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❖ Management of Care – (9)
➢ Advance Directives – (1)
▪ Legal Responsibilities: Purpose of a Living Will (RM FUND 9.0 Chp 4)
• A living will is a 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. Most state laws include
provisions that protect health care providers who follow a living will
from liability.
➢ Assignment, Delegation and Supervision – (2)
▪ Delegation and Supervision: Delegating Tasks to an Assistive Personnel
(RM FUND
9.0 Chp 6)
• Examples of tasks nurses may delegate to Aps (provided the
facility’s policy and state’s practice guidelines permit)
◆ 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)
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▪ Managing Client Care: Delegation Strategy for Effective Task
Management (RM Leadership 7.0 Chp 1)
• Consideration for selection of an appropriate delegate include the
following: education, training, and experience; knowledge and skill to
perform the task; level of critical thinking required to complete the
task; ability to communicate with others as it pertains to the task;
demonstrated competence; the delegatee’s culture; agency policies
and procedures and licensing legislation (state nurse practice acts)
➢ Case Management – (1)
▪ Cardiovascular Disorders: Tetralogy of Fallot (RM NCC RN 10.0 Chp 20)
• Tetralogy of Fallot – four defects that result in mixed blood flow:
Pulmonary stenosis, ventricular septal defect, overriding aorta, right
ventricular hypertrophy
◆ Cyanosis at birth: progressive cyanosis over the first year of
life. Systolic murmur. Episodes of acute cyanosis and hypoxia
(blue or “Tet” spells)
• Surgical procedures – shunt placement until able to undergo
primary repair; complete repair within the first year of life
➢ Collaboration with Interdisciplinary Team – (1)
▪ Communicable Diseases, Disasters, and Bioterrorism: CDC
Reportable Diagnoses (RM CH RN 7.0 Chp 6)
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• Anthrax. Botulism. Cholera. Congenital rubella syndrome (CRS).
Diphtheria. Giardiasis. Gonorrhea. Hepatitis A, B, C. HIV infection.
Influenza-associated pediatric mortality. Legionellosis/Legionnaires’
disease. Lyme disease. Malaria. Meningococcal disease. Mumps.
Pertussis (whooping cough). Poliomyelitis, paralytic. Poliovirus
infection, nonparalytic. Rabies (human or animal). Rubella (German
measles). Salmonellosis. Severe acute respiratory syndrome-
associated coronavirus disease (SARS-CoV). Shigellosis. Smallpox.
Syphilis. Tetanus/C. tetani. Toxic shock syndrome (TSS) (other than
Streptococcal). Tuberculosis
VATI RN COMPREHENSIVE PREDICTOR
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(TB). Typhoid fever. Vancomycin-intermediate and vancomycin-
resistant. Staphylococcus aureus (VISA/VRSA)
➢ Continuity of Care – (1)
▪ Information Technology: Change-of-Shift Report (RM FUND 9.0 Chp 5)
• Nurses give this report at the conclusion of each shift to the
nurse assuming responsibility for the clients.
◆ Formats include face to face, audiotaping, or presentation during
walking rounds in each client’s room (unless the client has a
roommate or visitors are present)
◆ An effective report should: include significant objective
information about the client’s health problems; proceed in a
logical sequence; include no gossip or personal opinion; relate
recent changes in medications, treatments, procedures, and the
discharge plan
➢ Establishing Priorities – (1)
▪ Managing Client Care: Determining Priority Care for a Group of
Clients (RM Leadership 7.0 Chp 1)
• Prioritize systemic before local (“life before limb”)
◆ Prioritizing interventions for a client in shock over interventions
for a client who has a localized limb injury
• Prioritize acute (less opportunity for physical adaptation) before
VATI RN COMPREHENSIVE PREDICTOR
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