Transcript CRITICAL THINKING

CRITICAL THINKING
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KHUDAZI AULAWI
Critical Thinking
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Definition
Critical Thinking Skills
 Intellectual activities used in complex
thinking process such critical analysis,
problem solving, and decision making
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Critical Thinking in Clinical
Scenarios
Clinical Scenarios
 (1) applying concepts and theories to
clinical practice
 (2) learning how to analyze a clinical
situation
 (3) identifying problems and solutions
 (4) comparing alternate decisions
possible and developing decision
making ability
 (5) considering multiple perspectives in
a clinical situation
Applying Concepts and
Theories to Practice
Case 1
 The nurse visits a patient who was sent
home from the hospital two days after
the normal delivery of her third child.
The baby is jaundiced and appears
dehydrated. When the nurse tells the
mother that she is calling the doctor, the
mother begins to cry and yells, "I can't
handle this right now.”
Questions
 1. What are possible reasons for the
baby's jaundice? Describe the physiology
of this occurrence in the newborn.
 2. What should the nurse do now? Why?
 3. Select one theory that can help explain
the mother's reaction.
 Analyze the mother's response in terms of
this theory.
Analyzing a Clinical
Situation
Case 2
 Mrs. K is in her 32nd week of pregnancy.
Her ankles and hands are swollen, and
her blood pressure is 160/90.
 1. Discuss the relationship between Mrs.
K's swelling of the ankles and hands and
her blood pressure.
 2. What additional data should be
collected at this time? Why is this
information important?
Identifying Problems and
Solutions
Case 3
 Mr. Z, 26 years old, was admitted
with extensive burns on his face and
ears. When walking toward the
room, you see him crying while
looking in the mirror. When you walk
into the room to console him, he
stops and says, "I'm fine now.”
 1. What are two possible responses
you could make to Mr. Z? Provide a
rationale for each of these.
 2. What problems need
solved in this scenario?
to
be
 3. What approaches would you
plan for Mr. Z's continuing care?
Why would these be effective?
Developing Decision
Making Skills
Case 4
 You overhear your friend telling a new
nurse on the unit not to worry about
wearing sterile gloves when changing the
patient's dressings because "he has an
infection any way."
 1. What are your options?
 2. What are the consequences of each of
these options?
 3. What would you do? Why?
Considering Multiple
Perspectives
Case 5
 Ms. P is 18 years old and dying from
bone cancer. She has severe pain that is
not relieved with medications. She asks
you if she can refuse her next dose of
chemotherapy because it is "not working
any way. I am only taking the
chemotherapy because my mother wants
me to.”
 1. How would you respond to Ms. P?
Why is this an appropriate response?
 2. What questions would you ask her?
 3. What assumptions did you make
about Ms. P?
 4. What are issues to be resolved in
this situation?
 5. What are Ms. P's options?
Scenario for Interdisciplinary
Education
Case 6
 Mr. P was involved in an accident at the
factory where he worked resulting in a
closed head injury, when he arrived at the
emergency department, the admitting
nurse recorded in the medical record that
the patient was "restless and incoherent."
His vital signs were: BP 130/80 HR 92bpm
Respirations 20/minute.
 After admission Mr. P became
increasingly incoherent and drowsy.
The physician ordered a computed
tomography (CT) scan that showed a
left-sided epidural hematoma.
 1. Describe the pathophysiology of an
epidural hematoma, what are anticipated
responses of the patient to an epidural
hematoma that is left-sided?
 2. what is the classic clinical picture of
epidural hematoma? Are Mr. P's responses
consistent with this diagnosis? Why or why
not? What additional data should be
collected?
 3. The physician is concerned about
an uncal hernation. Describe this
condition from a medical perspective.
What observations should the nurse
make?
 4. Discuss surgical and medical
options for the patient. Compare
these in terms of effectiveness.
 5. Mr. P is sent for another CT scan.
What actions by the technician
could
result
in
increased
intracranial pressure? What actions
by other providers might increase
intracranial pressure? Why?
 6. What pharmacologic agents
decrease cerebral edema for a
patient
with
an
epidural
hematoma? How do these work?
 7. As a group, plan care for Mr. P.
How
would
you
include
occupational health?