Nursing

• Asking “Why” questions can be perceived as interrogation by the client and can put them on the “defensive”, except in an emergency situation where the use of probing and direct questioning may be appropriate to gain a greater volume of data in a shorter period of time.
• Neutral questions are questions that the client can answer without direction or pressure from the nurse, and are open-ended and used in nondirective interviews.
• The stages of an interview include the opening, body, and closing.
• During the body of an interview, the client communicates what they think, feel, know, and perceive in response to questions from the nurse.
• During the opening of an interview, it is important to establish rapport and orient the client to the purpose and nature of the interview.
• Planning the interview and setting includes considering the time, place, seating arrangement, distance/proxemics, and language.
• Examining can involve physical examination or physical assessment, which is a systematic data collection that uses observation (senses) to detect health problems.
• During the closing of an interview, it is important to offer to answer questions, conclude, provide a summary to verify accuracy and agreement, thank the client, express concern for the person’s welfare and future, and plan for the next meeting.
• A leading question usually directs the client’s answer and gives them less opportunity to decide whether the answer is true or not, which can lead to inaccurate data.
• Techniques used to conduct a physical examination include inspection, auscultation, palpation, and percussion.
• The nursing process is a systematic, rational method of planning and providing individualized nursing care.
• The nursing process follows a logical sequence, enabling the nurse to respond to the changing status of the client.
• The nursing process identifies client’s health status – actual or potential health problems or needs.
• The purposes of the nursing process are to establish plans to meet the identified needs, deliver specific nursing interventions to meet those needs, and focus on problem solving and decision making.
• The client in the nursing process may be a family, a community, a group, or an individual.
• The nursing process is characterized as cyclic and dynamic, with data from each phase providing input to the next phase.
• The nursing process is client-centered, with the plan of care according to the client’s problems/needs.
• The nursing process focuses on problem solving and decision making, with approaches including trial and error, intuition, and research.
• The nursing process is interpersonal and collaborative, involving communication with clients, significant others, and support groups, and collaboration with the health care team.
• The nursing process is universal in its applicability, used as a framework for nursing care for all types of settings with clients from all age groups.
• The nursing process involves the use of critical thinking and clinical reasoning, making clinical judgements based on knowledge base in nursing and clinical experience.
• Attitudes that foster critical thinking include independence, fair-mindedness, insight into ego-centricity, intellectual humility, and intellectual courage to challenge status quo and rituals.
• Components of clinical reasoning include setting priorities and developing rationale.
• Assessing/assessment in nursing involves collecting, organizing, validating and documenting client data to establish a database about the client’s response to health concerns or illnesses and the ability to manage healthcare needs.
• Implementing/implementation in nursing involves carrying out (or delegating) and documenting the planned nursing interventions to assist the client to meet desired goals/outcomes; promote wellness; prevent illness/disease; restore health; facilitate coping with altered functioning.
• Evaluating/evaluation in nursing involves measuring the degree to which goals/outcomes have been achieved and identifying factors that positively or negatively influence goal achievement.
• Ability to recognize changes in a client’s condition over time is a key aspect of clinical reasoning in transition.
• Planning in nursing involves determining how to prevent, reduce or resolve the identified priority client problems; how to support client strengths; and how to implement nursing interventions in an organized, individualized and goal-directed manner.
• Ability to detect changes, identify change in priorities, adjust nursing care and alert primary care provider when appropriate is a crucial aspect of responding to changes in a client’s condition.
• Thinking back or reviewing interventions implemented and whether they were effective is a crucial aspect of reflection.
• Diagnosing/diagnosis in nursing involves analyzing and synthesizing data to identify client’s strengths and health problems that can be prevented or resolved by collaborative and independent nursing interventions.
• Identifying factors that improved client care and those that required changing or elimination is an integral part of reflection.
• A leading question can be perceived as interrogation by the client, which can put the client on the “defensive”, but in an emergency situation the use of probing and direct questioning may be appropriate to gain a greater volume of data in a shorter period of time.
• During the opening stage of an interview, it is important to establish rapport and orient the client to the purpose and nature of the interview.
• A leading question usually directs the client’s answer and gives the client less opportunity to decide whether the answer is true or not, which may create problems if the client gives inaccurate answers just to please the nurse, resulting in inaccurate data.
• Neutral questions are questions that the client can answer without direction or pressure from the nurse, and are open-ended and used in nondirective interviews.
• A neutral question is usually closed, but can be open-ended, and is used in nondirective interviews.
• Planning the interview and setting includes time, place, seating arrangement, distance/proxemics, and language.
• Examining includes physical examination or physical assessment, which is a systematic data collection that uses observation (senses) to detect health problems.
• During the closing stage of an interview, it is important to offer to answer questions, conclude, provide a summary to verify accuracy and agreement, thank the client, express concern for the person’s welfare and future, and plan for the next meeting.