https:\/\/learnexams.com\/search\/study?query=NR<\/a><\/li>\n<\/ul>\n\n\n\nclinical judgement observed outcome of critical thinking and decision making
nursing practice learning\/learned to question wonder and explore different perspectives
What are smart goals? S: Specific = what are you trying to achieve?M: Measurable = how will you know you achieved?A: Attainable = is it possible to achieve it?R: Relevant = does it contribute T: Time = when do you want to achieve by?
What are the two different layers to general critical thinking? 1. Intuitive: well structured with familiar tasks2. Analytic: required for unfamiliar tasks
what are the two different layers to specific critical thinking? 1. diagnostic reasoning: being able to understand and think through clinical problems2. clinical decision making: inductive\/deductive
What are the levels to critical thinking? 1. BASIC: answers complex problems as right\/wrong (task oriented, concrete thinking)2. COMPLEX: makes clinical decisions independently (thinking is more innovative)3. COMMITMENT: able to make choices without any assistance and accepts accountability.
What are the professional standards? – Standards of practice- ethical criteria for nursing judgement – criteria for evaluation – professional responsibility
What is the evaluation of clinical judgement? R: recall eventsE: examine ur responseF: acknowledge feelingsL: learn from expierenceE: explore options C: create plan of action T: set a time
Monitoring client for side effects is an example of what clinical judgement? EVALUATION
Identifying signs\/symptoms is an example of what clinical judgement? ASSESSMENT
administering medication is an example of what clinical judgement? INTERVENTION
describing patient outcomes is an example of what clinical judgement? PLANNING
identifying problem and risks is an example of what clinical judgement? DIAGNOSIS
What are nurse initiated interventions? AKA INDEPENDENT NURSING: nurse initates without supervision (client education, adl assistance, health promotion)
what are HCP initated interventions? AKA DEPENDENT NURSING INTERVENTIONS: requires an order and intended to treat clients medical issues
what are collaborative interventions? AKA INDEPENDENT INTERVENTIONS: combined knowledge, skills, expertise from others on the team
What are examples of direct care? – ADLS\/IADLS- hands on- counselling – client education
what are examples of indirect care? – documentation – delegation – infection control- collab with others
What is team nursing? care provided by group of people led by an rn (requires team leadership, collab, communication)
what is primary nursing? one rn takes responsibility for case load of pts from admission to discharge. (when rn not scheduled, they are to leave instructions on how to care for pt)
what is total patient care? rn responsible for all aspects of care for more than one patient (similar to primary nursing)
what is patient-family centered care? – dignitiy and respect- information sharing -participation- collab
what is case managements role? coordinates and aligns all healthcare services across all levels of care for patients and their families; focused on achieving pt outcomes with effective time frames
what are the rights to delegation? 5 Rights:- task- circumstance- person – communication – supervision\/evaluation
what are the donts to delegation? – simply bc you dont wanna-assign out of scope- nursing process\/judgement- critical decision making
What can you delegate to a UAP? – assist with adls- vs, i\/o, achs, phleb
what can you NOT delegate to UAP? – assessments- nursing process- education – anything involving clinical judgement
what can i delegate to an LPN? -admin meds that are lowrisk- admin ng tube\/check patency- perform wound care – montior blood products (CANT start them)- trach care\/suctioning -admin enteral feedings-insertation of cath
what can you NOT delegate to lpn – high risk meds-admin of iv push meds- independently provide pt education – titrate medications – preform admission\/discharge
VERCITY TELL THE TRUTH
AUTONOMY INDEPENDENCE TO MAKE DECISIONS
BENEFICENCE BEST INTEREST OF PT
NONMALEFICENCE DO NO HARM
JUSTICE FAIRNESS
FIDELITY KEEPING PROMISES
What are the ethical approaches? deontologyutillarisism casuistryfeministethics of care
Deontology defines actions of right or wrong based on adherence to values
utillarisism value of something based off its usefulness; greatest good for greatest number of people
casuistry looks at individual contexts
feminist natural caring for others is the basis for moral behavior
ethics of care focuses on understanding relationships, personal narratives, context in which ethical problems rise
