Critical Thinking Notes for Quiz
1)Collection of Information Skill and defination | Why important | How | Question to ask | a) Identifying assumption: Recognizing when something is taken for granted or presented as fact without supporting evidence (e.g., you might assume a woman on a maternity unit has just had a baby) | By identifying assumptions, you begin to apply logic to the situation and avoid jumping to conclusions and making errors in judgment. | To identify assumptions, make sure that you have a complete picture of what's going on with the patient | What's being taken for granted here?” and “How do I know that I've got the facts right?” | b)Assessing systematically and comprehensively: Using an organized, systematic approach that enhances your ability to discover all the information needed to fully understand a person's health status (e.g., What are the actual and potential problems? What needs aren't being met? What are the person's strengths and resources?) | Having an organized approach to assessment prevents you from forgetting something Use both subjective and objective data | You must decide the purpose of your assessment and use an approach that gets the information needed to achieve your purpose. For example, medical assessments focus on identifying diseases or organ or system problems, rather than problems with human responses or activities of daily living | What infor I Need to know in order to treat this person?What would be my approach for this age?What are the tools I am going to use? | c)Checking Realibilty and accuracy: Collecting more data to verify whether information you gathered is correct and complete. Acurracy is exectness | Verifying that your information is accurate, factual, and complete helps you avoid making assumptions and making decisions based on incorrect or incomplete data. | Compare subjective and objective data.More than one souce, more likely ofcourse. | How do I know if this info are accurate and reliable?Can the info be verified?accuracy of the tool?does tha data make sense in this context? |
2) Analysis of situations: Skill and Defination | Why important | How | Questions to ask | a)distingusing normal from abnormal: Analyzing patient data and deciding what's within normal range and what's outside the usual range for normalcy; then deciding whether abnormal data may be signs or symptoms of a specific problem. | Signs and symptoms are like red flags that prompt you to suspect a problem. If you miss these red flags, you allow problems to go untreated. | Asking question to youself: How does my patient's current information compare with the previously collected data? Does my patient take any medications or have any chronic conditions that change normal function? | How does my patient's information compare with accepted standards for normal for someone of this age, culture, disease process, and lifestyle? | b)Making inferences(drawing valid conclusion): Making deductions or forming opinions that follow logically, based on patient cues (subjective and objective data) | Your ability to interpret data and draw valid conclusions (make inferences) is essential to determining health status. If you draw incorrect conclusions, your clinical judgments will be flawed, which may cause the entire treatment plan to be flawed. | To avoid jumping to conclusions, begin your statements about inferences by saying, “I suspect this information indicates.…”More than one cue more like true. | Ask yourself if the sign and symptoms are due to “MMA” (medications, medical problems, allergies). | c)Clustering Related Cues (Data): Grouping data together in a way that you can see patterns and relationships among the data. | It enhance ability to see relationships between and among data | cluster the data according to body systems. Concept mapping is especially helpful for identifying relationships. | | d) Distinguishing Relevant from Irrelevant: Deciding what information is pertinent to understanding the situations at hand and what information is immaterial | When faced with a lot of information, narrowing it down to only the pertinent facts prevents your brain from being cluttered with unnecessary facts. | you analyze the data you put together and decide what information is related to a specific health concern. | ask yourself, “Could there be any connection between this (abnormal data) and that (abnormal data)?” | e) Recognizing Inconsistencies: Realizing when pieces of information contradict each other. | It prompts you to investigate issues more closely. It sends up a red flag that tells you to probe more deeply to get to the facts. helps you focus your assessment to clarify the issues. | compare what the patient states (subjective data) with what you observe (objective data) | Focus assessment needed. Ask more questions to the pt. | F) Identifying Patterns: Deciding what patterns of health, illness, or