STUDY GUIDE
Davis Advantage for Understanding
Medical-Surgical Nursing 7th Edition
By Hopper, Williams, All Chapter's 1 - 57
1
,(DaviswAdvantagewforwUnderstandingwMedical-SurgicalwNursing,w7ewLindawWilliams,wPaulawHopper)
Answers
CHAPTER 1 w
towcollectwappropriatewdata,widentifywawpatientwproblem,wa
ndwdeterminewthewbestwpossiblewplanwofwaction.wClinicalwju
CRITICAL THINKING,
w
dgmentwiswbasedwonwgoodwcriticalwthinking.
CLINICAL JUDGMENT, ANDTHE
w w w
Cue
w
wNURSING PROCESS w
Definition:wSignificantworwrelevantwdata.wNotwallwdataware
cuesw(relevant),wbutwallwcueswarewdata.
AUDIOw CASEw STUDY Collaboration
Janew Practicesw Clinicalw Judgment Definition:wWorkingwtogetherwwithwthewhealthwteamwtowi
mprovewpatientwoutcomes.
1. Identifywandwanalyzewcues;wprioritizewhypotheses;wgeneratewsol
utions;wtakewaction;wevaluatewoutcomes;wrepeat. Intervention
2. Janewwaswexhausted,wfailedwawtest,wandwwaswpulledwinwtoow Definition:wTakingwactionwtowcarrywoutwawplan.
manywdirections.wShewwaswalsowcryingwinwherwcarwandwhadwp
Evaluation
oorwstudywhabitswandwnotwenoughwsleep.
3. Jane’swresourceswincludedwawgoodwfriend,wsickwtimewfromww Definition:wComparingwthewoutcomeswyouwexpectedwwithwac
ork,wandwwastedwtimewbetweenwclasseswthatwshewcouldwbett tualwoutcomes.wDidwthewplanwwork?wWerewexpectedwout
erwutilize.wYourwresourceswwillwbewdifferent,wbutwtheywexist comeswmet?
! Vigilance
4. Criticalwthinking— Definition:wThewactwofwbeingwattentive,walert,wandwwatchful.
thewwhy:wJanewuseswcriticalwthinkingwtowdeterminewwhywherw
currentwplanwisn’twworking.wShewthinkswhonestlywaboutwher CRITICALw THINKINGw ANDw CLINICALwJUDGMENT
wpoorwstudywhabits,wherwtime-
wmanagementwproblems,wandwthewimpactwthiswiswhavingwonw Criticalwthinkingwandwclinicalwjudgmentwbothwfollowwawsimilarwfor
herwandwherwfamily. mat.wBothwfollowwstepswfromwcollectingwdatawtowdetermin-
wingwproblemswandwoutcomes,wdevelopingwandwtakingwactions,wa
Clinicalwjudgment—
thewdo:wJanewuseswherwthinkingwtowdevelopwandwcarrywoutwawpl ndwevaluatingwoutcomes.wHowever,wcriticalwthinkingwhelpswyouw
anwthatwuseswherwresourceswandwprovideswmorewproductivewst thinkwaboutwthewproblem:wWhatwiswit?wWhywiswitwhappen-
wing?wAndwclinicalwjudgmentwleadswyouwtowdowsomethingwtowman
udywtimewandwmorewqualitywtimewwithwherwkids.
agewthewproblem.
VOCABULARY
CUEw RECOGNITION
SamplewsentenceswwillwvarywforwthewVocabularywproblems.
Youwwillwdowmanywthingswforweachwindividual,wbutwthewFIRSTwthingwiswlis
Nursingw process tedwbelow.
Definition:wAnworganizingwframeworkwthatwlinkswthinkingwwithw
nursingwactions.wStepswincludewassessment/datawcollection,wn 1. Sitwthewpatientwupright.
ursingwdiagnosis,wplanning,wimplementation,wandwevaluation. 2. Callw911wwhilewrunningwacrosswthewstreet.
3. Elevatewthewfeetwoffwthewbedwbywplacingwawpillowwunderwthew
Criticalwthinking calveswandwallowingwthewfeetwtowhangwoffwthewedgewofwthewpi
Definition:wThewusewofwthosewcognitivew(knowledge)wskillsworw llow.
strategieswthatwincreasewthewprobabilitywofwawdesirablewoutco 4. Checkwbloodwglucosewandwhavewawglucosewsourcewready.
me.wAlsowinvolveswreflection,wproblem- 5. Turnwthewpatientwtowthewsidewtowpreventwaspiration.
solving,wandwrelatedwthinkingwskills.
