Exam (elaborations)
TOPICS TO REVIEW
- Course
- VOCN
- Institution
- American Career College
These are notes that I used to study for the exam. I passed on the first try scoring in the 80's Pediatric exam was my final
[Show more]
Content preview
Topics to Review Diana RevillaCoordinated care
Advanced Directives
- purpose of advance directives is to communicate a client’s wishes regarding end-of-life care
should the client become unable to do so.
- Staff should give clients who do not have advance directives written information that
outlines their rights related to health care decisions and how to formulate advance
directives
- Types of advance directives
- Living will: 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.
- Durable power of attorney: a document in which clients designate a health care proxy
to make health care decisions for them if they are unable to do so.
- Provider’s orders: Unless a provider writes a “do not resuscitate” (DNR) or “allow
natural death” (AND) prescription in the client’s medical record, the nurse initiates
cardiopulmonary resuscitation (CPR) when the client has no pulse or respirations.
Advocacy
- Advocacy: support and defend clients’ health, wellness, safety, wishes, and personal rights,
including privacy.
Assignment / Delegation
- Managing Client Care: Assigning Care for a Client who has Restraints
- Restraints:
- Remove and check every 2 hours.
- Provider’s order needed every 24 hours.
- Should be able to fit two fingers into wrist restraint.
- Restraints can be applied if the client is a danger to himself or others
- IF an ORDER isn’t received within an hour, remove restraints.
- Physical restraints before chemical restraint.
- Hand mitten is the least restrictive restraint.
- Second least restrictive is wrist, then belt, then vest.
- Required to remove restraints every two hours.
- One at a time for 15 minutes.
- Do a NeuroVascular check every hour for adults, 30 minutes for kids,
capillary refill, sensation, color, pulse, temperature, and pain.
Collaboration with Interdisciplinary Team
Information to include in an Interprofessional Meeting
, - The interprofessional healthcare team works collaboratively to provide holistic
care to clients. Holistic: characterized by the treatment of the whole person, taking
into account mental and social factors, rather than just the symptoms of an illness.
- Share appropriate information among team members
- Initiate referrals for client assistance
- Including health education
- And identify community resources
- The nurse is most often the care manager and must understand the roles and
responsibilities of other healthcare team members to collaborate and make appropriate
referrals.
- Occupational therapist: Assesses and plans for clients to regain activities of daily living
(ADL) skills, especially motor skills of the upper extremities.
- Example of when to refer: A client has difficulties using an eating utensil with their
dominant hand following a stroke.
- Physical therapist: Assesses and plans for clients to increase musculoskeletal function,
especially of the lower extremities, to maintain mobility.
- Example of when to refer: Following hip arthroplasty, a client requires assistance learning
to ambulate and regain strength.
Managing Client Care: Intervention When Supervising an Assistive Personnel
• A licensed nurse is responsible for providing clear directions when a task is initially delegated
• Must provide supervision either directly or indirectly
• Monitor performance
• Intervene if unsafe
• Provide feed back
- Basic Mental Health Nursing Concepts: Making Referrals using the Interdisciplinary
Team
- Case management: coordinating holistic care to include medical, mental health,
and social services
- Collaboration with peers and the clinical interdisciplinary team enhances the nurse’s
ability to examine their own thoughts and feelings, maintain boundaries, and continue to
learn from nurse-client relationships.
- Coordinating care, particularly for clients who have complex health care needs
- Facilitating continuity of care
- Improving efficiency of care and utilization of resources QTC
- Enhancing quality of care provided
- Limiting unnecessary costs and lengthy stays
- Advocating for the client and family
Concepts of Management and supervision
, - Bowel Elimination: Reinforcing Teaching about Ostomy Care
- Foods that cause odor: fish, eggs, asparagus, garlic, beans, and dark green leafy
vegetables
- Foods that cause gas: dark green leafy vegetables, beer, carbonated beverages,
dairy products, and corn, chewing gum, skipping meals, and smoking can also
cause gas.
- Yogurt, crackers, and toast can be ingested to decrease gas
Managing Client care: supervising an Assistive Personnel
- AP can do ADL’s, bathing, grooming, dressing, toileting, ambulating, feeding, Blood
sugar checks and changing simple dressings.
- The delegating nurse must…
- provide supervision, either directly or indirectly.
- Provide clear direction and expectations of the tasks to be performed (time frame /
what to report)
- Monitor performance
- Provide feedback
- Intervene if necessary
- Evaluate client to determine if outcomes were met
- Evaluate client care test and idenitify
Continuity of Care
- Information Technology: Change-of-shift-Report
- Formats include face-to-face, audiotaping, or during rounds (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.
- Arthroplasty: Reinforcing Discharge Teaching following a Total Hip Arthroplasty
- Extensive physical therapy is required to regain mobility. If discharged home,
outpatient or in-home therapy is provided.
- Monitor for evidence of incisional infection (fever, increased redness, swelling,
purulent drainage).
- Care for the incision (clean daily with soap and water).
- Monitor for DVT (swelling, redness, pain in calf)
, - Monitor for Pulmonary Embolism (SOB, chest pain), and bleeding (if taking an
anticoagulant).
Keep abductor pillow in place while in bed or while turning
• Do not flex hip more than 90 degrees
• Do not position the client on the operative site
• Use elevated seating and a raised toilet seat
• Use straight chairs with arms
• Externally rotate the toes
• Use extended handles on shoehorn and dressing sticks
• Avoid low chairs
• Do not cross legs for at least 3 months
• Do not internally rotate toes
• Follow exercise program at home
- Medications Affecting Blood Pressure: Addressing A/E of ACE inhibitors “-pril”
- Orthostatic Hypotension - change positions slowly
- Report a cough
- Monitor for hyperkalemia
- Report angioedema (swelling of the tissues under the skin) that affects the lips,
tongue and glottis, and can progress to a life-threatening obstruction).
- Report manifestations of heart failure (edema).
Establishing Priorities
- Managing client care: Prioritizing Care for a group of Clients
- The three-level system of triage consist of these categories:
- emergent (life-threatening),
- urgent (treat within 2 hr), and
- nonurgent (can delay treatment).
- resuscitation (level one), emergent (level two), urgent (level three), less urgent
(level four), and nonurgent (level five).
- Resuscitation triage requires immediate treatment to prevent death. Nonurgent is
a non-life-threatening condition requiring simple evaluation and care
management.
• Prioritize by:
o Systemic before localo Acute before chronic
o Actual problems before potential problems
Ethical Practice
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller revilladianaa. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $15.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
73091 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now