o Benner’s Chart. What’s the difference between each level?

Stage 1: Novice (beginner)

o Has no experience in situations where they are meant to perform.

o Lacks confidence in demonstrating safe practice

o Needs continuous verbal and continuous cues

o Unable to use discretionary judgement

Stage 2: Advanced Beginner

o Demonstrate (to an extent) acceptable performance due to prior experience

o Efficient and skillful in certain parts; only needs occasional cues

o Knowledge is developing

Stage 3: Competent

o Has been on the job for the same or similar situation for 2-3 years.

o Demonstrates efficiency, coordination, and is confident in their actions.

o Able to develop a plan based on anticipated outcomes

Stage 4: Proficient

o Perceives situations as a whole and not in ‘chopped up’ parts (it is because they perceive

its meaning in terms of long-term goals)

o Knows how plans need to be modified in response to certain events. (easily identify the

issue)

o Can recognize how patients respond to interventions

Stage 5: The expert

o Make quick patient assessments and clinical decisions.

o Performance is fluid and flexible & highly proficient

o High skilled analytic ability

o What is ADPIE? A nursing process approach

Assessment

Diagnosis

Planning (outcomes & interventions)

Implementation

Evaluation

o Application of nursing process: how do you apply it related to patient care; benefits you

get from nursing process as a nurse when dealing with patients.

o Applied with ADPIE

o Benefits:

o Patients: scientifically based, holistic individualized patient care, continuity of care, clear

& efficient & cost-effective plan of action.

o Nurse: opportunity to work collaboratively with other health care workers, satisfaction of

making a difference in lives of patients, opportunity to grow professionally.

Subjective = what the patient tells you

Objective = what is observable and measurable

o What is a nursing diagnosis and how do you come up with it?

• Nursing Dx = a clinical judgment about individual, family, or community responses to

actual or potential health/life problems

How do you come up with it? Need a Medical Dx and analyzing patients’ subjective and

objective data to help identify patterns.

o What is the difference between a Medical Dx and a Nursing Dx?

Medical Dx = focuses on identifying the disease

Nursing Dx = focuses on the patients’ response to the illness

Ex: Nursing: Blood glucose management vs. Medical: Diabetes mellitus

Key Words for nursing dx: Risk; Knowledge; Ineffective

o What are the types of nursing diagnosis & what do we use?

Use = NANDA-I

Types =

1. Problem-focused: clinical judgment concerning an undesirable human response to a

health/life process.
 2. Risk factor: clinical judgment concerning the vulnerability of an individual, family,

group, or community for developing and undesirable human response to health

conditions

3. Health promotion: clinical judgment concerning motivation and desire to increase

well-being.

o What are the three parts of a Nursing Dx?

1.) Problem (must be NANDA-I) = Describes the health state or problem of the patient

2.) Etiology = Identifies the physiologic, psychological, sociologic, spiritual, and

environmental factors believed to be related to the problem. (How do you identify it?

Look at associated factors. Ex: location, exposure to chemicals)

3.) Defining characteristics = Subjective and objective data that signals the existence of

the actual or possible health problem

o What is the component of nursing diagnosis statement?

Problem related to (r/t) etiology as evidenced by (aeb) defining characteristics

¡ Ex: Ineffective airway clearance related to excessive mucus as evidenced by adventitious

breath sounds

o What Is the difference between nursing and medical assessment?

• Nursing = focus on the patient’s response to health problems

• Medical = focus on finding data that points to pathologic conditions

• Cue = using the subjective and objective data obtained to identify that something might

be wrong with the patient

• Inference = is the judgment that is reached about the cue

• Used to = analyze the data they obtain from the patient

o Maslow’s Pyramid:
 o What are the different types of outcomes?

o Cognitive- used to increase patient knowledge or intellectual behaviors

o Psychomotor- used to help the patient achieve new skills

o Affective- used to described changes in patient values, beliefs, and attitudes

o What is SMART?

Specific

Measurable

Attainable

Realistic

Timely

o What are the different types of interventions?

o Direct intervention is a treatment performed through interaction with the patient

• Includes physiologic and psychosocial nursing actions

o Indirect intervention is a treatment performed away from the patient but on

behalf of the patient

• Manage the patient environment and interdisciplinary collaboration

o Community interventions are a treatment that promotes and preserves the health

of populations as a whole

• Emphasize health and promotion

Cognitive process that is essential to evaluate and manage a patient’s medical problem.

o What is a Physiological diagnosis?

A medical dx that identifies an illness/diseases based on a patient’s physical exam, health

history, and signs and symptoms.

- dx you are working on now with what is physically wrong w/ patient

o Health promotion vs education diagnosis

Health promotion: clinical judgment concerning motivation and desire to increase well-

being.

Education diagnosis: a pre-assessment that identifies a student’s strength and weakness in

learning.

o What critical thinking skills help a nurse see the relationships among different data?

Clustering related cues

https://quizlet.com/193175778/jarvis-ch1-evidence-based-assessment-flash-cards/