Med-Surg Exam

________ is the ability to keep the patient and staff free from harm and minimize errors in care.

Safety

How do diuretics affect acid-base balance?

Diuretics can cause metabolic alkalosis

___ ________ __________ requires that health care organizations create a culture of safety by following the NPSGs. (National Patient Safety Goals)

The Joint Commission

Small, firm, elevated lesions less than 1 cm are called _________ (Examples include elevated moles, warts)

Papules

Causes of respiratory acidosis

Respiratory depression: Anesthetics Drugs (especially opioids) Electrolyte imbalance Inadequate chest expansion: Muscle weakness Airway obstruction Alveolar-capillary block

Two types of carcinomas:

basal cell carcinoma and squamous cell carcinoma

To avoid mistaking dehydration for dry skin in an older adult, assess skin turgor on the __________ or __________.

forehead, chest

How does the renin-angiotensin-aldosterone system balance with sodium?

A low blood sodium level also is a triggering event because sodium and water are closely linked. Where sodium goes, water follows. So anything that causes the blood to have too little sodium prevents water from staying in the blood. The result is low blood volume with low blood pressure and poor tissue perfusion. This causes the RAAS system to act to establish balance again.

Which teaching will the nurse provide to the client who just underwent a skin biopsy and had sutures placed to close the wound? Select all that apply. A. Use antibiotic ointment as prescribed. B. Return for suture removal in 2 to 3 days. C. Report redness to the health care provider. D. Keep dressing moist so skin does not dry out. E. Use tap water or saline to remove any crusting.

A. Use antibiotic ointment as prescribed. C. Report redness to the health care provider. E. Use tap water or saline to remove any crusting.

The nurse is caring for an older client who is experiencing acute confusion and agitation following a fractured hip repair this morning. Which risk factors may be contributing to the client's delirium? Select all that apply. A. Anesthesia used during surgery B. Surgical pain C. Unfamiliar environment D. Noisy hospital unit E. Medications used to manage pain

A. Anesthesia used during surgery B. Surgical pain C. Unfamiliar environment D. Noisy hospital unit E. Medications used to manage pain

Which clinical indicators are most relevant for the nurse to monitor during IV fluid replacement for a client with dehydration? Select all that apply. A. Blood pressure B. Deep tendon reflexes C. Hand-grip strength D. Pulse rate and quality E. Skin turgor F. Urine output

A. Blood pressure D. Pulse rate and quality F. Urine output

The nurse performs an initial health assessment of an older adult. Which assessment findings indicate that the client may be at risk for falls? Select all that apply. A. Has presbyopia B. Has peripheral neuropathy C. Uses a cane D. Takes multiple medications E. Has bilateral cataracts F. Has thin papery skin

A. Has presbyopia B. Has peripheral neuropathy C. Uses a cane D. Takes multiple medications E. Has bilateral cataracts

The nurse collaborates with the registered dietitian nutritionist to improve the nutritional status of clients on a hospital unit. Which priority professional nursing concepts apply in this situation? Select all that apply. A. Quality Improvement B. Ethics C. Health Care Disparities D. Systems Thinking E. Teamwork and Collaboration

A. Quality Improvement D. Systems Thinking E. Teamwork and Collaboration

The nurse provides an SBAR hand-off communication regarding a client whose blood pressure and respiratory rate have decreased. Where will the nurse include these data as part of the SBAR format? A. Situation B. Background C. Assessment D. Recommendation

A. Situation

Which intervention will the nurse delegate to assistive personnel (AP) for a client who has poor personal hygiene? Select all that apply. A. Obtain a social history. B. Assist the client with bathing. C. Help the client with brushing of teeth. D. Tell the client that he or she smells bad. E. Consult social services to assess the client's living conditions. F. Teach client and family members how to help with personal hygiene. G. Notify the health care provider of suspected drug or alcohol addiction. H. Assess for cognitive function or physical limitations that can interfere with grooming.

B. Assist the client with bathing. C. Help the client with brushing of teeth.

Which assessment data regarding a lesion found on a 39-year-old client who uses a tanning bed requires nursing intervention? Select all that apply. A. Symmetrical and light pink B. Brownish-purple with irregular borders C. Changed in shape since last appointment D. 8 mm wide and described as itching often E. Regular border with fixed size and elevation

B. Brownish-purple with irregular borders C. Changed in shape since last appointment D. 8 mm wide and described as itching often

An older adult's furosemide dosage was increased 2 days ago to 40 mg daily. This morning the nurse observes that the client has become confused and very weak. What is the nurse's best action? A. Encourage fluid intake. B. Withhold this morning's dose of furosemide. C. Review the most recent serum electrolyte levels. D. Place the patient on strict intake and output.