Constitutional Law derived from federal and state laws (right-to-refuse)
Statutory Law congress and state legislatures (nurse practice act)
criminal law protects society
Administrative Law defines expectations of civil and criminal law (ADPIE)
Common law originates from decisions made in absence of the law (pt confidentiality)
case law whose getting sued
FEDERAL STATUES – aca-emtala-hippa-ada-mental health parity -psda-advance directives-uniform anatomical gift act-omnibus budget act
ACA affordable care act – always changing- consumer rights and protections – affordable health care coverage- increased access to care- quality of care – includes the pt bill of rights (pts cant be denied health care)
EMTALA emergency medical treatment and active labor actually assessing pt before transferring; prevents pt dumping
HIPPA health insurance portability and accountability health into technology act (HITECH)
ADA american with disabilities act Employers required to take steps to accommodate individuals who are physically challenged. i.e. wheel chair accessible, accommodations for people with sight or hearing limitation
Mental Health parity and addiction equity act parity = equaility- insurance must provide coverage for mental health\/substance abuse disorder treatment- insurances can NOT discriminate or deny coverage
PSDA patient self determination act right to refuse treatment- durable power of attorney- advance directives
advanced directives – signed when pt is competent- CPR, intubation, enteral feedings- courts can order for children if parents refuse- DNR must be on file
uniform anatomical gift act regulation of organ donor system (honors automy and trust)
omnibus budget act addresses the use of both physical and chemical restraints- legal definition: any manual, physical, mechanical, material, equipment that immoblizes pt to move freely or alter behavior of patient
when can we use restraints? – ensuring safety of pt and others- other interventions unsuccessful – must have order from HCP
STATE STATUES – nurse practice acts- health care acts and informed consent- good samaritan lawpublic health lawsabortionsphysician assisted suicide uniform determination of death act
nurse practice act regulated by the state- state boards of nursing: holds nurses accountable and protects the public- periodic auditscompact licensure: able to practice in multiple states
informed consent – emanipated minors: preg (in some states), married, divorce, military- unemancipated minors: sti\/substance treatment, mental health, preg- considered battery if performed w out consent and provider obtains that
what is the consent order? 1. healthcare proxy2. closest relative\/spouse3. adult child4. parent5. adult sibling 6. grandparent7. guardian
good samaritan law healthcare individuals to assist in emergencies
public health laws cdc\/osha
abortion – roe v wade 1973- webster v repro 19891 dobbs v jackson 2022
physician assisted suicide ana position: nurses participation is in violation of our code of ethics
uniform determination of death act cardiopulmonary: irreversible cessation of circ\/resp functionswhole brain standard: irreversible cessation of all functions of entire brain and stem
what are TORTS civil wrongful acts or omissions made against a person or property
intentional assualt, battery, false imprisonment
quasi-intentional causes harm wout consent- invasion of privacy, deformation of character (slander)
unintentional negligence and malpractice
what are nurses safegaurds? – standard of proof: evidence must show breach – malpractice insurance: professional licensure defense- risk management: occurrence report after pt assessed; does not go in the med rec<\/p>\n","protected":false},"excerpt":{"rendered":"
Exam 1: NR224 \/ NR 224 (Latest Update 2024\/2025) Fundamentals: Skills Review| Complete Guide with Questions and Verified Answers| 100% Correct -Chamberlain Exam 1: NR224 \/ NR 224 (Latest Update2024\/2025) Fundamentals: Skills Review|Complete Guide with Questions and VerifiedAnswers| 100% Correct -ChamberlainQ: Monitoring client for side effects is an example of what clinical judgement?-Answer:EVALUATIONQ: Identifying signs\/symptoms […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-132095","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/132095","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=132095"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/132095\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=132095"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=132095"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=132095"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}