Management Of Care - Ethical Practice Study Guide

Management Of Care (2 Items) Ethical Practice (1 Item) Communicating With a Client's Family About a DNR Order Provide written information about advance directives Document the client’s advance directive status Ensure that the advance directives reflect the client’s current decisions Recognizing that the client’s choices takes priority when there is a conflict between te client and family, or between the client and the provider Inform all members of the health care team of the client’s advance directives Continuity of Care (1 Item) Using SBAR When Notifying the Provider Situation: describes the issue or reason for contacting the physician. Background: Describes the patients background information and relates to the situation you described previously Assessment: Describe what you assessed about the patient that relates to the situation. Recommendation: either offer owns recommendation or ask the physician for their recommendation on how to move forward with the patient. Safety and Infection Control (2 Items) Homes Safety (2 Items) Teaching About Items That Can Trigger an Allergic Reaction Before beginning any task or procedure that requires aseptic technique, health care team members must check for latex allergies. If the client or any member of the team has a latex allergy, the team must use latex-free gloves, equipment, and supplies. Most facilities use non-latex (nitrile) gloves. However, it is the health care team’s responsibility to identify latex allergies and use items that are latex-free Allergies to banana or kiwi can indicate the client is at risk for a reaction to latex Allergies to egg or soybean oil is a contraindication to the use of propofol for anesthesia Allergies to shellfish can result in a reaction to provide-iodine Teaching Parents About Firearms in the Home Keep firearms unloaded, locked up, and out of reach Teach to never touch a gun or stay at a friend’s house where a gun is accessible Store bullets in a different location from guns Psychosocial Integrity (1 Item) Stress Management (1 Item) Providing Encouragement for Learning Self-Care Be empathetic in communication, and encourage the client to verbalize feelings Identify the client’s and family strengths and abelites Encourage client’s autonomy with decision-making Discuss the client’s and family’s abilities to deal with the current situation Encourage the client to describe coping skills used effectively in the past Identify available community resources, and refer the client for counseling if needed Basic Care and Comfort (2 Items) Mobility/Immobility (1 Item) Maintaining Skin Integrity Bathe with tepid water and avoid scrubbing Apply dimethicone-based moisture barrier creams or alcohol-free barrier films to the skin of clients who have incontinence Do not use powder or cornstarch to prevent friction or repel moisture Do not massage bony prominences Nutrition and Oral Hydration (1 Item) Caring for a Client Who Is Postoperative Monitor Level of consciousness and ensure clients safety Provide oral and IV rehydration therapy as prescribed Monitor I&O. Encourage fluids as tolerated. Alert the provider to a urine output less than 30 mL/hr Pharmacological and Parenteral (1 Item) Medication Administration (1 Item) Instilling an Ophthalmic Medication Rest your dominant hand on the clients forehead, hold the dropper above the conjunctival sac about 1 to 2 cm, drop the medication into the sac, avoiding placing it directly on the cornea, and have them close the eye gently. Apply gentle pressure with your finger and a clean facial tissue on the nasolacrimal duct for 30 to 60 seconds to prevent systemic absorption of the medication If instilling more than one medication in the same eye, wait at least 5 min between them Reduction of Risk Potential (2 Items) Potential for Complications of Diagnostic Tests/Treatments/Procedures (2 Items) Priority Action for Possible Enteral Feeding Aspiration Withhold the feeding Turn the client to the side Suction the airway Provide oxygen if indicated Monitor vital signs for elevated temperature Monitor for decreased oxygen saturation or increased respiratory rate Auscultate breath sounds for increased congestion Verifying Placement of a Client's NG Tube Check placement. Aspirate gently to collect gastric contents, testing pH (4 or less is expected), and assess odor, color, and consistency After placement verification, secure the NG tube on the nose, avoiding pressure on the nares Confirm placement with an x-ray Injecting air into the tube and then listening over the abdomen is not an acceptable practice If the tube is not in the stomach, advance it 2.5 to 5 cm (1 to 2 in) Physiological Adaptation (1 Item) Fluid and Electrolyte imbalances (1 Item) Manifestations of Hypokalemia Gastrointestinal: hypoactive bowel sounds, nausea, vomiting, constipation, abdominal distention. Paralytic ileus can develop Muscular: Weakness. Deep tendon reflexes can be reduced Respiratory: Shallow breathing ECG: Flattened T wave, prominent U wave, ST depression, prolonged PR interval Describe two (2) priority nursing considerations for a client who appears to be having an allergic reaction to his medication. Treat anaphylaxis with epinephrine, bronchodilators, and antihistamines Provide respiratory support and notify the provider A nurse is providing home safety education to the mother of a toddler. The mother is a law enforcement officer and is required to carry a hand gun. What recommendation should the nurse make regarding firearms in the home? Keep firearms unloaded, locked up, and out of reach Teach to never touch a gun or stay at a friend’s house where a gun is accessible Store bullets in a different location from guns Provide three (3) possible manifestations of hypokalemia. Gastrointestinal: hypoactive bowel sounds, nausea, vomiting, constipation, abdominal distention. Paralytic ileus can develop Muscular: Weakness. Deep tendon reflexes can be reduced Respiratory: Shallow breathing ECG: Flattened T wave, prominent U wave, ST depression, prolonged PR interval