function are indicated by patient data. | helps you (1) get a beginning picture of problems, and (2) recognize gaps in data collection | Analyze the cues you put together and decide which of the following patterns they represent:▪ Normal Pattern (no signs and symptoms of the pattern present)▪ Risk for Abnormal Pattern (risk factors for the pattern present)▪ Abnormal Pattern (signs and symptoms of an abnormal pattern present | After you get a beginning idea of the patterns, look for gaps in data collection by asking, “What other information might clarify my understanding of this pattern?” | G) Identifying Missing Information: Recognizing gaps in data collection and searching for information to fill in the gaps | Recognizing gaps in information and filling in those gaps prevents you from making one of the most common clinical reasoning errors: making judgments based on incomplete information. | 1 Don't try to do it all in your head—reflect on recorded data and ask, “What's missing here?” You may have to print out electronic information so that you can see more of it at once.2 If you're not sure if you really need more information, ask questions like, “What difference will it make?” or “How will knowing this information change the approach to treatment?” If the information won't change your approach, then you may not need to take the time to gather it. | 3 Other strategies for recognizing missing information include accomplishing all of the following clinical reasoning skills: identifying assumptions; checking accuracy and reliability; clustering related cues; recognizing inconsistencies; identifying patterns; and evaluating and correcting thinking. | H) Promoting Health by Identifying and Managing Risk Factors: Maximizing well-being by detecting and managing factors that evidence shows contribute to health problems (e.g., sedentary lifestyles contribute to many health problems) | By identifying risk factors, you apply the proactive predict, prevent, manage, promote (PPMP) approach, rather than the reactive diagnose and treat (DT) approach | 1)Assess people's awareness of—and motivation for—identifying and managing risk factors. For example, do they know what's required for adequate nutrition, rest, exercise, and spiritual and psychological well-being?2)Keep growth and development in mind3)Look for risk factors that are known to put people at risk for a variety of common problems. Examples: Obesity, poor diet, high | 5)Also assess for the following:▪ Genetic, cultural, or biologic factors (e.g., race, family history, and personal history predisposing one to health problems)▪ Behavioral factors (e.g., problems with anger management, attention-deficit disorders)▪ Psychosocial and/or economic factors (e.g., lack of significant others, poverty)▪ Environmental factors (e.g., air quality)▪ Age-related factors (e.g., women after menopause are at risk for osteoporosis; infants are at risk for ear infection)▪ Sexual-pattern factors (e.g., whether one is sexually active and with whom)▪ Safety-related factors (e.g., whether seat belts are worn, whether the home environment is safe for children)▪ Disease-related factors (e.g., someone with chronic lung disease is at risk for pneumonia; someone with diabetes is at risk for skin problems)▪ Treatment-related factors (e.g., complicated medication or treatment regimen) | I)Diagnosis actual and potential problems: Ensuring that the actual and potential problems your patient has are correctly named, based on evidence from the health assessment and patient records | Making definitive diagnoses (the most specific, correct diagnoses) is key to being able to determine the specific actions designed to prevent, manage, or resolve them | Verify that your information is correct and complete. Avoid drawing conclusions or identifying problems based on only one cue or one source.P=problemE=EtiologySS=signs and symptoms | Ask yourself whether any of the patient's problems could be related to any of the medications (remember SODA).S—Side effect?O—Overdose?D—Drug interaction?A—Allergy or Adverse reaction? | J)Setting priorities: differentiating between problems needing immediate attention and those requiring subsequent action, | If you don't know how to set priorities, you may cause life-threatening treatment delays.Remember:ABCs plus V”:A—Airway problemsB—Breathing problemsC—Cardiac and circulation problemsV—Vital signs concerns (e.g., high fever; hypertension, hypotension) | 1)Survival needs (e.g., food, fluids, oxygen, elimination, warmth, physical comfort)2) Safety and security needs (e.g., risks of injury or infection, threats to feeling secure, emotional discomfort)3) Love and belonging needs (e.g., family problems, separation from loved ones) | 80/20 rule: figure out the 20% that must get done to stay on track and keep patients safe. This is where you need to spend 80% of your time. |