Leal Responsibilities: Documenting Admission Data
1. All clients should be asked whether they have advance directives upon admission to a health
care
... [Show More] facility.
2. Staff should give clients who do not have advance directives written information that outlines
their rights related to health care decisions and how to formulate advance directives.
3. The purpose of advance directives is to communicate a client’s wishes regarding end-of-life care
should the client become unable to do so.
Professional Responsibilities: Admission Requirements from the Patient Self-Determination Act
1. Professional responsibilities are the obligations that nurses have to their clients. To meet their
professional responsibilities, nurses must be knowledgeable in the following area: client rights,
advocacy, informed consent, advance directives, information technology, legal practice,
disruptive behavior, and ethical practice.
2. The Patient Self-Determination Act stipulates that on admission to a health care facility, all
clients must be informed of their right to accept or refuse care. Competent adults have the right
to refuse treatment, including the right to leave a health care facility without a prescription for
discharge from the provider.
3. If the client refuses a treatment or procedure, the client is asked to sign a document indicating
that they understand the risk involved with refusing the treatment or procedure, and that they
have chosen to refuse it.
Managing Client Care: Evaluating an Assistive Personnel’s Performance
1. Examples of tasks that nurses can delegate to assistive personnel are: activities of daily living
(ADLs), bathing, grooming, dressing, toileting, ambulating, feeding (without swallowing
precautions), positioning, routine tasks, bed making, specimen collection, intake and output, and
vital signs (for stable clients).
2. A licensed nurse is responsible for providing clear directions when a task is initially delegated
and for periodic reassessment and evaluation of the outcome of the task.
3. The nurse should use judgment and knowledge related to the scope of practice and the
delegatee’s skill level when delegating.
Cancer Disorders: Planning Discharge Teaching for a client who is Postoperative Following a Modified
Radical Mastectomy
1. Radical mastectomy includes lymph nodes and muscle removal as opposed to modified radical
mastectomy which is removal of lymph nodes only.
2. The nurse should teach the client to sit with the head of the bed elevated 30 degree when
awake and support their arm on a pillow. Lying on the affected side can relieve pain.
3. Also teach about avoiding administering injections, taking blood pressure, or obtaining blood
from the affected arm.
Home safety: Planning Care for a Client Who Has Vision Loss
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1. The nurse should remove items that could cause the client to trip such as throw rugs and loose
carpets. Place electrical cords and extension cords against a wall behind furniture.
2. Ensure that lighting (75 watts) is adequate inside and outside the home and remove clutter.
3. Place grab bars near the toilet and in the tub or shower and install a stool riser.
Continuity of Care: Interventions to Promote Client Independence in a Rural Area
1. A community-based social worker is necessary to help with self-care as well as helping the client
face challenges with self-care and paying for necessary supplies.
2. A home health nurse can assist a client in learning to care for conditions, medication
management, and emotional support.
3. The establishment of an ongoing relationship between an individual and a health care provider
leads to improve health outcomes. [Show Less]