B. Withhold this morning's dose of furosemide.

Basal cell carcinoma

Basal cell carcinoma arises from the basal cell layer of the epidermis and is the most common skin cancer worldwide. Early lesions often go unnoticed, and although metastasis is rare, underlying tissue destruction can occur. Genetic predisposition and chronic irritation are risk factors; however, UV exposure is the most common cause. Appearance: Pearly papule with a central crater and rolled, waxy borders. Telangiectasias (small, widened blood vessels) and pigment flecks visible on close inspection. Distribution: Sun-exposed areas, especially head, neck, and central portion of face

The nurse is participating in a unit meeting to discuss daily nursing care expectations. Which nursing statement reflects systems level thinking? A. "It is important to provide care consistent with the client's expectation." B. "I will always consider my client's cultural preferences when delivering care." C. "I have been comparing our rates of infection with other units in the hospital." D. "I will look for the policy about family visitation to show my client."

C. "I have been comparing our rates of infection with other units in the hospital."

Which client statement regarding treatment of a skin infection requires intervention by the nurse? A. "I am not going to share my clothes with anyone else." B. "Because I am over 60, I am going to get the shingles vaccine." C. "It is important to keep my skin very moist, so I will use lotion." D. "If I get a fever or chills, I will contact my primary health care provider."

C. "It is important to keep my skin very moist, so I will use lotion."

A nurse conducts an assessment of an older adult's medications, including both prescription and over-the-counter drugs. Which drug would the nurse identify as being potentially inappropriate for older adults? A. Vitamin D B. Losartan C. Nortriptyline D. Hydrochlorothiazide (HCTZ)

C. Nortriptyline

A client with a large, irregularly shaped mole on the upper chest expresses concern about the cosmetic appearance of the lesion. What is the priority nursing intervention? A. Refer to a dermatologic health care provider. B. Ask if there are any other lesions that are bothersome. C. Perform a head-to-toe skin assessment and document the findings. D. Teach about the importance of avoiding excessive sun exposure and tanning beds.

C. Perform a head-to-toe skin assessment and document the findings.

In reviewing the electrolytes of a client, the nurse notes the serum potassium level has increased from 4.6 mEq/L (mmol/L) to 6.1 mEq/L (mmol/L). Which assessment does the nurse perform first to prevent harm? A. Deep tendon reflexes B. Oxygen saturation C. Pulse rate and rhythm D. Respiratory rate and depth

C. Pulse rate and rhythm

A client shows the nurse two pictures of the same lesion, taken 1 month apart. Which assessment finding requires nursing intervention? A. The light pink color of the lesion is the same in both photographs. B. The lesion has almost disappeared by the time of the second photograph. C. The lesion borders have expanded and are shaped differently in the second picture. D. The lesion's well-approximated margins and size look no different in either photograph.

C. The lesion borders have expanded and are shaped differently in the second picture.

Cardiovascular changes with hyperkalemia

Cardiovascular changes are the most severe problems from hyperkalemia and are the most common cause of death in patients with hyperkalemia. Cardiac symptoms include bradycardia, hypotension, and ECG changes of tall, peaked T waves, prolonged PR intervals, flat or absent P waves, and wide QRS complexes. Ectopic beats may appear. Complete heart block, asystole, and ventricular fibrillation are life-threatening complications of severe hyperkalemia.

_______________ is an essential process for evaluating patient care together using an interprofessional (IP) plan of care.

Communication

Hypomagnesemia

Hypomagnesemia is a serum magnesium (Mg2+) level below 1.8 mEq/L or 0.74 mmol/L. It is most often caused by decreased absorption of dietary magnesium or increased kidney magnesium excretion. Two major causes of hypomagnesemia are inadequate intake and the use of loop or thiazide diuretics.

How will the nurse describe a shave biopsy to a client? A. "A scalpel will be used to remove a deep sample of skin." B. "A small plug of tissue will be removed with a circular cutting instrument." C. "A deep specimen of skin will be taken, and the area will be sutured closed." D. "A razor blade will be gently moved across the skin's surface to obtain a sample."

