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Fundamentals of Nursing: Clinical Reasoning, Process, & Care, Study notes of Nursing

Ridgewater College Nursing

A comprehensive overview of fundamental nursing concepts, including clinical reasoning, the nursing process, documentation methods, health promotion strategies, and the importance of spirituality in patient care. It covers key aspects of nursing practice, such as assessment, diagnosis, planning, implementation, and evaluation, and emphasizes the ethical and holistic approach to patient care.

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2023/2024

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Nursing Process Notes

Critical Thinking

- Think for a purpose.

- Question

oInformation

oConclusions

oPoints of view

- Logical and fair with thinking

- No single simple definition explains all of the aspects of critical thinking.

- Nurses must be able to perform skills and also think about what they are doing.

- Use knowledge base to

oMake decisions

oGenerate new ideas

oSolve problems

Characteristics of Critical Thinkers

- Reflect/think about what is being learned.

- Look for relationships between concepts or ideas

- Analyze or critique behaviors

- Make self-correction

- Realize they do not know everything

- Involve creative thinking

Individuals Can Become Better Critical Thinkers

- Verbalize thoughts aloud.

- Hear others think aloud to help learn how other people reason.

- Study to gain specific theoretical knowledge; ask other people to evaluate their thinking; and use mistakes to

learn.

4 Basic Steps of Critical Thinking

-Critical Reading – reading for meaning

-Critical Listening – a conscious commitment to focus on the topic of discussion

-Critical Writing – the ability to state thoughts coherently, clearly, and concisely

-Critical Speaking – clear, logical, and accurate spoken communication

Clinical Judgment

- Clinical judgment is the result of critical thinking and clinical reasoning using inductive and deductive reasoning.

- Clinical judgment is defined by the National Council of State Boards of Nursing (NCSBN) as “the observed

outcome of critical thinking and decision-making. It uses nursing knowledge to observe and assess

presenting situations, identify a prioritized patient concern, and generate the best possible evidence-

based solutions in order to deliver safe patient care.”

Clinical Reasoning

- Clinical judgment is the result of critical thinking and clinical reasoning using inductive and deductive reasoning.

- Clinical judgment is defined by the National Council of State Boards of Nursing (NCSBN) as “the observed

outcome of critical thinking and decision-making. It uses nursing knowledge to observe and assess

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Nursing Process Notes

Critical Thinking

Think for a purpose.
Question o Information o Conclusions o Points of view
Logical and fair with thinking
No single simple definition explains all of the aspects of critical thinking.
Nurses must be able to perform skills and also think about what they are doing.
Use knowledge base to o Make decisions o Generate new ideas o Solve problems Characteristics of Critical Thinkers
Reflect/think about what is being learned.
Look for relationships between concepts or ideas
Analyze or critique behaviors
Make self-correction
Realize they do not know everything
Involve creative thinking Individuals Can Become Better Critical Thinkers
Verbalize thoughts aloud.
Hear others think aloud to help learn how other people reason.
Study to gain specific theoretical knowledge; ask other people to evaluate their thinking; and use mistakes to learn. 4 Basic Steps of Critical Thinking
Critical Reading – reading for meaning
Critical Listening – a conscious commitment to focus on the topic of discussion
Critical Writing – the ability to state thoughts coherently, clearly, and concisely
Critical Speaking – clear, logical, and accurate spoken communication Clinical Judgment
Clinical judgment is the result of critical thinking and clinical reasoning using inductive and deductive reasoning.
Clinical judgment is defined by the National Council of State Boards of Nursing (NCSBN) as “the observed outcome of critical thinking and decision-making. It uses nursing knowledge to observe and assess presenting situations, identify a prioritized patient concern, and generate the best possible evidence- based solutions in order to deliver safe patient care.” Clinical Reasoning
Clinical judgment is the result of critical thinking and clinical reasoning using inductive and deductive reasoning.
Clinical judgment is defined by the National Council of State Boards of Nursing (NCSBN) as “the observed outcome of critical thinking and decision-making. It uses nursing knowledge to observe and assess

presenting situations, identify a prioritized patient concern, and generate the best possible evidence- based solutions in order to deliver safe patient care.” Nursing Process

