NR 226- Exam 1 Study Guide ANSWERS 100% CORRECT SOLVED SPRING FALL-2022 LATEST GUARANTEED GRADE A+

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Managing Patient Care 1. Nursing care delivery models; clinical application, Case Management; discharge planning, referrals delivery models: team nursing – work and help each other; starts w/ sam ... e level then going higher in level if help is still needed; RN leads team of other RN’s, LPN & UAP; team lead creates care plan, coordination of team & provides care for required difficult skills (team for quality care of one pt) total patient care – RN responsible for full care of one or more pt during shift; care can be delegated; works w/ pt, family & team members (charge nurse gives assignment) primary nursing – one RN accountable/responsible for individual; to put more RN’s at bedside; assess pt, creates care plan & gives appropriate nursing interventions; communication is lateral(Rn gives the antibiotic, not transferring to another person) Case management – works with continued care outside of acute care; coordinates outpatient care; helps keep cost down but still maintain quality (setting up pt for rehab) 2. Decentralized management; responsibility, autonomy, authority, accountability Decentralized management: decision making is moved down to the level of staff; managers & staff actively involved; potentially greater collaborative effort, increased success, increased motivation, great sense of satisfaction. Responsibility – performing the job you were assigned Autonomy – including pt’s in decisions; allowing them to make a choice in their healthcare; self-governing Authority – having power to give commands & make final decisions according to position Accountability – answering to your actions 3. Staff involvement; effective communication with staff, collaboration, professional development, In-services Effective communication w/ staff – manager using a variety of communicating styles; quickly & accurately (biweekly or monthly newsletters, staff meetings, info from meeting available for staff to read) Collaboration – RN & doctor working together; two different views combined to solve problems; improves pt safety, outcomes & reduces errors Professional development – continuing education to better yourself & keep up w/ current medical & nursing practice In-services - 4. Establishing priorities; high, intermediate and low; nursing implications High – immediate threat to pts safety & survival (pain, airway, circulation, loss of consciousness, blood loss) Intermediate – non-emergent, non-life threatening (teaching pt, avoiding post-op problems, infection, rash, bp of 150, lab values rising) Low – actual or potential problems may or may not be directly related to disease or illness; developmental needs or long-term care needs (edema, slipped IV w/ low meds, skin breakdown, uti from foley, pt being admitted w/ need teaching at discharge) Nursing implication – make careful judgements; when pt has more than one issue focus on worst one first 5. Delegation; rights of delegation, interventions that may/may not be delegated to LPN or UAP, interventions only the RN can perform Delegation – giving responsibility to someone else but you are still accountable for it; person needs to know what you are asking them to do; give it to the right person The 5 Rights of delegation • Right task • Right circumstance • Right person • Right direction • Right supervision Delegations that LPN or UAP can & cannot do - Only RN can – perform any interventions that fall under ADPIE Ethics and Values 1. Ethics: autonomy, beneficence, nonmaleficence, justice, fidelity; clinical application Ethics – study of conduct & character; determining what acting “good” for everyone is; reflects who you are. Autonomy – self-governing; including pt’s in decisions; allowing them to make a choice in their healthcare (having pt clean themselves if they are willing to try) Beneficence – doing good for your pt; doing what is best for them not you (giving pt a pain med before cleaning wound) Nonmaleficence – avoiding harm to pt; (unintentional harm – breaking ribs while doing CPR) Justice – being fair (having two family of different cultures and giving them same type of care) Fidelity – keeping promises; not abandoning pt when it care becomes to difficult (saying your going to give a letter to family after surgery in case they die & going through with your word) 2. Code of ethics; responsibility, accountability, confidentiality (HIPAA) Code of ethics – govern by ANA; foundation & guideline of nursing; a collective statement about the group’s expectations & standard behavior Responsibility – the will to respect an obligation & following through on the promise. Accountability – answering for your own actions; being able to explain to pt & employer your actions Confidentiality (HIPPA) – must maintain at all times; protects personal health info; fined for violation 3. Ethical dilemma; steps for solving an ethical dilemma; nursing implications Ethical dilemma – usually occur when there are conflicting values; cause distress & controversy; processing issues requires negotiation of differences of opinion & should promote free expression of feeling and opinions Steps to solve – 1. Ask if this is an ethical dilemma 2. Gather all relevant info 3. Clarify values 4. Verbalize the problem 5. Identify possible course of action 6. Negotiate a plan 7. Evaluate the plan Respect your values and respect the values of others if they are different; you don’t have to agree but you have respect. 4. Ethical issues and the older adult; nurse role/responsibilities They don’t know about autonomy (become uncomfortable disagreeing w/ doc, view assertiveness as violation of trust); communication problems(decreased hearing & vision, memory problems, & chronic illnesses [stroke or disease], multiple meds); consensus about medical goals is harder to achieve. Teach pt about being a part of medical plan and that it is ok to disagree if they are uncomfortable; always assess pt for understanding of treatment and assist when needed; 5. Ethical issues and minors Privacy has to be maintained for the minor if the minor request for the parent to not know about sexual activity; parent has control over decisions on the minor unless minor is legally married, a parent, pregnant, has VD, or has drug problem. [Show More]

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