ATI Leadership Proctored Study Guide
Chapter One: Managing Client Care
Prioritization of Patient Care ABCDE
Principle
- A: Airway – Ensure patient’s airway is patent. At the same time secure the cervical
spine if head or neck injury is suspected. No injury: head-neck, chin lift to secure
airway. Injury: Use modified jaw-thrust maneuver
- B: Breathing – Assess respiratory status. The rate, depth, etc.
- C: Circulation – Assess HR, BP, cap refill, adequate circulation throughout the body
- D: Disability: Assess LOC
- E: Exposure – Assess body for trauma, or exposure to heat or cold Prioritization:
- Always assess before taking action (Dyspnea: assess patient before taking further
action, insulin: assess blood sugar before giving)
- Unstable patients before stable patients (patients with findings that are expected for
their medical diagnosis). COPD patient expected to have low SpO2 whereas patient.
Patient with stroke with facial drooping expected, patient with other diagnosis
having facial drooping unexpected, Albuterol side effects: tachycardia, tremors,
restlessness
(EXPECTED)
- Acute over chronic: Patient with abnormal vital signs, low urinary output are acute
situations and need attention before patients with stage 4 pressure injury (not
developed over night)
- Systemic issues over local issues. Systemic: fever, hypotension, tachycardia
(infection or sepsis). Local: bad skin tear, erythema on the foot (need to address but
others are priority)
- ABCDE: Administering pain medication is RARELY an answer.
- Maslow’s Hierarchy of Needs: Physiological, safety, love and belonging, self-esteem,
self-actualization
- Least invasive interventions before more invasive interventions. (move near nursing
station, sitter, distractions before restraints. Patient difficulty urinating – run water
in room before catheter
Efficient Nursing Practice and Delegation
Efficient Nursing Practice
- Take time at the beginning of sift to plan and prioritize day
- Always chart interventions and nursing care as soon after completing the task as
possible. Throughout the day best practice
- Group tasks for a single patient as much as possible. Get as much supplies for all
patients at once if possible.
, RN role:
Blood transfusion
Administer medications
Right Circumstance: Stable patient
-
Quality Improvement: A process to improve quality of care in a unit or team. Also used to
correct performance deficiencies.
Chapter One: Managing Client Care
Prioritization of Patient Care ABCDE
Principle
- A: Airway – Ensure patient’s airway is patent. At the same time secure the cervical
spine if head or neck injury is suspected. No injury: head-neck, chin lift to secure
airway. Injury: Use modified jaw-thrust maneuver
- B: Breathing – Assess respiratory status. The rate, depth, etc.
- C: Circulation – Assess HR, BP, cap refill, adequate circulation throughout the body
- D: Disability: Assess LOC
- E: Exposure – Assess body for trauma, or exposure to heat or cold Prioritization:
- Always assess before taking action (Dyspnea: assess patient before taking further
action, insulin: assess blood sugar before giving)
- Unstable patients before stable patients (patients with findings that are expected for
their medical diagnosis). COPD patient expected to have low SpO2 whereas patient.
Patient with stroke with facial drooping expected, patient with other diagnosis
having facial drooping unexpected, Albuterol side effects: tachycardia, tremors,
restlessness
(EXPECTED)
- Acute over chronic: Patient with abnormal vital signs, low urinary output are acute
situations and need attention before patients with stage 4 pressure injury (not
developed over night)
- Systemic issues over local issues. Systemic: fever, hypotension, tachycardia
(infection or sepsis). Local: bad skin tear, erythema on the foot (need to address but
others are priority)
- ABCDE: Administering pain medication is RARELY an answer.
- Maslow’s Hierarchy of Needs: Physiological, safety, love and belonging, self-esteem,
self-actualization
- Least invasive interventions before more invasive interventions. (move near nursing
station, sitter, distractions before restraints. Patient difficulty urinating – run water
in room before catheter
Efficient Nursing Practice and Delegation
Efficient Nursing Practice
- Take time at the beginning of sift to plan and prioritize day
- Always chart interventions and nursing care as soon after completing the task as
possible. Throughout the day best practice
- Group tasks for a single patient as much as possible. Get as much supplies for all
patients at once if possible.
, RN role:
Blood transfusion
Administer medications
Right Circumstance: Stable patient
-
Quality Improvement: A process to improve quality of care in a unit or team. Also used to
correct performance deficiencies.
