PN Comprehensive Predictor 2017
Topic Facts
Professional Responsibilities: evaluating
client understanding of advance directives and health care proxy - A durable power of attorney for health care/health care proxy
...
PN Comprehensive Predictor 2017
Topic 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 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 must
protect 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 of
mutual 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.
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