VATI RN COMPREHENSIVE PREDICTOR FOCUSED REVIEW

VATI RN COMPREHENSIVE PREDICT
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OR FOCUSED REVIEW
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❖ ManagementtoftCaret–t(9)
➢ AdvancetDirectivest–t(1)
▪ LegaltResponsibilities:tPurposetoftatLivingtWillt(RMtFUNDt9.0tChpt4)
• Atlivingtwilltistatlegaltdocumenttthattexpressestthetclient’stwishestregardingtmedicaltt
reatmenttinttheteventtthetclienttbecomestincapacitatedtandtistfacingtend-tof-
lifetissues.tMosttstatetlawstincludetprovisionstthattprotectthealthtcaretproviderstwhotf
ollowtatlivingtwilltfromtliability.
➢ Assignment,tDelegationtandtSupervisiont–t(2)
▪ DelegationtandtSupervision:tDelegatingtTasksttotantAssistivetPersonnelt(RMtFUND
9.0tChpt6)
• ExamplestofttaskstnursestmaytdelegatettotApst(providedtthetfacility’stpolicytandtstat
e’stpracticetguidelinestpermit)
◆ Activitiestoftdailytlivingt(ADLs)t–
tbathing,tgrooming,tdressing,ttoileting, tambulating, tfeedingt(withouttswallo

wingtprecautions),tpositioning
◆ Routinettaskst–
tbedtmaking,tspecimen tcollection, tintaketandtoutput,tvitaltsignst(fortstabletcl

ients)
▪ ManagingtClienttCare:tDelegationtStrategytfortEffectivetTasktManagementt(RMtL
eadershipt7.0tChpt1)
• Considerationtfortselectiontoftantappropriatetdelegatetincludetthetfollowing:teducatio
n,ttraining,tandtexperience;tknowledgetandtskillttotperformtthettask;tleveltoftcriticaltth
inkingtrequiredttotcompletetthettask;tabilityttotcommunicatetwithtotherstastittpertainstt
otthettask;tdemonstratedtcompetence;tthetdelegatee’stculture;tagencytpoliciestandtpro
cedurestandtlicensingtlegislationt(statetnursetpracticetacts)
➢ CasetManagementt–t(1)
▪ CardiovasculartDisorders:tTetralogytoftFallott(RMtNCCtRNt10.0tChpt20)
• TetralogytoftFallott–
tfourtdefectstthattresulttintmixedtbloodtflow:tPulmonarytstenosis,tventriculartseptalt

defect,toverridingtaorta,trighttventricularthypertrophy
◆ Cyanosistattbirth:tprogressivetcyanosistovertthetfirsttyeartoftlife.tSystolictmu
rmur.tEpisodestoftacutetcyanosistandthypoxiat(bluetort“Tet”tspells)
• Surgicaltprocedurest–
tshunttplacementtuntiltablettotundergotprimarytrepair;tcompletetrepairtwithintt

hetfirsttyeartoftlife
➢ CollaborationtwithtInterdisciplinarytTeamt–t(1)
▪ CommunicabletDiseases,tDisasters,tandtBioterrorism:tCDCtReportabletDiagnosest(
RMtCHtRNt7.0tChpt6)
• Anthrax.tBotulism.tCholera.tCongenitaltrubellatsyndromet(CRS).tDiphtheria.tGiar
diasis.tGonorrhea.tHepatitistA,tB,tC.tHIVtinfection.tInfluenza-
associatedtpediatrictmortality.tLegionellosis/
Legionnaires’tdisease.tLymetdisease.tMalaria.tMeningococcaltdisease.tMumps.tPe
rtussist(whoopingtcough).tPoliomyelitis,tparalytic.tPoliovirustinfection,tnonparaly
tic.tRabiest(humantortanimal).tRubellat(Germantmeasles).tSalmonellosis.tSeveretac
utetrespiratorytsyndrome-associatedtcoronavirustdiseaset(SARS-

,CoV).tShigellosis.tSmallpox.tSyphilis.tTetanus/
C.ttetani.tToxictshocktsyndromet(TSS)t(othertthantStreptococcal).tTuberculosis

, (TB).tTyphoidtfever.tVancomycin-intermediatetandtvancomycin-
resistant.tStaphylococcustaureust(VISA/VRSA)
➢ ContinuitytoftCaret–t(1)
▪ InformationtTechnology:tChange-of-ShifttReportt(RMtFUNDt9.0tChpt5)
• Nursestgivetthistreporttattthetconclusiontofteachtshiftttotthetnursetassumingtres
ponsibilitytfortthetclients.
◆ Formatstincludetfacettotface,taudiotaping,tortpresentationtduringtwalkingtround
stinteachtclient’stroomt(unlesstthetclientthastatroommatetortvisitorstaretpresent)
◆ Anteffectivetreporttshould:tincludetsignificanttobjectivetinformationtabouttthetcli
ent’sthealthtproblems;tproceedtintatlogicaltsequence;tincludetnotgossiptortpersona
ltopinion;trelatetrecenttchangestintmedications,ttreatments,tprocedures,tandtthetdi
schargetplan
➢ EstablishingtPrioritiest–t(1)
▪ ManagingtClienttCare:tDeterminingtPrioritytCaretfortatGrouptoftClientst(RMtLe
adershipt7.0tChpt1)
• Prioritizetsystemictbeforetlocalt(“lifetbeforetlimb”)
◆ Prioritizingtinterventionstfortatclienttintshocktovertinterventionstfortatclienttwh
othastatlocalizedtlimbtinjury
• Prioritizetacutet(lesstopportunitytfortphysicaltadaptation)tbeforetchronict(greatertop
portunitytfortphysicaltadaptation)
◆ Prioritizingtthetcaretoftatclienttwhothastatnewtinjury/
illnesst(e.g.tmentaltconfusion,tchesttpain)tortantacutetexacerbationtoftatprevious
tillnesstovertthetcaretoftatclient twhothastatlong-termtchronictillness


• Prioritizetactualtproblemstbeforetpotentialtfuturetproblems
◆ Prioritizingtadministrationtoftmedicationttotatclienttexperiencingtoftmedicatio
nttotatclienttexperiencingtacutetpaintovertambulationtoftatclienttattrisktfortthrom
bophlebitis
• Listentcarefullyttotclientstandtdon’ttassume
◆ Askingtatclienttwhothastatnewtdiagnosistoftdiabetestmellitustwhatthetfeelstistmos
ttimportantttotlearntabouttdiseasetmanagement
• Recognizetandtrespondttottrendstvs.ttransienttfindings
◆ Recognizingtatgradualtdeteriorationtintatclient’stleveltoftconsciousnesstand/
ortGlasgowtComatScaletscore
• Recognizetindicationstoftmedicaltemergenciestandtcomplicationstvs.texpectedtfi
ndings
◆ Recognizingtindicationstoftincreasingtintracranialtpressuretintatclienttwhothastatn
ewtdiagnosistoftatstroketvs.tthetfindingstexpectedtfollowingtatstroke
• Applytclinicaltknowledgettotproceduraltstandardsttotdeterminetthetprioritytaction
◆ Recognizingtthattthettimingtoftadministrationtoftantidiabetictandtantimicro
bialtmedicationstistmoretimportanttthantadministrationtoftsometothertmedic
ations
➢ EthicaltPracticet–t(1)