Nursing Critical Thinking and Safety

Critical Thinking Components

• Nursing theory supporting health and wellness is a component of critical thinking.
• Attitudes like perseverance, fairness, and conciseness are crucial.
• Intellectual standards in measurement and evidence-based criteria for evaluation are essential.

Implementation

• Reassess the patient's condition frequently.
• Complete a full head-to-toe assessment once per shift.
• Conduct focused assessments as needed.
• Check IVs after 30 minutes to observe if they are effective. Check oral intake every 3 hours.
• Common environmental hazards like MVA, poison, falls, fires, and disasters affect patient safety.
• Developmental stages influence patient risk, impacting safety.
• Factors like lifestyle, impairments, and economic resources influence patient safety.
• Assess home environment for patient safety.

Infection Prevention and Control

• Handwashing is critical for infection prevention.
• Use soap and water to wash hands.
• Different types of drainage color describe serosanguinous, serous, sanguineous, and purulent.
• Health care-associated infections like Central Line Associated Bloodstream Infections (CLABSI), surgical site infections (SSIs), and Foley catheters require care to prevent infections.

Delegation (Five Rights)

• The right task must be delegated within the delegatee's job description or agency policies.
• The patient's condition must be stable for delegation.
• The delegatee must report any changes in patient condition to the licensed nurse.
• Provide clear and concise directions, including objectives, limits, and expectations.
• Communication is ongoing and needed between the licensed nurse and the delegatee.
• Supervise and evaluate the delegatee at the activity's end.
• Values like pH, sodium, potassium, calcium, chloride, magnesium should be evaluated.

Activity and Exercise

• Assess patient readiness for exercise, including mobility and balance.
• Consider patient home environment during planning.
• Exercise plans should be tailored to individual patient needs.
• Use isotonic and isometric exercises, following SMART goals.
• Utilize assistive devices, such as canes, for walking support.
• Always consider body weight distribution; focus on a "strong side" approach.
• Carefully utilize assistive devices during patient mobility.

Crutches

• Four point gait involves weight-bearing on both legs and crutches.
• Three point gait involves weight-bearing on one leg and two crutches.
• Two point gait involves weight-bearing on two legs and two crutches.

Activity and Exercise (continued)

• Use walkers for patients with lower extremity weakness or balance problems.
• Hoyer lifts and Sara Steadies assist patients in transferring from bed to chair or other surfaces.
• Document skin on admission.
• Use different patient positioning techniques.
• Assess range of motion (ROM).

Immobility

• Adverse effects of immobility.
• Slowed wound healing.
• Abnormal lab data.
• Muscle atrophy.
• Edema or fluid and electrolyte imbalances.
• Reduced metabolic rate.
• GI, renal, respiratory issues.

Pressure Injuries

• Risk factors increase for immobile patients; monitor closely.
• Reposition every 2 hours in bed or every hour in a chair.
• Assess skin regularly.
• Stage 1-4 injuries are all different grades of tissue loss.
• Deep tissue injuries and those with slough/eschar need extra attention.
• Understanding stage 1-4, and medical/adhesive related injuries is crucial for care.

Wound Healing

• Wound assessment, including color, edges, drainage, and consistency, is necessary.
• Nutritional status, pain, mobility, infection should be considered during wound assessment.
• Wound care and healing are affected by a variety of factors.

Oxygenation

• Early signs of hypoxia include restlessness and confusion.
• Late signs include abnormal breathing, irritability, anxiety, and tachycardia.
• Recognize hypoxia and ensure adequate oxygenation and respiratory function.
• Assess patient pain, breathing, and position often.

Restraints

• Check restraints every 30 minutes.
• Obtain an order for restraints.
• A physician order is typically good for 24 hours; reassess and reorder frequently.

Intake and Output

• Record intake and output.
• Monitor for decreased urine output and dehydration.
• Maintain hydration.

Medication Administration

• Utilize the six medication rights (patient, medication, route, dose, time, documentation).
• Use various routes for medication administration, including oral, IV, IM, SubQ, etc.
• Follow proper procedures for each method.

Intravenous (IV) Care

• IV tubing and lines need proper use and care. Monitoring IV complications is critical.
• Carefully use and monitor IV types, avoiding IV complications.
• Date IV tubing and adhere to changing frequency guidelines.
• Maintain careful technique for proper IV insertion points.
• Observe blood return before administering medication.
• Follow proper procedures when removing IV lines.

Intravenous (IV) Medication Routes

• Recognize various routes for medicine administration.
• Different routes for delivering medications, including subcutaneous, and intramuscular methods.

Death and Grief

• Patients experience numerous losses (physical, emotional, social, and psychological).
• Support patients during various emotional responses.
• Provide appropriate support.
• Utilize appropriate resources for patient support.

Other

• Other topics like pain management, positioning, wound care, nutrition, oxygenation, and infection prevention are vital.

This quiz focuses on the components of critical thinking in nursing, including health assessments and patient safety. It emphasizes the importance of intellectual standards, environmental hazards, and infection prevention methods. Test your understanding of the best practices for ensuring patient well-being.