Author Question: A nurse is checking over the past charting of the previous shift, paying special attention to how a ... (Read 18 times)

brutforce · **on:** Jul 23, 2018

A nurse is checking over the past charting of the previous shift, paying special attention to how a particular client responded to nursing interventions throughout the day.

The nurse is caring for this client and wants to see what has been effective, as well as what didn't work. This nurse is utilizing which of the steps of the decision-making process?
1. Set the criteria
2. Examine alternatives
3. Implement
4. Evaluate the outcome

Question 2

A nurse is being questioned by the parents of a client whose physician ordered a battery of invasive tests. They are wondering why their child should have to go through all the pain and discomfort of these studies.

The nurse is not familiar with the situation and has just come on duty for the evening shift. A limited report was given by the previous shift. The nurse understands that the child is stable at this time and has no pain, but the nurse has not been able to review the chart or do an initial assessment at this point. The best response by the nurse is:
1. I'm not sure I can answer your question just now.
2. It's a good idea to listen to what your physician wants.
3. Your child's doctor is the best there is. I don't see why you wouldn't follow his advice.
4. Maybe you should get another opinion if you're not comfortable with your doctor.

LVPMS · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 4
Rationale: In evaluating, the nurse determines the effectiveness of the plan and whether the initial purpose was achieved. In this situation, the nurse wants to determine what worked on the previous shift and what didn't. This will help with deciding on interventions for the client during the shift. Setting criteria is based on three questions: What is the desired outcome? What needs to be preserved? What needs to be avoided? Examining alternatives ensures that there is an objective rationale in relation to the established criteria for choosing one strategy over another. In this case, the nurse is evaluating the previous nurse's alternatives, not choosing new ones. Implementation is putting a plan into action.

Answer to Question 2

Correct Answer: 1
Rationale: Suspending judgment means tolerating ambiguity for a time. If an issue is complex it may not be resolved quickly and judgment should be postponed. In this case, the nurse just doesn't have enough information to give a good answer to the parents. For a while, the nurse will need to say, I don't know and be comfortable with that answer. Telling the parents to agree with the physician before the nurse knows all the facts might be premature, even if he is the best physician in the area. It would also be premature to tell the parents to get another opinion. Nurses should not give advice or counsel, merely information.