ATI COMPREHENSIVE ON LEADERSHIP

ATI COMPREHENSIVE ON LEADERSHIP 1)The home health nurse is visiting the home of a client that has been diagnosed with a brain tumor. The family states that the client has been having more frequent seizures. What nursing care should be provided? (Found in Adult Med Surg Review Module) • Maintain airway (monitor oxygen levels, administer oxygen as needed, monitor lung sounds). • Monitor neurological status — in particular, assessing for changes in level of consciousness, neurological deficits, and occurrence of seizures. • Maintain client safety. (Assist with transfers and ambulation, provide assistive devices as needed.) • Implement seizure precautions. • Administer medications as prescribed. 2)The nurse is collaborating with the health care team to create a plan of care for a client following a stroke. Explain the nurse’s role in continuity of care. The nurse role in continuity care is a coordinator, documentation, communication, consultations, referrals, transfer and discharge planning. 3)An elderly client is being discharged from the hospital to home following a long hospitalization. What are some community resources that the nurse should initiate referrals for this client? • Specialized equipment (cane, walker, wheelchair, grab bars in bathroom) • Specialized therapists (physical, occupational, speech) • Care providers (home health nurse, hospice nurse, home health aide 4) What behaviors would indicate to the charge nurse that one of the nurses could be experiencing countertransference? (Found in the Mental Health Review Module) • Nurse overly identifies with client • Nurse competes with client • Nurse argues with client 5)List the six (6) Quality and Safety Education for Nurses (QSEN) competencies and explain their importance. 1. PATIENT-CENTERED CARE: The provision of caring and compassionate, culturally sensitive care that addresses clients’ physiological, psychological, sociological, spiritual, and cultural needs, preferences, and values. 2. TEAMWORK AND COLLABORATION: The delivery of client care in partnership with multidisciplinary members of the health care team to achieve continuity of care and positive client outcomes. 3. EVIDENCE-BASED PRACTICE: The use of current knowledge from research and other credible sources on which to base clinical judgment and client care. 4. QUALITY IMPROVEMENT: Care-related and organizational processes that involve the development and implementation of a plan to improve health care services and better meet clients’ needs. 5. SAFETY: The minimization of risk factors that could cause injury or harm while promoting quality care and maintaining a secure environment for clients, self, and others. 6. INFORMATICS: The use of information technology as a communication and information-gathering tool that supports clinical decision-making and scientifically-based nursing practice 6)A client's wife calls the charge nurse to the room and states she is very angry with the nursing staff because her husband is "not receiving adequate nursing care". What problem solving strategies should the charge nurse use in this situation? • Conflict Management Strategies: Identify the problem – State it in objective terms, minimizing emotional overlay. • Discuss possible solutions – Brainstorming solutions as a group may stimulate new solutions to old problems. Encourage individuals to "think outside the box. "Analyze identified solutions – The potential pros and cons of each possible solution should be discussed in an attempt to narrow down the number of viable solutions. Select a solution – Based on this analysis, select a solution for implementation. Implement the selected solution – A procedure and timeline for implementation should accompany the implementation of the selected solution. Evaluate the solution's ability to resolve the original problem – The outcomes surrounding the new solution should be evaluated according to the predetermined timeline. The solution should be given adequate time to become established as a new routine before it is evaluated. If the solution is deemed unsuccessful, the problem-solving process will need to be reinstituted and the problem discussed again. 7)Upon admission to a healthcare facility, what are the nurse’s responsibilities regarding a living will? • Providing written information regarding advance directives • Documenting the client’s advance directives status • Ensuring that advance directives are current and reflective of the client’s current decisions • Recognizing that the client’s choice takes priority when there is a conflict between the client and family, or between the client and the provider • Informing all members of the health care team of the client’s advance directive 8)The charge nurse takes a telephone order for morphine 50 mg IVP every 3 hours. After hanging up the phone, the nurse feels this order is not safe. List three (3) strategies to prevent errors of miscommunication when receiving telephone orders. Use strategies to prevent errors when taking a medical prescription that is given verbally or over the phone by the provider. • Repeat back the prescription given, making sure to include the medication name (spell if necessary), dosage, time, and route. • Question any prescription that seems contraindicated due to a previous or concurrent prescription or client condition. 9)An ethical dilemma regarding sustaining life is being examined. What would be some appropriate resources for the nurse to use to help review and address ethical dilemmas? • The American Nurses Association Code of Ethics for Nurses • The Uniform Determination of Death Act (UDDA) can be used to assist with end-of-life and organ donor issues. • International Council of Nurses’ Code of Ethics for Nurses • The Code of Ethics for Licensed Practical/Vocational Nurses 10)A nurse is caring for a client with acute cystitis that has been prescribed nitrofurantoin (Macrobid). What client education should be provided to the client regarding this medication? (Review the Pharmacology Review Module) • Inform clients that nitrofurantoin turns urine rust-yellow to brown and can stain teeth. • Encourage clients to take it with food if adverse GI effects occur. • Instruct clients to complete the entire course of therapy, even if manifestations resolve sooner. • Recommend that clients avoid crushing, chewing, or opening capsules because of the possibility of tooth staining. • Instruct clients to avoid nitrofurantoin while pregnant (can cause birth defects).