12 Chapter 12 The Nursing Process and Critical Thinking ___________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 12.1
Slide 27
Question 1
• Which of the following is the first step in the nursing process?
A. Evaluation
B. Planning
C. Assessment
D. Implementation
TALKING POINTS:
Slide 28
Question 2
• Which of the following is NOT true about the nursing process?
A. A registered nurse must perform the initial admission assessment for each patient.
B. The LPN/LVN collects data through surveillance and monitoring to contribute to the
comprehensive assessment.
C. Subjective data usually are documented in the patient’s own words and include
information such as previous experiences and sensations or emotions that only the
patient can describe.
D. Objective data consist of information that is reported by the patient and family
members in a health history in response to direct questioning or in spontaneous
statements.
TALKING POINTS:
___________________________________________ Chapter 12 The Nursing Process and Critical Thinking 13
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 12.1
Activities
Classroom Choose from below to make 30 minutes
1
ASSESS BASELINE
• Have the class complete the Pretest. Collect
their work and use the results to guide how
you teach the class.
DISCUSS
• Discuss the value of the nursing process in
facilitating continuity and quality of care.
Why is it important that nurses use a
systematic method of providing care to
patients?
• Divide the class into several small groups.
2
DISCUSS
• Discuss the components of a nursing
assessment.
• Discuss the importance of ongoing evaluation
in relation to the nursing process. What is the
14 Chapter 12 The Nursing Process and Critical Thinking ___________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 12.1
3
DISCUSS
• Discuss common pitfalls experienced by
nurses regarding faulty documentation of the
nursing process.
• Ask each student to write three complete
nursing diagnoses using the NANDA-
approved nursing diagnoses listed in Box
12-3 (p. 157). Emphasize that the
LPN/LVN’s role is not to develop nursing
diagnoses, but to contribute to their
4
DISCUSS
• Discuss the reasons for the focus on critical
thinking in nursing education. How does
critical thinking enhance a nurse’s ability to
plan and care for patients?
•
• Using the information provided in Table 12-1
with the class.
___________________________________________ Chapter 12 The Nursing Process and Critical Thinking 15
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 12.1
Critical Thinking Question
A patient is admitted to the medical-surgical unit with congestive heart failure. She is very
frail, underweight, and has had multiple falls in the past. She lives alone and is worried
about being put in a nursing home. What would be the most likely nursing diagnoses for this
patient and how would the care of this patient be prioritized?
Discussion Guidelines: The patient has multiple medical and psychosocial problems. Some of the
Instructor Notes/Student Feedback
16 Chapter 12 The Nursing Process and Critical Thinking ___________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 12.2
Textbook Objectives Covered
5. Describe the characteristics of a critical thinker.
7. Describe principles of setting priorities for nursing care.
Lesson Preparation Checklist
• Prepare lecture from TEACH lecture slides available on Evolve.
• Student performance evaluation of all entry-level skills required for student comprehension of
principles underlying the nursing process and critical thinking, including:
• Components of the nursing process
Materials and Supplies
• computer and PowerPoint
projector
Key Terms
• assessment (p. 151)
• auscultation (p. 155)
• critical thinking (p. 163)
• evaluation (p. 151)
• evidence-based practice (p.
163)
• focused assessment (p. 152)
• implementation (p. 151)
• inspection (p. 155)
• nursing diagnosis (p. 151)
• nursing process (p. 151)
• objective data (p. 152)
• palpation (p. 155)
• percussion (p. 155)
• planning (p. 151)
• problem-oriented medical
record (POMR) (p. 161)
• standard of care (p. 152)
• subjective data (p. 152)
Student Preparation
Assignments 2 hours
5
READ – Textbook (pp. 164-165)
ANSWER – Text
ANSWER – Study Guide
• Part IIG: 7 (p. 60)
6
READ – Textbook (pp. 163-164)
REVIEW
• Table 12-1: Analysis of Critical Thinking in a Clinical Situation (p. 164)
___________________________________________ Chapter 12 The Nursing Process and Critical Thinking 17
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 12.2
7
READ – Textbook (pp. 160-161)
ANSWER – Study Guide
• Part IIIH: 9, 10 (p. 61)
Lecture Outline 20 minutes
5
Slide 29
Characteristics of a Critical Thinker
• Curiosity
• The desire to understand how and why; to apply knowledge
• Systematic thinking
• Uses an organized approach to problem-solving, rather than knee-jerk responses
• Analytic
Slide 30
Characteristics of a Critical Thinker (cont.)
