nurse delegation

What are four requirements to become qualified to receive delegation? There are four primary actions you are responsible for in a delegation:

1) Be a NA-R, a NA-C, or a HCA in the state of Washington 2) Have completed the education requirements for delegation 3) Be willing to preform the specific task to be delegated 4) Demonstrate to the delegating RN you competence to correctly perform the specific task without direction supervision. 1. Performing the delegated task according to the specific instructions of the RN. 2. Observing the client for: - Potential side effects from medications. - Negative reactions to procedures. - Complications from diseases. 3. Reporting changes in your client's condition promptly to the delegating RN. 4. Reporting new or changed medications or treatments. 5. Renewing your registration or certification on time so you can legally perform a delegated task.

List FIVE steps in the medication administration process int he right order using numbered spaces below

1) Evaluate the client 2) prepare medication 3) administer the medication 4) document the medication administration 5) observe the client for the effects of the medication

Select the four specific tasks that cannot be delegated to you. what you can do

1) Injections, other than insulin 2) sterile procedures 3) maintenance of central lines 4) Tasks that require nursing Judgement medications. Non-sterile dressing changes. Urinary catheterization using clean technique. Ostomy care in established and healed condition. Blood glucose monitoring. Gastrostomy feedings in established and healed condition.

When you receive a delegation what are two of the things you are responsible for?

1) Performing the delegated task according to the instructions 2) Reporting changes in the client's condition promptly

list five rights of medication administration

1) right client 2) right medication 3) right dose 4) right route 5) right time

In the delegation process, there are five key roles that you should understand. The role of the:

1. Client 2. Delegating RN 3. Nursing Assistant/Home Care Aide 4. Case Manager 5. Home care agency supervisor or facility Administrator

What is a common disorder found in each body system?

Cardiovascular = hypertension Respiratory = Asthma Integumentary = bed sores Genito-Urinary = Urinary tract infection Gastrointestinal = GERD Nervous = Traumatic brain injury Musculoskeletal = Arthritis Sensory = Tinnitis

List four of the the nine body systems described in the workbook/

Cardiovascular, Respiratory, Integumentary, Genito-urinary,Endocrine, Nervous, Musculoskeletal, Sensory

In the delegation process, there are five key roles that you should understand. The role of the: 1. Client 2. Delegating RN 3. Nursing Assistant/Home Care Aide 4. Case Manager 5. Home care agency supervisor or facility Administrator The client or his/her representative must give consent for nurse delegation. The RN has five main areas of responsibility in delegation: 1. Assessing the client and evaluating the appropriateness of the delegation. 2. Obtaining written informed consent from the client or authorized representative for the delegation process. 3. Delegating the task. 4. Supervising the delegation. 5. Rescinding (canceling) the delegation. There are four primary actions you are responsible for in a delegation: 1. Performing the delegated task according to the specific instructions of the RN. 2. Observing the client for: - Potential side effects from medications. - Negative reactions to procedures. - Complications from diseases. 3. Reporting changes in your client's condition promptly to the delegating RN. 4. Reporting new or changed medications or treatments. 5. Renewing your registration or certification on time so you can legally perform a delegated task. Discuss the following special situations with your delegating RN so that you are prepared to handle each one: • The client declines a medication. • You make or discover a medication error. • Medications should be stored in original containers, with the legible, original label. • Non-refrigerated medications should be kept in a dry place, not warmer than 85°F. • Refrigerated medications should be stored at 35-50°F. It is safest to keep refrigerated medication in a zip-lock style plastic bag or other leak-proof container such as a locking metal tackle box. • Be sure to separate refrigerated medication storage from food storage. • If you work in a facility, follow the policy where you work regarding medication storage. When a medication is discontinued, it needs to be disposed of. • Ask the client, or representative, how he or she would like you to dispose of the medication. • If you work in a facility, always document the outcome when you dispose of medications. You and a witness must sign the Medication Disposition Form. All labels should contain the following information: • Client name • Medication name • Dose • Route • Schedule • Expiration date The most common packaging types for medications are: • Vials or bottles • Bubble packs • Medication organizers • Unit dose packaging • A medication is any compound that changes the chemical activity within the human body. • There are two types of medications: - Legend drugs - can only be dispensed with a prescription - Non-legend drugs - can be purchased without a prescription, also known as OTC medications. • A prescription is an order for medication or treatment given by an authorized health care professional with specific instructions for use. Health care professionals who can give prescriptions include doctors, nurse practitioners, physician's assistants, or dentists. • Medications have two names you need to know: - Generic name - Brand name • Scheduled medications are called controlled substances. These medications could be dangerous or have a high potential for abuse and addiction. Examples are narcotics, depressants, stimulants, and psychedelic medications.

