nur 330 exam 1 UPDATED ACTUAL Questions and CORRECT
Answers
clinical judgement an interpretation or conclusion about a patient's needs, concerns, or health
problems, and/or the decision to take action (or not), use or modify standard
approaches, or improvise new ones as deemed appropriate by the patient's
response
clinical judgement requires - flexible ability to "recognize salient aspects of an undefined clinical situation,
interpret their meanings, and respond appropriately"
- understanding of pathophysiological and diagnostic aspects of clinical
presentation
- understanding of illness experience for both patient and family:
-Physical, social, and emotional strengths
-Coping resources
clinical judgement can be thrown off by -# of patients a nurse is caring for and making clinical judgments
-resolution of conflicting info between families, patients, and other care providers
-coordination of complex discharges and admissions
-delegation and follow up of nursing care responsibilities
-individual nurses experiences
clinical judgement model -noticing (context, background, relationships)
-interpreting (reasoning patterns, analytic, intuitive, narrative)
-responding
-reflection (on actions and clinical learning)
context (noticing) unit culture
patterns of care
complexity of work environment
nurses background (noticing) -vision of excellent practice
-values r/t particular patient situations
-clinical or practical knowledge of similar patients
-textbook knowledge
relationship (noticing) -"knowing the patient"
-pattern pattern of responses
-patient as a person
noticing -focused observation
-recognition of deviations from expected patterns
-info seeking from patient and family
interpreting -developing a sufficient understanding of the situation to determine an
appropriate response
, interpreting involves making sense of the data, prioritization of data, development of an intervention
plan
reasoning patterns analytic, intuitive, and narrative
analytic reasoning -Processes used to break a situation down into its more basic elements
-characterized by generation of alternatives and weighting them against clinical
data
-used when: essential knowledge is lacking, expectations and reality mismatched,
multiple options are available
intuitive thinking -immediate understanding of the situation
-function of experience and pattern recognition
narrative thinking -telling and interpreting stories to make sense of and explain a situation
-interpretation of human concerns, intents, and motivations
-seeking and understanding of meaning attributed to illness
responding -deciding on most appropriate course of action and carrying it out (may include
no immediate action)
responding involves -development of calm, confident leadership
-clear communication with patients, families, and team members.
-Well planned and flexible intervention, individualized to the patient, responsive
to patient response
-proficiency/mastery in use of nursing skills
reflection involves -evaluation and analysis of choices and decisions made in clinical performance
-commitment to ongoing improvement of personal nursing practice
reflection-in-action -assessment of patients response to nursing intervention
-adjustment of nursing intervention based on assessment of outcome
-may not be obvious for experienced nurse unless expected outcomes do not
occur
reflection-on-action -how experience contribute to ongoing knowledge and clinical judgement
development
-requires sense of responsibility to connect own actions with outcomes
nursing process Assessment
Diagnosis
Planning
Implementation
Evaluation
assessment health history, physical assessment
diagnosis nursing diagnosis, collaborative problems
planning goals and priorities, planning of nursing care, expected outcomes
Answers
clinical judgement an interpretation or conclusion about a patient's needs, concerns, or health
problems, and/or the decision to take action (or not), use or modify standard
approaches, or improvise new ones as deemed appropriate by the patient's
response
clinical judgement requires - flexible ability to "recognize salient aspects of an undefined clinical situation,
interpret their meanings, and respond appropriately"
- understanding of pathophysiological and diagnostic aspects of clinical
presentation
- understanding of illness experience for both patient and family:
-Physical, social, and emotional strengths
-Coping resources
clinical judgement can be thrown off by -# of patients a nurse is caring for and making clinical judgments
-resolution of conflicting info between families, patients, and other care providers
-coordination of complex discharges and admissions
-delegation and follow up of nursing care responsibilities
-individual nurses experiences
clinical judgement model -noticing (context, background, relationships)
-interpreting (reasoning patterns, analytic, intuitive, narrative)
-responding
-reflection (on actions and clinical learning)
context (noticing) unit culture
patterns of care
complexity of work environment
nurses background (noticing) -vision of excellent practice
-values r/t particular patient situations
-clinical or practical knowledge of similar patients
-textbook knowledge
relationship (noticing) -"knowing the patient"
-pattern pattern of responses
-patient as a person
noticing -focused observation
-recognition of deviations from expected patterns
-info seeking from patient and family
interpreting -developing a sufficient understanding of the situation to determine an
appropriate response
, interpreting involves making sense of the data, prioritization of data, development of an intervention
plan
reasoning patterns analytic, intuitive, and narrative
analytic reasoning -Processes used to break a situation down into its more basic elements
-characterized by generation of alternatives and weighting them against clinical
data
-used when: essential knowledge is lacking, expectations and reality mismatched,
multiple options are available
intuitive thinking -immediate understanding of the situation
-function of experience and pattern recognition
narrative thinking -telling and interpreting stories to make sense of and explain a situation
-interpretation of human concerns, intents, and motivations
-seeking and understanding of meaning attributed to illness
responding -deciding on most appropriate course of action and carrying it out (may include
no immediate action)
responding involves -development of calm, confident leadership
-clear communication with patients, families, and team members.
-Well planned and flexible intervention, individualized to the patient, responsive
to patient response
-proficiency/mastery in use of nursing skills
reflection involves -evaluation and analysis of choices and decisions made in clinical performance
-commitment to ongoing improvement of personal nursing practice
reflection-in-action -assessment of patients response to nursing intervention
-adjustment of nursing intervention based on assessment of outcome
-may not be obvious for experienced nurse unless expected outcomes do not
occur
reflection-on-action -how experience contribute to ongoing knowledge and clinical judgement
development
-requires sense of responsibility to connect own actions with outcomes
nursing process Assessment
Diagnosis
Planning
Implementation
Evaluation
assessment health history, physical assessment
diagnosis nursing diagnosis, collaborative problems
planning goals and priorities, planning of nursing care, expected outcomes