• Open-minded
• Willing to consider various alternatives
• Self-confident
• Eager to know, asking questions, seeking answers, reevaluates “common knowledge”
6
Slide 31
Critical Thinking Tools
• Interpretation
• Clarifying meaning of events, data
• Analysis
Slide 32
Critical Thinking Tools (cont.)
• Inference
• Deriving alternatives, drawing conclusions
• Explanation
7
Slide 33
Priorities in Nursing Care
• Used based on Maslow’s hierarchy of needs
• Physiologic needs are the priority
• Followed by safety and security, self-esteem needs, etc.
TALKING POINTS:
18 Chapter 12 The Nursing Process and Critical Thinking ___________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 12.2
Activities
Classroom Choose from below to make 30 minutes
5
DISCUSS
• Discuss and define each of the
characteristics of a critical thinker.
• In small groups, have students discuss and
identify ways in which each characteristic of
the critical thinker can be beneficial to a
6
DISCUSS
• Divide the class into small groups. Present
the groups with the following scenario. Ask
each group to discuss and identify what a
nurse using critical thinking skills might do in
this situation. Have each group present its
findings to the class.
• You are assigned to care for Mrs. L.
today. It is her second postoperative day
after a left hip replacement. She had
severe degeneration and fusion of her
___________________________________________ Chapter 12 The Nursing Process and Critical Thinking 19
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 12.2
7
DISCUSS
• Provide the following list of patients to
students. Have students explain who they
would treat first, second, etc., and why.
• A patient with undefined chest pain
• A patient with myasthenia gravis who
Critical Thinking Question
A patient is admitted to the unit after undergoing surgery to repair a hip fracture. The
nursing care plan includes nursing diagnoses of Impaired mobility and Impaired comfort.
The patient is scheduled to attend physical therapy to improve his mobility, but he is
complaining of severe pain. How might a nurse use critical thinking skills when caring for
this patient?
Discussion Guidelines: The nurse can use critical thinking skills by performing an ongoing
assessment of the patient’s level of pain, particularly before he is due to go to therapy, and
Instructor Notes/Student Feedback
20 Chapter 12 The Nursing Process and Critical Thinking ___________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
12
Assessments for
The Nursing Process and Critical Thinking
CHAPTER OBJECTIVES
Lesson 12.1:
1. Describe the components of the nursing process.
3. Explain the importance of documentation of the nursing process.
5. Describe the characteristics of a critical thinker.
7. Describe principles of setting priorities for nursing care.
Assessments by Lesson & Objective
Lesson 12.1
1
Study Guide
• Part IA: 1-10 (p. 57)
• Part IB: 1-12 (p. 58)
• Part IC: 1-4 (p. 58)
Evolve Instructor Resources
• Test Bank: 1-3, 9, 12, 14, 15, 18-20, 29
Evolve Student Resources
• NCLEX Review: 4, 6-8, 10
• Prioritization: 4
2
Evolve Instructor Resources
• Test Bank: 4-6, 8, 26
Evolve Student Resources
• NCLEX Review: 1, 9
• Prioritization: 5
3
Study Guide
• Part IIIH: 1-5 (p. 60)
Evolve Instructor Resources
Evolve Student Resources
___________________________________________ Chapter 12 The Nursing Process and Critical Thinking 21
Introduction to Medical-Surgical Nursing, 6th ed.
Assessments by Lesson & Objective
4
Study Guide
• Part ID: 1-6 (p. 58)
Evolve Instructor Resources
• Test Bank: 11, 25
Lesson 12.2
5
Study Guide
• Part IIG: 7 (p. 60)
Evolve Instructor Resources
• Test Bank: 24, 30
7
Study Guide
• Part IIIH: 9, 10 (p. 61)
Evolve Instructor Resources
Instructor’s Notes/Student Feedback