The nursing process is an organized, systematic approach used by nurses to meet the health needs of clients, families, and communities. The input of nurse and patient/family is critical.
Nurses use the nursing process to perform clinical reasoning and make clinical judgments when providing patient care.
The nursing process is a decision-making approach that promotes critical thinking.
The mnemonic “ADOPIE” is an easy way to remember the ANA Standards and the nursing process. Each letter refers to the six components of the nursing process: Assessment, Diagnosis, Outcome identification, Planning, Implementation, and Evaluation.
A series of steps that lead to accomplishing a goal or purpose. Assessment [Is the first part of the nursing process]
Systematic ongoing data collection: Includes observing, interviewing, physical examination, and exploring secondary sources such as diagnostic tests and lab results.
The RN “completes the larger picture” by interpreting, analyzing, and attaching significance to the data
Organizing data: creation of a database (we will reference Gordon as our framework for this process) The RN validates data for accuracy, omissions, congruency or inconsistency, recognition of abnormal data
Document the data: Sharing pertinent data with other healthcare professionals.
Cultural considerations: Respect the unfamiliar and be sensitive to the patient’s uniqueness, ask questions, clarify, and don’t assume. o What are we going to assess?  Subjective  Is the client  Their perspective  Their feelings  Their complaints  Their whatever they say  Objective  Is what I observe

Health promotion – readiness to increase well-being and human health potential
- “Readiness for Enhanced”… Outcomes Identification

The “outcomes identification” standard of practice is defined as “[identification of] expected outcomes for a plan individualized to the health care consumer or the situation.”
An outcome is a “measurable behavior demonstrated by the patient responsive to nursing interventions.”
The nurse sets measurable and achievable short- and long-term goals and specific outcomes in collaboration with the patient based on their assessment data and nursing diagnoses.
Collaborated inter- dependent o Therapy referrals o Dietitian referrals
Collaborated dependent would be a provider o Medication request o Orders for treatments Expected Outcomes
Goals are broad, general statements, but outcomes are specific and measurable.
Expected outcomes are statements of measurable action for the patient within a specific time frame that are responsive to nursing interventions.
Nurses may create expected outcomes independently or refer to classification systems for assistance. Just as NANDA-I creates and revises standardized nursing diagnoses, a similar classification and standardization process exists for expected nursing outcomes.
Patient-centered o SMART (Specific-Measurable-Attainable-Realistic-Time limited) o Not realistic: “The patient will jog one mile every day when starting the exercise program.” o Realistic: “The patient will walk ½ mile three times a week for two weeks.” o Not time-limited: “The patient will stop smoking cigarettes.” o Time-limited: “The patient will complete the smoking cessation plan by December 12, 2021.” Planning
The “planning” standard of practice is defined as “[development of] a collaborative plan encompassing strategies to achieve expected outcomes.”
Setting priorities –acute versus chronic, systemic before local, actual before potential, client’s priority, trends, Maslow
Identifying goal

Identifying outcomes – needs to be observable, measurable, time-limited, realistic
Selecting evidence-based nursing interventions customized to each patient’s needs and concerns – uses resources effectively – independent or interdependent? Implementation
The “implementation” standard of practice is defined as “[implementation of] the identified plan.”
Nursing interventions are implemented or delegated with supervision according to the care plan to assure continuity of care across multiple nurses and health professionals caring for the patient.
Interventions are also documented in the patient’s electronic medical record as they are completed. o Getting patient up and moving o Putting care plan in motion o The doing part + document Implementing Care  Evaluation
The “evaluation” standard of practice is defined as “[evaluation of] progress toward attainment of goals and outcomes.”
Compare the patient’s current status with the stated goal and outcome(s).
Evaluation indicates the degree to which the client’s outcomes have been met.
Decision statement – Met, Not Met, Partially Met Gordon’s Functional Healthcare Patterns

Health Perception – Health Management Pattern  Describes client’s perceived pattern of health and well-being and how health is managed.
Nutritional – Metabolic Pattern  Describes pattern of food and fluid consumption relative to metabolic need and pattern indicators of local nutrient supply.
Elimination Pattern  Describes pattern of excretory function (bowel, bladder, and s
Activity – Exercise Pattern  Describes pattern of exercise, activity, leisure, and recreation.
Cognitive – Perceptual Pattern  Describes sensory, perceptual, and cognitive pattern
Sleep – Rest Pattern  Describes patterns of sleep, rest, and relaxation.
Self-perception – Self-concept Pattern  Describes self-concept and perceptions of self (body comfort, image, feeling state)
Role – Relationship Pattern  Describes pattern of role engagements and relationships.
Sexuality – Reproductive Pattern  Describes client’s pattern of satisfaction and dissatisfaction with sexuality pattern, describes reproductive patterns.
Coping – Stress Tolerance Pattern  Describes general coping patterns and effectiveness of the pattern in terms of stress tolerance.
Value – Belief Pattern  Describes pattern of values and beliefs, including spiritual and /or goals that guide choices or decisions.

o This bias can be linked to a general lack of knowledge about the aging process and misunderstandings about older adults.

