient Outcomes and Safety
o Over 200,000 pts die in hospitals every year due to medical errors
o Clinical Judgment: a nurses’ interpretation and/or conclusions about a situation.
Nursing diagnosis+patient problems = clinical judgment
- Judgment or Diagnostic Error
o Incorrect interpretation of patient data and thinking errors missed, incorrect or
delayed Dx, delayed care and poor pt outcomes.
- Nurses’ Clinical Decisions Impact Patient Safety and Outcomes
o Implements appropriate interventions to positively impact patient outcomes and safety.
- Accurate Clinical Judgment Good Clinical Decisions
o The NDx consist of the problem or label and includes likely etiologies of the problem.
o Interventions are designed to impact the causes of the problem
o Clinical Decision (intervention): EHOB, encourage and assist with deep breaths, VS
- Focus of pt care
-Factors That Positively Impact Nurses’ Decision Making Processes
o Art of nursing: (Experiences, sensitivity, caring behaviors, creativity, and ability to adapt care)
o Science of nursing: Theoretical knowledge---includes knowledge, skills, and attitudes
Nursing
o Dx, Tx, prevent human response to health px
o Care for the pt
o Holistic
o Promote health self-management
o promote wellness
Medical
o Diagnose and treat disease
o Cure disease
o Focus on pathophysiology
o Teach patients about the tx
for their disease/injury
o Have very good clinical reasoning abilities to identify and help solve pt problems and
enhance health
o Focus on promoting wellness, preventing illness, and restoring health.
o Intellectual skills: clinical reasoning, domain knowledge
- Critical Thinking and Standards of Care
o We use CT processes that include applying standards such as QSEN (Quality and Safety
in Educating Nurses) and ANA when developing our nursing plans of care.
o We must assure that our POC are pt Centered, Evidence Based, Collaborative, Safe AND
within our scope of practice.
- Theory: We use nursing theories to guide our practice--Helps us to explain our nursing actions in
explicit terms and then communicate those actions to others
- Ethical and Cultural Considerations
o ANA’s Standard #7: Ethics
o Delivers care in a manner that preserves/protects pt autonomy, dignity and rights, values,
and beliefs
o Respects centrality of patient/family
o Therapeutic and professional nurse-pt relationship
o Contributes to resolving ethical issues
o Demonstrates professional comportment (honest, integrity, openness, authenticity)
- Plans of care: should be- Pt centered, Dx/problem driven(actual, risk, health promotion), outcome
focused.
“Nursing process chapter 1”
- What is nursing? Blend of art and science, applied within context of interpersonal relationships,
purpose to promote well, preventing illness, and restoring health, used to care for individuals,
families and communities.
- **ANA definition: Nursing is the protection, promotion, and optimization of health and abilities,
prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of
human response, and advocacy in the care of individuals, families, communities, and populations
- ANA’s social policy statement: consider human experience, not the problem, integration patient’s
subjective experience with objective data, use CT, provide caring relationship, promote social justice.
- Nursing theory overview:
o Nursing is a unique blend of art and science (knowledge and problem solving processes),
Holistic(concerned about the pt’s physical, psychosocial, cultural and spiritual needs), Its
purpose is to promote wellness; Prevent illness and restore health in individuals, families
and communities.
- Interdisciplinary practice: collaborative practice. HCPs work together to plan and provide pt care.
- Nursing process: specific to the nursing profession, a framework for CT, purpose: diagnose and
treat human responses to actual or potential health problems, organized framework to guide
practice, problem solving method-client focused, systematic(5 sequential steps), goal orientedoutcome criteria, dynamic(always changing and flexible), utilizes CT processes.
What is nursing process: Systematic, creative approach used to identify, prevent and treat
actual or potential health problems, identify pt strength and poromote wellness.
- Scientific method of problem solving: ID problem, collect data, form hypothesis, plan of action,
hypothesis testing, interpret results, evaluate findings.
- Advantages of NP: individualized care, client is active participant, promote continuity of care,
provides more effective communication among nurses and HCPs, develops clear and efficient
POC, provides personal satisfaction as you see patient achieve goals, professional growth as you
evaluate effectiveness of your interventions.
- 6 steps in NP: Assessment, Dx, planning outcomes, planning interventions, implementing, evaluating.
- Assessment: Gather info, collect data. Nursing interview, health assessment(physical exam)
o Primary Source - Client / Family
o Secondary Source - physical exam, nursing history, team members, lab reports,
diagnostic tests, etc.
o Subjective -from the client (symptom) - “I have a headache”
o Objective - observable data (sign)- Blood Pressure 130/80
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