Clinicalwjudgment
Definition:wThewobservedwoutcomewofwcriticalwthinkingwandwdeci
sionwmaking.wAwprocesswthatwuseswnursingwknowledge
,2 Chapterw1 Answers
CRITICALw THINKING
Thiswiswjustwonewpossiblewwaywtowcompletewawcognitivewmap.
Couldwitwbewlow Frontalware "Sick"w feelin Hard Tylenolwhelps
Amw Iw diabetic a g Hungerwmake
? s
bloodwsugar? itwworse
Patient's Wherewiswit Quality Aggravating w and
perception ? alleviating w factor
s
Foodw help
Headache s
Usefulw othe Severity Timing
r
data
Sometimesw fee Motherwi 7–8w onw 0– Lastsw1– Beforewmeal Earlywinwth
l s 10 2whours s e
sickw tow stomac diabetic scale oncew starts morning
h
REVIEWw QUESTIONS takingwvitalwsigns;wdatawcollectionwiswthewfirstwstepwinwthewn
ursingwprocess.w(2,w3,w4)warewallwstepswinwthewnursingwproc
Thewcorrectwanswerswarewinwboldface.
ess,wforwwhichwthewregisteredwnursewiswresponsible;wthewLP
1. (2)wCriticalwthinkingwcanwleadwtowbetterwoutcomeswforwthewp N/LVNwmaywassistwthewregisteredwnursewwithwthese.wNitrog
atient.w(1,w3,w4)wmaywbewtruewbutwarewnotwthewbestwanswer. lycerinwshouldwnotwbewadministeredwwithoutwfirstwknowingwt
2. (4)wiswcorrect.wThewnursewwhowcanwadmitwtownotwknowingw hewpatient’swbloodwpressure.
somethingwiswexhibitingwintellectualwhumility.w(1)wshowswex 7. (2)windicateswthatwthewpatientwiswconcernedwaboutwfreedomwf
pertisewbutwnotwnecessarilywintellectualwhumility; romwinjurywandwharm.w(1)wrelateswtowbasicwneedswsuchwaswai
(2) reportingwanwerrorwshowswintellectualwintegrity; r,woxygen,wandwwater.w(3)wrelateswtowfeelingwloved.w(4)wiswre
(3) empathizingwiswpositivewbutwdoeswiswnotwevidencewo latedwtowhavingwpositivewself-esteem.
fwhumility. 8. (3,w1,w2,w4)wiswthewcorrectworderwaccordingwtowMaslow.
3. (3,w4,w5,w1,w2)wiswthewcorrectworder. 9. (5,w2,w1,w4,w6,w3)wiswthewcorrectworder.
4. (1)wiswthewbestwdefinition.w(2,w3,w4)wdownotwdefinewcritical 10. (3)wshowswthewpatientwiswactuallywtakingwaction.w(1,w2,w4)w
wthinkingwbutwarewexampleswofwgoodwthinking. arewallwpositivewbutwdownotwshowwintentwtowtakewaction.
5. (4)wiswcorrect.wEvaluationwdetermineswwhetherwgoalswarewach 11. (4)wiswthewnurse’swanalysiswofwthewsituation.w(1,w2)warew
ievedwandwinterventionsweffective.w(2)wiswthewrolewofwthewphys data;w(3)wiswawrecommendation.
ician.w(1,w3)wencompasswdatawcollectionwandwimple- 12. (1,w2,w3,w4)wshouldwbewpresent.wSincewthewdatawprovidesw
wmentation,wwhichwarewearlierwstepswinwthewnursingwprocess. onlywhipwreplacementwaswthewpatient’swproblem,w(5)wthewd
6. (1)wiswcorrect.wThewlicensedwpracticalwnurse/licensedwvoca- ietitianwiswnotwnecessary.
wtionalwnursew(LPN/LVN)wcanwcollectwdata,wwhichwincludes
1
, Answers
CHAPTER 2 w EVIDENCE-BASEDw PRACTICE
EVIDENCE-BASED PRACTICE w 1. proof
2. context
AUDIOw CASEw STUDY 3. quality
4. care
Mariew andw Evidence-Basedw Practice 5. randomized
1. Thirdhandwsmokewiswthewdangerouswtoxinswofwsmokewthatwli 6. outcomes
ngerwonwhair,wclothing,wfurniture,wandwotherwsurfaceswinwan 7. gold
wareawafterwawcigarettewiswputwout.wMariewlearnedwthatwexp 8. nursing
osurewtowthesewtoxinswcanwbewneurotoxicwtowchildrenwandwc 9. patient’s
anwtriggerwasthmawattackswinwsensitivewpeople. 10. information
2. Evidence-
basedwpracticewiswconsideredwthewgoldwstandardwofwhealthwca CLINICALw JUDGMENT
re.
