Capstone B
Management of Care (15 items)
1. Home safety: Planning care for a client who has vision loss (Fundies Chp 13)
a Remove throw rugs loose carpets
b Electrical cord/ extension against the wall behind the furniture
c Monitor gait
d Steps/ sidewalks are in good repair
e. Grab bar near toilet/tub stool riser
f. Non skid mat in tub shower
g. Shower chair and Bedside commode
h. Proper lightning
2. Cystic Fibrosis: Priority Assessment for a Group of Children (Nursing Care of Children
Chp 19)
a. Assess lung sounds and respiratory status
12 yr old child has difficulty swallowing secretion
3. Infection Control: Infectious Diseases to Report (Fundies Chp 11)
a. Report any communicable diseases (TB STI communicable disease)
4. Legal Responsibilities: Documenting Admission Data (Fundies Chp 4)
a. Fall risk data advance directives (living will POA)
5. Disorders of the Eye: Evaluating a Client's Understanding of Cataract Removal (Med Surg
Chp 12)
a. Provider will remove lens and use replacement lense sand grains in the eye is
normal wear sunglasses increase light in room prevent IOP prevent
infection provide pain relief fall prevention
6. Crisis Management: Crisis Intervention for Intimate Partner Abuse (Mental Health Chp
29)
a. Safety first Precautions of safeguard on the client
7. Delegation and Supervision: Scope of Practice of Registered Nurses (Fundies Chp 6)
a. Provide supervision either directly or indirectly (assigning supervision
toanother licensed nurse)
b. Monitor performance Intervene if necessary (for unsafe clinical practice)
c. Provide feedback
d. Evaluate the client and determine the client’s outcome status
e. Evaluate task performance and identify needs for performance-improvement
activities and additional resources
,8. Facility Protocols: Discovering a Medication Errors (Leadership Chp 5)
a. 1st assess client
b. then call hcp
c. Then do an incident report within 24 hrs (AVOID telling client or place in client’s
chart)
d. Submit to risk manager
9. Managing Client Care: Evaluating an Assistive Personnel Performance (Leadership Chp 1)
a. Assist with breakfast with client who has vision loss
i. AP can do ADL feeding without swallow precaution positioning
routinetask i/o specimen collection vitals (if client is stable)
10. Continuity of Care: Interventions Promoting Independence (Community Health Chp 7)
● home health nurse: nursing home traditional home assisted living
● -work as part of team holistic care nurses pt OT home health aids
socialworkers and dieticians part of the care
● -provide skilled assessment wound care lab draws med education
parenteralnutrition IV fluids & meds central line care urinary catheter
insertion and maintenance coordination of other participants in health
● -evaluate living environment for safety - older adults= increase fall risk
● -ask about food in home help with household activities living alone
supportsystem set up and dispense of medications access to health care
● -encourage clients to be independent and involved
11. Legal and Ethical Issues: Respecting Clients Rights (Mental Health Chp 2)
a. Veracity- honest justice- being fair fidelity- loyal/ faithful beneficence-
doinggood nonmaleficence- no harm
b. A voluntarily admitted client has the right to apply for release at any time
Thisclient is considered competent and so has the right to refuse medication
and treatment
12. Managing Client Care: Planning an Audit of Quality Control (Leadership Chp 1)
a. Structure audits evaluate the influence of elements that exist separate from or
outside of the client-staff interaction
b. Process audits review how care was provided and assume a relationship exists
between nurses and the quality of care provided
c. Outcome audits determine what results if any occurred as a result of
thenursing care provided
d. Retrospective audits occur after the client receives care
e. Concurrent audits occur while the client is receiving care
f. Prospective audits predict how future client care will be affected by current level
of services
NI: nurses use reliable resources understand facility policies provide and document
client care participate in the collection of information/data related to staff’s adherence
, to selected policy or procedure Assist with analysis of the information/data Compare
