VATI RN COMPREHENSIVE PREDICTOR FOCUSED REVIEW

VATI RN COMPREHENSIVE PREDICTOR FOCUSED REVIEW  Management of Care – (9)  Advance Directives – (1)  Legal Responsibilities: Purpose of a Living Will (RM FUND 9.0 Chp 4)  A living will is a legal document that exp ...

VATI RN COMPREHENSIVE PREDICTOR FOCUSED REVIEW  Management of Care – (9)  Advance Directives – (1)  Legal Responsibilities: Purpose of a Living Will (RM FUND 9.0 Chp 4)  A living will is a legal document that expresses the client’s wishes regarding medical treatment in the event the client becomes incapacitated and is facing endof-life issues. Most state laws include provisions that protect health care providers who follow a living will from liability.  Assignment, Delegation and Supervision – (2)  Delegation and Supervision: Delegating Tasks to an Assistive Personnel (RM FUND 9.0 Chp 6)  Examples of tasks nurses may delegate to Aps (provided the facility’s policy and state’s practice guidelines permit)  Activities of daily living (ADLs) – bathing, grooming, dressing, toileting, ambulating, feeding (without swallowing precautions), positioning  Routine tasks – bed making, specimen collection, intake and output, vital signs (for stable clients)  Managing Client Care: Delegation Strategy for Effective Task Management (RM Leadership 7.0 Chp 1)  Consideration for selection of an appropriate delegate include the following: education, training, and experience; knowledge and skill to perform the task; level of critical thinking required to complete the task; ability to communicate with others as it pertains to the task; demonstrated competence; the delegatee’s culture; agency policies and procedures and licensing legislation (state nurse practice acts)  Case Management – (1)  Cardiovascular Disorders: Tetralogy of Fallot (RM NCC RN 10.0 Chp 20)  Tetralogy of Fallot – four defects that result in mixed blood flow: Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy  Cyanosis at birth: progressive cyanosis over the first year of life. Systolic murmur. Episodes of acute cyanosis and hypoxia (blue or “Tet” spells)  Surgical procedures – shunt placement until able to undergo primary repair; complete repair within the first year of life  Collaboration with Interdisciplinary Team – (1)  Communicable Diseases, Disasters, and Bioterrorism: CDC Reportable Diagnoses (RM CH RN 7.0 Chp 6)  Anthrax. Botulism. Cholera. Congenital rubella syndrome (CRS). Diphtheria. Giardiasis. Gonorrhea. Hepatitis A, B, C. HIV infection. Influenza-associated pediatric mortality. Legionellosis/Legionnaires’ disease. Lyme disease. Malaria. Meningococcal disease. Mumps. Pertussis (whooping cough). Poliomyelitis, paralytic. Poliovirus infection, nonparalytic. Rabies (human or animal). Rubella (German measles). Salmonellosis. Severe acute respiratory syndrome-associated coronavirus disease (SARS-CoV). Shigellosis. Smallpox. Syphilis. Tetanus/C. tetani. Toxic shock syndrome (TSS) (other than Streptococcal). Tuberculosis (TB). Typhoid fever. Vancomycin-intermediate and vancomycin-resistant. Staphylococcus aureus (VISA/VRSA)  Continuity of Care – (1)  Information Technology: Change-of-Shift Report (RM FUND 9.0 Chp 5)  Nurses give this report at the conclusion of each shift to the nurse assuming responsibility for the clients.  Formats include face to face, audiotaping, or presentation during walking rounds in each client’s room (unless the client has a roommate or visitors are present)  An effective report should: include significant objective information about the client’s health problems; proceed in a logical sequence; include no gossip or personal opinion; relate recent changes in medications, treatments, procedures, and the discharge plan  Establishing Priorities – (1)  Managing Client Care: Determining Priority Care for a Group of Clients (RM Leadership 7.0 Chp 1)  Prioritize systemic before local (“life before limb”)  Prioritizing interventions for a client in shock over interventions for a client who has a localized limb injury  Prioritize acute (less opportunity for physical adaptation) before chronic (greater opportunity for physical adaptation)  Prioritizing the care of a client who has a new injury/illness (e.g. mental confusion, chest pain) or an acute exacerbation of a previous illness over the care of a client who has a long-term chronic illness  Prioritize actual problems before potential future problems  Prioritizing administration of medication to a client experiencing of medication to a client experiencing acute pain over ambulation of a client at risk for thrombophlebitis  Listen carefully to clients and don’t assume  Asking a client who has a new diagnosis of diabetes mellitus what he feels is most important to learn about disease management  Recognize and respond to trends vs. transient findings  Recognizing a gradual deterioration in a client’s level of consciousness and/or Glasgow Coma Scale score  Recognize indications of medical emergencies and complications vs. expected findings  Recognizing indications of increasing intracranial pressure in a client who has a new diagnosis of a stroke vs. the findings expected following a stroke  Apply clinical knowledge to procedural standards to determine the priority action  Recognizing that the timing of administration of antidiabetic and antimicrobial medications is more important than administration of some other medications