Nursing Process/Clinical Judgment/Critical Thinking Nursing Diagnoses & Concept Maps

Florence Nightingale

Founder of modern nursing; emphasized sanitation, data-based practice, and the environment's role in healing.

Purpose of studying nursing history

Provides professional identity, context, and understanding of nursing's evolution and challenges.

Three pathways to become an RN

Diploma, Associate Degree (ADN), and Baccalaureate (BSN) — all eligible for NCLEX-RN.

Mildred Montag

Developed ADN programs to address post-WWII nursing shortages.

BSN degree

College-based; prepares nurses for leadership, research, and graduate education.

Accreditation bodies

CCNE (BSN+) and ACEN (Diploma-BSN); ensure program quality.

Certification

Voluntary recognition of expertise in a specialty; issued by ANCC.

Continuing education (CE)

Maintains competence and licensure; focuses on lifelong learning.

Professional socialization

Process of acquiring values, behaviors, and attitudes of the nursing profession.

Reality shock

Difficulty new grads face when adapting from school to practice.

Professional identity

Reflects responsibility, accountability, and leadership as a nurse.

Professional boundaries

Maintain respect and avoid personal or online relationships with clients.

Professional Nursing Organizations (PNOs)

Groups that set standards, advocate, and support nurses (ANA, NLN, AACN, NSNA, Sigma Theta Tau).

American Nurses Association (ANA)

Sets standards, code of ethics, and advocates for nurses politically and professionally.

National League for Nursing (NLN)

Focuses on nursing education standards and faculty development.

Sigma Theta Tau Honor Society

Promotes nursing scholarship and leadership; invitation-only membership.

Levels of prevention

Primary: prevent disease; Secondary: early detection; Tertiary: manage disease to prevent complications.

Healthy People 2030 goals

Promote health, eliminate disparities, create supportive environments, foster healthy behaviors, and engage leadership.

Modifiable risk factors

Diet, exercise, smoking, substance use.

Health-promoting behaviors

Physical activity, balanced diet, adequate sleep, and stress management.

Role of nurse in health promotion

Modify behavior, educate, advocate, and connect clients to resources.

Evidence-based interventions for behavior change

Motivational counseling, trust-building, goal-setting, and written contracting.

Teaching in nursing

Integral nursing role; promotes health, prevents illness, and fosters self-care.

Learning domains

Cognitive (thinking), Affective (values), Psychomotor (skills).

Bloom's taxonomy

Organizes objectives from simple to complex (remember → understand → apply → analyze → evaluate → create).

Teach-back method

Client repeats instructions in own words to confirm understanding.

Learning styles

VARK — Visual, Auditory, Reading/Writing, Kinesthetic.

Barriers to learning

Pain, anxiety, fatigue, low motivation, literacy, distractions.

Health literacy

Ability to understand and apply health information for decision-making.

Adult learning principle

Adults learn best when content is relevant, self-directed, and problem-focused.

Teaching plan process

Assess → Plan outcomes → Implement strategies → Evaluate outcomes.

SMART outcomes

Specific, Measurable, Achievable, Realistic, Time-bound.

Nursing process steps

Assessment, Diagnosis, Planning, Implementation, Evaluation.

Purpose of the nursing process

Provides a systematic, patient-centered, outcome-focused framework for care.

Nursing diagnosis

Clinical judgment about client's response to health conditions; basis for interventions.

Actual vs. Risk diagnosis

Actual: existing problem with evidence (AEB); Risk: potential problem without symptoms yet.

PES format

Problem → Etiology (r/t) → Symptoms (AEB).

Example of PES statement

Deficient fluid volume r/t insufficient intake AEB dry mucous membranes, low BP, concentrated urine.

SMART outcome example

Client will maintain BP 100-120/60-80 and urine output ≥30 mL/hr by end of shift.

Intervention categories

Assess, Do, Teach — include one of each per outcome.

Evaluation outcomes

Met, Partially Met, or Not Met — adjust care plan accordingly.

Concept map purpose

Visual organization of data showing relationships between problems, outcomes, and interventions.

Critical thinking

Active, organized, and systematic process for making clinical judgments.

Maslow's hierarchy of needs

Used to prioritize nursing diagnoses (physiologic before psychosocial).

Role conflict

When multiple job demands or values compete (e.g., caregiver vs. leader roles).

Role overload

Too many responsibilities with limited time; manage by prioritizing and delegating.

Empowerment

Nurses' autonomy to make decisions and influence care and policy.

Whistle-blowing

Reporting unethical or unsafe practices to protect patients.

Caregiver role

Provides direct patient-centered care with empathy and compassion.

Educator role

Teaches patients, families, and staff to promote understanding and self-care.

Manager role

Coordinates care, delegates tasks, and ensures safe, effective practice.

Advocate role

Protects patient rights and promotes ethical, equitable care.

Mentor vs. preceptor

Mentor: long-term career guidance; Preceptor: short-term skills orientation.

Deep vs. surface learning

Deep: understanding and applying; Surface: memorizing without context.

Community health promotion examples

Worksite screenings, school-based programs, walking clubs, and Meals on Wheels.

Environmental wellness

Promotes safe, pollution-free, and stress-managed living environments.