Management of Care – (9)
Advance Directives – (1)
Legal Responsibilities: Purpose of a Living Will (RM FUND 9.0 Chp 4)
A living will is ... [Show More] 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
Ethical Practice – (1)
Professional Responsibilities: Demonstration of Veracity (RM Leadership 7.0 Chp 3)
Veracity: the nurse’s duty to tell the truth [Show Less]
