ATI Fundamentals for Nursing ATI
Medicare - ✅✅ -for clients over age 65 and/or with permanent disabilities.
premiums applied as insurance program reimburses providers based on DRGs.
Premiums applied as Managed Care Organizations (MCOs) provide enrolled clients
with comprehensive care overseen by a primary care provider. Is federally funded.
Medicaid - ✅✅ -for clients with low income. is federally funded and individual states
determine eligibility requirements.
✅✅-reimburses for services on fee-for-service basis.
Traditional Insurance -
Managed Care Organizations (MCOs) - ✅✅-comprehensive care is overseen by a
primary care provider & focuses on prevention and health promotion
Preferred Provider Organizations (PPOs) - ✅✅ -client chooses from a list of
contracted providers. using non-contracted providers increases the client's out of
pocket costs
Exclusive Provider Organizations (EPOs) - ✅✅-the client chooses from a list of
providers within a contracted organization
Long-Term Care Insurance - ✅✅-provides for long-term care expenses not
covered by Medicare
Preventive health care - ✅✅ -focuses on educating and equipping clients to reduce
and control risk factors of disease. Examples include immunizations, stress
management programs, and seat belt use
Primary health care - ✅✅ -emphasizes health promotion, and includes prenatal and
well-baby care, nutrition counseling, and disease control. is based on a sustained
partnership between client and provider. examples include office or clinic visits and
scheduled school/work centered screenings (vision, hearing, obesity)
Secondary health care - ✅✅ -includes the diagnosis and treatment of emergency,
acute illness, or injury. examples include care given in hospital settings (inpatient and
EDs), diagnostic centers, or emergent care centers
Tertiary health care -✅✅ -involves the provision of specialized highly technical
care. examples include oncology centers and burn centers
Restorative health care - ✅✅ -involves intermediate follow-up care for restoring
health. examples include home health care, rehab centers, and skilled nursing
facilities
,Continuing health care - ✅✅
-designed to address long-term or chronic health care
needs. examples include hospice, adult day care, and in-home respite care
Health care regulatory agencies include: - ✅✅ --US Dept of Health and Human
Srvcs
-US FDA
-State and local public health agencies
-State licensing boards (to ensure providers & agencies comply with state
regulations)
-the Joint Commission/JCAHO (set quality standards for accreditation of health care
facilities)
-Professional Standards Review Organizations (PSROs)
-Utilization review committees (monitor for appropriate diagnosis and treatment of
hospitalized clients)
Clergy - ✅✅-Job: provide spiritual care to client (pastors, rabbis, priests)
Refer to when: the client requests communication or the family asks for prayer prior
to client undergoing a procedure
Registered dietitian - ✅✅ -Job: assess, plan for, and educate the client reg.
nutritional needs; direct care of nutritional aids
Refer to when: ex- the client has low nutrient levels and/or experienced a recent
unexplained weight loss
Lab tech - ✅✅-Job: obtain specimens of the client's body fluids and perform the
necessary diagnostic tests
Refer to when: ex- the provider orders a CBC to be performed immediately
Occupational therapist - ✅✅ -Job: assess and plan for the client to regain ADLs,
esp motor skills of the upper extremities; direct care of occupational therapy
assistants
Refer to when: ex- client has difficulties using an eating utensil with dominate hand
following a stroke
Pharmacist - ✅✅ -Job: provide & monitor meds for the client as prescribed by the
provider; supervises pharm techs in states in which the practice is allowed
Refer to when: client concerns over meds; dosage concerns; etc
,Physical Therapist - ✅✅ -Job: assess and plan for client to increase
musculoskeletal functions, esp of lower extremities, to maintain mobility; direct care
of physical therapy assistants
Refer to when: ex- following a hip replacement, a client requires assistance learning
to ambulate and regain strength
Provider - ✅✅ -Job: assess, diagnose, and treat cllient for disease and/or injury;
includes MDs, DOs, APNs, and PAs
Refer to when: ex- client experiences change in vital signs
Rad Tech - ✅✅ -Job: position client and perform x-rays and other imaging
procedures for providers to review for diagnosis of disorders of various body parts
Refer to when: ex- provider orders x-ray of client's hip after a fall
Respiratory therapist - ✅✅ -Job: evaluate resp status and provide prescribed resp
treatments including O2 therapy, chest physiotherapy, inhalation therapy, and
artificial mechanical ventilation
Refer to when: ex- client with resp disease experiences SOB and requests nebulizer
treatment that is ordered PRN
Social Worker - ✅✅ -Job: work with client and client's family by coordinating
inpatient and community resources to meet psychosocial and environmental needs
that are necessary for recovery and/or discharge
Refer to when: ex- client dying of cancer wishes to go home but is unable to perform
ADLs; the spouse needs med equipment in the home to care for client
Speech therapist - ✅✅ -Job: evaluate and make recommendations regarding the
functions of speech, language, and swallowing impacted by various client disorders
or injuries; teach client techniques and exercises to improve function when possible
Refer to when: ex- a client is having difficulty swallowing a regular diet after trauma
to the head and neck
Registered Nurse (RN) - ✅✅ --Functions under state nurse practice laws
-Perform assessments; establish nursing diagnoses, goals, and interventions;
conducts ongoing client evaluations
-Participate in developing interdisciplinary plans for client care
-Share best practices; continuing education
, Licensed Practical Nurse (LPN) - ✅✅ --Works under supervision of the RN
-Collaborate with other team members
-Possess technical knowledge and skills
-Participate in the delivery of nursing care, using the nursing process as a framework
Unlicensed Assistive Personnel (UAP) - ✅✅ --Includes CNAs, CMAs, and
non-nursing personnel
-Work under direct supervision of an RN or LPN
-Specific tasks usually outlined in position description
-Tasks may including feeding clients, preparing meals, lifting, basic care, measuring
& recording vital signs, and ambulating clients
The foundation of ethics is based on: - ✅✅ -an expected behavior of a certain
group in relation to what is considered right and wrong; it is the study of conduct and
character
Morals are: - ✅✅-the values and beliefs held by people that guide their behaviors
and decision making
Ethical theory examines: - ✅✅
-the different principles, ideas, systems, and
philosophies used to make judgments about what is right/wrong and good/bad
Ethical principles - ✅✅-standards of what is right/wrong with regard to important
social values and norms
Autonomy - ✅✅-ability of client to make personal decisions, even when those
decisions may not be in the client's best interest
Beneficence - ✅✅ -agreement that the care given is in the best interest of the
client; taking positive actions to help others
Fidelity - ✅✅-agreement to keep one's promise to the client about care that was
offered
Justice - ✅✅
-fair treatment in matters related to physical and psychosocial care
and use of resources
Nonmaleficence - ✅✅-avoidance of harm or pain as much as possible when giving
treatments
Hospital's ethics committee - ✅✅-may meet to discuss/resolve unusual or complex
ethical issues; not a legal entity