D. "A razor blade will be gently moved across the skin's surface to obtain a sample."

With which client does the nurse remain alert for and assess most frequently for signs and symptoms of hypokalemia to prevent harm? A. 72-year-old taking the diuretic spironolactone for control of hypertension B. 62-year-old receiving an IV solution of Ringer's lactate at a rate of 200 mL/hr C. 42-year-old trauma victim receiving a third infusion of packed red blood cells in 12 hours D. 22-year-old receiving an IV infusion of regular insulin to manage an episode of ketoacidosis

D. 22-year-old receiving an IV infusion of regular insulin to manage an episode of ketoacidosis

Which nursing action reflects implementation of systems level thinking? A. Conducting a skin assessment on a newly admitted client B. Documenting a pressure injury in the electronic health record C. Notifying the health care provider of a 2″ × 1″ pressure injury on the coccyx D. Participating in a quality improvement project about eliminating pressure injury occurrences

D. Participating in a quality improvement project about eliminating pressure injury occurrences

The nurse is conducting an assessment of an older adult living in the community. Which assessment findings are considered usual physiologic changes of aging? Select all that apply. A. Dementia B. Relocation stress C. Urinary incontinence D. Presbyopia E. Obesity

D. Presbyopia

How will the experienced nurse explain systems thinking to a new nurse? A. Reading a journal article to enhance one's understanding of a specific disorder B. Providing patient-centered care to each individual, recognizing his or her uniqueness C. Engaging in a professional development activity to earn continuing education credit D. Using information from individual client care to improve outcomes at a macro level

D. Using information from individual client care to improve outcomes at a macro level

Renin and angiotensin system balance with sodium

Decrease in urine formation means increase in water and sodium reabsorption thus increase in kidney reabsorption

Nurses must show respect and compassion for the __________ of every individual to ensure Patient-Centered and family-centered Care.

uniqueness

Elevated, irregularly shaped, transient, areas of dermal edemas caused by insect bites and urticaria are ________

wheals

Hypocalcemia

Hypocalcemia is a total serum calcium (Ca2+) level below 9.0 mg/dL. Hypocalcemia is caused by many chronic and acute conditions, as well as medical or surgical treatments. Table 13.8 lists causes of hypocalcemia. Acute hypocalcemia results in the rapid onset of life-threatening symptoms. Chronic hypocalcemia occurs slowly over time, and excitable membrane symptoms may not be severe because the body has adjusted to the gradual reduction of serum calcium levels.

_________ _____ __________ are differences in the access or availability of health care; members of minority groups and other vulnerable populations are particularly at risk for this.

Health Care Disparities

Hypercalcemia

Hypercalcemia is a total serum calcium level above 10.5 mg/dL. Even small increases above normal have severe effects, and all systems are affected. Hypercalcemia causes excitable tissues to be less sensitive to normal stimuli, thus requiring a stronger stimulus to function. The excitable tissues affected most by hypercalcemia are the heart, skeletal muscles, nerves, and intestinal smooth muscles.

Hypermagnesemia

Hypermagnesemia is a serum magnesium level above 2.6 mEq/L or 1.07 mmol/L. Magnesium is a membrane stabilizer. Most symptoms of hypermagnesemia occur as a result of reduced membrane excitability. They usually are not apparent until serum magnesium levels exceed 4 mEq/L (1.6 mmol/L).

Causes of respiratory alkalosis

Hyperventilation, fear, anxiety Mechanical ventilation Salicylate toxicity High altitudes Early-stage acute pulmonary problems

Which step of ADPIE involves responding, taking actions, monitoring responses, reflecting, and making adjustments?

Implementation

Acidosis

In acidosis the acid-base balance of arterial is upset by an excess of free hydrogen ions (H+). This is seen as an arterial blood pH below 7.35. The amount of acids present is greater than normal compared with the amount of bases. Acidosis is not a disease; it is a condition caused by a disorder or pathologic process. It can be caused by metabolic problems, respiratory problems, or both. Patients at greatest risk for acute acidosis are those with problems that impair breathing. Older adults with chronic health problems are at greater risk for developing acidosis.

Cardiovascular changes with hypokalemia

In hypokalemia the pulse is usually thready and weak. Palpation is difficult, and the pulse is easily blocked. Pulse rate ranges from very slow to very rapid, and an irregular heartbeat (dysrhythmia) may be present. Measure blood pressure with the patient in the lying, sitting, and standing positions because orthostatic (postural) hypotension occurs with hypokalemia.

