NUR 321 Advanced Nursing Skills: Introduction to Clinical Practice

Flashcards covering time management, I-SBAR communication, the Clinical Judgement Model steps, prioritizing care, and differentiation between RN and LPN scope of practice in advanced nursing skills.

What are key components of time management in clinical practice?

Reviewing the client’s electronic medical record, receiving SBAR from the previous shift, applying the Clinical Judgement Model, and prioritizing assessment.

What does the acronym I-SBAR stand for?

Introduction, Situation, Background, Assessment, Recommendation/Request.

What is the primary purpose of using I-SBAR communication?

To ensure complete and clearly understood communication.

What are the six steps of the Clinical Judgement Model?

Recognize cues, Analyze cues, Prioritize hypotheses, Generate solutions, Take actions, Evaluate outcomes.

What does the 'Recognize cues' step of the Clinical Judgement Model involve?

Identifying relevant information related to the client's condition and recognizing relevant subjective and objective data.

What considerations are part of the 'Analyze cues' step in the Clinical Judgement Model?

Identifying how pathophysiology relates to the clinical presentation; distinguishing between expected vs. unexpected, acute vs. chronic; and identifying 'critical' vs. 'supportive' data.

How do nurses prioritize hypotheses in the 'Prioritize hypotheses' step of the Clinical Judgement Model?

Identifying the top three (3) clinical problems/concerns, considering Airway, Breathing, Circulation (ABC), and Maslow's Hierarchy of Needs.

What elements are involved in the 'Generate solutions' step of the Clinical Judgement Model?

Planning, setting goals/outcomes, asking if additional data is needed, and utilizing interdisciplinary teamwork.

What is the focus of the 'Take actions' step in the Clinical Judgement Model?

Implementing priority nursing actions based on the collected data.

What does 'Evaluate outcomes' involve in the Clinical Judgement Model?

Recognizing the client's response to nursing actions and 'closing the loop' on the intervention's effectiveness.

What are the two main contexts for prioritizing care in nursing?

'What do I do first in the care of this particular client?' (case study) and 'Which client do I assess first?'

What are the primary assessment responsibilities of a Registered Nurse (RN) as opposed to a Licensed Practical Nurse (LPN)?

RNs perform initial assessments (admission, post-op) and assessments of unstable clients, while LPNs monitor RN findings, gather data, and perform focused/subsequent assessments of stable clients.

Name some advanced interventions that an RN can perform but an LPN generally cannot in terms of medication administration and access.

Administering IV push, blood products, TPN, and medications requiring titration/continuous monitoring, as well as accessing implanted devices.

What is the RN's role in interpreting client data and developing care plans?

RNs interpret and analyze data requiring complex critical thinking and are responsible for care plan development.

What is the LPN's role in basic patient care and reporting client status?

LPNs provide basic patient care (e.g., changing bandages, inserting catheters) and report client status and concerns to the RN or HCP.

Who is primarily responsible for initial and discharge teaching for clients?

The Registered Nurse (RN).

What is the LPN's role in client education?

Reinforcing RN education.

Which nursing professional typically cares for stable clients with predictable outcomes?

The Licensed Practical Nurse (LPN) cares for stable clients with predictable outcomes (e.g., chronic conditions, expected findings, ready for discharge, consistent labs).