Cardiovascular Move blood in order to deliver oxygen and remove carbon dioxide from the different parts of the body • Heart • Blood vessels • Arteries,veins,and capillaries • Blood • Blood vessels lose flexibility • Heart does not pump as effectively • Hypertension • Hypotension • Congestive Heart Failure (CHF) • Heart attack • Stroke orCVA • Heart arrhythmia Respiratory Manage the transfer of oxygen from the airto the blood, and removecarbon dioxide from the blood for transfer to the air • Nose • Throat (pharynx) • Voice box(larynx) • Windpipe (trachea) • Bronchi • Lungs • Lessbreathingcapacity • Lungs are less elastic • Thetransferofoxygen andcarbondioxidein the lungs is less efficient • Upper Respiratory Infections (URI) • Pneumonia • Chronic Obstructive Pulmonary Disease (COPD) • Asthma Integumentary (Skin) Epidermis - barrier against bacteria and moisture. Holds in moisturetokeepbody tissues from drying out Dermis - contains hair follicles, oil glands, sweat glands that regulate body temperature, and sense receptors that identify pain, pressure, heat, cold, etc. Subcutaneous tissue - fibrous tissue connects theupperskinlayersto theskeletalmuscles.Fatty tissueholdsinbodyheat, provides insulation, and provides an energy source. 3 layers of skin • Epidermis • Dermis - Hair follicles - Oil glands - Sweat glands - Sense receptors • Subcutaneous tissue - Fibrous tissue - Fatty tissue • Epidermis becomes thinnerandpaler • Dermis and subcutaneous tissue have less blood supply • Subcutaneous fat decreases, especially in arms and legs • Skin becomes folded, linedandwrinkled,and is less abletoregulate body temperature • Nails become dull, brittle, hard, and thick • Pressure injuries (bed sores) • Stasis/venous ulcers • Arterial ulcers(Diabetic) • Rashesandinfections • Burns • Skin cancer/lesions • Dehisced wounds • Fistulas Medication side effects are unintended effects of medications on the body that are not part of the goal of medication therapy. Examples are dizziness, headache, insomnia, nausea, and upset stomach. A medication interaction occurs when the administration of one medication given before, at the same time, or after another medication alters the effect of one or both medications. The effect of one or both medications may be either increased or decreased. An allergic reaction happens when the body's immune system reacts to a medication in a way that causes the body to produce chemicals that cause itching, swelling, muscle spasms, and can lead to throat and airway tightening. The reaction can range from mild to life threatening Other factors that might affect response to a medication are: • Route of administration • Time of day the medication is given • Number of medications a person takes and size of dose • Environmental conditions

Diabetes Mellitus affects which body system?

Endocrine

True or False: Maintenance of a central line maintenance can be delegated to a nursing assistant (NA)

False

Refrigerated medication storage should be separated from?

Food storage

What are the two type of medications? List and provide a definition for each.

Legend drugs- are drugs that can only be sold or given with prescription, Non-legend drugs are drugs that can be purchased without a prescription.Non-refrigerated medications should be kept in a dry place, not warmer than 85°F. • Refrigerated medications should be stored at 35-50°F. It is safest to keep refrigerated medication in a zip-lock style plastic bag or other leak-proof container such as a locking metal tackle box.

what are two examples of a developmental disability?

Mental retardation, Cerebral Palsy, Epilepsy, Autism, Down Syndrome

scheduled medications are called controlled substances. they could be dangerous or have high potential for abuse. examples of this type of medication are..

Narcotics, depressants,stimulants or psychotropic medication

If you are unable to preform a delegated task for any reason, what shoulf you do/

Notify the delegating RN and you employer as soon as possible when you are unable to complete the delegated task

True or False: The nursing assistant should report changes in the clients condition prompty to the delegating RN

TRUE

True or False: A licensed practical nurse (LPN) can delegate tasks to a NA

True or false: False

What is a medication?

any compound that changes the chemical activity within the human body

list two of the things that should always be on the medication label?

client name, medication name, dose, route,schedule, and expiration date

define side effects

side effects are unintended effects of medication on the body that are not part of the goal of medication therapy

Glucometer testing measures the

the sugar or glucose in a persons blood

True or False: a route of medication administration is the was the medication is given?

true

True or False: when you have been delegated oral medication administration, you are allowed to put the pill int he clients mouth?

true

There are five conditions for nurse delegation: A licensed Registered Nurse transfers performance of a task. There are four specific tasks that may not be delegated. A delegation covers a specific task for one client. Only qualified Nursing Assistants/Home Care Aides can accept a delegation. Delegation can only happen in four community settings. The following four tasks may NOT be delegated to you. Injections, other than insulin. Sterile procedures. Maintenance of central lines. Tasks that require nursing judgment.

