C H A P T E R 2
Clinical Judgment
Learning Outcomes After completing this chapter, you should be able to:
Key Concepts Clinical judgment Clinical reasoning Critical thinking Full-spectrum nursing Nursing knowledge Related Concepts See the Concept Map on Davis Advantage.
➤ Give one definition and one example of clinical judgment. ➤ List and describe at least one clinical judgment model. ➤ List the four types of nursing knowledge. ➤ Discuss the relationship between critical thinking and clinical judgment. ➤ Discuss the relationship between clinical reasoning and clinical judgment.
➤ Explain ways in which nurses use clinical judgment. ➤ Name and describe the main concepts of the full-spectrum nursing model. ➤ Explain how nursing knowledge, clinical reasoning, critical thinking, nursing process, and clinical judgment work together in full-spectrum nursing. ➤ Relate clinical judgment to person- centered care.
Jan graduated from nursing school 8 months ago and has worked on the medical-surgical unit for 3 months. She completed orientation 6 weeks ago and is on the 1900-to-0700 shift. She has five clients.At 2045, Jan received an admission from the postanesthesia care unit (PACU) and was given the following report: Mr.Anderson, 72-year- old patient, had a colon resection several hours earlier. He is accompanied by his wife, Lilly. Mr.Anderson had an uneventful recovery.Vital signs stable (VSS) at 2025: blood pressure (BP) 158/82, pulse (P) 78, respirations (R) 14, tempera- ture (T) 98.9. Oxygen saturation 99% on room air, IV fluid (IVF) intake 500 mL, urinary output via Foley catheter, 200 mL, clean and yellow. Abdominal dressing clean, dry, and intact. Nasoga- stric tube patent with 100 mL of gastric drainage. Jan did not have any questions and documented the following information in the nurses’ notes: 2100: Admission vital signs (VS), BP 160/84, P 82, R 16, and T 99.1. Abdominal dressing clean, dry, and intact. Drowsy, oriented. Skin warm and dry. Rated Explore Your Nursing Role
his pain as 2 on a 10-point scale (2/10). IVF infus- ing at 125 mL/hour. History positive for non–insulin- dependent diabetes (type 2), high blood pressure, and early-stage Alzheimer disease.The nursing plan of care discussed with the Andersons. No questions asked. —Jan Watsone, RN 2200:VS stable at BP 150/78, P 90, R 20,T 99.5. He rates his pain as 4/10 but refuses pain medication. He is drowsy, sleepy. His wife says he has been sleeping since admission. — Jan Watsone, RN
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