DavisAdvantageforUnderstanding
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Medical-SurgicalNursing7thEdition
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ByHopper,Williams,AllChapter's1-57
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,(Davis Advantage for Understanding Medical-Surgical Nursing, 7e Linda Williams, Paula Hopper)
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Answers
CHAPTER 1 CRITICAL B B
to collect appropriate data, identify a patient problem, a nd
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determine the best possible plan of action. Clinical ju
THINKING,
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dgment is based on good critical thinking.
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CLINICAL JUDGMENT, ANDTHE B B
Cue
O
NURSING PROCESSB B
Definition: Significant or relevant data. Not all data arecues B B B B B B B B B
(relevant), but all cues are data.
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AUDIO CASE STUDY B B
Collaboration
Jane Practices Clinical Judgment
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Definition: Working together with the health team to improve B B B B B B B B
patient outcomes.
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1. Identify and analyze cues; prioritize hypotheses; generate sol B B B B B B B
utions; take action; evaluate outcomes; repeat.
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Intervention
2. Jane was exhausted, failed a test, and was pulled in too
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Definition: Taking action to carry out a plan. B B B B B B B
manydirections.She wasalsocryinginhercarand had poor
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study habits and not enough sleep.
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Evaluation
3. Jane’s resources included a good friend, sick time from B B B B B B B B
Definition: Comparing the outcomes you expected with a B B B B B B B
work, and wasted time between classes that she could b
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ctual outcomes. Did the plan work? Were expected o
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etter utilize. Your resources will be different, but theye
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utcomes met?
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xist!B
Vigilance
4. Critical thinking— B
Definition: The act of being attentive, alert, and watchful. B B B B B B B B
the why: Jane uses critical thinking to determine why her
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current plan isn’t working. She thinks honestly about h er
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CRITICAL THINKING AND CLINICALJUDGMENT B B B B
poor study habits, her time-
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management problems, and the impact this is having on her B B B B B B B B B
Critical thinking and clinical judgment both follow a similar fo
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and her family.
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rmat. Both follow steps from collecting data to determin-
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Clinical judgment— B
ing problems and outcomes, developing and taking actions,
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the do: Jane uses her thinking todevelop and carry out a plan
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and evaluating outcomes. However, critical thinking helps yo u
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that uses her resources and provides more productive study
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think about the problem: What is it? Why is it happen- ing?
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time and more quality time with her kids.
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And clinical judgment leads you to dosomething to ma nage
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Bthe problem. B
VOCABULARY
CUE RECOGNITION B
Sample sentences willvaryOfortheVocabulary problems.
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You will do many things for each individual, but the FIRSTthing is l isted
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Nursing process B
below.
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Definition: An organizing framework that links thinking with B B B B B B B
nursing actions. Steps include assessment/data collection,
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1. Sit the patient upright. B B B
nursingdiagnosis,planning,implementation,andevaluatio n.
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2. Call 911 while running across the street.B B B B B B
3. Elevate the feet off the bed by placing a pillow under the B B B B B B B B B B B
Critical thinking B
calves and allowing the feet to hang off the edge of the
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Definition: The use of those cognitive (knowledge) skills or B B B B B B B B
pillow. B
strategies that increase the probability of a desirable outc
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4. Check blood glucose and have a glucose source ready. B B B B B B B B
ome. Also involves reflection, problem-
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5. Turn the patient to the side to prevent aspiration.
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solving, and related thinking skills. B B B B
Clinical judgment B
Definition: The observed outcome of critical thinking and dec B B B B B B B B
ision making. A process that uses nursing knowledge
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,2 Chapter 1 B Answers
CRITICAL THINKING B
This is just one possible way to complete a cognitive map.
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Could it be low B B B B B
B
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Patient's
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Headache
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1– B B B
s
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B
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2 hours B
REVIEW QUESTIONS B
taking vital signs; data collection is the first step in the
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nursing process. (2, 3, 4) are all steps in the nursing pr
TheOcorrect answers are in boldface.
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ocess, for which the registered nurse is responsible; the
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1. (2) Critical thinking can lead to better outcomes for the
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LPN/LVN may assist the registered nurse with these. Ni
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patient. (1, 3, 4) may be true but are not the best answ er.
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troglycerin should not be administered withoutfirst knowing
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2. (4) is correct. The nurse who can admit to not knowin g
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Bthe patient’s blood pressure.
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something is exhibiting intellectual humility. (1) shows
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7. (2) indicates that the patient is concerned about freedom
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expertise but not necessarily intellectual humility;
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from injury and harm. (1) relates to basic needs such as air,
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(2) reporting an error shows intellectual integrity; B B B B B
oxygen, and water. (3) relates to feeling loved. (4) i srelated
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(3) empathizing is positive but does is not evidence of B B B B B B B B
to having positive self-esteem.
