Management of Care
Advocacy
1. Professional Responsibilities: Caring for an Older Adult Client Who Might Be
Abused (RM Leadership 8.0 Chp 3
... [Show More] Professional Responsibilities)
ActiveLearningTemplate: Basic Concept
Reasons for not reporting:
- may be embarrassed or ashamed of abuse
- worry about how their report may affect lives of loved ones
- feel guilty and have come to believe they're cause of abuse
- afraid no one will believe them
- afraid of unknown future if they're removed from care of abuser
- worst nightmare is to end in a nursing home
Assessment for abuse:
- examine client alone
- don't rush during interview
- don't be judgmental or allow personal feelings to interfere
- don't diagnose prematurely
Subjective data:
- ask client to describe a typical day to determine degree if independence
- ask client role and expectations for self and caregiver
- inquire any recent family crisis
- ask if there is any alcohol, drug use, mental illnesses in home
Objective Data:
- assess if patient senses being ignored or is made to feel like burden
- assess degree of dependence of caregiver (financial, physical, and/or emotional support)
- observe and document any new lesions
Assignment, delegation and supervision
2. Managing Client Care: Assigning Client Care to a Licensed Practical Nurse (RM
Leadership 8.0 Chp 1 Managing Client Care) ActiveLearningTemplate: Basic
Concept
Monitoring client findings (as input to the RN’s ongoing assessment of the client) ›
Reinforcement of client teaching from a standard care plan ›
Tracheostomy care ›
Suctioning ›
Checking nasogastric tube patency
Administration of enteral feedings
Insertion of a urinary catheter
Medication administration (excluding intravenous medications in several states)
3. Managing Client Care: Feeding a Client Who Has Dysphagia (RM Leadership 8.0
Chp 1 Managing Client Care) ActiveLearningTemplate: Basic Concept
place client in an upright or high Fowler's position to facilitate swallowing
stay with client due to risk for aspiration
refer to speech therapist for evaluation
make diet alterations, avoid thin liquids and sticky foods
4. Managing Client Care: Nursing Assessment to Perform Prior to Delegation of Care
(RM Leadership 8.0 Chp 1 Managing Client Care) ActiveLearningTemplate: Basic
Concept
Case Management
5. Coordinating Client Care: Addressing Priority Issues During Case Management
(RM Leadership 8.0 Chp 2 Coordinating Client Care) ActiveLearningTemplate:
Basic Concept
Open communication: Use “I” statements, and remember to focus on the problem, not on
personal differences. Listen carefully to what the other people are saying. Move a conflict
that is escalating to a private location or postpone the discussion
Share ground rules with participants. For example, everyone is to be treated with respect,
only one person can speak at a time, and everyone should have a chance to speak.
Steps of the problem-solving process
identify the problem
Discuss possible solutions
Analyze identified solutions – The potential pros and cons of each possible solution
should be discussed
Select a solution.
Evaluate the solution’s ability to resolve the original problem. The outcomes surrounding
the new solution should be evaluated according to the predetermined time line. The
solution should be given adequate time to become established as a new routine before it
is evaluated. If the solution is deemed unsuccessful, the problem-solving process will
need to be reinstituted and the problem discussed again.
negotiation
Client Rights
6. Professional Responsibilities: Inappropriate Use of Restraints (RM Leadership 8.0
Chp 3 Professional Responsibilities) ActiveLearningTemplate: Basic Concept
Prevents harm of self or others
Never used for:
- Convenience of the staff
- Punishment for the client
- Clients who are extremely physically or mentally unstable
- Clients who cannot tolerate the decreased stimulation of a seclusion room
7. Professional Responsibilities: Treatment Decisions (RM Leadership 8.0 Chp 3
Professional Responsibilities) ActiveLearningTemplate: Basic Concept
Competent adults have the right to refuse treatment, including the right to leave a health
care facility without a discharge order from the provider.
If the client refuses a treatment or procedure, the client is asked to sign a document
indicating that he understands the risk involved with refusing the treatment or procedure,
and that he has chosen to refuse it.
Advance Directives/Self-determination/Life planning
8. Professional Responsibilities: Client Advocacy Regarding Advance Directives (RM
Leadership 8.0 Chp 3 Professional Responsibilities) ActiveLearningTemplate: Basic
Concept
Providing written information regarding advance directives
Documenting the client’s advance directives status
Ensuring that advance directives are current and reflective of the client’s current
decisions
Recognizing that the client’s choice takes priority when there is a conflict between the
client and family, or between the client and the provider
Informing all members of the health care team of the client’s advance directives
Collaboration with interdisciplinary team
9. Assessment of Fetal Well-Being: Interdisciplinary Care Conference (RM MN RN
11.0 Chp 6 Assessment of Fetal Well- Being) ActiveLearningTemplate: Basic
Concept
The nonstress test (NST) is a noninvasive antepartum evaluation of fetal wellbeing.
Fetal movement and fetal heart rate accelerations correlate with adequate
oxygenation.
Normal function of the autonomic nervous system and adequate oxygenation is
observed in a fetus through reactivity of the fetal heart rate. [Show Less]