NUR 321 VCE # 1 Lesson 3- Critical Thinking in Nursing Practice

Reading Assignment in Potter, P., Perry, A., Stockert, P., & Hall, A. (2013). Fundamentals of nursing (8th ed.). St. Louis, MO: Elsevier Mosby. • Nursing Assessment (Chapter 16) • Nursing Diagnosis (Chapter 17) • Planning for Nursing Care (Chapter 18) • Implementing Nursing Care (Chapter 19) • Evaluation (Chapter 20) • Documentation and Informatics (Chapter 26, pages 357-358) Patient: Patricia Newman, Medical-Surgical Floor, Room 406 Objectives: • Assess the health care needs of two patients. • Develop nursing diagnoses from available data. • Identify priorities of nursing care for two patients. • Develop goals and outcome statements. • Discuss factors to consider in choosing nursing interventions. Exercise 1 Writing This exercise will take approximately 30 minutes to complete. 1. A nurse is preparing to start her shift on a medical-surgical unit. Which of the following factors concerning the change-of-shift report (hand-off report) will be most important for the nurse to consider? (Hint: See pages 357-358 in your textbook.) a. Next anticipated dressing change b. Patient's personality c. Patient's family support d. Off-going nurse's opinion about the patient's family background Ans: 2. Ans: 3. Indicate whether the following statement is true or false. Physiologic diagnoses have a higher priority than psychologic diagnoses. Indicate whether the following statement is true or false. The Kardex provides a filing system for recording the physician's orders. Ans 4. The statement that outlines the desired change in the patient's condition or behavior is termed the . (Hint: See page 238 in your textbook.) Ans: 5. You are assigned to provide care to a patient who has recently had abdominal surgery. When you are updating the nursing care plan, which of the following patient outcomes would be appropriate to include? Select all that apply. a. The nurse will observe the patient's understanding of use of the incentive spirometer. b. The patient will demonstrate an increased level of comfort. c. The patient will initiate turning and deep breathing within 2 hours. d. The patient will be more comfortable. e. The patient will report lessened pain using the pain scale within 3 hours. Ans 6. A review of the care planned for a patient during a given shift reveals the interventions listed below. Which of these interventions is classified as an independent nursing intervention? Select all that apply. a. Anchor an indwelling Foley catheter. b. Discontinue IV. c. Refer the patient for home health care. d. Review complications to report after discharge. e. Record intake and output. Ans: 7. The nurse is assisting a newly graduated nurse in completing a care plan. Which of the nursing interventions planned by the graduate and listed below indicate the need for further instruction? Select all that apply. a. Push fluids. b. Monitor blood pressure. c. Monitor blood pressure every 4 hours. d. Call physician for elevated temperature. e. Assist patient to turn, cough, and deep-breathe every 2 hours. Ans: 8. A(n) (A.) (B.) is a preprinted form with orders for routine therapies, monitoring guidelines, and/or diagnostic procedures for specific patients with identified clinical problems. Ans A Ans B: 9. A patient has become disabled as a result of an automobile accident. The case manager has documented concerns about the patient's ability to perform instrumental activities of daily living. Based on your knowledge, what activities are included in this listing? Since the patient may have difficulty moving and doing things on his own, some activities that should be included in this list: Toileting, Transferring, Walking, Bathing, Feeding, Phone use, Dressing and grooming. Exercise 2 Online This exercise will take approximately 45 minutes to complete. Sign in to work at Pacific View Regional Hospital on the Medical-Surgical Floor for Period of Care 1. (Note: If you are already in the virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to get to the sign- in window.) ............................................continued......................................................