_____ is "a theoretical and reflective domain of human knowledge that addresses issues and questions about morality in human choices, actions, character, and ends." Applied professional nursing ________ is about considering what is right and wrong when using clinical judgment to make clinical decisions. Therefore the primary interrelated concept is clinical judgment.

ethics

Patient, family, healthcare providers, nurses, assistive personnel, and other health care professionals all form the _______________ _______ ______ ______

Interprofessional health care team

Nursing management of metabolic alkalosis

Interventions are planned to prevent further losses of hydrogen, potassium, calcium, and chloride ions; to restore fluid balance; to monitor changes; and to provide for patient safety. Treatments that may have caused alkalosis (e.g., prolonged gastric suctioning, excessive infusion of certain IV solutions, drugs that promote hydrogen ion excretion) are modified or stopped. Drug therapy is prescribed to resolve the causes of alkalosis and to restore normal fluid, electrolyte, and acid-base balance. For example, the patient with metabolic alkalosis caused by diuretic therapy receives fluid and electrolyte replacement, and the diuretic therapy is adjusted or stopped. Antiemetic drugs are prescribed for vomiting. Monitor the patient's progress and adjust fluid and electrolyte therapy. Monitor electrolytes daily until they return to near normal.

Electrolyte levels have to be monitored with a patient on Lasix (furosemide) because:

It can cause hypernatremia and hypokalemia. It can be used to lower hypermagnesemia, hypercalcemia, and hyperkalemia.

metabolic acidosis

Metabolic acidosis is reflected by several changes in ABG values. The pH is low (<7.35) because buffering and respiratory compensation are not adequate to keep the amount of free hydrogen ions at a normal level. The bicarbonate level is usually low (<21 mEq/L [mmol/L]) because bicarbonate has been lost or its production is inadequate as causes of the acidosis. The classic ABG values that distinguish metabolic acidosis from respiratory acidosis when pH is below 7.35 are a normal partial pressure of arterial oxygen (Pao2) together with a normal or even slightly low partial pressure of arterial carbon dioxide (PaCO 2).

____________ __________ _________ _______ address high-risk issues such as safe drug administration, prevention of health care-associated infections, and communication effectiveness among the interprofessional team.

National Patient Safety Goals

diabetes insipidus

Occurs when the body can't regulate how it handles fluids Caused by a hormonal abnormality and isn't related to diabetes -Extreme thirst and heavy urination may occur -Hormone therapy, a low salt diet, or drinking more water

_________________ is the use of multiple drugs, duplicative drug therapy, high-dosage drugs, and drugs prescribed for too long a period of time.

Polypharmacy

Foods that affect potassium levels

Potato Bananas Meat Fish Citrus juices Raisins

______ ________ _______ save lives and decrease the risk for patient harm before a respiratory or cardiac arrest occurs.

Rapid response teams

respiratory acidosis

Respiratory acidosis results when respiratory function is impaired and the exchange of oxygen (O2) and carbon dioxide (CO2) is reduced. This problem causes CO2 retention, which leads to the same increase in free hydrogen ion levels and acidosis.

Respiratory alkalosis

Respiratory alkalosis is usually caused by an excessive loss of CO2 through hyperventilation (rapid respirations). Patients may hyperventilate in response to anxiety, fear, or improper settings on mechanical ventilators. Hyperventilation can also result from direct stimulation of central respiratory centers because of fever, central nervous system lesions, and salicylates. The hallmark of respiratory alkalosis is an ABG result with an elevated pH coupled with a low carbon dioxide level. Usually the oxygen and bicarbonate levels are normal.

Squamous cell carcinoma (SCC)

Squamous cell carcinoma (SCC) is a cancer of the epidermis. These cancers can invade locally and are potentially metastatic. SCC is the most common cause of lip cancer, often seen in older Caucasian men. Chronic skin damage from repeated injury or irritation increases risk for this malignancy. Chronic wounds that remain open for long periods are also at increased risk for malignant transformation to cancer. Appearance: Firm, nodular lesion topped with a crust or a central area of ulceration, Indurated (thick, hardened) margins. Fixation to underlying tissue with deep invasion. Distribution: Sun-exposed areas, especially head, neck, and lower lip. Sites of chronic irritation or injury (e.g., scars, irradiated skin, burns, leg ulcers)

metabolic alkalosis

The hallmark of a base excess alkalosis is an ABG result with an elevated pH and an elevated bicarbonate level, along with normal oxygen and carbon dioxide levels.