results with the established benchmark Make a judgment about performance in
regardto the finding Assist with provision of education or training necessary to
improve the performance of staff Act as a role model by practicing in accordance with
the established standard Assist with re-evaluation of staff performance by collection
of information/data at a specified time
13. Cancers Disorders: Planning discharge Teaching for a client who is postoperative
following a modified radical mastectomy (Med Surg Chp 92)
a. Discharge teaching includes incision care and drainage tubes (Drains are
usuallyleft in for 1 to 3 weeks )
b. AVOID placing her arm in a dependent position
c. Encourage early arm and hand exercises (squeezing a rubber ball elbow flexion
and extension and hand-wall climbing) to prevent lymphedema and to regain
fullrange of motion
d. AVOID tight clothing
e. Teach BSE
f. Report numbness pain heaviness or impaired motor function of the
affectedarm to the surgeon
g. Encourage discuss breast reconstruction alternatives with the surgeon
(Reconstruction can begin during the original breast removal procedure or after
some healing has occurred Nipple reconstruction from labia abdomen or
inner thigh)
h. Genetic counseling for BRCA 1 and 2
i. Recommendation of bilateral mastectomy oophorectomy to prevent cancer
occurrence Clients who do not choose this option should have early
frequent thorough screening for breast and ovarian cancer
14. Acute and Infectious Respiratory Illness: Prioritizing Care for a Group of Children
(Nursing Care Children Chp 17)
a. PRIORITY s a child that’s drooling sitting upright with tongue out
stridor(croup can be fatal)
15. Legal and Ethical Issues: Identifying an Ethical Principle(Mental Health Chp 2)
a. Veracity- honest justice- being fair fidelity- loyal/ faithful beneficence-
doinggood nonmaleficence- no harm
16. Care of Special Populations: Recommending Appropriate Referrals (Community Health
Chp 5)
a. social services to eliminate financial difficulties (Know what each role does)
Safety and Infection Control (9 items= missing 2)
1. Nursing Care and Discharge Teaching: Vehicle Safety (Maternity Chp 26)
Management of Care (15 items)
1. Home safety: Planning care for a client who has vision loss (Fundies Chp 13)
a Remove throw rugs loose carpets
b Electrical cord/ extension against the wall behind the furniture
c Monitor gait
d Steps/ sidewalks are in good repair
e. Grab bar near toilet/tub stool riser
f. Non skid mat in tub shower
g. Shower chair and Bedside commode
h. Proper lightning
2. Cystic Fibrosis: Priority Assessment for a Group of Children (Nursing Care of Children
Chp 19)
a. Assess lung sounds and respiratory status
12 yr old child has difficulty swallowing secretion
3. Infection Control: Infectious Diseases to Report (Fundies Chp 11)
a. Report any communicable diseases (TB STI communicable disease)
4. Legal Responsibilities: Documenting Admission Data (Fundies Chp 4)
a. Fall risk data advance directives (living will POA)
5. Disorders of the Eye: Evaluating a Client's Understanding of Cataract Removal (Med Surg
Chp 12)
a. Provider will remove lens and use replacement lense sand grains in the eye is
normal wear sunglasses increase light in room prevent IOP prevent
infection provide pain relief fall prevention
6. Crisis Management: Crisis Intervention for Intimate Partner Abuse (Mental Health Chp
29)
a. Safety first Precautions of safeguard on the client
7. Delegation and Supervision: Scope of Practice of Registered Nurses (Fundies Chp 6)
a. Provide supervision either directly or indirectly (assigning supervision
toanother licensed nurse)
b. Monitor performance Intervene if necessary (for unsafe clinical practice)
c. Provide feedback
d. Evaluate the client and determine the client’s outcome status
e. Evaluate task performance and identify needs for performance-improvement
activities and additional resources
,8. Facility Protocols: Discovering a Medication Errors (Leadership Chp 5)
a. 1st assess client
b. then call hcp
c. Then do an incident report within 24 hrs (AVOID telling client or place in client’s
chart)
d. Submit to risk manager
9. Managing Client Care: Evaluating an Assistive Personnel Performance (Leadership Chp 1)
a. Assist with breakfast with client who has vision loss