There are five requirements to be qualified to receive a delegation. You must: Be an HCA, NA-R or a NA-C current and in good standing in Washington State. Have completed the educational requirements for delegation. Be willing to perform the specific task to be delegated. Demonstrate your competence to perform the specific tasks to be delegated correctly and without direct supervision to the delegating RN. There are four settings in which delegation can occur: Certified community residential programs for the developmentally disabled. Licensed adult family homes. Licensed assisted living facilities. In clients' homes

List of the things a delegating RN is responsible for in the delegating process?

- Obtaining written consent from the client or authorized representative for the delegation - delegation the task - supervising the delegation - rescinding or canceling the delegation -assessing the client and evaluating

What are the five conditions that must be met for nurse delegation?

1) There are four specific tasks that may not be delegated. 2) A licensed Registered Nurse transfers performance. 3) A delegation covers a specific task for one client. 4) Delegation can only happen in four community settings. 5) Only qualified Nursing Assistants/Home Care Aides can accept a delegation.

there are four settings in which delegation can occur what are they? Here are a few additional

1) certified community residential programs for the developmentally disabled, 2) licensed adult family homes 3) Licensed assisted living facilities 4) In the client's home notes on nurse delegation that will help you. • Remember, a delegation only applies to a specific task for one client. If you have been delegated a task for one client, Mary Jones, you cannot perform multiple tasks for Mary without additional delegations from the RN. Likewise, you cannot perform the task you have been delegated for Mary for other clients. • The delegating RN must reassess the client and supervise the delegation every 90 days. • The client, or the client's legal representative, must be aware that the task is being delegated to you, must agree to it, and give written consent. • The delegation must be in writing. • The delegation is a three-way agreement between the delegating RN, the client, and you.

RolesandResponsibilities—TheNursingAssistantorHomeCareAide You play a very important role in the care and well-being of your clients. Once you receive a delegated task, you are responsible for five primary actions

1. Performing the delegated task according to the specific instructions of the RN. This may include documenting the task according to instructions from the delegating RN. 2. Observing the client for changes which may indicate: - Potential side effects from medications. - Negative reactions to procedures. - Complications from the client's disease. 3. Reporting changes in the client's condition promptly. - If you work in a facility or home care agency, report to the delegating RN and your supervisor according to your employer's policy. - If you are an Individual Provider, report to the delegating RN and the case manager. 4. Reporting to the delegating RN any new or changed medications or treatments. 5. Renewing your registration or certification on time so you can legally perform a delegated task.

define medication interaction

A medication Interaction occurs when the administration of the one medication given before, at the same time, or after another medication alters the effect of one or both medications. the effect of one or both medications may be either increased or decreased

there are two important rights that clients have regarding medication administration

Clients have there right to refuse medication or treatments, clients have the right to privacy when medications are administered

what are three of the factors that can affect a medications action? Other factors that might affect response to a medication are

any of these three is correct, age, sex,size,genetic inheritance, physical condition and emotional condition • Route of administration • Time of day the medication is given • Number of medications a person takes and size of dose • Environmental conditions

It is the Case Manager's responsibility to: • Identify the need for nurse delegation on the client's careplan. • Assist a client in finding a qualified nurse delegation provider. • Make a referral to a contracted RN or nurse delegation provider. • Authorize payment to the delegating RN. The home care agency is responsible for: • Deciding whether the agency will provide nurse delegation. • Scheduling qualified caregiver(s) to meet client's needs. • Supervising the personal care duties. • Ensuring there is a back-up worker for client care. It is the employer/administrator's responsibility to: • Ensure all legal requirements are met. • Set the policies and procedures for the facility.

• You are not required to accept delegated tasks. You can refuse if you feel the client's safety is at risk or that you are not competent to perform the task. • There are three people involved in the delegation who must agree to it: the RN, the client or authorized representative, and you. • Injections, other than insulin, sterile procedures, and central line maintenance cannot be delegated to you. • The RN must evaluate the delegation periodically. • Nurse Delegation tasks are only for one client. You cannot perform a delegated task for another client unless you are specifically delegated to do that task for