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ATI / Fundamentals of Nursing STUDY GUIDE LATEST EDITION
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07/24/15 April 3, 2019 1:26 PM rm_rn_2019_fund_FRONT-MATTERFUNDAMENTALS FOR NURSING IFundamentals forNursing
REVIEW MODULE EDITION 10.0 07/24/15 April 3, 2019 12:30 PM rm_rn_2019_fund_TOC
FUNDAMENTALS FOR NURSING TABLE OF CONTENTS VTable of Contents
NCLEX® Connections 1
UNIT 1 Safe, Effective Care Environment 3
SECTION: Management of Care 3
CHAPTER 1 Health Care Delivery Systems 3
CHAPTER 2 The Interprofessional Team 7
CHAPTER 3 Ethical Responsibilities 11
CHAPTER 4 Legal Responsibilities 15
CHAPTER 5 Information Technology 21
CHAPTER 6 Delegation and Supervision 27
CHAPTER 7 Nursing Process 31
CHAPTER 8 Critical Thinking and Clinical Judgment 37
CHAPTER 9 Admissions, Transfers, and Discharge 41
NCLEX® Connections 47
SECTION: Safety and Infection Control 49
CHAPTER 10 Medical and Surgical Asepsis 49
CHAPTER 11 Infection Control 53
CHAPTER 12 Client Safety 59
CHAPTER 13 Home Safety 65
CHAPTER 14 Ergonomic Principles 73
CHAPTER 15 Security and Disaster Plans 77 07/24/15 April 3, 2019 12:30 PM rm_rn_2019_fund_TOC 07/24/15 April 3, 2019 12:30 PM rm_rn_2019_fund_TOC
VI TABLE OF CONTENTS CONTENT MASTERY SERIESNCLEX® Connections 83
UNIT 2 Health Promotion 85
SECTION: Nursing Throughout the Lifespan 85
CHAPTER 16 Health Promotion and Disease Prevention 85
CHAPTER 17 Client Education 89
Chapter 18 Infants (2/uni00A0Days/uni00A0to/uni00A01/uni00A0Year) 93
CHAPTER 19 Toddlers (1/uni00A0to/uni00A03/uni00A0Years) 99
CHAPTER 20 Preschoolers (3/uni00A0to/uni00A06/uni00A0Years) 103
CHAPTER 21 School-Age Children (6 to 12 Years) 107
CHAPTER 22 Adolescents (12/uni00A0to/uni00A020/uni00A0Years) 111
CHAPTER 23 Young Adults (20/uni00A0to/uni00A035/uni00A0Years) 115
CHAPTER 24 Middle Adults (35 to 65 Years) 119
CHAPTER 25 Older Adults (65/uni00A0Years/uni00A0and/uni00A0Older) 123
NCLEX® Connections 127
SECTION: Health Assessment/Data Collection 129
CHAPTER 26 Data Collection and General Survey 129
CHAPTER 27 Vital Signs 135
CHAPTER 28 Head and Neck 145
CHAPTER 29 Thorax, Heart, and Abdomen 153
CHAPTER 30 Integumentary and Peripheral Vascular Systems 163
CHAPTER 31 Musculoskeletal and Neurologic Systems 169 07/24/15 April 3, 2019 12:30 PM rm_rn_2019_fund_TOC
FUNDAMENTALS FOR NURSING TABLE OF CONTENTS VIINCLEX® Connections 175
UNIT 3 Psychosocial Integrity 177
CHAPTER 32 Therapeutic Communication 177
CHAPTER 33 Coping 183
CHAPTER 34 Self-Concept and Sexuality 189
CHAPTER 35 Cultural and/uni00A0Spiritual Nursing Care 193
CHAPTER 36 Grief, Loss, and Palliative Care 203
NCLEX® Connections 209
UNIT 4 Physiological Integrity 211
SECTION: Basic Care and Comfort 211
CHAPTER 37 Hygiene 211
CHAPTER 38 Rest and Sleep 217
CHAPTER 39 Nutrition and Oral Hydration 221
CHAPTER 40 Mobility and Immobility 227
CHAPTER 41 Pain Management 235
CHAPTER 42 Complementary and Alternative Therapies 241
CHAPTER 43 Bowel Elimination 245
CHAPTER 44 Urinary Elimination 251
CHAPTER 45 Sensory Perception 259 07/24/15 April 3, 2019 12:30 PM rm_rn_2019_fund_TOC 07/24/15 April 3, 2019 12:30 PM rm_rn_2019_fund_TOC
VIII TABLE OF CONTENTS CONTENT MASTERY SERIESNCLEX® Connections 267
SECTION: Pharmacological and Parenteral Therapies 269
CHAPTER 46 Pharmacokinetics and Routes of Administration 269
CHAPTER 47 Safe Medication Administration and Error Reduction 277
CHAPTER 48 Dosage Calculation 285
CHAPTER 49 Intravenous Therapy 299
CHAPTER 50 Adverse Effects, Interactions, and Contraindications 307
CHAPTER 51 Individual Considerations of Medication Administration 313
NCLEX® Connections 317
SECTION: Reduction of Risk Potential 319
