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General Course Objective: At the end of the course, the student will be able to demonstrate the transition to a higher-level

thinking process that is necessary to perform competently in the role of a professional nurse.


At the end of the course, the student will be able to: 1. place data in logical order to sequence events. 2. demonstrate deliberate strategies that reflect a transfer of theory knowledge to the practice setting. 3. analyze situations for similarities with previous experiences. 4. identify cause-and-effect relationship. 5. adapt knowledge and skill gained in previous situations to present the problem.


6. demonstrate the ability to apply sound reasoning to nursing practice. 7. exhibit adequate knowledge in basic nursing concepts covered in NCM 100-103. 8. explain basic nursing concepts covered in NCM 100-103. 9. demonstrate critical thinking skills in solving basic nursing problems. 10. exhibit adequate skills in carrying out the nursing process.

DEFINITION OF TERMS: Appraisal a review or survey of performance, normally for the purpose of career and/or educational development. Collaborative problem physiological complication that the nurse monitors to detect the onset of changes in client status but for which the nurse cannot independently initiate the definitive treatment Competency the degree of accomplishment that meets a satisfactory standard of performance.

Critical Thinking process of purposeful, self-regulatory judgment; in nursing, it is discipline-specific reflective reasoning that guides the process of deciding what to do or believe in unique situations Experiential learning an approach to education and training based on providing students with structured activities and the opportunity to reflect on them so they can learn by doing. Inference the nurses judgment or interpretation of cues, such as judging a blood pressure to be lower than normal

Learning opportunities a wide range of knowledge, skills and attitudes that a student may be exposed to during clinical/ practice placement. Nursing Diagnosis nurses ethical judgment about the clients responses to actual or potential health problems or state of wellness. Objective data includes measurable and observable data that can be detected by someone other than the client

Performance indicator a pointer that draws attention to whether or not students are competent at carrying out tasks. Subjective data data that originates form the client


He/ She understands reason for task: and is able to perform task independently. but needs supervision. and is able to perform with assistance.


He/ She: understands reason for task but performs task at provisional level. is unable to state reason for task and performs task at a dependent level.

Why do we need to assess?


ascertain: The level of theoretical knowledge The level of practical clinical skills Insight into the level of professional attitudes


I should have never qualified my skills & attitude are inadequate I am ashamed that I have reached this far but still my skills and knowledge are inadequate for my level Reflect on the feelings evoked by the statements above. Suggest reasons/ factors that you assessed that lead to these statements. How could you, as a Level 4 student nurse, address this situation?



essential to increasing the quality of thinking. How should we ask then, to cultivate critical thinking? 1. Clarity Could you elaborate further? Could you give me an example? Could you illustrate what you mean? 2. Accuracy (In the interpretation of data) How could we check on that? How could we find out if that is true? How could we verify or test that?

3. Precision Could you be more specific? Could you give me more details? Could you be more exact? 4. Relevance (Pertinent data) How does that relate to the problem? How does that bear on the question? How does that help us with the issue?

5. Depth (Analyzing deeper into the problem to check the root cause) What factors make this a difficult question? What are some of the complexities of this question? What are some of the difficulties we need to deal with? 6. Breadth (thinking about a situation from different points of view) Do we need to look at this from another perspective? Do we need to consider another point of view?

7. Logic (Nursing procedures done in logical manner) Does all this make sense together? Does your first paragraph fit in with your last? Does what you say follow from the evidence? 8. Significance (Identifying critical information from trivial in a given situation) Is this the most important problem to consider? Is this the central idea to focus on? Which of these facts are most important? 9. Fairness (Being open to new ideas) Am I sympathetically entering the view points of others? Am I putting views I oppose in their strongest form?

Activity 2 Scenario Assessment & Interpretation

During the assessment, Mr. Yoso relates a history of sudden onset of chest pain rated at 10 on a 1 to 10 scale, unrelieved by rest, which started while he was mowing the lawn. He describes the pain as crushing, like a truck ran over my chest. His blood pressure is 200/110 mmHg, temperature is 36.7C; pulse is 106 beats/min; and respirations are 24 breaths/min. The pulse is irregular and thread, and the respirations are slightly dyspneic. The cardiac monitor reveals atrial fibrillation. During the assessment, his wife confides to the nurse that Mr. Yoso was treated 3 years ago for alcohol dependence. Currently he is complaining of nausea and indigestion. His skin is pale and diaphoretic. He is restless and anxious. His wife is sitting at the bedside very tearful and emotional.

List where you might find pertinent data Identify what the nurse can do to collect significant data in an organized manner Where would the nurse seek information to identify missing data? What other points of view should the novice nurse seek in order to verify conclusions? How can the nurse evaluate the opinions of others fairly? Recognize assumptions Possible pharmacologic or surgical treatments are anticipated



The physician informed the The diagnosis of cancer caused All patients who learn they have patient that the lab data results the patient to feel sad. a life-threatening disease are are positive for cancer and that sad. the disease has spread t the liver. The patient is very upset

The physician told the patient A variation in the WBC indicates All patients with a variation in that his WBC was abnormal and an infection the WBC have an infection that it indicated an infection The patient rang the call light for pain medication. The nurse had gone to lunch, and a delay resulted in the patient experiencing extreme pain for an extended time. The patient was in pain because All nurses cause patients to the nurse attended to her own experience pain while attending needs instead of the patients to their own needs need


Scenario Assessment & Interpretation

Frank Furter, a 72 year old patient admitted for acute confusion presented in the ER with a history of hypertension, DM type 1, and arthritis. He lives in a single-family home with his wife. The patient is slightly confused and has an unsteady gait. He frequently forgets to use his walker and fails to call for assistance from the nursing staff when ambulating to the bathroom. Based on this scenario, discuss your interpretation, analysis, evaluation, inference, and explanation and how you would use these to resolve a situation related to the patients safety?

Clarify that the behavior means During assessment, what questions should the nurse ask to determine the best plan of care? What outcomes do you expect to achieve with your patient today? What conclusion could the nurse make, based on the analysis? During implementation, how can the nurse justify the actions being initiated? What should the nurse reexamine to correct or improve the nursing care?