3. Stepw1:wAskwthewburningwquestion.wStepw2:wSearchwandwc 1. Bywquestioningwthewexistingwwaywofwdoingwthingswtowens
ollectwthewmostwrelevantwandwbestwevidencewavailable.wSte urewthatwthewpatientwreceiveswthewbestwcarewpossible
pw3:wThinkwcritically.wAppraisewthewevidencewforwvalidity, 2. Awthoroughwsearchwofwthewliterature,wwithwthewassistancewofwt
wrelevancewtowthewsituation,wandwapplicability.
hewmedicalwlibrarian,winwthewareawofwtheirwburningwques-
wtionwregardingwmusicwreducingwpreoperativewanxiety.
Stepw4:wMeasurewthewoutcomeswbeforewandwafterwinstitutingwt
hewchange.wStepw5:wMakewitwhappen.wStepw6:wEvaluatewthewpr 3. CumulativewIndexwtowNursingwandwAlliedwHealthwLiterature
acticewdecisionworwchange. w(CINAHL)wDatabase,wJoannawBriggswInstitutewevidence-
4. Combinationwtherapywwithwawnicotinewpatchwandwnicotinewloz basedwresources,wCochranewReviews,wMedline/wPubMed
engeswworkedwbest,walthoughwbupropionw(Zyban)worwvarenicl 4. Measurewpatientwoutcomeswbeforewinstitutingwthewevidence
inew(Chantix)wandwnicotinewlozengeswworkedwwell,wtoo.wAwC -
ochranewReviewwfoundwthatwadvicewandwsupportwfromwnursin basedwchangewinwpracticewsowcomparisonswcanwbewmadewafte
gwstaffwcanwincreasewpatients’wsuccesswinwquit- rwimplementationwtowdeterminewifwthewinter-
wtingwsmoking,wespeciallywinwawhospitalwsetting. wventionwworked
5. Evaluatewthewresultswtowdeterminewwhetherwthewchangewm
VOCABULARY adewawsignificantwdifferencewandwifwitwwaswvaluablewinwter
mswofwcostwandwtime
SamplewsentenceswwillwvarywforwthewVocabularywproblems.
1. Evidence- REVIEWw QUESTIONS
basedwpractice:wAwsystematicwprocesswthatwuseswcurrentwevid Thewcorrectwanswerswarewinwboldface.
encewinwmakingwdecisionswaboutwpatientwcare.
2. Evidence- 1. (3)wiswcorrect.wProvidingwanwexplanationwofwwhywsome-
informedwpractice:wConsiderationwofwpatientwfactorswalongwwi wthingwiswdonewpromoteswthewunderstandingwforwwhywitwisw
thwthewusewofwevidencewforwsharedwdecisionwmakingwbetweenwt importantwtowbewdonewandwthereforewwillwmorewlikelywbew
hewhealth-carewproviderwandwthewpatient. done.w(1,w2,w4)wonlywcommunicatewthewneedwtowperformwa
wtask.wTheywdownotwprovidewrationalewforwthewtaskwtowpro-
3. Randomizedwcontrolledwtrials:wTruewexperimentalwstudieswin
wmotewunderstandingwofwthewimportancewofwthewtask.
wwhichwaswmanywfactorswaswpossiblewthatwcouldwfalselywchang
ewthewresultswarewcontrolled. 2. (3)wiswcorrect.wEvidence-
4. Research:wScientificwstudy,winvestigation,worwexperimenta- basedwnursingwcarewthatwhaswbeenwevaluatedwaswappropriatewf
wtionwtowestablishwfactswandwanalyzewtheirwsignificance.
orwanwagencywprovideswthewbestwandwsafestwpatientwcare.w(1)w
5. Systematicwreview:wAwreviewwofwrelevantwresearchwusingwgu Opinionswmaywnotwbewbasedwon
idelines.