Fundamentals Exam #2

Methods of Data Collection:

*establish connection and communication OBSERVATION: gathering data using your senses, knowing the right questions to ask, overall appearance, body language NURSING HX: therapeutic relationship, developmental level, interview process with open ended questions and letting patient lead the conversation PHYSICAL EXAM: palpating lungs, coming up with a plan for interventions POTENTIAL PROBLEMS W/ DATA: failure to establish rapport, failure to update database with new information, forget allergies, lacking enough data

Potential Errors in Decision Making:

-Bias (example: cannot care for your loved ones) -Failure to see the whole picture -Impatience

Older Adults

-ID safety hazards and modify the environment as necessary -attend defensive driving courses, encourage regular vision and hearing tests and wearing hearing aids and eyeglasses -have operational smoke detectors, report signs of abuse

Formats of Documentation

-Problem Oriented -Planning -Charting by Exception (only unexpected info)

PHASE 2: DIAGNOSIS *NANDA list of acceptable diagnoses ONLY

-actual or potential diagnosis based on findings -not a medical diagnosis! -includes strengths, problems, factors contributing to the problem -using critical thinking skills to ID patterns in data and draw conclusions -this includes: ruling out similar issues, naming potential diagnosis and clarify what is causing the issue, determine risk factors example: med dx: renal failure nursing dx: risk for imbalanced fluids

Patients at Risk of Developing an Infection

-alterations in skin integrity and mucous membranes -reliability and number of the body's WBC to fight infection -age, sex, race, heredity (predisposition to infection, neonates and elderly) -pre-existing illnesses, previous or current treatments, meds -use of invasive or indwelling medical devices such as as catheter -change in environment

Evaluating & Revising the Care Plan CONT

-asking open ended questions -collecting more data -documenting judgement -terminating, continuing, or modifying the plan, interpreting and summarizing findings

Physical Assessment

-assess mobility status, communication, level of awareness and orientation, sensory perception -identify potential safety hazards -recognize manifestations of domestic violence or neglect

PLANNING CONT

-be realistic when setting goals, looking at overall health -set goal mutually with patient (pt needs to be willing!) -ID one behavior per outcome -use short-term and long-term goals -avoid being vague and immeasurable -use cognitive, psychomotor, and affective outcomes

Nursing Interventions Classification: (NIC)

-consists of a label, definition, list of specific activities -linked to NANDA diagnoses -applicable to all settings

PLANNING:

-describe what is wanted, an aim, an end -influenced by interventions/care plan -restate the first clause in a statement that describes improvement, control, or absence of a problem -outcomes need to be time related -based on clinical judgment and nursing knowledge

Factors Affecting Safety

-developmental considerations (child vs elderly) -lifestyle (outside of facility) -social behavior -environment -mobility -sensory perception -knowledge -ability to communicate (language barriers?) -physical and psychosocial health state

What is an infection?

-disease resulting from pathogens in or on the body -bacteria, virus, fungi, parasites -occurs as a result of a cyclic process, consisting of six components -not all organisms you are exposed to cause disease dependent on factors.... (normal flora) >number of organisms, virulence, competence of the person's immune system, length extent of the contact

Why is critical thinking important for nurses?

-each patient is unique -nursing is fast paced, applied discipline, and it uses knowledge from previous experiences to provide holistic care

Lab Data Indicating Infections

-elevated WBC count, normally is 5,000 to 10,000/mm3 -erythrocyte sedimentation rate: indicates nonspecific inflammation -lactate: sepsis/systemic, cells produce this when the body is fighting at a high rate, normally low -presence of pathogen in urine, blood sputum, or draining cultures

Adults

-enroll in defensive driving course, evaluate workplace safety, counsel about domestic violence and unsafe health habits -remind them of the effects of stress on lifestyle and health, such as working too much or "life just happening" -safety planning for pregnancy, pets, children, abusive partner, leaving a relationship

Extrinsic Factors

-environment-based -dim lighting, lack of grab bars or rails, poor stair design, tripping hazards, uneven surfaces, psychoactive medications

Barriers to Patient Compliance for the Care Plan

-lack of family support, understanding about the benefits -low value attached to the outcomes (pt doesn't see benefits) -Adverse effects of treatment (anger, causing pain) -Inability to afford treatment -Limited access to treatment

What is critical thinking?