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humility.
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8. (3, 1, 2, 4) is the correct order according to Maslow.
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3. (3, 4, 5, 1, 2) is the correct order.
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9. (5, 2, 1, 4, 6, 3) is the correct order.
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4. (1) is the best definition. (2, 3, 4) do not define critic al
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10. (3) shows the patient is actually taking action. (1, 2, 4
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thinking but are examples of good thinking.
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)are all positive but do not show intent to take action.
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5. (4) is correct. Evaluation determines whether goals are ac
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11. (4) is the nurse’s analysis of the situation. (1, 2) are
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hieved and interventions effective. (2) is the role of theph
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data; (3) is a recommendation.
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ysician. (1, 3) encompass data collection and imple-
B B B B B B B B 12. (1, 2, 3, 4) should be present. Since the data provide s
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mentation, which are earlier steps in the nursing process.
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only hip replacement as the patient’s problem, (5) th e
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6. (1) is correct. The licensed practical nurse/licensed voca-
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dietitian is not necessary.
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tional nurse (LPN/LVN) can collect data, which includes
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1
, Answers
CHAPTER 2 B
EVIDENCE-BASED PRACTICE
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1. proof
2. context
AUDIO CASE STUDY B B
3. quality
4. care
Marie and Evidence-Based Practice
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5. randomized
1. Thirdhand smoke is the dangerous toxins of smoke thatl B B B B B B B B B
6. outcomes
inger on hair, clothing, furniture, and other surfaces ina n
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area after a cigarette is put out. Marie learned that e
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8. nursing
xposure to these toxins can be neurotoxic to children a nd
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9. patient’s
can trigger asthma attacks in sensitive people.
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10. information
2. Evidence-
based practice is considered the gold standardof health care.
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CLINICAL JUDGMENT B
3. Step 1: Ask the burning question. Step 2: Search and
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collect the most relevant and best evidence available.S
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1. By questioning the existing way of doing things to en
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tep 3: Think critically. Appraise the evidence for validi
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sure that the patient receives the best care possible
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ty, relevance to the situation, and applicability.
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2. A thorough search of the literature, with the assistance of
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Step 4: Measure the outcomes before and after institutingt he
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the medical librarian, in the area of their burning ques-
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change. Step 5: Make it happen. Step 6: Evaluate the
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tion regarding music reducing preoperative anxiety.
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practice decision or change.
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3. Cumulative Index to Nursing and Allied Health Literature B B B B B B B B
4. Combination therapy with a nicotine patch and nicotine lo B B B B B B B B
(CINAHL) Database, Joanna Briggs Instituteevidence-
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zenges worked best, although bupropion (Zyban) or vareni
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based resources, Cochrane Reviews, Medline/PubMed
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cline (Chantix) and nicotine lozenges worked well,too. A
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4. Measure patient outcomes before instituting the evidence B B B B B B
Cochrane Review found that advice and support from nurs
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-
ing staff can increase patients’ success in quit-
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based change in practice so comparisons can be made aft er
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ting smoking, especially in a hospital setting.
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implementation to determine if the inter-
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vention worked B
VOCABULARY 5. Evaluate the results to determine whether the change B B B B B B B
made a significant difference and if it was valuable int
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SampleOsentences will varyOfor the Vocabulary problems.
erms of cost and time
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1. Evidence-
based practice: A systematic process that uses current evid
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REVIEW QUESTIONS B
ence in making decisions about patient care.
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Thecorrect answers areinboldface.
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2. Evidence-
informed practice: Considerationofpatient factors along w ith B B B B B B B B
1. (3) is correct. Providing an explanation of why some-
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the use of evidence for shared decision making between the
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thing is done promotes the understanding for why it is
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Bhealth-care provider and the patient. B B B B
important to be done and therefore will more likely b e
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3. Randomized controlled trials: True experimental studies in B B B B B B
done. (1, 2, 4) only communicate the need to perfor m a
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which as many factors as possible that could falsely chan ge
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task. They do not provide rationale for the task to pro-
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Bthe results are controlled.
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mote understanding of the importance of the task.
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4. Research: Scientific study, investigation, or experimenta- B B B B B
2. (3) is correct. Evidence-
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tion to establish facts and analyze their significance.
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based nursing care that has been evaluated as appropriate f or
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5. Systematic review: A review of relevant research using g B B B B B B B B
an agency provides the best and safest patient care. (1)
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uidelines.
B
Opinions may not be based on
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