A large study of almost 16,000 older adults living in the community found that those with severe limitations in mobility experienced increased _______ that often led to negative health outcomes when compared with those with adequate mobility

falls

The older adult population is at high risk for _________ ________ _________ (ADEs) directly related to the number of drugs taken and the frequency with which they are taken. Drug-drug, food-drug, drug-herb, and drug-disease interactions are common ADEs that often lead to hospital admission.

adverse drug events

A vital role of the nurse is as an _________ to empower patients and their families to have control over their health care and function as safety partners.

advocate

Six essential ethical principles to consider when making clinical decisions are:

autonomy, beneficence, nonmaleficence, fidelity, veracity, and social justice.

Older adults need an increased dietary intake of ________ and vitamins _, _, and _ because aging changes disrupt the ability to store, use, and absorb these substances.

calcium, D, C, A

Applied professional nursing ethics is about considering what is right and wrong when using _________ _______ to make clinical decisions.

clinical judgement

Remember to always observe for changes in patient condition and intervene appropriately using ________ _________.

clinical judgement

________ _________ is the process by which nurses collect cues, process the information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes, and reflect on and learn from the process. It takes place through a process known as ADPIE—Assessing, (Nursing) Diagnosis, Planning, Implementing, and Evaluating

clinical reasoning

Examples of nursing teamwork and collaboration are:

communication, delegation/supervision, SBAR, 5 Rights

The ways in which people adapt to old age depend largely on the personality traits and ________ _________ that have characterized them throughout their lives.

coping strategies

Best safety practices reduce error and harm through:

established protocols, memory checklists, and systems such as bar-code medication administration

Skin __________ ____________ plays a major role in protection by protecting the body against invasion of pathogenic organisms by providing first, second, and third lines of defense

tissue integrity

Inadequate or decreased nutrition may also be related to _____________

loneliness

metabolic acidosis

low pH, low HCO3

Hypovolemia:

lower than normal circulating blood volume which leads to reduced perfusion. The body's defenses compensate during dehydration to maintain perfusion to vital organs in spite of hypovolemia. The main defense is increasing vasoconstriction and peripheral resistance to maintain blood pressure and circulation. Check and monitor daily weight for fluid loss Monitor vital signs and assess for mucous membrane moisture

A major contributing factor to falls in older adults is _________ ______

medication use

____________ protects the skin from damage by UV light.

melanin

Reduced income, chronic disease, fatigue, and decreased ability to perform ADLs are other factors that contribute to inadequate or decreased __________.

nutrition

Topical Corticosteroids

o Can be used to treat parasitic disorders such as bed bugs o May be provided to a patient with psoriasis to reduce itching and inflammation

Diagnostic testing of integumentary include:

o Skin biopsy: A small piece of skin may be obtained for diagnosis or to assess effectiveness of an intervention o Wood lamp examination: A handheld long-wavelength ultraviolet (black) light used for exposure of certain skin infections with specific color o Diascopy: A painless technique to eliminate erythema caused by increased blood flow to the skin, easing the inspection of skin lesions o Fungal culture: Cultures obtained for fungal infections o Bacterial culture: Cultures obtained for bacterial infections o Viral culture: Culture obtained for viral infections

According to the Centers for Disease Control and Prevention (CDC), more than _______ in ______ older adults experience at least one fall each year

one, four

The major advantage of maintaining appropriate levels of _________ ____________ includes decreased risk for falls

physical acitivity

Elevated plateau like patches more than 1 cm in diameter that do not extend into lower skin layers are called _________________ (Examples include psoriasis)

plaque

________ care is perhaps the most recognizable form of care provided, as this serves as a point of entry into the health care system for many people

primary

___________ care is perhaps the most recognizable form of care provided, as this serves as a point of entry into the health care system for many people

primary

Vesicles filled with cloudy or purulent fluid are called ___________ (Examples include acne and acute impetigo)

pustules

A major regulator of fluid balance is the:

renin-angiotensin-aldosterone system (RAAS)

The ______ __ _______ can be described as unsafe, possibly causing harm or even death, or safe to help prevent harm or minimize negative outcomes.