Because of these influences, many individuals have anxiety about aging which can lead to negative stereotypes of older individuals, called ageism. Theories of Growth & Development
Psychosocial theories o Psychosocial development: development of personality o Personality: outward expression of inner self o Enduring pattern of thinking, feeling, and behavior that make individual unique o Endures over time, may be influenced by or adapt to changes in education, environments, experiences - Freud (Don’t really need to know about him) o Proposed many of the earliest theories about personality development o Most relevant part of his work centers on development of ego defense mechanisms - Components o Psychosocial o Cognitive o Moral o Spiritual o Biophysical
Psychosocial theories – Erikson (Know this guy) o Life is a sequence of developmental stages or levels of achievement. o Each stage signals a task that must be accomplished. o The health of a personality depends on the level of success at each stage or crisis.  Resolution can be complete, partial, or unsuccessful.  Failure to complete a stage interferes with the ability to progress to the next. o No stage can be bypassed, people can become fixated at a stage or regress. o Stress or anxiety can cause a regression to an unresolved stage. Integrity Versus Despair
Aging individuals must continually adjust to changes in health and physical strength, lifestyle changes (e.g., as a result of retirement), loss of significant others, and changing roles and relationships with family members and friends.
Nurses can support older adults in maintaining a positive self-image and outlook by considering Erikson’s theory of development.
This stage begins at approximately age 65 and ends at death. During this stage, an older adult reflects on their accomplishments and the person they have become. If they feel they have led a successful life, they often feel satisfied and develop a sense of integrity. Definition of Health
Health is more than the absence of disease.
A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (WHO, 1947).
A state of being that people define in relation to their own values, personality, and lifestyle. Definition of Illness
A state in which a person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired

Acute Illness o Short duration and severe
Chronic Illness o Persists longer than 6 months Wellness-Illness Continuum
This paradigm portrays movement along a continuum from high-level wellness to the depletion of health or adaptation to disease and disability.
People move back and forth along the continuum as they incorporate healthy behaviors or strive to recover from illness. Health Promotion
Nurses can provide patient education that focuses on good nutrition, physical activity, smoking cessation, and moderate alcohol use to promote improved health outcomes. Health Promotion – Screening
Advantages & Disadvantages o Terminology related to significance – Screening instruments: (Know this)  Reliability  How much is reliable  Validity  Valid  sensitivity  Identify the false –  specificity  Identify the false +
Costs – positive and negatives
Nurse Role
Noncompliant – why (money, time, transportation, age [young & old]) Risk Factors
Modifiable o What you can change with yourself (tobacco use, diet, exercise)
Non modifiable o What you cannot change with yourself

The nursing process and the teaching process are not the same.
The nursing process focuses on the patient’s total healthcare needs.
The teaching process focuses on the patient’s learning needs and ability to learn.
When education becomes part of the care plan, the teaching process begins. Health Promotion Models (Don’t need to know just know that they are different)
Health Belief Model
Transtheoretical Model of Change
Orem’s Self-Care Model
Locus of Control
Cognitive Behavioral Therapy
Motivational Interviewing
12-step program Teaching and Learning
Interactive process
Learning is the purposeful acquisition of new knowledge, attitudes, behaviors, and skills.
Initiatives to support the nurse’s ethical responsibility to teach include The Patient Care Partnerships (AHA,2003) & Speak Up Initiatives (JC, 2010) Health Literacy
Includes reading & math skills, comprehension, ability to make health-related decisions, and successful functioning as a consumer of health care.
At-risk populations includes those > 65 years of age, minority & immigrant populations, persons of low income (Medicare & Medicaid), and chronic mental or physical disease. Assessing Health Literacy
The inability to read above a 5th^ grade level in America is a major problem.
Consider lowering the literacy level of printed material given to learners by removing medical terminology.
Printed material should be provided in a cultural sensitive manner.
How can a nurse practically assess literacy levels of learners? Learning Objectives
What do you want the learner to know, feel, or do upon completion of the teaching session?
Multiple factors affect the teaching & learning experience.
An effective session includes feedback and evaluation of learning that has occurred.
The learner will… (verb)…(specific measurable behavior).
An effective T & L experiences incorporates all 3 domains of learning. Domains of Learning
Different teaching methods are appropriate for each domain of learning.
Cognitive: discussion (one-on-one or group), lecture, question-and-answer session, role play, discovery, independent project, field experience
Affective: role play, discussion (one-on-one or group)
Psychomotor: demonstration, practice, return demonstration, independent projects, games

