Leadership/Management: Prioritizing Care HESI

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What type of delivery method is used when the nurse provides care to the same client for the entire work period?

Case method The premise of the case method is that one nurse provides total care for one client during the entire work period. In primary nursing, the primary nurse is accountable for the clients' care 24 hours a day from admission through discharge. Case management is the process of coordinating health care by planning, facilitating, and evaluating interventions across levels of care to achieve measurable cost and quality outcomes. In the practice partnership model an RN is paired with a technical assistant. The partner works with the RN consistently

Which client is observed for hemorrhage and infection as a nursing safety priority?

Client A In the clients who undergo allografts, the nurse must observe for signs of hemorrhage, infection, and fracture. Therefore client A is observed for hemorrhage and infection. While caring for the client who underwent spinal reconstructive surgery, it is important to assess respiratory status and encourage deep breathing exercises. Therefore, client B is assessed for respiratory status. Client C with two fractured ribs is assessed for pain. Neurovascular assessment is done for a client D with a wet plaster cast.

Who is responsible for client outcomes in the functional model of care?

Nurse manager In the functional model of nursing, the nurse manager is responsible for client outcome achievement because staff members are only responsible for specific tasks. The charge nurse coordinates care and assignments. The registered nurse is assigned specific tasks such as assessments and intravenous medications. The medication nurse is responsible for administering medications.

What does the nurse consider to be a critical aspect for appropriate priority setting and safety in a rapidly changing environment?

Situational awareness Developing and maintaining accurate situational awareness is critical for appropriate priority setting and safety in a rapidly changing environment. After triage, nurses provide on-site first aid and emergency care and are also involved in teaching and supervising volunteers. Rescue-trained personnel and disaster-trained personnel are utilized and involved in the emergency care in a rapidly changing environment.

Which delivery system was developed to provide care through others as an adaptation to functional nursing?

Team The hallmark of team nursing is "care through others," which was designed as an adaptation to functional nursing. Primary nursing is an adaptation to the case method. Case management is the process of coordinating health care by planning, facilitating, and evaluating interventions across levels of care to achieve measurable cost and quality outcomes. Differentiated practice consists of models of care delivery that are differentiated by level of education, expected clinical skills or competencies, job descriptions, pay scales, and participation in decision making.

What term began to be used in the 1960s to describe case management?

Utilization management

The registered nurse teaches the student nurse about the care of clients with frostbite. Which priority intervention performed by the student nurse indicates effective learning?

Warming the frostbite area in water bath For clients suffering partial thickness to full thickness frostbite, rewarming in a water bath at a temperature range of 104° F to 108° F is needed to thaw the frozen part. The client may experience severe pain during this process. Therefore the client should be administered analgesics, especially intravenous opiates. When the rewarming process is complete, the injured area should be gently handled and elevated above heart level to decrease tissue edema. Then the area should be covered with a loose and nonadherent sterile dressing.

The healthcare team is caring for clients in an emergency department. How soon should the clients triaged as an emergency severity index-3 (ESI-3) be seen by the physician according to the five level triage system?

Within1hour The clients triaged as an ESI-3 should be seen by the physician within an hour. The clients with life-threatening problems are triaged as ESI-1, and they should be provided with immediate care. The care of the clients in ESI-4 and ESI-5 can be delayed for some time because the condition of the clients in this level is stable. Clients with major injuries are triaged as an ESI-2 and require treatment within 10 minutes.


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