-learned from experience and is not linear -a combination of reasoned thinking, fair minded, openness to alternatives, flexible, ability to reflect, a desire to seek truth -prioritization to identify the goal or potential problems

Factors that Contribute to Falls

-lower body weakness, poor vision, balance issues, problems with feet or shoes -use of psychoactive medications, postural dizziness, orthostatic hypertension, hazards in the home, altered perception

Health Teaching in the Schools

-monitor and limit children's use of the internet -get involved in school activities and ask pertinent questions, such as the background of coaches -volunteer for safety committees that include staff and parents -ensure that the school's emergency preparedness plan is current

ASSESSMENT CONT

-organizing, validating (diagnostic tests), clustering data -free from error, bias, misinterpretation -coming up with plan -allows patterns to be recognized, are Maslow's Needs being met? -holistic approach, by body system

SMART goals

-patient centered -Specific, Measurable, Attainable, Relevant, Time Bound

Intrinsic Factors

-person-based -advanced age, previous falls, muscle weakness, balance problems, poor vision, postural hypotension, chronic conditions

Prioritizing Nursing Diagnosis

-placing problems in order of importance -priorities determined by framework.. 1. highest 2. medium 3. lowest -example: choking vs bleeding...use ABC

Guidelines for Implementation

-plan ahead being organized (discharge) -act in partnership with family and patient -modify nursing interventions according to the patient's background, willingness to participate, previous responses Documentation--> The final step of implementation--> Records nursing activities and the patient's response (every time)

IMPLEMENTATION:

-record findings -reassess patient for changes in status that may dictate a difference set of interventions -be sure that research supports the interventions -be open to better ways of addressing issues -always monitor patient's responses -impression could change

Safety Devices to Prevent Falls

-side rails -brakes on -nonskid socks *MORSE FALL SCALE*

Adolescents

-teach avoidance of tobacco and alcohol, limiting people in cars, using seatbelt, don't drink and drive and text and drive -emphasizing gun safety, healthy lifestyles, teaching about STIs, birth control, sexuality -get physical examination, clean piercings and tattoos, discuss dangers of the internet

School Age Children-Safety

-teach parents about fire safety, abduction, bicycle safety -avoid dangerous activities -reinforce teaching to recognize symptoms that require immediate attention -continue immunizations -wear seatbelts

Process for Interventions:

-theories -professional standards (ANA, QSED) -guidelines with evidence -individualize standardized interventions -choosing the best interventions from a variety of options -using standardized language

Why is it important for nurses to understand the infectious process?

1) Healthcare Associated Infections (HAI): can be either exogenous, endogenous or iatrogenic. Could be a Catheter-Associated UTI, Surgical Site Infection, etc -FROG: frictions rubs off germs -most common pathogen: Staph aureus (others include E.coli, Enterococi) -understanding the process can lengthen recovery times, prevent illness for vulnerable populations, limit costs to the healthcare system, break the chain/cycle

Chain of Infection

1) Infectious agent 2) Reservoir (soil, dirt, food, people, animals, doorknob) 3) Portal of exit from reservoir (GI, breaks in skin, blood/tissue, respiratory -gloves, hand hygiene 4) Means of transmission (direct, indirect, airborne) 5) Portal of entry (where organism enters...soiled materials) 6) Susceptible host (whoever gets infection)

Nursing Dx Types - 3 of them!

3+ S&S: actual problem 1 S&S: potential problem Problem-Focused: actual problem, actual evidence of S&S of diagnosis exist >example: fluid volume deficit Risk Nursing: potential/risk for a problem, database contains risk factor of diagnosis but no true evidence >example: risk for altered skin integrity-->ulcers Health Promotion: describes health status, but not a problem >example: patient is comfortable and pain free

Indications of a Concussion

A concussion is a traumatic brain injury that affects tour brain function Could be...a direct impact, an acceleration-deceleration, or a blast brain injury Physical: headache, vomiting, balance issues Cognitive: mentally fogging, bad memory Emotional: irritable, overly emotional Sleep: disturbed, drowsiness, more or less

Surgical Asepsis

A process used to eliminate every potential microorganism in and around a sterile field while also maintaining objects as free from microorganisms as possible. -uses a sterile field during sutures, catheter placement, changing wound dressings, labor and delivery, central line -sterile technique uses gloves to touch ONLY items that are already sterilized -includes meticulous hand washing -uses cleansers such as betadine and chlorhexadine