Learner Assessment

Patient resources – education level, literacy level, social support, financial support
Educational resources
Developmental stage – pedagogy versus androgogy – generational differences
Adult learning theory – e.g. Knowles o emphasizes that adults are self-directed and expect to take responsibility for decisions. Adult learning programs must accommodate this fundamental aspect.
Barriers: o Nurse  Language  Noise  Confidence about what I know. o Patients  Willingness to learn  Comprehension  Psychological

Special Considerations, Culture, Grief and Loss, Spirituality

Learning Objectives

Reflect upon personal and cultural values, beliefs, biases, and heritage
Embrace diversity, equity, inclusivity, health promotion, and health care for individuals of diverse geographic, cultural, ethnic, racial, gender, and spiritual backgrounds across the lifespan
Demonstrate respect, equity, and empathy in actions and interactions with all healthcare consumers
Participate in lifelong learning to understand cultural preferences, worldviews, choices, and decision-making processes of diverse patients
Protect patient dignity
Demonstrate principles of patient-centered care and cultural humility
Make adaptations to patient care to reduce health disparities
Adhere to the Patient’s Bill of Rights
Identify strategies to advocate for patients
Use evidence-based practices What is holistic nursing?
Defined as “all nursing practice that has healing the whole person as its goal”.
Holistic nursing emphasizes self-care, intentionality, presence, mindfulness, and therapeutic use of self to facilitate healing and pattern wellness in others.
Encompasses both traditional and alternative modalities into practice. o Examples o Cupping o Acupuncture

Biculturalism : Dual pattern of identification o Example: A woman of Christian faith married to a Muslim adopts some Muslim practices and also maintains some traditional Christian practices The Patient’s Bill of Rights
The Patient’s Bill of Rights is an evolving document related to providing culturally competent care. In 1973, the American Hospital Association (AHA) adopted the Patient’s Bill of Rights.
The bill has since been updated, revised, and adapted for use throughout the world in all healthcare settings. There are different versions of the bill, but, in general, it safeguards a patient’s right to accurate and complete information, fair treatment, and self-determination when making health care decisions. Patients should expect to be treated with sensitivity and dignity and with respect for their cultural values. While the Patient’s Bill of Rights extends beyond the scope of cultural considerations, its basic principles underscore the importance of cultural competency when caring for people. Culture and Healthcare
Culture is an essential part of health care because of the increasing diversity in the United States.
Examples of groups that identify themselves as part of a culture include ethnic groups, persons with disability, persons who are lesbian, gay, bisexual, or transgender, the mentally ill, persons with addiction, caregivers, etc.
Self-awareness involves identifying one’s own cultural identity.
Cultural desire: striving to understand someone different than yourself. Helps overcome biases.
What avenues would a nurse have to learn about someone different from themselves? o Ask questions, researcher, ask people with similar beliefs. Concept Elements
How does culture influence the three categories?
How are they different?
How are they similar?
In what ways are they dependent upon one another? Shared Beliefs Values Behaviors Health Care Disparities
In your learning group, discuss the term health care disparities. o What does this term mean?

 Preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations. o How is it linked to the concept of culture?  o How can this be minimized by nurses?  Referrals to social workers  Resources for transportation Developing Cultural Competence

What are specific ways you can develop and improve in the following areas: o Greater cultural awareness o Greater cultural knowledge o Greater cultural skill o Greater cultural desire Cultural Competence and Interrelated Constructs
Cultural Desire o Self-awareness o Cultural Knowledge o Cultural Skill Conveyed Acceptance and Nonacceptance
Bias
Stigma
Verbal and nonverbal communication demonstrates acceptance or non-acceptance of others
What are examples of verbal and nonverbal communication by a nurse that could demonstrate acceptance and non-acceptance toward a patient who has not followed a prescribed treatment plan? Caregivers as a culture
Caregiving is a situation in which a lay individual provides direct care to another individual with a health-related condition. o Types: spousal, adult children caring for elderly parents, grandparents raising grandchildren, and parenteral o Caregiver experience: qualitative research practice problem. How can nurses support caregivers effectively? Literature search
In groups, perform a literature search related to “caregiver role strain”. Choose one article that discusses this phenomenon. Be prepared to share what you’ve learned from the reading with the rest of the group.
Think about the following as you read and discuss in your groups:

What type of research is this article?
What was the practice problem identified? What type of caregiver situation was explored?
What physical manifestations were present as a result of caregiver role strain?
What resources would be available to support this caregiving situation?

