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NCLEX-RN Flashcard Study System: NCLEX Test Practice Questions and Exam Review (2020)

NCLEX-RN Flashcard Study System: NCLEX Test Practice Questions and Exam Review (2020) is designed to boost your confidence, covering exam-relevant content, practice tests, and expert study tips.

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    Management of Care © Mometrix Media - flashcardsecrets.com/nclex NCLEX-RN Discuss the following advanced directives : living will, health care agent/proxy, power of attorney, DNR, and DNI.

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    Management of Care In accordance to Federal and state laws, individuals have the right to self-determination in health care, including decisions about end of life care through advanced directives such as living wills and the right to assign a surrogate person (healthcare proxy) to make decisions through a durable power of attorney (POA) . A durable power of attorney allows the designated person to make all legal decisions for a client, including decisions about health care, even if the client remains competent. A living will provide instructions to medical staff regarding end-of-life care and may include provisions regarding organ donation. An advance directive may include a living will, and DNR, and designation of a healthcare proxy. A healthcare proxy designates a person to make decisions about healthcare and DNR if the client becomes incapable of making the decisions. Clients should routinely be questioned about advanced directives as they may present at a healthcare organization without the document. Clients who have indicated they desire a do-not- resuscitate (DNR) order should not receive resuscitative treatments for terminal illness or conditions in which meaningful recovery cannot occur. More specifically, a do-not-intubate (DNI) order may also be requested by clients who, in the case of respiratory failure, do not want to be intubated.

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    Management of Care © Mometrix Media - flashcardsecrets.com/nclex NCLEX-RN Define advance directive , and discuss the nurses’ responsibilities when it comes to advance directives.

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    Management of Care An advance directive is a legal list of the wishes a patient may have regarding the level and type of health care they want provided in a specific situation. Typical advance directives include code status, (limited treatment measures and Do-Not-Resuscitate [DNR] orders), most often stating the client’s wishes regarding end-of-life issues, including feeding decisions and life support. In order to be legally binding, the document is witnessed, and clearly states the wishes of the client regarding health care–related situations. The directive must be drawn up when the patient is of sound mind and mentally and emotionally capable of making these types of decisions. It is encouraged for every patient to have some sort of advance directive, regardless of age or health. On admission to an acute care facility, every patient should be asked and offered the opportunity to execute advance directives, and a copy placed on the patient’s record. The nurse has some responsibilities when it comes to helping patients with advance directives. First, the nurse helps the patient obtain copies of advance directives, ensuring the forms are filled out correctly. The nurse educates the patient and their family about keeping papers in a safe place and submitting copies to the physician, attorney, and others who may need them. The nurse ensures that copies of all documents are in the chart, and that they are copied and sent if the patient is transferred.

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    Management of Care © Mometrix Media - flashcardsecrets.com/nclex NCLEX-RN Discuss the following resources that can be utilized for client advocacy : social worker, chain of command, interpreter.

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    Management of Care The following can be utilized for client advocacy : · Social worker : Can assess the needs of the client and determine if the client is eligible for assistance, such as through Medicaid or SSI, food stamps, or other government or community programs. Social workers also respond to complaints of abuse and carry out observations and investigations. · Chain of command : Leadership comprises the governing body, chief executive officer, nurse executive, and senior managers, department leaders, leaders (both elected and appointed) of staff or departments, and other nurse leaders as well as team members and support staff. The chain of command provides a system by which a client or nurse can appeal for assistance or advice. · Interpreter : Ensures that the client/family are accurately informed and able to communicate needs and wants.

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    Management of Care © Mometrix Media - flashcardsecrets.com/nclex NCLEX-RN Discuss the principle of advocacy as it relates to nursing.

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    Management of Care Advocacy is an ethical concept that means the act or incidence of beseeching for, supporting, urging public argument, recommending publicity, and espousing actively things that promote the health and well-being of individuals and communities. In simpler terms, advocacy is speaking for those who cannot speak for themselves. Nurses are responsible for recognizing situations that might compromise patients’ rights, and advocating for their patients. Nurse advocates accept responsibility to safeguard patient rights, and ensure quality of care for the patients they care for. The role of nurse advocate involves informing the patient of their own rights, providing information needed to make informed decisions, and supporting patient decisions and autonomy.

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    Management of Care © Mometrix Media - flashcardsecrets.com/nclex NCLEX-RN Outline the tasks that can be delegated to the following members of the healthcare team: LPN/VN, assistive personnel (client care technicians), other RNs.

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    Management of Care The delegating nurse must be aware of the state laws and regulations regarding delegation and must understand the responsibility and the risks and benefits of delegation. Generally, an RN cannot delegate tasks to LPNs/LVNs that require the person to teach, assess, plan, or evaluate because these tasks are in the scope of practice of the RN. Members of the healthcare team to whom tasks can be delegated include: · Other RNs : May carry out any responsibility in the nursing process to which they have adequate knowledge and training. May delegate duties to LPNs/LVNs or UAPs. · LPNs/LVNs : May carry out specific tasks and procedures, report observations, gather data (vital signs, wound condition), implement interventions outlined in the care plan (in accordance with scope of practice). State laws vary, so some may be able to give medications, administer IV, and delegate to UAPs but others may not. · Assistive personnel (PCTs, CNAs) : May carry out routine care, such as bathing, linen changes, toileting, and vital signs (for stable clients). May not give medications or carry out invasive procedures. State laws may vary in relation to allowed practice.

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    Management of Care © Mometrix Media - flashcardsecrets.com/nclex NCLEX-RN Discuss the differences between managed care and case management.

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    Management of Care Managed care is a broad term referring to an organized delivery of care or services. It involves a select panel of care providers who give out their services based on a prepayment arrangement between the provider and the managed care organization. For instance, a hospital may be the managed care organization, and the physicians who are part of the hospital staff are prepaid for the services they render to patients who seek care from that institution. HMOs and PPOs are examples of those types of managed care services. Case management is an individual patient care delivery system specific to the patient, their diagnosis, and their individual needs. The main difference is that managed care is the function of the health care reimbursement system, while case management is the structure used to provide individual patient care to affect expected treatments and outcomes.

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