PN Comprehensive Predictor 2017 Remediation. All the Topics and Facts.

Professional Responsibilities: evaluating client understanding of advance directives and health care proxy - A durable power of attorney for health care/health care proxy is a legal document that designates a health ...

Professional Responsibilities: evaluating client understanding of advance directives and health care proxy - A durable power of attorney for health care/health care proxy is a legal document that designates a health care surrogate, who is an individual authorized to make health care decisions for a client who is unable to. - The person who serves the role of the health care surrogate will make decisions for the client and should be very familiar with the client’s wishes. - Living wills can be difficult to interpret, especially in the face of unexpected circumstances. A durable power of attorney for health care, as an adjunct to a living will, can be a more effective way of ensuring that the client’s decisions about health care are honored. Legal responsibilities: client advocacy - Understanding the laws governing nursing practice helps nurses protect clients’ rights and reduce the risk of nursing liability. - Nurses are accountable for protecting the rights of clients. Examples include informed consent, refusal of treatment, advance directives, confidentiality, and information security. - Nurses must ensure that clients understand their rights, and mustprotect their clients’ rights. Managing client care: requesting reassignment of a client - Assigning is performed in a downward or lateral manner with regard to members of the health care team. - The five major management functions are planning, organizing, staffing, directing, and controlling. - The 5 rights of delegation: right task, circumstance, person, direction and communication. Protecting the rights of a dying client - Nurses are accountable for protecting the rights of clients. Situations that require particular attention include informed consent, refusal of treatment, advance directives, confidentiality, and information security. - Nurses must ensure that clients understand their rights. Nurses also must protect clients’ rights during nursing care. - Regardless of the client’s age, nursing needs, or the setting in which care is provided, the basic tenants are the same. Bulimia Nervosa - Pt demonstrates high interest in preparing food, but not eating. - Binge eating and inappropriate compensatory behaviors both occur on average of once per week for 3 months. - Most pts who have bulimia nervosa maintain a weight within the normal range or slightly higher. Reporting client care issues to an interprofessional team - Nurse‑provider collaboration should be fostered to create a climate ofmutual respect and collaborative practice. - Collaboration occurs among different levels of nurses and nurses with different areas of expertise. - Collaboration should also occur between the interprofessional team, the client, and the client’s family/significant others when an interprofessional plan of care is being developed. Managing client care: initial assessment - Give priority to clients who have a reasonable chance of survival with prompt intervention. Clients who have a limited likelihood of survival even with intense intervention are assigned the lowest priority. - Use this framework for situations in which health resources are extremely limited (mass casualty, disaster triage). - Look first for a safety risk. For example, is there a finding that suggests a risk for airway obstruction, hypoxia, bleeding, infection, or injury? Recommendations for time management - Nurses must continuously set and reset priorities in order to meet the needs of multiple clients and to maintain client safety. - Priority setting requires that decisions be made regarding the order in which; - Clients are seen. - Assessments are completed. - Interventions are provided. - Steps in a client procedure are completed. - Components of client care are completed.- Establishing priorities in nursing practice requires that the nurse make these decisions based on evidence obtained: - During shift reports and other communications with members of the health care team. - Through careful review of documents. - By continuously and accurately collecting client data. Maintaining client safety - Augments core measures and promotes patient safety through patient identification, effective staff communication, safe medication use, infection prevention, safety risk identification, and preventing wrong‑site surgery. - Nurses are accountable for practicing nursing in accordance with the various sources of law affecting nursing practice. It is important that nurses know and comply with these laws. - Avoid disclosing any client health information online. Be sure no one can overhear conversations about a client when speaking on the telephone. Client safety vs breach of confidentiality - The nurse should share information about the client, either verbal or written, only with those who are responsible for implementing the client’s treatment plan. - Only if the client provides consent should the nurse share information with other persons not involved in the client's treatment plan. - When a breach of duty has occurred, it may be characterized as malpractice.The following basic elements of nursing malpractice lawsuit must be present. - A duty to the client existed based on the recognized standards of care. - A breach of duty occurred. - The client was injured. - The injury was directly caused by the breach of a standard of care. Electroconvulsive therapy - ECT uses electrical current to induce a brief seizure activity while the client is anesthetized. The exact mechanism of ECT is still unknown. - One theory suggests that the seizure activity produced by ECT enhances the effects of neurotransmitters (serotonin, dopamine, and norepinephrine) in the brain. - At the time of the procedure, an anesthesia provider administers a short‑acting anesthetic (methohexital, propofol) via IV bolus. Obtaining a telephone prescription from a provider - Have a second nurse listen to a telephone prescription. - Repeat it back, making sure to include the medication’s name (spell if necessary), dosage, time, and route. - Question any prescription that seems inappropriate for the client. - Make sure the provider signs the prescription in person within the time frame the facility specifies, typically 24 hr. Emergency management of an evisceration - Protrusion of the abdominal contents through the incisional wound of theabdominal cavity, caused by failure to splint when moving or coughing, delayed healing due to obesity or diabetes mellitus. - Call for help. - Cover the wound with sterile saline soaked dressings or towel. - Position the client in semi‑Fowler’s position with hips and knees bent. Supplies to have available at the client’s bedside during a seizure. - Have suction ready. - Administer AEDs such as phenytoin, carbamazepine, valproic acid, or gabapentin. - Get oxygen ready. Assisting with a tub bath - Bathe clients to cleanse the body, stimulate circulation, provide relaxation, and enhance healing. - Bathing clients is often delegated to assistive personnel. However, the nurse is responsible for data collection and client care. - Bathe clients whose health problems have exhausted them or limited their mobility.