ATI
HEALTH CARE FINANCING MECHANISMS PUBLIC FEDERALLY FUNDED
PROGRAMS
Medicare is for clients 65 years of age or older and those who have permanent
disabilities.
*Part A: Insurance for hospital stays, home health, and hospice (available to those 65
years of age or older and those who have permanent disabilities)
*Part B: Insurance for outpatient and provider services (available to those 65 years or
older and those who have permanent disabilities, but is voluntary and requires a
monthly premium)
*Part C: A Medicare advantage or supplement plan (covering parts A and B, and
sometimes D)
*Part D: Medication coverage for those eligible and requires a monthly premium
Medicaid is for clients who have low incomes.
-It is federally and state funded.
-Individual states determine eligibility requirements.
-Restorative health care involves intermediate follow-up care for restoring health and
promoting self-care. Examples include home health care, rehabilitation centers, and
skilled nursing facilities.
-Continuing health care addresses long-term or chronic health care needs over a
period of time. Examples include end-of-life care, palliative care, hospice, adult day
care, assisted living, and in-home respite care.
Hospice
-Service that is provided to the patient and their families as the end of their life
approaches
-Care designed not to treat an illness but to provide physical and emotional comfort to
the patient and support and guidance to his or her family, typically takes place before
the period where hospice care is necessary
-A type of end-of-life care for persons who are terminally ill, characterized by the
following:
,(1) patients are kept as free of pain as possible so that they may die comfortably and
with dignity;
(2) patients receive continuity of care, are not abandoned, and do not lose personal
identity;
(3) patients retain as much control as possible over decisions regarding their care and
are allowed to refuse further life-prolonging technologic interventions; and
(4) patients are viewed as individuals with personal fears, thoughts, feelings, values,
and hopes
Palliative care
-hospice care; taking care of the whole person—body, mind, spirit, heart and soul—with
the goal of giving patients with life-threatening illnesses the best quality of life they can
have through the aggressive management of symptoms
-Care designed not to treat an illness but to provide physical and emotional comfort to
the patient and support and guidance to his or her family, typically takes place before
the period where hospice care is necessary
Respite care
-a type of care provided for caregivers of homebound ill, disabled, or elderly patients
-Care provided for long-term or chronic clients so family members can have some time
off or time away
Adult Daycare
-Care given at a facility during day time hours; generally for potentially functionally or
cognitively impaired individuals who need some assistance and/or supervision; provides
health care, social and recreational activities
-services provided by Adult Daycares
**Transportation, social services, meals, limited nursing care, personal care, counseling,
therapeutic services, rehabilitation services, crafts and other recreational activities
ETHICS AND LAWS
BASIC PRINCIPLES OF ETHICS
Advocacy: support and defend clients’ health, wellness, safety, wishes, and personal
rights, including privacy.
Responsibility: willingness to respect obligations and follow through on promises.
,Accountability: ability to answer for one’s own actions
. Confidentiality: protection of privacy without diminishing access to high-quality care.
ETHICAL PRINCIPLES FOR CLIENT CARE
Autonomy: the right to make one’s own personal decisions, even when those decisions
might not be in that person’s own best interest.
Beneficence: action that promotes good for others, without any self-interest.
Fidelity: fulfillment of promises.
Justice: fairness in care delivery and use of resources. Nonmaleficence: a
commitment to do no harm.
Veracity: a commitment to tell the truth.
LAWS
Omission: failure to report (abuse, error, communicable disease)
Liability: legal responsibility for ones actions
Malpractice: example - giving wrong med to pt and pt has adverse reaction that causes
death
Negligence: failure to fuffill nursing duties
-Types of advance directives :
Living will: legal document that expresses the client’s wishes regarding medical
treatment in the event the client becomes incapacitated and is facing end-of-life issues.
DELEGATION
A licensed nurse is responsible for providing clear directions when delegating a task
initially and for periodic reassessment and evaluation of the outcome of the task.
-PNs can delegate to other PNs and to AP.
The five rights of delegation:
Right task
Right circumstance
Right person
, Right direction and communication
Right supervision and evaluation
EXAMPLE ATI QUESTION: DELEGATION
A nurse on a medical‑surgical unit has received change‑of‑shift report and will care for
four clients. Which of the following client's needs should the nurse assign to an assistive
personnel.
A.Feeding a client who was admitted 24 hr ago with aspiration pneumonia
B.reinforcing teaching with a client who is learning to walk using a quad cane
C.reapplying a condom catheter for a client who has urinary incontinence
D.applying a sterile dressing to a pressure ulcer
A. it would be inappropriate to delegate the feeding of a client who has aspiration
pneumonia to an ap because the client is at risk for further aspiration.
C. CORRECT: the application of a condom catheter is a noninvasive, routine
procedure that the nurse may delegate to an ap.
STAGES OF GRIEF
Denial: The client has difficulty believing in an expected or actual loss.
Anger: The client directs anger toward the self, others, a deity, objects, or the current
circumstances.
Bargaining: The client negotiates for more time or a cure.
Depression: The client is overwhelmingly saddened by the inability to change the
situation.
Acceptance: The client acknowledges what is happening and plans for the future by
moving forward.
BODY SYSTEM CHANGES + PSYCHOLOGICAL CHANGES IN OLDER ADULT
Integumentary
-Decreased skin turgor, subcutaneous fat, and connective tissue (dermis), which leads
to wrinkles and dry, transparent skin ⥀
HEALTH CARE FINANCING MECHANISMS PUBLIC FEDERALLY FUNDED
PROGRAMS
Medicare is for clients 65 years of age or older and those who have permanent
disabilities.