Classification of Infections

ACUTE: redness, heat, swelling, pain due to histamines, loss of function, bursitis CHRONIC: caused by pathogens with slow growth rates promoting an infection that is persistent for long-term periods... -hep c, helicobacter pylori LATENT: the pathogen takes residence in the body without any manifesting symptom, simply just remains. The infections out lives the disease, but can have outbreaks (exacerbation) -herpes simplex & zoster, epstein barr, HIV

Applying the Nursing Process to Infection

ASSESSMENT: nursing history, physical assessment, VS, S&S, documenting "what brought you in?", first speaking to patient DIAGNOSIS: risk for infection, related to impaired immunity, tissue damage, etc. Risk of shock PLANNING: hand and respiratory hygiene, monitoring VS and lab data, standard precautions, aseptic technique IMPLEMENTATION: precautions and PPE, educating, reporting abnormal lab data, administering prescribed antimicrobials examples: limiting visitors if patient needs sleep EVALUATION: have outcomes been met? Is pain gone? Preventing worsening or actual infection

Report and Record...

Accurately + Comprehensively -HIPAA -data should be reported verbally immediately when assessment findings are critical -documentation kept in patient record (written or electronic), with clear, concise, factual information, with all information/phases of the nursing process. *what you see* -Record only relevant, pertinent, and relevant data

ABC

Airway, Breathing, Circulation

STANDARD PRECAUTIONS

Apply to all care activities regardless of suspected or confirmed infection status. This includes hand hygiene, PPE, cleaning of equipment

ADPIE

Assessment: data collection (health needs, strengths and weaknesses) Diagnosis: evaluated problem, identify Planning: ID patient, bring other disciplines for wellness, write care plan! Implementation: actions delegated and carried out Evaluation: did/is plan working? Observe extent to which goals were achieved. Revise plan as needed.

Check your Knowledge: A patient's activity level has decreased after hip replacement surgery She has been receiving opioid analgesia and has decreased fluid intake. Which of the following nursing dx is appropriate for this patient? a. Problem Focused Nursing Dx b. Risk Nursing Dx c. Health Promotion Nursing Dx d. Medical DX

B. Risk Nursing Diagnosis >Medical Dx will never be right!!

Multi Drug Resistant Organisms (MDRO's)

Bacteria that have become resistant to certain antibiotics, so typical antibiotics can no longer be used to kill or control the bacteria. This is most often spread from patient to patient on the hands of healthcare workers. -MERSA, VRE Cause: when antibiotics are taken longer than necessary/or when they're not needed. The more often antibiotics are used, the more likely it is that resistant bacteria will develop. -The CDC recommends avoiding sharing difficult to clean equipment, and promotes meticulous hand hygiene and disinfection techniques *using antimicrobials only when indicated and only the appropriate amount

Infectious Agents

Bacteria: most significant and most relevant in hospital settings, categorized by shape, type, gram stain, aerobic/aerobic -TB, Streptococcus, Staphylococcus Virus: smallest of all microorganisms -antibiotics don't work -antivirals: when given in the prodromal stage of certain viruses, can shorten the full stage of illness -influenza, common cold, hep b and c, MMR illness

Check Your Knowledge: The nurse is completing a head-to-toe assessment on a patient at the beginning of their shift. This would be considered what type of assessment? a. Focused b. Initial/Admission c. Comprehensive/Shift d. Emergency

C. Comprehensive/Shift

Checkpoint: In order for an actual nursing diagnosis to be valid, the diagnosis must contain one or more of the following? a. Laboratory results b. Diagnostic data c. Defining Characteristics d. Medical diagnoses

C. Defining characteristics >the rest is all medical

Check Your Knowledge: The nurse is caring for a patient admitted yesterday diagnosed with an acute cerebral vascular accident (CVA/Stroke). Which one of the following nursing diagnosis has the highest priority? a. Anxiety b. Knowledge Deficit c. Impaired Swallowing d. Altered Family Process

C. Impaired Swallowing

Restraints

CANNOT delegate restraints as an RN Violent behavior: risk of harm to self or others -in an emergency, obtain order after application, prescriber must see patient within 1 hour, face to face assessment, every 15 mins for safety checks, every 2 hour RN assessment + documentation Nonviolent behavior: risk for interfering with medical treatment -medical support (protection of lines and equipment) -obtain order after application, prescriber must see patient within 24 hours, every 1 hour safety checks, every 2 hours RN assessment + documentation