scope of safety

Age related changes for skin

skin transparency and fragility, delayed wound healing, skin hyperplasia and skin cancers, increased risk for irritation, decreased skin inflammatory response, increased risk for sunburn, changes in pigmentation (liver spots, age spots), increased risk for osteomalacia, increased risk for shearing forces and pressure ulcers, increased risk for heat stroke and hypothermia, thin and transparent skin, decreased tone and elasticity, reduced sensory perception

People who have close, intimate, ___________ ____________ with others in whom they confide are often more likely to cope with crisis, whether present or past.

stable relationships

Older adults often have less ability to taste ________ and ________ than to taste bitter and sour.

sweet, salt

The ability to recognize, understand, and synthesize the interactions and interdependencies in a set of components designed for a specific purpose is called:

systems thinking

To provide patient- and family-centered care and be competent in ___________ and ____________, the nurse "functions effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care".

teamwork and collaboration

Teaching about prevention of sun damage and skin cancer:

• Avoid sun exposure between 11 a.m. and 3 p.m. • Avoid all tanning beds. • Use sunscreens with the appropriate skin protection factor for your skin type. • Wear a hat, opaque clothing, and sunglasses when you are in the sun. • Examine your body monthly for possibly cancerous or precancerous lesions. • Taking pictures of lesions and comparing them month by month can demonstrate changes. • Keep a "body map" of your skin spots, scars, and lesions to detect when changes have occurred. • Contact your primary health care provider if you note any of these: • A change in the color of a lesion, especially if it darkens or shows evidence of spreading • A change in the size of a lesion, especially rapid growth • A change in the shape of a lesion, such as a sharp border becoming irregular or a flat lesion becoming raised • Redness or swelling of the skin around a lesion • A change in sensation, especially itching or increased tenderness of a lesion • A change in the character of a lesion, such as oozing, crusting, bleeding, or scaling

Effects of hypermagnesemia

• Bradycardia • Cardiac arrest • Drowsy and lethargy • Absent deep tendon reflexes • Peripheral vasodilation and hypotension

S/S of hypercalcemia

• Decreased muscle contraction • Constipation • Anorexia • Dehydration • Nausea and vomiting • Hypoactive deep tendon reflexes • Cardiovascular signs are the most serious- causes bradycardia

Causes of metabolic acidosis

• Diabetic ketoacidosis - blood glucose greater than 400 • Starvation • Hypermetabolism • Seizures • Fever- Body temperature greater than 100 degrees Fahrenheit • Hypoxia- low oxygen saturation

Causes of hypovolemia

• Diarrhea • Vomiting • Burns • Diuretic therapy • Impaired thirst • Fever

Effects of hypomagnesemia

• Hypertension • Dysrhythmias • Hyperactive deep tendon reflexes • Numbness, painful, and tingling muscle contractions • Reduced motility, nausea, and constipation

Signs and symptoms of dehydration (hypovolemia)

• Low blood pressure • Dizziness • Decreased skin turgor • Concentrated urine • Acute weight loss

S/S of hypocalcemia

• Muscle spasms • Trousseau sign • Diarrhea • Chvostek sign • Twitching • Tetany • Seizures

Types of community-based care in the US:

• Private medical practices • Hospital-based (outpatient) services such as support groups and health information workshops • Freestanding points of care, such as small emergency departments, urgent care, or ambulatory surgery facilities • Retail clinics, such as "minute clinics" located inside drug stores or other retailers • Mobile medical, diagnostic, and screening services • Home health care • Hospice services • Ambulatory long-term care services • Public health services • Community health centers • Free clinics • Telehealth access

Attributes of Teamwork and Collaboration: In 2016 the Interprofessional Education Collaborative (IPEC) Expert Panel published their latest competencies to guide health professionals in education and practice. The four major IPEC competencies include:

• Values/Ethics for Interprofessional Practice: Work with individuals of other professions to maintain a climate of mutual respect and shared values. • Role-Responsibilities: Use the knowledge of one's own role and those of other professions to appropriately assess and address the health care needs of patients and populations served. • Interprofessional Communication: Communicate with patients, families, communities, and other health professionals in a responsive and responsible manner that supports a team approach to the maintenance of health and the treatment of disease. • Teams and Teamwork: Apply relationship-building values and the principles of team dynamics to perform effectively in different team roles to plan and deliver patient-population-centered care that is safe, timely, efficient, effective, and equitable.