ATI remediation RN Leadership 2019
Management of Care
Advocacy
1. Professional Responsibilities: Caring for an Older Adult Client Who Might Be
Abused (RM Leadership 8.0 Chp 3 Professional Responsibilities)
ActiveLearningTemplate: Basic Concept
Reasons for not reporting:
- may be embarrassed or ashamed of abuse
- worry about how their report may affect lives of loved ones
- feel guilty and have come to believe they're cause of abuse
- afraid no one will believe them
- afraid of unknown future if they're removed from care of abuser
- worst nightmare is to end in a nursing home
Assessment for abuse:
- examine client alone
- don't rush during interview
- don't be judgmental or allow personal feelings to interfere
- don't diagnose prematurely
Subjective data:
- ask client to describe a typical day to determine degree if independence
- ask client role and expectations for self and caregiver
- inquire any recent family crisis
- ask if there is any alcohol, drug use, mental illnesses in home
Objective Data:
- assess if patient senses being ignored or is made to feel like burden
- assess degree of dependence of caregiver (financial, physical, and/or emotional support)
- observe and document any new lesions
Assignment, delegation and supervision
2. Managing Client Care: Assigning Client Care to a Licensed Practical Nurse (RM
Leadership 8.0 Chp 1 Managing Client Care) ActiveLearningTemplate: Basic
Concept
, • Monitoring client findings (as input to the RN’s ongoing assessment of the client) ›
• Reinforcement of client teaching from a standard care plan ›
• Tracheostomy care ›
• Suctioning ›
• Checking nasogastric tube patency
• Administration of enteral feedings
• Insertion of a urinary catheter
• Medication administration (excluding intravenous medications in several states)
3. Managing Client Care: Feeding a Client Who Has Dysphagia (RM Leadership 8.0
Chp 1 Managing Client Care) ActiveLearningTemplate: Basic Concept
• place client in an upright or high Fowler's position to facilitate swallowing
• stay with client due to risk for aspiration
• refer to speech therapist for evaluation
• make diet alterations, avoid thin liquids and sticky foods
4. Managing Client Care: Nursing Assessment to Perform Prior to Delegation of Care
(RM Leadership 8.0 Chp 1 Managing Client Care) ActiveLearningTemplate: Basic
Concept
Case Management
5. Coordinating Client Care: Addressing Priority Issues During Case Management
(RM Leadership 8.0 Chp 2 Coordinating Client Care) ActiveLearningTemplate:
Basic Concept
• Open communication: Use “I” statements, and remember to focus on the problem, not on
personal differences. Listen carefully to what the other people are saying. Move a
conflict that is escalating to a private location or postpone the discussion
• Share ground rules with participants. For example, everyone is to be treated with respect,
only one person can speak at a time, and everyone should have a chance to speak.
• Steps of the problem-solving process
• identify the problem
• Discuss possible solutions
• Analyze identified solutions – The potential pros and cons of each possible solution
should be discussed
• Select a solution.
Management of Care
Advocacy
1. Professional Responsibilities: Caring for an Older Adult Client Who Might Be
Abused (RM Leadership 8.0 Chp 3 Professional Responsibilities)
ActiveLearningTemplate: Basic Concept
Reasons for not reporting:
- may be embarrassed or ashamed of abuse
- worry about how their report may affect lives of loved ones
- feel guilty and have come to believe they're cause of abuse
- afraid no one will believe them
- afraid of unknown future if they're removed from care of abuser
- worst nightmare is to end in a nursing home
Assessment for abuse:
- examine client alone
- don't rush during interview
- don't be judgmental or allow personal feelings to interfere
- don't diagnose prematurely
Subjective data:
- ask client to describe a typical day to determine degree if independence
- ask client role and expectations for self and caregiver
- inquire any recent family crisis
- ask if there is any alcohol, drug use, mental illnesses in home
Objective Data:
- assess if patient senses being ignored or is made to feel like burden
- assess degree of dependence of caregiver (financial, physical, and/or emotional support)
- observe and document any new lesions
Assignment, delegation and supervision
2. Managing Client Care: Assigning Client Care to a Licensed Practical Nurse (RM
Leadership 8.0 Chp 1 Managing Client Care) ActiveLearningTemplate: Basic
Concept
, • Monitoring client findings (as input to the RN’s ongoing assessment of the client) ›
• Reinforcement of client teaching from a standard care plan ›
• Tracheostomy care ›
• Suctioning ›
• Checking nasogastric tube patency
• Administration of enteral feedings
• Insertion of a urinary catheter
• Medication administration (excluding intravenous medications in several states)
3. Managing Client Care: Feeding a Client Who Has Dysphagia (RM Leadership 8.0
Chp 1 Managing Client Care) ActiveLearningTemplate: Basic Concept
• place client in an upright or high Fowler's position to facilitate swallowing
• stay with client due to risk for aspiration
• refer to speech therapist for evaluation
• make diet alterations, avoid thin liquids and sticky foods
4. Managing Client Care: Nursing Assessment to Perform Prior to Delegation of Care
(RM Leadership 8.0 Chp 1 Managing Client Care) ActiveLearningTemplate: Basic
Concept
Case Management
5. Coordinating Client Care: Addressing Priority Issues During Case Management
(RM Leadership 8.0 Chp 2 Coordinating Client Care) ActiveLearningTemplate:
Basic Concept
• Open communication: Use “I” statements, and remember to focus on the problem, not on
personal differences. Listen carefully to what the other people are saying. Move a
conflict that is escalating to a private location or postpone the discussion
• Share ground rules with participants. For example, everyone is to be treated with respect,
only one person can speak at a time, and everyone should have a chance to speak.
• Steps of the problem-solving process
• identify the problem
• Discuss possible solutions
• Analyze identified solutions – The potential pros and cons of each possible solution
should be discussed
• Select a solution.