Evaluating & Revising the Care Plan

Cognitive: asking patient to repeat information or apply new knowledge Psychomotor: asking patient to demonstrate new skill, such as cane walking Affective: observing patient behavior and conversation Physiologic: using physical assessment skill to collect and compare data using what you see

Health History

Contains... -emotional needs -social status/needs -physical and developmental level -intellectual status -spiritual requirements

Checkpoint: Nursing diagnosis are aimed at identifying patient problems that are treatable by which of the following? a. The physician b. The nurse c. Invasive techniques d. Complementary strategies

D. Complementary strategies

Check Your Knowledge: The nurse assigns the nursing diagnosis Risk for Aspiration for a patient with a swallowing disorder. In deciding which feeding technique will prevent aspiration, which action would be the most appropriate? a. Ask the nursing assistant with 20 years of experience b. Perform an internet search on the topic c. Ask the NP to write an order d. search for evidence based, clinical based guidelines

D. Evidence-based *this will always be correct!!

Checkpoint: when interviewing a patient, the nurse uses which open-ended style sentence? a. Do you have any concerns right now? b. Is your family worried about you being in the hospital? c. How many times do you get up to go to the bathroom at night? (finite) d. What do you mean when you say "I don't feel quite right?"

D. What do you mean when you say "I don't feel quite right?"

Exogenous, Endogenous, Iatrogenic

Exogenous: acquired from other people >contaminated device, health care worker, surface, or another vector Endogenous: growing or originating from within. Infected by our own microflora >bowel perforation Iatrogenic: results from a treatment or diagnostic procedure >medications cause neutropenia >peritoneal fluid aspiration results in infection

Infectious Agents

Fungi: plant-like organisms present in air, soil, and water -molds, athletes foot, yeast -treated with anti-fungal medications, many fungal infections are resistant to treatment Parasites + Protozoa: organisms that live on or in a host's blood and rely on it for nourishment -mosquitoes infected feeds on humans' (transmission of Malaria) -hookworm, roundworm, chagas disease, giardia (intestinal issues in animals leading to diarrhea)

Problem Urgency

High priority: Life-threatening Medium priority: Not a direct threat to life, but may cause destructive physical or emotional changes Low priority: Requires minimal supportive nursing intervention

Communicating and Recording Nursing Care Plans

Including info... -basic needs and ADL's -medical tx, nursing dx and collaborative problems -special discharge needs (OT, PT, acute rehab)

Stages of Infection

Incubation Period: 1-2 days, no symptoms, bacteria growing, behind the scenes Prodromal Stage: contagious, not specific and very vague, first symptoms begin Full Stage Illness: mounted immune response, all symptoms, fell unwell, more specific Convalescent Period: immediate symptoms decrease (days-->months), not as sick, could be contagious, recovery period

Types of Nursing Interventions

Independent: any action the nurse can initiate without direct supervision, do not need order for Dependent (Physician initiated): need order for test, nursing actions requiring provider orders Interdependent (Collaborative): patient needs more education, nursing actions performed jointly with other health care members ex: diabetic, knowledge deficit

Comprehensive Planning:

Initial Planning: begins with the first patient contact, written ASAP after initial assessment Ongoing Planning: changes made in the plan as the nurse evaluates the patient responses to care Discharge Planning: begins with the patient is admitted for treatment (time frame)

Assessment Types:

Initial/Admission: upon admission to gather data for the plan of care Focused: more specific like having a fever, to find specific problems Comprehensive/Shift: prioritizing care Emergency: ID life threatening issue/emergencies Time-Lapsed: comparing status to baseline Special Needs: changes in status, wellness in general (psychosocial), cultural preferences spiritual health, OT/PT needed?

Safety Hazards for Healthcare Workers

Injury: back, needle stick, radiation, violence Prevention: incident reporting, sharps awareness, proper body mechanics, radiation precautions, environmental awareness of personal safety

Infections CONT

LOCAL: inflammation, warmth, redness, limited area, increased odor, pain/tenderness, restricted movement, increased respirate efforts SYSTEMIC: larger, raised body temp, general malaise, headache, nausea, changes in VS, confusion, involves greater parts, induration of a wound (>2 cm)

How to prioritize:

Maslow's Hierarchy of Human Needs -physiological, safety, belonging/love, esteem, self-actualization

Medical Assessment vs Nursing Assessments

Medical assessments focus on disease and pathology. Nursing assessments focus on patient response to illness.

