Prioritizing Client Care

Functional Nursing

Task approach to client care with tasks being delegated by the charge nurse to members of the team.

Rights of Delegation

Right: task, circumstance, person, direction, and supervision

Difference between primary assessment and secondary assessment when in triage

the primary assessment is to identify any client problem that poses an immediate or potential threat to life whereas secondary identifies any other problems after primary has been dealt with

Team Nursing

Team led by RN who is responsible for assessing clients, analyzing data, and evaluating each circumstance.

The charge nurse is planning the assignment for the day. Which factors should the nurse remain mindful of when planning the assignment? Select all that apply. -The acuity level of the clients -Specific requests from the staff -The clustering of the rooms on the unit -The number of anticipated client discharges -Client needs and workers' needs and abilities

1 and 5

The registered nurse is planning the client assignments for the day. Which is the most appropriate assignment for an unlicensed assistive personnel (UAP)? 1. A client requiring a colostomy irrigation 2. A client receiving continuous tube feedings 3. A client who requires urine specimen collections 4. A client with difficulty swallowing food and fluids

3

Difference between UAP and LPN

LPN can perform not only the tasks that a UAP can perform, but also certain invasive tasks, such as dressing changes, suctioning, urinary catheterization, and medication administration (oral, subcutaneous, intramuscular, and selected piggyback medications)

The nurse manager has implemented a change in the method of the nursing delivery system from functional to team nursing. An unlicensed assistive personnel (UAP) is resistant to the change and is not taking an active part in facilitating the process of change. Which is the best approach in dealing with the UAP? 1. Ignore the resistance. 2. Exert coercion on the UAP. 3. Provide a positive reward system for the UAP. 4. Confront the UAP to encourage verbalization of feelings regarding the change.

4

A nursing graduate is attending an agency orientation regarding the nursing model of practice implemented in the health care facility. The nurse is told that the nursing model is a team nursing approach. The nurse determines that which scenario is characteristic of the team-based model of nursing practice? 1. Each staff member is assigned a specific task for a group of clients. 2. A staff member is assigned to determine the client's needs at home and begin discharge planning. 3. A single registered nurse (RN) is responsible for providing care to a group of 6 clients with the aid of an unlicensed assistive personnel (UAP). 4. An RN leads 2 licensed practical nurses (LPNs) and 3 UAPs in providing care to a group of 12 clients.

4

The nurse employed in an emergency department is assigned to triage clients coming to the emergency department for treatment on the evening shift. The nurse should assign priority to which client? 1. A client complaining of muscle aches, a headache, and history of seizures 2. A client who twisted her ankle when rollerblading and is requesting medication for pain 3. A client with a minor laceration on the index finger sustained while cutting an eggplant 4. A client with chest pain who states that he just ate pizza that was made with a very spicy sauce

4

The nurse has received the assignment for the day shift. After making initial rounds and checking all of the assigned clients, which client should the nurse plan to care for first? 1. A client who is ambulatory demonstrating steady gait 2. A postoperative client who has just received an opioid pain medication 3. A client scheduled for physical therapy for the first crutch-walking session 4. A client with a white blood cell count of 14,000 mm3 (14×109/L) and a temperature of 38.4 °C

4

The nurse is giving a bed bath to an assigned client when an unlicensed assistive personnel (UAP) enters the client's room and tells the nurse that another assigned client is in pain and needs pain medication. Which is the most appropriate nursing action? 1. Finish the bed bath and then administer the pain medication to the other client. 2. Ask the UAP to find out when the last pain medication was given to the client. 3. Ask the UAP to tell the client in pain that medication will be administered as soon as the bed bath is complete. 4. Cover the client, raise the side rails, tell the client that you will return shortly, and administer the pain medication to the other client.

4

The nurse is the first responder at the scene of a school bus accident. The nurse triages the victims from highest to lowest priority as follows: 1. Confused child with bright red blood pulsating from a leg wound 2. Child with a closed head wound and multiple compound fractures of the arms and legs 3. Child with a simple fracture of the arm complaining of arm pain 4. Sobbing child with several minor lacerations on the face, arms, and legs

The correct answer is 1,2,3, then 4

Situational Leadership

Uses a combination of styles based on current circumstances

The nurse is assigned to the following clients. The order of priority in assessing the clients is as follows: 1. A client with heart failure who has a 4-lb weight gain since yesterday and is experiencing shortness of breath 2. A 24-hour postoperative client who had a wedge resection of the lung and has a closed chest tube drainage system 3. A client admitted to the hospital for observation who has absent bowel sounds 4. A client who is undergoing surgery for a hysterectomy on the following day

You would see patient A first

What are a nurse's role in disaster planning?

-make preparations -know the plan -maintain certifications (CPR) -participate in mock disaster drills -prepare professional emergency response items

Process for Medication Reconciliation

1.) Obtain a list of current medications 2.) develop an accurate list of new medications 3.) compare the two lists 4.) identify and investigate discrepancies 5.) communicate final list with patient

Autocratic Leadership

Leader is focused and maintains strong control, makes decisions, and addresses all problems.

Triage levels for Emergency Department

Red: highest and assigned to those who have life-threatening injuries and need immediate attention Yellow: Urgent and is assigned to those who require treatment and whose injuries have complications that are not life threatening Green: Non-urgent and assigned to those with local injuries without complications

Relationship-Based Practice

concerned with keeping the nurses at the bedside and actively involved.

Reasons for Resisting Change

conformity, dissimuliar beliefs, habit, secondary gains, etc

Key components of discharge teaching

how to administer medications, side effects, dietary measures, complications, equipment, community resources

Difference between multi-casualty and mass casualty event

multi involves a limited number of victims and can be managed by a hospital whereas mass involves a number of causalities that exceeds the resources of a hospital

Managed Care

strategies used in health care system that reduce cost of health care. Outcome driven and managed by case management process.