Lewis Medical Surgical chpt 1

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What is An advanced practice registered nurse (APRN)

A nurse educated at the master's or doctoral level, with advanced education in pathophysiology, pharmacology, and health assessment and expertise in a specialized area of practice. Ie: clinical nurse specialists, nurse practitioners, nurse midwives, and nurse anesthetists.

Learning Outcome 8. Apply concepts of evidence-based practice to nursing practice.

Evidence-based practice (EBP) is a problem-solving approach to clinical decision making. Step 1 is asking a clinical question in the PICOT format. Step 2 is searching for the best evidence that applies to the clinical question. Step 3 is to critically appraise the evidence you found. Step 4 involves implementing the evidence in practice. Step 5 is evaluating the outcome of the practice change. Step 6 is sharing the results of the EBP change.

Learning outcome 2. Compare the different scopes of practice available to professional nurses.

Generalists: AA or BS in Nursing + RN license ( obviously) Common nursing specialties include critical care, women's health, geriatric, medical-surgical, perinatal, emergency, psychiatric/mental health, and community health nursing. (pg 2.) An advanced practice registered nurse (APRN) : a nurse becomes more educated at the masters or doctoral level and can work as a clinical nurse specialist, nurse practitioner, nurse midwife, and nurse anesthetists. Doctor of nursing practice (DNP) degree: same level as other health professions that offer practice doctorates (e.g., pharmacy [PharmD], physical therapy [DPT]). Nurses with a research-focused doctorate (PhD) typically are used in health care settings as nurse faculty, clinical experts, researchers, and health care system executives.

3. The nurse is assigned to care for a newly admitted patient. Number in order the steps for using the nursing process to prioritize care. (Number 1 is the first step, and number 5 is the last step.) ___ Evaluate whether the plan was effective. ___ Identify any health problems. ___ Collect patient information. ___ Carry out the plan. ___ Decide a plan of action.

___Decide a plan of action ___Identify any health problems. ___Evaluate whether the plan was effective. ___Carry out the plan. ___Collect patient information.

4. Using the SBAR format, number in order the steps for how the nurse would communicate information with the provider. (Number 1 is the first step, and number 4 is the last step.) ____ "I would like you to order an IV medication and come evaluate the patient as soon as possible." ____ "This is Nurse M.H. I am calling from the unit because your patient, D.R., has a new onset of atrial fibrillation." ____ "The atrial fibrillation started about 10 minutes ago. The heart rate is 124; BP 90/60. The patient is experiencing dizziness." ____ "D.R., who is 2 days postoperative for a bowel resection for diverticulitis, has a history of mitral valve disease."

_____"D.R., who is 2 days postoperative for a bowel resection for diverticulitis, has a history of mitral valve disease." _____"I would like you to order an IV medication and come evaluate the patient as soon as possible." _____"The atrial fibrillation started about 10 minutes ago. The heart rate is 124; BP 90/60. The patient is experiencing dizziness." _____ "This is Nurse M.H. I am calling from the unit because your patient, D.R., has a new onset of atrial fibrillation."

Define Nursing

"the diagnosis and treatment of human responses to actual and potential health problems."

Learning outcome 1. Describe professional nursing practice in terms of domain, definitions, and recipients of care.

Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.1 ( May need to edit)

Learning Outcome 7. Evaluate the role of informatics and technology in nursing practice.

Technology plays a key role in providing safe, quality patient care. Computers and mobile devices allow you to document at the time you deliver care and give you quick and easy access to information, including clinical decision-making tools, patient education materials, and references. Texting, video chat, and e-mail enhance communication among healthcare team members and help you deliver the right message to the right person at the right time. Computerized provider order entry (CPOE) systems can reduce errors caused by misreading or misinterpreting handwritten orders. (p. 12).

Learning outcome 3. Describe the role of critical thinking skills and using the nursing process to provide patient-centered care.

The nursing process is a problem-solving approach to the identification and treatment of patient problems that is the foundation of nursing practice. outcomes. Once started, the nursing process is continuous and cyclic. The nursing process consists of 5 phases: assessment, diagnosis, planning, implementation, and evaluation (ADPIE)

5. The nurse is caring for a diabetic patient in the ambulatory surgical unit who has undergone wound debridement. Which task is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)? a.) Check the patient's vital signs. b.) Assess the patient's pain level. c) Palpate the patient's pedal pulses. d.) Monitor the patient's IV catheter site.

a. Check the patient's vital signs.

6. The nurse's role in addressing the National Patient Safety Goals established by The Joint Commission includes (select all that apply) a.) answering all patient monitoring alarms promptly. b.) memorizing all the rules published by The Joint Commission. c.) obtaining a correct list of the patient's medications on admission. d.) encouraging patients to be actively involved in their own health care. e). using side rails and alarm systems as necessary to prevent patient falls.

a.) answering all patient monitoring alarms promptly. c.) obtaining a correct list of the patient's medications on admission. e). using side rails and alarm systems as necessary to prevent patient falls.

1. An example of a nursing activity that best reflects the American Nurses Association's definition of nursing is : a.) treating dysrhythmias that occur in a patient in the coronary care unit. b.) diagnosing a patient with a feeding tube as being at risk for aspiration. c.) setting up protocols for treating patients in the emergency department. d. offering antianxiety drugs to a patient with a disturbed sleep pattern.

b.) diagnosing a patient with a feeding tube as being at risk for aspiration.

2. A nurse working on the medical-surgical unit at an urban hospital would like to become certified in medical-surgical nursing. The nurse knows that this process would most likely require : a.) a bachelor's degree in nursing. b). formal education in advanced nursing practice. c). experience for a specific period in medical-surgical nursing. d). membership in a medical-surgical nursing specialty organization.

c). experience for a specific period in medical-surgical nursing.

7. Advantages of using informatics in health care delivery are (select all that apply): a.) reduced need for nurses in acute care. b.) increased patient anonymity and confidentiality. c.) the ability to achieve and maintain high standards of care. d.) access to standard plans of care for many health problems. e.) improved communication of the patient's health status to the health care team.

c.) the ability to achieve and maintain high standards of care. d.) access to standard plans of care for many health problems. e.) improved communication of the patient's health status to the health care team.

8. When using evidence-based practice, the nurse: a.) must use clinical practice guidelines developed by national health agencies. b.) should use findings from randomized controlled trials to plan care for all patient problems. c.) uses clinical decision making and judgment to decide what evidence is appropriate for a specific clinical situation. d.) analyzes the relationship of nursing interventions to patient outcomes to discover evidence for patient interventions.

c.) uses clinical decision making and judgment to decide what evidence is appropriate for a specific clinical situation.


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