CHAPTER 52 Specimen Collection for Glucose Monitoring 319
CHAPTER 53 Airway Management 323
Pulse oximetry and oxygen therapy 323
Specimen collection and airway clearance 327
Artificial airways and tracheostomy care 329
CHAPTER 54 Nasogastric Intubation and Enteral Feedings 333
NCLEX® Connections 339
SECTION: Physiological Adaptation 341
CHAPTER 55 Pressure Injury, Wounds, and Wound Management 341
CHAPTER 56 Bacterial, Viral, Fungal, and Parasitic Infections 349
CHAPTER 57 Fluid Imbalances 355 07/24/15 April 3, 2019 12:30 PM rm_rn_2019_fund_TOC
FUNDAMENTALS FOR NURSING TABLE OF CONTENTS IXCHAPTER 58 Electrolyte Imbalances 359
Sodium imbalances 359
Potassium imbalances 360
Calcium imbalances 362
Magnesium imbalances 363
References 367
Active Learning Templates A1
Basic Concept A1
Diagnostic Procedure A3
Growth and Development A5
Medication A7
Nursing Skill A9
System Disorder A11
Therapeutic Procedure A13
Concept Analysis A15 07/24/15 April 3, 2019 1:29 PM rm_rn_2019_fund_unit1sec1
FUNDAMENTALS FOR NURSING NCLEX® CONNECTIONS 1NCLEX® Connections
When reviewing the following chapters, keep in mind the relevant topics and tasks of the NCLEX outline, in partic ular:
Management of Care
CONCEPTS OF MANAGEMENT: Identify roles/
responsibilities of health care team members.
ASSIGNMENT, DELEGATION AND SUPERVISION: Identify tasks for assignment or delegation based on client needs.
CONTINUITY OF CARE
Perform procedures necessary to safely admit, transfer, or discharge a client.
Provide and receive off of care (report) on assigned clients.
ESTABLISHING PRIORITIES: Prioritize the delivery of client care.
ETHICAL PRACTICE
Recognize ethical dilemmas and take appropriate action.
Practice in a manner consistent with a code of ethics for nurses.
INFORMATION TECHNOLOGY: Utilize valid resources to enhance the care provided to a client.
LEGAL RIGHTS AND RESPONSIBILITIES:
Identify legal issues affecting the client.
REFERRALS: Assess the need for referrals and obtain necessary orders.
ADVANCE DIRECTIVES/SELF-DETERMINATION/LIFE PLANNING:
Assess client and/or staff member knowledge of advance directives.
INFORMED CONSENT: Participate in obtaining informed consent.
CONFIDENTIALITY/INFORMATION SECURITY: Assess staff member and client understanding of confidentiality requirements.
Safety and Infection Control
REPORTING OF INCIDENT/EVENT/IRREGULAR OCCURENCE/
VARIENCE: Identify need/situation where reporting of incident/
event/irregular occurence/cariance is appropriate. 07/24/15 April 3, 2019 1:29 PM rm_rn_2019_fund_unit1sec1
2 NCLEX® CONNECTIONS CONTENT MASTERY SERIESHealth Promotion and Maintenance
HEALTH PROMOTION/DISEASE PREVENTION: Assist the client in maintaining an optimum level of health.
TECHNIQUES OF PHYSICAL ASSESSMENT: Apply knowledge of nursing procedures and psychomotor skills to techniques of physical assessment. FUNDAMENTALS FOR NURSING CHAPTER 1 HEALTH C ARE DELIVE RY SYSTEMS 3UNIT 1 SAFE, EFFECTIVE CARE ENVIRONMENT
SECTION: MANAGEMENT OF CARE
CHAPTER 1 Health Care Delivery Systems
Health care delivery systems incorporate interactions between health care providers and clients within the constraints of financing mechanisms and regulatory agencies.
Health care systems include the clients who participate, the settings in which health care takes place, the agencies that regulate health care, and the mechanisms that provide financial/uni00A0support.
Most nurses deliver care within the context of health care systems. As these systems continue to become more business-driven and less service-oriented, the challenge to nursing today is to retain its caring values while practicing within a cost-containment structure.