*Part A: Insurance for hospital stays, home health, and hospice (available to those 65
years of age or older and those who have permanent disabilities)
*Part B: Insurance for outpatient and provider services (available to those 65 years or
older and those who have permanent disabilities, but is voluntary and requires a
monthly premium)
*Part C: A Medicare advantage or supplement plan (covering parts A and B, and
sometimes D)
*Part D: Medication coverage for those eligible and requires a monthly premium
Medicaid is for clients who have low incomes.
-It is federally and state funded.
-Individual states determine eligibility requirements.
-Restorative health care involves intermediate follow-up care for restoring health and
promoting self-care. Examples include home health care, rehabilitation centers, and
skilled nursing facilities.
-Continuing health care addresses long-term or chronic health care needs over a
period of time. Examples include end-of-life care, palliative care, hospice, adult day
care, assisted living, and in-home respite care.
Hospice
-Service that is provided to the patient and their families as the end of their life
approaches
-Care designed not to treat an illness but to provide physical and emotional comfort to
the patient and support and guidance to his or her family, typically takes place before
the period where hospice care is necessary
-A type of end-of-life care for persons who are terminally ill, characterized by the
following:
,(1) patients are kept as free of pain as possible so that they may die comfortably and
with dignity;
(2) patients receive continuity of care, are not abandoned, and do not lose personal
identity;
(3) patients retain as much control as possible over decisions regarding their care and
are allowed to refuse further life-prolonging technologic interventions; and
(4) patients are viewed as individuals with personal fears, thoughts, feelings, values,
and hopes
Palliative care
-hospice care; taking care of the whole person—body, mind, spirit, heart and soul—with
the goal of giving patients with life-threatening illnesses the best quality of life they can
have through the aggressive management of symptoms
-Care designed not to treat an illness but to provide physical and emotional comfort to
the patient and support and guidance to his or her family, typically takes place before
the period where hospice care is necessary
Respite care
-a type of care provided for caregivers of homebound ill, disabled, or elderly patients
-Care provided for long-term or chronic clients so family members can have some time
off or time away
Adult Daycare
-Care given at a facility during day time hours; generally for potentially functionally or
cognitively impaired individuals who need some assistance and/or supervision; provides
health care, social and recreational activities
-services provided by Adult Daycares
**Transportation, social services, meals, limited nursing care, personal care, counseling,
therapeutic services, rehabilitation services, crafts and other recreational activities
ETHICS AND LAWS
BASIC PRINCIPLES OF ETHICS
Advocacy: support and defend clients’ health, wellness, safety, wishes, and personal
rights, including privacy.
Responsibility: willingness to respect obligations and follow through on promises.
,Accountability: ability to answer for one’s own actions
. Confidentiality: protection of privacy without diminishing access to high-quality care.
ETHICAL PRINCIPLES FOR CLIENT CARE
Autonomy: the right to make one’s own personal decisions, even when those decisions
might not be in that person’s own best interest.
Beneficence: action that promotes good for others, without any self-interest.
Fidelity: fulfillment of promises.
Justice: fairness in care delivery and use of resources. Nonmaleficence: a
commitment to do no harm.
Veracity: a commitment to tell the truth.
LAWS
Omission: failure to report (abuse, error, communicable disease)
Liability: legal responsibility for ones actions
Malpractice: example - giving wrong med to pt and pt has adverse reaction that causes
death
Negligence: failure to fuffill nursing duties
-Types of advance directives :
Living will: legal document that expresses the client’s wishes regarding medical
treatment in the event the client becomes incapacitated and is facing end-of-life issues.
DELEGATION
A licensed nurse is responsible for providing clear directions when delegating a task
initially and for periodic reassessment and evaluation of the outcome of the task.
-PNs can delegate to other PNs and to AP.
The five rights of delegation:
Right task
Right circumstance
Right person
, Right direction and communication
Right supervision and evaluation
EXAMPLE ATI QUESTION: DELEGATION
A nurse on a medical‑surgical unit has received change‑of‑shift report and will care for
four clients. Which of the following client's needs should the nurse assign to an assistive
personnel.
A.Feeding a client who was admitted 24 hr ago with aspiration pneumonia
B.reinforcing teaching with a client who is learning to walk using a quad cane
C.reapplying a condom catheter for a client who has urinary incontinence
D.applying a sterile dressing to a pressure ulcer
A. it would be inappropriate to delegate the feeding of a client who has aspiration
pneumonia to an ap because the client is at risk for further aspiration.
C. CORRECT: the application of a condom catheter is a noninvasive, routine
procedure that the nurse may delegate to an ap.
STAGES OF GRIEF
Denial: The client has difficulty believing in an expected or actual loss.
Anger: The client directs anger toward the self, others, a deity, objects, or the current
circumstances.
Bargaining: The client negotiates for more time or a cure.
Depression: The client is overwhelmingly saddened by the inability to change the
situation.
Acceptance: The client acknowledges what is happening and plans for the future by
moving forward.
BODY SYSTEM CHANGES + PSYCHOLOGICAL CHANGES IN OLDER ADULT
Integumentary
-Decreased skin turgor, subcutaneous fat, and connective tissue (dermis), which leads
to wrinkles and dry, transparent skin ⥀
