NURS 309 Exam #1 Study Guide Questions and Answers 2024

Identify characteristics of evidence-based practice. - -1850s: historical evolution of "research" evidence began w/ Florence Nightingale -best evidence from critical review of literature (research articles) -clinical expertise -patient preferences -clinical knowledge (physical assessment) Identify characteristics of diagnostic reasoning. - -attend to available cues (pick up on pieces of info pt. gives you) ex: pt. alert and oriented when first came in, now confused and clammy -formulate diagnostic hypothesis (make a guess about what is happening) ex: pt. diabetic, maybe low blood sugar? -gather data relative to hypothesis ex: take blood sugar -evaluate each hypothesis w/ new data collected to arrive at final diagnosis ex: give orange juice and food, see if blood sugar went up and plan worked Identify characteristics of nursing process. - -Assessment: collect all info, health hx, diet assessment, risk assessment -Diagnosis: cluster data, identify what pt. needs are -Outcome Identification: if pt. has impaired skin integrity, outcome is to have reduction/healing of wound -Planning: set timeline, specific type of dressing, reposition frequently -Implementation: document what you do, coordinate w/ other HC workers -evaluation: see if it is working, sometimes they don't work and need to come up w/ different plan Identify characteristics of critical thinking. - -novice: starting out in learning, uses rules to guide performance -competent: building on 2-3 years of clinical experience, see actions in context of pt. goals or plans -proficient: adding time to experience, understands pt. situation as a whole rather than individual parts - apply long term goals -expert: attained mastery of an area of learning, performs clinical judgement using ituitive analysis What different types of data should be gathered during an assessment? - -complete (total health) database: all health hx, physical assessment, creating database for initial stage of care (ex: brand new pt, new hospital admit) -focused (problem-centered) database: if pt. has specific problem (ex: rash - do assessment/database for particular problem) -follow-up database: on a problem to see if it's gotten better or worse (ex: if rash pt. back, only assess to see if improved or not) -emergency database: assessment while giving life saving measures (ex: pt. bleeding on ground, putting pressure while asking questions about what happend) Describe subjective and objective data. - -subjective: data pt. gives you about themselves, something they feel (ex: knee pain) -objective: data collected using assessment skills (inspection, auscultation, etc.) Identify and set priorities. - -1st level priorities: life threatening, immediate priorities (ABCV) -2nd level priorities: urgent needs, but won't die immediately (ex: acute pain, abnormal potassium, low blood glucose) -3rd level priorities: important for patient's health; interventions are long-term, may require collaboration among HC professionals (ex: developing healthy plan for diabetic) Understand demographic profile of U.S. - -total population passed 321 million in 2015 -61.6% of population identified as non-Hispanic whites -minority/emerging majority accounts for 38% -Hispanics: largest and fastest growing group -Blacks: second largest population -Asians, American Indians, Alaska Natives, Native Hawaiians, and other Pacific Islanders make up 3rd largest part of population Describe determinants of health. - -neighborhood and built environment, health/health care, social/community context, education, economic stability -constellation of related factors -affect person from preconception to death -EBP indicates poverty has greatest influence on health status Describe ethnicity. - -social group w/ shared traits -ethnic identity: self-identification w/ particular ethnic group -share geographic origin, migratory status, religion, race, language, values, traditions, symbols, food preferences Describe acculturation. - -process of adopting the culture and behavior of majority culture -assimilation: unidirectional in linear fashion