VATI RN COMPREHENSIVE PREDICTOR FOCUSED REVIEW
❖ Management of Care – (9)
➢ Advance Directives – (1)
▪ Legal Responsibilities: Purpose of a Living Will (RM FUND 9.0 Chp 4)
• A living will is a legal document that expresses the client’s wishes regarding
medical treatment in the event the client becomes incapacitated and is facing end-
of-life issues. Most state laws include provisions that protect health care providers
who follow a living will from liability.
➢ Assignment, Delegation and Supervision – (2)
▪ Delegation and Supervision: Delegating Tasks to an Assistive Personnel (RM FUND
9.0 Chp 6)
• Examples of tasks nurses may delegate to Aps (provided the facility’s policy and
state’s practice guidelines permit)
◆ Activities of daily living (ADLs) – bathing, grooming, dressing, toileting,
ambulating, feeding (without swallowing precautions), positioning
◆ Routine tasks – bed making, specimen collection, intake and output, vital
signs (for stable clients)
▪ Managing Client Care: Delegation Strategy for Effective Task Management (RM
Leadership 7.0 Chp 1)
• Consideration for selection of an appropriate delegate include the following:
education, training, and experience; knowledge and skill to perform the task; level
of critical thinking required to complete the task; ability to communicate with
others as it pertains to the task; demonstrated competence; the delegatee’s culture;
agency policies and procedures and licensing legislation (state nurse practice acts)
➢ Case Management – (1)
▪ Cardiovascular Disorders: Tetralogy of Fallot (RM NCC RN 10.0 Chp 20)
• Tetralogy of Fallot – four defects that result in mixed blood flow: Pulmonary
stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
◆ Cyanosis at birth: progressive cyanosis over the first year of life. Systolic
murmur. Episodes of acute cyanosis and hypoxia (blue or “Tet” spells)
• Surgical procedures – shunt placement until able to undergo primary repair;
complete repair within the first year of life
➢ Collaboration with Interdisciplinary Team – (1)
▪ Communicable Diseases, Disasters, and Bioterrorism: CDC Reportable Diagnoses
(TB). Typhoid fever. Vancomycin-intermediate and vancomycin-resistant.
Staphylococcus aureus (VISA/VRSA)
➢ Continuity of Care – (1)
▪ Information Technology: Change-of-Shift Report (RM FUND 9.0 Chp 5)
• Nurses give this report at the conclusion of each shift to the nurse assuming
responsibility for the clients.
◆ Formats include face to face, audiotaping, or presentation during walking
rounds in each client’s room (unless the client has a roommate or visitors are
present)
◆ An effective report should: include significant objective information about the
client’s health problems; proceed in a logical sequence; include no gossip or
personal opinion; relate recent changes in medications, treatments,
procedures, and the discharge plan
➢ Establishing Priorities – (1)
▪ Managing Client Care: Determining Priority Care for a Group of Clients (RM
Leadership 7.0 Chp 1)
• Prioritize systemic before local (“life before limb”)
◆ Prioritizing interventions for a client in shock over interventions for a client
who has a localized limb injury
• Prioritize acute (less opportunity for physical adaptation) before chronic (greater
opportunity for physical adaptation)
◆ Prioritizing the care of a client who has a new injury/illness (e.g. mental
confusion, chest pain) or an acute exacerbation of a previous illness over the
care of a client who has a long-term chronic illness
• Prioritize actual problems before potential future problems
◆ Prioritizing administration of medication to a client experiencing of
medication to a client experiencing acute pain over ambulation of a client at
risk for thrombophlebitis
• Listen carefully to clients and don’t assume
◆ Asking a client who has a new diagnosis of diabetes mellitus what he feels is
most important to learn about disease management
• Recognize and respond to trends vs. transient findings
◆ Recognizing a gradual deterioration in a client’s level of consciousness and/or
Glasgow Coma Scale score
• Recognize indications of medical emergencies and complications vs. expected
findings
◆ Recognizing indications of increasing intracranial pressure in a client who has
a new diagnosis of a stroke vs. the findings expected following a stroke
• Apply clinical knowledge to procedural standards to determine the priority action
◆ Recognizing that the timing of administration of antidiabetic and
antimicrobial medications is more important than administration of some
other medications
➢ Ethical Practice – (1)
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