Safety Considerations

NEONATES: sleeping on back, using car seats, crib rails, never leave unattended, support head, eliminate choking hazards TODDLERS: car seats, fire safety, domestic abuse, close supervision, appropriate toys, never leave alone close to water, childproof house

WBC's

Neutrophils: large number, move to infected tissue, engulf bacteria Eosinophils: response to parasite infection, allergic reaction Basophils: fewest number, allergic reaction Lymphocytes: broken down into T and B cells -T cells: distinguishing between good and bad antigens. Initiate immune response, natural killer cells -B cells: antibodies target infectious agent Monocytes: eat bacteria, chronic infection

Focused Assessment: Safety

Person: assess for history of falls or accidents, obtain knowledge of family support systems and home environment The Environment: note assistive devices, surroundings, including rugs and bars, and abuse Specific Risk Factors: focused questioning, history of drug or alcohol abuse (can affect cognitive abilities), poisoning, fire, suffocation, choking, firearm injuries

Primary and Secondary Infections

Primary: develops as a direct result of a particular bacterial invasion, strep throat, sore throat, fever Secondary: result of another infection or treatment, AIDS caused by HIV, yeast infection

Sources of Data

Primary: patient directly says... >ex: "my mother had congestive heart failure" Secondary: heard from another source, not directly from patient. This could be from a family member or consultation. >ex: medical history, assessment findings (CT scan)

Parts of Diagnostic Statement

Problem, Etiology, S&S >example: ulcer from the bed P: impaired skin integrity, intervention E: related to... immobility S: as evidence by... Stage 3 decubitus ulcer, red inflamed skin, purulent

Types of Nursing Interventions CONT

Protocols: written plan specifying the procedures to be followed during care of a patient with a select clinical condition or situation Standing Orders: document containing orders for the conduct of routine therapies, monitoring guidelines, and/or diagnostic procedure for specific condition

Nursing Accountability:

Provides the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable

Nursing Care Plans CONT

Purpose: written guidelines for patient care that is organized so nurse can quickly ID nursing actions. Coordinates resources for care, enhances the continuity of care and encourages sage handoff >requirement set forth by the ANA and TJC to guide care through standardized practice >basis for NCLEX exam through critical thinking >based on principles and rules

Quality of Care

Quality Improvement (QI) Goal: structure of the program, evaluates and improves care provided in a healthcare setting >involves structures, outcomes, processes

5 Rights of Delegation

Right task, right circumstances, right person, right directions and communication, right supervision and evaluation

ASSESSMENT!

STEPS: determine status, gather info, putting pieces together to make a decision, entire plan based on data, complete data, find missing data, establish database *assigning priorities for holistic based care with examples... Health Orientation: (health tools, risk) Wheelchair for fall risk Developmental Stage: pediatric, is height and weight within normal range? Culture: does patient need an interpreter, is there a language barrier? Need for nursing: Confirming allergies, what more info do you need (history, family)?

Short Term vs Long Term

Short term: to be achieved within a few days or week Long term: to be achieved over a longer period of time such as weeks, months, or more

Gram Stain

Shows anaerobic or aerobic organism Gram positive: thick cell wall, purple Gram negative: complex, thin, pink

Components of a Patient Centered Outcome with an Example

Subject: patient Action (Verb): walking Performance Criteria: what do you want to see? Target Time: days, time? Special Conditions: using cane to ambulate

Collecting Data: Subjective vs Objective

Subjective: what do they look like? >more opinionated, based on appearance Objective: vital signs, HR, temperature >measured, concrete, proven by fact

Characteristics of the Nursing Process

Systemic: ADPIE approach, sequence Dynamic: fluid, always changing, quick Continuous: always ongoing until finding an outcome Interpersonal: patient centered care Outcome Oriented: depended on outcomes, working with the patient Universally Accepted: everywhere-simple approach.

REMEMBER

TB is airborne Influenza is droplet Pain on a scale from 1-10 is subjective

EVALUATION

The final step of the nursing process, patient's progress toward goals to view the effectiveness of the nursing care plan and the quality of care in the healthcare setting. Includes modifying, altering, or lengthening a plan. -measures the patient's response to actions and interventions -terminate the care plan (or discharge) when goals are met

Delegation

The nurse can delegate an assignment to an LNA. However, according to the ANA, it should be within the LNA's scope of practice and be within reason/appropriate task.