COMPONENTS OF HEALTH CARE SYSTEMS
PARTICIPANTS
Consumers (clients)
Licensed providers
/uni25CFRegistered nurses
/uni25CFLicensed practical nurses (also known as licensed vocational nurses)
/uni25CFAdvanced practice nurses (APN)
/uni25CFMedical doctors
/uni25CFPharmacists
/uni25CFDentists
/uni25CFDietitians
/uni25CFPhysical, respiratory, and occupational therapists
Unlicensed providers (assistive personnel)
SETTINGS /uni25CFHospitals /uni25CFHomes /uni25CFSkilled -nursing, assisted -living, and extended -carefacilities /uni25CFCommunity/health departments /uni25CFAdult day care centers /uni25CFSchools /uni25CFHospices /uni25CFProviders’ offices /uni25CFAmbulatory care clinics /uni25CFOccupational health clinics /uni25CFStand -alone surgical centers /uni25CFUrgent care centers /uni25CFComplementary therapy centers /uni25CFUrgent and emergent care centers /uni25CFPublic health agencies /uni25CFCrisis centers /uni25CFDiagnostic centers /uni25CFSpecialized services (dialysis, oncology, rehabilitation, burn) centers
REGULATO RY AGENCIES /uni25CFU.S. Department of Health and Human Services /uni25CFU.S. Food and Drug Administration (FDA) /uni25CFState and local public health agencies /uni25CFState licensing boards to ensure that health care providers and agencies comply with state regulations /uni25CFThe Joint Commission to set quality standards for accreditation of health care facilities /uni25CFProfessional Standards Review Organizations to monitor health care services provided /uni25CFUtilization review committees to monitor for appropriate diagnosis and treatment of hospitalized clients
HEALTH CARE FINANCING M ECHANISMS
PUBLIC FEDERALLY FUNDED PROGRAMS
Medicare is for clients 65 years of age or older and those who have permanent disabilities. /uni25CFPart A: Insurance for hospital stays, home health, and hospice (available to those 65 years of age or older and those who have permanent disabilities) /uni25CFPart B: Insurance for outpatient and provider services (available to those 65 years or older and those who have permanent disabilities, but is voluntary and requires a monthly premium) /uni25CFPart C: A Medicare advantage or supplement plan (covering parts A and B, and sometimes D) /uni25CFPart D: Medication coverage for those eligible and requires a monthly premium Medicaid is for clients who have low incomes. /uni25CFIt is federally and state funded. /uni25CFIndividual states determine eligibility requirements.
The Patient Protection and Affordable Care Act of 2010 is a federal statute aimed at: /uni25CFIncreasing access to health care for all individuals and instituting an individual mandate for health insurance. /uni25CFDecreasing health care costs. /uni25CFProviding opportunities for uninsured people to become insured at an affordable cost.
State Children’s Health Insurance Program: Coverage for uninsured children up to age 19 at low cost to parentsCHAPTER /one.lin 4 CHAPTER 1 HEALTH C ARE DELIVE RY SYSTEMS CONTENT MASTERY SERIESPRIVATE PLANS /uni25CFTraditional insurance reimburses for services on a fee-for-service basis. /uni25CFManaged care organizations (MCOs): Primary care providers oversee comprehensive care for enrolled clients and focus on prevention and health promotion. /uni25CFPreferred provider organizations (PPOs): Clients choose from a list of contracted providers and hospitals. Using non -contracted providers increases the out-of-pocket costs. /uni25CFExclusive provider organizations (EPOs): Clients choose from a list of providers and hospitals within a contracted organization with no out-of-network coverage. /uni25CFLong-term care insurance: A supplement for long-term care expenses Medicare does not cover
LEVELS OF HEALTH CARE
Preventive health care focuses on educating and equipping clients to reduce and control risk factors for disease. Examples include programs that promote immunization, stress management, occupational health, and seat belt use.
Primary health care emphasizes health promotion and includes prenatal and well-baby care, family planning, nutrition counseling, and disease control. This level of care is a sustained partnership between clients and providers. Examples include office or clinic visits, community health centers, and scheduled school- or work-centered screenings (vision, hearing, obesity).
Secondary health care includes the diagnosis and treatment of acute illness and injury. Examples include care in hospital settings (inpatient and emergency departments), diagnostic centers, and urgent and emergent care centers.
Tertiary health care , or acute care, involves the provision of specialized and highly technical care. Examples include intensive care, oncology centers, and burn centers.
Restorative health care involves intermediate follow -up care for restoring health and promoting self- care. Examples include home health care, rehabilitation centers, and skilled nursing facilities.
Continuing health care addresses long -term or chronic health care needs over a period of time. Examples include end-of-life care, palliative care, hospice, adult day care, assisted living, and in- home respite care.RELATIONSHIP BETWEEN HEALTH CARE SYSTEMS AND LEVELS OF CARE
People: The level of care depends on the needs of the client. Licensed and unlicensed health care personnel work in every level of care.
Setting: The settings for secondary and tertiary care are usually within a hospital or specific facility. Settings for other levels of care vary.
Regulatory agencies help ensure the quality and quantity of health care and the protection of health care consumers.
Health care finance influences the quality and type of care by setting parameters for cost containment and reimbursement. SAFETY AND QUALITY
In response to concerns about the safety and quality of client care in the United States, Quality and Safety Education for Nurses (QSEN) assists nursing programs in preparing nurses to provide safe, high-quality care. To draw attention to the six QSEN competencies, these icons appear throughout the review modules.
Safety: The minimization of risk factors that could cause injury or harm while promoting high-quality care and maintaining a secure environment for clients, self, and others
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. The client is included in the decision- making process.
Evidence Based Practice: The use of current knowledge from research and other credible sources on which to base clinical judgment and client care
Informatics: The use of information technology as a communication and information- gathering tool that supports clinical decision -making and scientifically-based nursing practice
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
Teamwork and Collaboration: The delivery of client care in partnership with interprofessional members of the health care team to achieve continuity of care and positive client outcomes
THE FUTURE OF HEALTH CARE
The ultimate issue in designing and delivering health care is ensuring the health and welfare of the population.
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