Critical Thinking

A patient has an increased body temperature 24 hours after surgery. The nurse contacts the physician for an order for Tylenol to reduce the patient's fever. Which state of Brenner's nursing proficiency does this reflect?

A novice nurse is likely to identify the immediate problem and reach a solution through simple problem solving. There will not likely be a further exploration of the underlying cause.

Which behavior demonstrates critical thinking as applied to cultural diversity?

A nurse recognizes that a patient may have special healthcare needs based on religious belief. This demonstrates awareness and sensitivity, as well as experience and knowledge, in caring for a particular religious group. A nurse asks a patient at the time of admission what is the preferred language for communication. Treating each patient as an individual and asking for preferences is an effective use of critical thinking skills. A nurse requests an interpreter because a patient does not speak English. Most hospitals have access to interpreters. Nurses, using critical thinking, should use this service to best communicate with patients who do not speak English. A nurse uses a reputable online resource to learn more about a certain cultural group's beliefs related to health and disease. Becoming familiar with a specific culture's approach to disease and wellness can help a nurse provide culturally sensitive care and optimize patient outcomes.

Which are characteristics of critical thinking in nursing?

Ability to anticipate patient needs Critical thinking involves anticipating what might be needed in a specific situation and planning ahead, instead of simple reaction to an individual problem. Ability to assess a situation globally Critical thinking involves seeking a deeper understanding of circumstances that may be causing a problem. This can be deducted through the application of knowledge and experience to a situation. Ability to determine appropriate intervention based on information and experience Critical thinking is a cognitive process that utilizes knowledge, experience, and creativity to help work through a situation to arrive at the best course of action.

Which behavior characterizes critical thinking?

Ability to assess a situation globally Critical thinking is a skill that nurses develop, using creativity, knowledge, and experience to make the most clinically sound decision.

How can nurses who use critical thinking adapt to evolving points of care?

Assist with transitional care Transitional care involves a continuation of care from a hospital to a community setting. Nurses can help facilitate a smooth transition. Gain a knowledge of community resources available Nurses can provide valuable information to patients to assist them in self-management of their health in the community. Anticipate a patient's discharge needs early in the hospitalization When discharge needs are anticipated early in an admission, this shortens the time of hospital stay and eases the transition of care. Gain experience and education to provide nursing care outside of a hospital Nurses can develop their own careers to provide care in a community, rather than a hospital setting, since the needs are increasing. Promote healthy behaviors and support community-wide education to prevent illness Prevention of disease is a way nurses can work with communities to keep people healthy and in need of fewer resources.

Which are concerns that Kenneth should address when transitioning Mrs. Jones to care in the home?

Cost of obtaining medications Older adults are more likely to live in poverty and require multiple medications. Kenneth should anticipate this being a concern and get the patient to clarify her position. Ability to move around in her home safely Limited mobility after hip surgery puts Mrs. Jones at higher risk for falls and injury. Kenneth should assess the patient's home safety concerns. Transportation to and from follow-up appointments The elderly may not have access to reliable transportation. Kenneth should provide information about community resources.

What is a critical thinking consideration that is applicable to caring for older adults?

Encouraging the use of advance directives As the population ages, end-of-life and elder-care needs should be considered. Nurses are using critical thinking when promoting the use of advance directives.

Kenneth provides a list of cab services that offer transportation to seniors at a reduced rate. Which challenge in the life of many older adults does this address?

Lack of access to resources By providing a list of cab services, the nurse is helping the patient gain access to resources available in the community.

Before discharging a patient, the nurse teaches the patient's family members how to change the patient's dressings. Which challenge is the nurse addressing?

Managing care cost Teaching the family to perform dressing changes will allow this aspect of care to be done in the home setting, which reduces the overall cost of hospitalization by shortening the length of stay.

Gwen, the expert nurse, is now assigned to Mrs. Morris. She finds Mrs. Morris in another patient's room. When Gwen asks her what is wrong, she says, "I think I forgot to check on the children." What intervention might be expected from Gwen?

Move the patient closer to the nurses' station and encourage family to visit Keeping the patient closer enables ease of observation. Encouraging family to visit will keep the patient occupied and help with safety considerations.

A nurse is assisting a patient with ambulation one day after surgery. Which might indicate critical thinking skills applied by an expert practitioner?

Provide pain medication prior to ambulation and get a second person to assist An expert practitioner will understand that the patient may have pain and be unsteady when ambulating after surgery.

In what ways might the advances in technology in health care require nurses to think critically?

Providing instruction to a patient and family on use of a new technology, such as the home oxygen system A family may need instruction on using a new device---an advancement in technology. A nurse who provides for this is using critical thinking. Ensuring that a complete, detailed list of patient medications is included in a patient's electronic medical record A patient's electronic medical record is usually available to multiple providers. Ensuring that the medication list is accurate is an important technological communication tool.

When Kelly is assigned to Mrs. Morris, what action might you expect her, as a novice nurse, to take in response to confusion and risk of falling?

Request a sitter to stay with the patient Kelly may request a sitter, which is a short-term solution. This action is more problem solving-based seen in novice nurses.

Which action is an effective way of helping a novice nurse develop critical thinking skills?

TPair the novice with a supportive, knowledgeable mentor A knowledgeable and supportive preceptor can help model critical thinking and challenge the novice to develop these skills.many more years.

The lab calls to notify a nurse about an elevated blood glucose level. The nurse calls the physician and anticipates a change in insulin dose. Which is true of the nurse's critical thinking skills?

The nurse is anticipating patient needs. The nurse applies knowledge and experience to this situation and identifies what is likely needed. The nurse is applying knowledge and experience to determine appropriate action. The nurse has applied critical thinking to this situation and called the physician, which is the appropriate action. The nurse understands that an elevated lab value requires an intervention. Recognizing an abnormal lab value and anticipating actions that will be required is an important characteristic of critical thinking.

Which is an example of applying critical thinking to caring for a 70-year-old female patient newly diagnosed with diabetes?

The patient should be given instruction on medications, diet, lifestyle changes, and disease process. A nurse using critical thinking can develop an educational program for a diabetic patient, taking the patient's lifestyle and needs into consideration. A 70-year-old female patient with new-onset of diabetes may live many more years.

A patient is nearing end of life. She talks often about her beloved pet dog and tells the nurse how much she misses him. She asks the nurse if he might be allowed to visit. Match the likely reaction be based on Benner's stages of nursing proficienc

Uncomfortable with request; against policy Novice Does not allow pets, but suggests an alternative, such as a picture Advanced Beginner Offers to help set up a scheduled visit. Makes the request to hospital administration Expert Practitioner Thinks of ways which the request can be honored; collaborates with family to meet patient needs Competent Practitioner