Capstone ATI Fundamentals Study Guide 2022

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Medicare Correct Answer: for clients over age 65 and/or with permanent disabilities. premiums applied as insurance program reimburses providers based on DRGs. Premiums applied as Managed Care Organiz... ations (MCOs) provide enrolled clients with comprehensive care overseen by a primary care provider. Is federally funded. Medicaid Correct Answer: for clients with low income. is federally funded and individual states determine eligibility requirements. Traditional Insurance Correct Answer: reimburses for services on fee-for-service basis. Managed Care Organizations (MCOs) Correct Answer: comprehensive care is overseen by a primary care provider & focuses on prevention and health promotion Preferred Provider Organizations (PPOs) Correct Answer: client chooses from a list of contracted providers. using non-contracted providers increases the client's out of pocket costs Exclusive Provider Organizations (EPOs) Correct Answer: the client chooses from a list of providers within a contracted organization Long-Term Care Insurance Correct Answer: provides for long-term care expenses not covered by Medicare Preventive health care Correct Answer: focuses on educating and equipping clients to reduce and control risk factors of disease. Examples include immunizations, stress management programs, and seat belt use Primary health care Correct Answer: emphasizes health promotion, and includes prenatal and well-baby care, nutrition counseling, and disease control. is based on a sustained partnership between client and provider. examples include office or clinic visits and scheduled school/work centered screenings (vision, hearing, obesity) Secondary health care Correct Answer: includes the diagnosis and treatment of emergency, acute illness, or injury. examples include care given in hospital settings (inpatient and EDs), diagnostic centers, or emergent care centers Tertiary health care Correct Answer: involves the provision of specialized highly technical care. examples include oncology centers and burn centers Restorative health care Correct Answer: involves intermediate follow-up care for restoring health. examples include home health care, rehab centers, and skilled nursing facilities Continuing health care Correct Answer: designed to address long-term or chronic health care needs. examples include hospice, adult day care, and in-home respite care Health care regulatory agencies include: Correct Answer: -US Dept of Health and Human Srvcs -US FDA -State and local public health agencies -State licensing boards (to ensure providers & agencies comply with state regulations) -the Joint Commission/JCAHO (set quality standards for accreditation of health care facilities) -Professional Standards Review Organizations (PSROs) -Utilization review committees (monitor for appropriate diagnosis and treatment of hospitalized clients) Clergy Correct Answer: Job: provide spiritual care to client (pastors, rabbis, priests) Refer to when: the client requests communication or the family asks for prayer prior to client undergoing a procedure Registered dietitian Correct Answer: Job: assess, plan for, and educate the client reg. nutritional needs; direct care of nutritional aids Refer to when: ex- the client has low nutrient levels and/or experienced a recent unexplained weight loss Lab tech Correct Answer: Job: obtain specimens of the client's body fluids and perform the necessary diagnostic tests Refer to when: ex- the provider orders a CBC to be performed immediately Occupational therapist Correct Answer: Job: assess and plan for the client to regain ADLs, esp motor skills of the upper extremities; direct care of occupational therapy assistants Refer to when: ex- client has difficulties using an eating utensil with dominate hand following a stroke Pharmacist Correct Answer: Job: provide & monitor meds for the client as prescribed by the provider; supervises pharm techs in states in which the practice is allowed Refer to when: client concerns over meds; dosage concerns; etc Physical Therapist Correct Answer: Job: assess and plan for client to increase musculoskeletal functions, esp of lower extr [Show More]

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