The grief process is not orderly and predictable. Emotional oscillation is normal and expected. There are times when the person experiencing the loss feels in control and accepting, and there are other times when the loss feels unbearable, and they feel out of control. Stages of grief
There are 5 stages of grief that may occur following a loss. It can be helpful for nurses to understand these stages to recognize emotional reactions as symptoms of grief so they can support patients and families as they cope with loss. Famed Swiss psychiatrist Elizabeth Kübler-Ross identified five main stages of grief in her book On Death and Dying.
Patients and families may experience these stages along a continuum, move randomly and repeatedly from stage to stage, or skip stages altogether. There is no one correct way to grieve, and an individual’s specific needs and feelings must remain central to care planning. Kubler-ross grief cycle
Kübler-Ross identified that patients and families demonstrate various characteristic responses to grief and loss. These stages include denial, anger, bargaining, depression, and acceptance, commonly referred to by the mnemonic “DABDA.” Denial
Denial occurs when the individual refuses to acknowledge a loss or pretends it isn’t happening.
This stage is characterized by an individual stating, “This can’t be happening.” The feeling of denial is self- protective, as an individual attempts to numb overwhelming emotions while they process the information. The denial process can help to offset the immediate shock of a loss.
Denial is commonly experienced during traumatic or sudden loss or when unexpected life-changing information or events occur. For example, a patient who presents to the physician for a severe headache and receives a diagnosis of terminal brain cancer may experience feelings of denial. Anger
Anger in the grief process often masks pain and sadness. The subject of anger can be quite variable; anger can be directed to the individual who was lost, internalized to self, or projected toward others.
Health care professionals should be aware that anger may often be directed at them as they provide information or provide care. It is important that healthcare team members, family members, and others who become the target of anger seek to recognize that the anger and emotion are not a personal attack, but rather a manifestation of challenging emotions that are a part of the grief process.

Bargaining

Bargaining can occur during the grief process in an attempt to regain control of the loss.
When individuals enter this phase, they are looking to find ways to change or negotiate the outcome by making a deal. Some may try to make a deal with God or their higher power to take away their pain or to change their reality by making promises to do better or give more of themselves if only the circumstances were different. Acceptance
Acceptance refers to an individual’s understanding of the loss and knowing it will be hard but acknowledging the new reality.
The acceptance phase does not mean absence of sadness but is the acknowledgment of one’s capabilities in coping with the grief experience. In the acceptance phase, individuals begin to re-engage with others, find comfort in new routines, and even experience happiness from life activities again. Ethical considerations
End-of-life care often includes unique complexities for the patient, family, and nurse. There may be times when what the physician or nurse believes to be the best treatment conflicts with the patient’s desire. There may also be challenges related to decision-making that cause disagreements within a family or cause conflict with the treatment plan.
Despite these complexities, it is important for the nurse to honor and respect the wishes of the patient. Despite any conflicts in decision-making among health care providers, family members, and the patient, the nurse must always advocate for the patient’s wishes.
If complex ethical dilemmas occur, many organizations have dedicated ethics committees that offer support, guidance, and resources. These committees can serve as support systems, share resources, provide legal insight, and make recommendations for action. The nurse should feel supported in raising concerns within their healthcare organization if they believe an ethical dilemma is occurring. DNR Orders & Advance Directives
A do-not-resuscitate (DNR) order is a medical order that instructs healthcare professionals not to perform cardiopulmonary resuscitation (CPR) if a patient’s breathing stops or their heart stops beating. o The order is only written with the permission of the patient (or the patient’s health care power of attorney, if activated). Ideally, a DNR order is set up before a critical condition occurs.
Advance directives include the health care power of attorney and living will. The health care power of attorney legally identifies a trusted individual to serve as a decision maker for health issues when the patient is no longer able to speak for themselves. It is the responsibility of this designated individual to carry out care actions in accordance with the patient’s wishes. o A healthcare power of attorney can be a trusted family member, friend, or colleague who is of sound mind and is over the age of 18. They should be someone who the patient is comfortable expressing their wishes to and someone who will enact those desired wishes on the patient’s behalf. Cultural Considerations Regarding Death
When assessing patients, family members, and caregivers, it is important to respect their values, beliefs, and traditions related to health, illness, family caregiver roles, and decision-making.
Information gathered through this comprehensive assessment is used to develop a nursing care plan that incorporates culturally sensitive resources and strategies to meet the needs of patients and their family members.

o Buddhists to lead a moral life by accepting the four Noble Truths.