i. AP can do ADL feeding without swallow precaution positioning
routinetask i/o specimen collection vitals (if client is stable)
10. Continuity of Care: Interventions Promoting Independence (Community Health Chp 7)
● home health nurse: nursing home traditional home assisted living
● -work as part of team holistic care nurses pt OT home health aids
socialworkers and dieticians part of the care
● -provide skilled assessment wound care lab draws med education
parenteralnutrition IV fluids & meds central line care urinary catheter
insertion and maintenance coordination of other participants in health
● -evaluate living environment for safety - older adults= increase fall risk
● -ask about food in home help with household activities living alone
supportsystem set up and dispense of medications access to health care
● -encourage clients to be independent and involved
11. Legal and Ethical Issues: Respecting Clients Rights (Mental Health Chp 2)
a. Veracity- honest justice- being fair fidelity- loyal/ faithful beneficence-
doinggood nonmaleficence- no harm
b. A voluntarily admitted client has the right to apply for release at any time
Thisclient is considered competent and so has the right to refuse medication
and treatment
12. Managing Client Care: Planning an Audit of Quality Control (Leadership Chp 1)
a. Structure audits evaluate the influence of elements that exist separate from or
outside of the client-staff interaction
b. Process audits review how care was provided and assume a relationship exists
between nurses and the quality of care provided
c. Outcome audits determine what results if any occurred as a result of
thenursing care provided
d. Retrospective audits occur after the client receives care
e. Concurrent audits occur while the client is receiving care
f. Prospective audits predict how future client care will be affected by current level
of services
NI: nurses use reliable resources understand facility policies provide and document
client care participate in the collection of information/data related to staff’s adherence
, to selected policy or procedure Assist with analysis of the information/data Compare
results with the established benchmark Make a judgment about performance in
regardto the finding Assist with provision of education or training necessary to
improve the performance of staff Act as a role model by practicing in accordance with
the established standard Assist with re-evaluation of staff performance by collection
of information/data at a specified time
13. Cancers Disorders: Planning discharge Teaching for a client who is postoperative
following a modified radical mastectomy (Med Surg Chp 92)
a. Discharge teaching includes incision care and drainage tubes (Drains are
usuallyleft in for 1 to 3 weeks )
b. AVOID placing her arm in a dependent position
c. Encourage early arm and hand exercises (squeezing a rubber ball elbow flexion
and extension and hand-wall climbing) to prevent lymphedema and to regain
fullrange of motion
d. AVOID tight clothing
e. Teach BSE
f. Report numbness pain heaviness or impaired motor function of the
affectedarm to the surgeon
g. Encourage discuss breast reconstruction alternatives with the surgeon
(Reconstruction can begin during the original breast removal procedure or after
some healing has occurred Nipple reconstruction from labia abdomen or
inner thigh)
h. Genetic counseling for BRCA 1 and 2
i. Recommendation of bilateral mastectomy oophorectomy to prevent cancer
occurrence Clients who do not choose this option should have early
frequent thorough screening for breast and ovarian cancer
14. Acute and Infectious Respiratory Illness: Prioritizing Care for a Group of Children
(Nursing Care Children Chp 17)
a. PRIORITY s a child that’s drooling sitting upright with tongue out
stridor(croup can be fatal)
15. Legal and Ethical Issues: Identifying an Ethical Principle(Mental Health Chp 2)
a. Veracity- honest justice- being fair fidelity- loyal/ faithful beneficence-
doinggood nonmaleficence- no harm
16. Care of Special Populations: Recommending Appropriate Referrals (Community Health
Chp 5)
a. social services to eliminate financial difficulties (Know what each role does)
Safety and Infection Control (9 items= missing 2)
1. Nursing Care and Discharge Teaching: Vehicle Safety (Maternity Chp 26)