Medical Asepsis

The purposeful reduction of pathogens to prevent the transfer of microorganisms from one person or object to another during a medical procedure. >"clean technique" -provides protective barrier -example: putting an IV in

Mrs. Castillo has late-stage cancer and is not expected to live more than a few months. With chemotherapy, she could live perhaps a year or two more. She cannot decide what to do. She knows that the chemo will have unpleasant side effects, and can be very expensive, and she wants to protect her family from the emotional and financial hardships of a lingering illness. She is showing physical signs of anxiety and distress, shown through increased HR, restlessness and tearfulness. You, the nurse want to provide her support for her decision.

Theoretical Knowledge: knowing the pathophysiology of cancer and the stages Critical Thinking Skills: costs and preferences Practical Knowledge: Is there a language barrier, how are you providing care, meds, ADL's Ethical Issue: length until death, cost (financing), caring aspect

Nursing Knowledge:

Theoretical: gained through learning, very fast, and based on principles Practical: through practice and experience Self-Knowledge: own intuition, values, morals and religion Ethical: knowing right from wrong Caring: knowing, being with, doing for, enabling/supporting, maintaining beliefs >example: Johovah's witness needs blood transfusion, what do you do?

CONTACT PRECAUTIONS

Transmitted by direct (with patient) or indirect contact from the environment (fomite). Some examples include RSV, MERSA, Hep A, C. diff, Conjunctivitis. Always wear gloves and a gown and follow standard precautions, including had hygiene with soap and water. Need a single room for these patients or group patients together that require the same precautions. PPE needs to be removed at the point of exit.

DROPLET PRECAUTIONS

Transmitted through respiratory droplets from coughing or sneezing that are larger, but travel less distance (3 ft). Enters through the nose or eyes, some examples are the Flu, Pneumonia, Meningitis. There are no special air requirements, but a surgical mask is to be worn at all times on top of standard precautions with PPE, and having visitors stand 3 feet away.

AIRBORNE PRECAUTIONS

Transmitted through respiratory droplets, the germ survives and if inhaled, it becomes dangerous. Some examples include TB, measles, herpes zoster. Airborne infections are regulated by negative pressure air flow, wearing an N95 mask for both patient and nurse, limiting transport of patient outside of the room, immunizations for susceptible people, and PPE.

Types of problem solving:

Trial + Error: testing a number of solutions until a valid solution is found Scientific: system and 7 steps (nursing process) >ID problem, collect data, hypothesis, plan action, test hypothesis, interpret results, evaluate results Intuitive: based on experience ("gut-feeling"), this is not used by novice nurses

ENTERIC PRECAUTIONS

Type of contact precaution is a patient has diarrhea or uncontained stools. Common conditions include C. diff, Rotavirus, acute diarrhea with unknown etiology. Use dedicated or disposable equipment and only essential supplies in room. Soap and water required.

Restraints CONT

Types include wrist/ankle (most common), elbow (for kids), blanket (for babies), leather (violent, stronger), bed veil, vest

Neutropenic/Reverse Isolation

Used for patients who have compromised immune systems and low neutrophil levels, this protects the patient from pathogens in the environment. This includes hand hygiene by everyone, frequently monitoring for S&S of sepsis and infection, not allowing any plants or foods with bacteria/fungi, placement in a positive pressure room or private room, limited transport/movement out of room. This can include chemotherapy

The Nursing Process

Using data to investigate Systemic and purposeful approach used by all nurses to... -gather data on a patient -critically examine data -analyze what you're seeing, data, response -identify patient responses -design outcomes -take appropriate action -evaluate if plan/action was successful/effective

How do nurses make decisions?

a. Knowledge base >for a hip surgery patient, you would need to know the background of caring for drainage before you perform the skill b. Blended competencies >scientific, creative, holistic c. Critical thinking >systemic way to form thinking

Check your knowledge: A nurse is caring for a patient who has been ordered a medication that the nurse has never given before. Prior to giving the medication, the nurses uses an electronic database to gather information about the medication. Which of the following components of critical thinking is the nurse demonstrating? a. Competence b. Knowledge c. Experience d. Independent Thinker

b. Knowledge >taking steps to gather information, getting more information to educate patient, using database gives more info

Safety Hazards in the Healthcare Facility

falls, alarm fatigue, equipment-related accidents, fires/electrical hazards, restraints, IV solutions, meds, transferring a patient, changing a dressing, applying external heat to a patient's extremity