Jehovah's Witnesses o The most defining tenant for Jehovah’s Witnesses in health care is a strict prohibition against receiving blood (i.e., red blood cells, white blood cells, platelets, or plasma) by transfusion Buddhists to lead a moral life by accepting the four Noble Truths. - Pentecostal Patients o Pentecostal patients may pray exuberantly. o Patients or families may request that relatively large numbers of people be allowed in the patient’s room for prayer. Spiritual assessment
Primary: Self-reflection (nurses) on personal beliefs and spirituality
Initial: identifying the client's religion, if any
Focused: ongoing, as nurses identify the clients at risk for spiritual distress
What can nursing do for screening for potential spiritual concerns?

Cognition, Sensory, Impairments, and Comfort

Cognitive Impairments

Learning Objectives o Identify factors related to cognitive impairments across the lifespan o Demonstrate respect for the dignity of patients with cognitive impairments o Collect data to identify patients experiencing alterations in cognition o Include adaptations to the environment to maintain safety for patients with impaired cognition o Incorporate nursing strategies to maximize cognitive functioning o Outline nursing interventions for specific cognitive disorders o Outline resources for patients with cognitive impairments and their family members or caregivers o Identify evidence-based practices in the care of cognitively impaired patients “Cognition”
Term used to describe our ability to think
Refers to the processes involved in human thought. (input, processing, storage, retrieval, and use)
Related terms: perception, (awareness or consciousness, ability to perceive the environment and respond)
Memory: retention and recall of past experiences and learning.
Executive function: higher-order thinking As humans, we are continually receiving input from the world around us and making decisions about how to respond. Some of these decisions are made with awareness, while others are reflexive responses. Infants develop cognitively based on their experiences with their environment. Cognitive processes continue to develop throughout childhood, adolescence, and adulthood as we learn how to adapt and use knowledge to solve problems and reach desired outcomes.

Populations at Risk

Advancing age
Significant risks found for women are overall poor health status, dependency, lack of social support, and insomnia.
Significant risk found for men is a history of stroke and/or diabetes.
Personal behaviors: chemical exposure and traumatic injury, substance abuse
Environmental exposure: toxic substances such as lead and/or pesticides
Congenital or genetic conditions: fetal alcohol or exposure to other chemicals in utero, cerebral palsy, chromosomal abnormalities (Down’s, PKU, Huntington’s Chorea)
Other comorbidities: F&E imbalance, electrolyte imbalance, sodium imbalance, UTI, hypoglycemia (sugar levels), delirium, etc. Cognitive impairments
“Cognitive impairment” is a term used to describe impairment in mental processes that drive how an individual understands and acts in the world, affecting the acquisition of information and knowledge.
The following areas are domains of cognitive functioning: o Attention o Decision-making o General knowledge o Judgment o Language o Memory o Perception o Planning o Reasoning o Visuospatial
Intellectual Disability o (formerly referred to as “mental retardation”) is a diagnostic term that describes intellectual and adaptive functioning deficits identified during a person‘s developmental period.
Dementia o is a chronic condition of impaired cognition caused by brain disease or injury and marked by personality changes, memory deficits, and impaired reasoning.
Delirium o is an acute state of cognitive impairment that typically occurs suddenly due to a physiological cause, such as infection, hypoxia, electrolyte imbalances, drug effects, or other acute brain injury.
Depression o is a brain disorder with a variety of causes, including genetic, biological, environmental, and psychological factors. It is commonly untreated in older adults and can result in impaired cognition and difficulty making decisions.
Alzheimer’s o disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. Delirium vs Dementia
Delirium – typically sudden onset, reversible if cause is detected and corrected

Fundamentals of Nursing: Clinical Reasoning, Process, & Care, Study notes of Nursing

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Nursing Process Notes

Critical Thinking

Special Considerations, Culture, Grief and Loss, Spirituality

Cognition, Sensory, Impairments, and Comfort