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RN ATI Capstone Leadership and Community Health Focused Review Chapter 3 - Professional Responsibilities: Living Will Requirements ● Unless a do not resuscitate (DNR) or allow natural death (AND) prescription is written, the nurse should initiate CPR when a client has no pulse or respirations. ● Even if their will requests no resuscitation, they need a DNR prescription from the provider ● The client’s decision is respected in regard to the use of antibiotics, initiation of diagnostic tests, and provision of nutrition by artificial means. Chapter 1 - Managing Client Care: Consulting Sources When Planning Staff Education ● Research: Resources available to address learning objectives based on evidence-based practice ● Staff education, or staff development, is the process by which a staff member gains knowledge and skills. ● The goal of staff education is to ensure that staff members have and maintain the most current knowledge and skills necessary to meet the needs of clients. Chapter 1 - Managing Client Care: Preparing to Delegate Client Care Tasks ● TO PN: ○ Monitoring findings (as input to the rn’s ongoing assessment) ○ reinforcing client teaching from a standard care plan ○ Performing tracheostomy care ○ Suctioning ○ Checking ng tube patency ○ administering enteral feedings ○ inserting a urinary catheter ○ administering medication (excluding IV medication in some states) ● TO AP: ○ activities of daily living (ADLs) ○ Bathing, grooming, dressing, toileting, ambulating, feeding (without swallowing precautions), positioning, routine tasks ○ Bed making ○ Specimen collection ○ Intake and output ○ Vital signs (for stable clients) Chapter 1 - Managing Client Care: Implementing Conflict Management Strategies ● Strategy: Avoiding/Withdrawing ○ Both parties know there is a conflict, but they refuse to face it or work toward are solution. ○ Can be appropriate for minor conflicts or when one party holds more power than the other party or if the issue can work itself out over time. ● Strategy: Smoothing ○ One party attempts to “smooth” another party by trying to satisfy the other party. ● Strategy: Competing/Coercing ○ One party pursues a desired solution at the expense of others. ○ Managers can use this when a quick or unpopular decision must be made. ● Strategy: Compromising/Negotiating ○ Each party gives up something ● Strategy: Collaborating ○ Both parties set aside their original individual goals work together to achieve a new common goal. Chapter 5 - Creating and Maintaining a Therapeutic and Safe Environment: Identifying Countertransference ● Nurse overly identifies with client ● Nurse competes with client ● Nurse argues with client Chapter 2 - Coordinating Client Care: Applying the Nursing Process to Case Management ● Coordinating care, particularly for clients who have complex health care needs ● Facilitating continuity of care ● Improving efficiency of care and utilization of resources ● Enhancing quality of care provided ● Limiting unnecessary costs and lengthy stays ● Advocating for the client and family Chapter 3 - Professional Responsibilities: Providers Who Have Telephone Medication Prescriptive Authority ● physicians, ● advanced practice nurses, ● dentists, & ● physician assistants Chapter 3 - Professional Responsibilities: Organ Donation ● Donor needs to use his signature to agree ● Upon admission it is required all clients over 18 yo be questioned about organ donation ● The National Organ Transplant Act prohibits the sale and purchase of organs ● Documentation about giving permission or refusing to donate is placed in the electronic medical record Chapter 4 - Maintaining a Safe Environment: Home Safety Assessment for an Older Adult Client ● Remove items that could cause the client to trip, such as throw rugs and loose carpets. ● Place electrical cords and extension cords against a wall behind furniture. ● Monitor gait and balance, and provide aids as needed. ● Make sure that steps and sidewalks are in good repair. ● Place grab bars near the toilet and in the tub or shower, and install a stool riser. ● Use a nonskid mat in the tub or shower. ● Wear nonskid footwear. ● Place a shower chair in the shower and provide a bedside commode if needed. ● Ensure that lighting is adequate inside and outside the home. Chapter 6 - Communicable Diseases, Disasters, and Bioterrorism: Interventions for Botulism Management ● MANIFESTATIONS ○ Double or blurred vision ○ Slurred speech ○ Difficulty swallowing ○ Progressive muscle weakness ○ Difficulty breathing ● PREVENTION: No approved vaccine ● TREATMENT ○ Airway management with possible mechanical ventilation ○ Administration of antitoxin ● ELIMINATION OF TOXIN: Induction of vomiting, enemas, surgical excision of wound tissue ● SUPPORTIVE CARE: Nutrition, fluids, prevent complications Chapter 4 - Practice Settings and Aggregates: Outcome Measures of Home Care Interventions ● Family members of clients who have tuberculosis should be screened. ● Individuals who have been exposed to TB but have not developed the disease can have latent TB. Chapter 4 - Practice Settings and Aggregates: Client Teaching About Hospice Care ● Hospice care is a comprehensive care delivery system for clients who are terminally ill. Further medical care aimed toward a cure is stopped. The focus becomes relief of pain and suffering, as well as enhancing quality of life. ● The hospice nurse provides care for the client and the client’s entire family. Hospice care includes skilled, direct services and indirect care coordination. ● The provider directs hospice care services which are then managed by the nurse. Chapter 5 - Care of Specific Populations: Teaching About Family Violence ● Assess and counsel anyone contemplating suicide or homicide, and refer the individual to the appropriate services. ● Support and educate the offender, even though a report must be made. ● Assess and help offenders address and deal with the stressors that can be causing or contributing to the abuse, such as mental illness or substance use Chapter 14 - Head Injury: Complications of a Minor Head Injury Reportable to Provider ● Deteriorating level of consciousness, restlessness, irritability ● Dilated or pinpoint nonreactive pupils ● Alteration in breathing pattern (Cheyne-Stokes respirations, central neurogenic hyperventilation,apnea) ● Deterioration in motor function, abnormal posturing (decerebrate, decorticate, flaccidity)

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