Question

Medical treatment stabilized Mr. Lawson's condition. He had a pulmonary embolus, but he is now on anticoagulants, medications that will reduce likelihood of more clot formation. Knowing that Mr. Lawson is on anticoagulants and has had recent surgery and the processes of normal wound healing (see Chapter 48 (Links to an external site.)Links to an external site.), Tonya believes that the patient is at risk for bleeding from his surgical wound. She acts by increasing assessments of the wound and teaching Mr. Lawson how to avoid placing stress on the wound 1. Describe the critical thinking skill that Tonya is demonstrating.After Tonya assesses the wound, she enters a note in the medical record. She describes the appearance of the incision in detail, reports on the length of the incision, and notes that one suture is loose but there is no drainage. 2. Identify the three intellectual standards that Tonya uses in making a note in the record. 3. Mr. Lawson complains of more discomfort after lying on his right side for 30 minutes. Tonya asks him to describe the pain; it is focused more on his right shoulder and ribs. Tonya sees that the drainage tubing exiting the surgical wound is caught underneath the patient. She moves it, questions the patient further to find out that he has a history of arthritis in the shoulder, and then repositions and aligns him. This is an example of which critical thinking competencies?

Answer 1

1. Describe the critical thinking skill that Tonya is demonstrating.

Tonya is demonstrating the critical thinking skill of Logical Reasoning. As the patient is on an anticoagulant for pulmonary embolus makes Tonya think of the risk of bleeding due to anticoagulants and to assess the surgical site. Her knowledge with the anticoagulants medication and previous experience of caring for a postoperative patient helps her in assessing of the surgical wound and teaching.

2. Identify the three intellectual standards that Tonya uses in making a note in the record.

Intellectual standards are the rationale for the nursing actions to make a good clinical decision.

• Accurate: Her note is accurate of what she assessed on the surgical wound.
• Precision: Her note is exact and free from error.
• Consistent: Her note is consistent with the needed details.

3. This is an example of diagnostic reasoning. Diagnostic reasoning is the analyzing of the clinical situation with the available clues and to make a clinical decision in order to solve the patient's problem.