NR 226 FUNDAMENTALS OF NURSING EXAM 3
Chapter 21: Managing Care
1. Prioritizing patient care:
extremely important because it allows the nurse to see relationships among patient problems &
avoid delays in taking action that can potentially prevent serious complications for a patient.
act immediately to stabilize conditions
remember ABC: airway, breathing, circulation as top priority
High Emergency; immediate threat to survival or safety
Example: obstructed airway, anxiety attack
Intermediate non-emergency, non life threatening actual or potential needs the
patient & family members are experiencing
Example: anticipating teaching needs of patient related to a new drug,
taking measures to decrease post-op pain
Low actual or potential problems that are not directly related to a patient's
illness or disease (developmental or long-term health needs)
example: patient at admission that will need patient teaching prior to
discharge
2. Types of Nursing:
Primary Nursing One RN assumes responsibility for the caseload Cons: model does not
lateral communication from nurse to nurse always decrease costs,
RNs have limited # of patients associate nurse cannot
RN assesses patients & develops care plans change care plan without
variety of staffing levels & mixes approval
Total Patient Care RN in charge of all aspects of care Cons: not cost effective due
delegation allowed to high # of RNs needed,
RN works directly with patient & family, other continuity of care a
healthcare team members problem if communication
RN plans care lacks
Functional Nursing
Case Management coordinates & links health care services to patients Cons: do not always
& their families while streamlining costs & provide direct care
maintaining quality
collaborative process of assessment, planning,
facilitation & advocacy
clinicians oversee management of patients with
specific healthcare problems & are held accountable
for costs management & quality
Team Nursing RN leads team of other RNs, LPNs, and MA Cons: TL takes time to
Team provides direct patient care under RN delegate, RN does not
supervision spend time with patients
, Leader develops care plans & provides complex
nursing skills
Hierarchy in communication
3. Magnet Hospital
clinical promotion systems, research & evidence-based practice
nurses have professional autonomy over their practice; control over their practice\environment
empower nursing team to make changes & be innovative
strong collaborative relationship amongst team & improved patient quality of care
4. Delegation including to medical assist and LPN: as transferring responsibility for the performance of
an activity or task while retaining accountability for the outcome.
Assess knowledge & skills, then match tasks
communicate clearly, listen, & give feedback
5 Rights of Delegation
Task things that are repetitive * relatively noninvasive
require little supervision * have predictable results
potential for minimum risk
Circumstance patient setting
available resources & other relevant factors
Person correct person performing
correct person receiving
Direction clear, concise description of task (objectives, limits, expectations)
ongoing communication is vital between NAP & RN
Supervision provide appropriate monitoring, evaluation & intervention as needed
NAP should be comfortable asking ?s & seeing assistance
Chapter 24: Communication
1. Communication techniques for special needs (i.e. cognitive, hearing loss, vision loss)
Cognitive use simple sentences
Impairment
Chapter 21: Managing Care
1. Prioritizing patient care:
extremely important because it allows the nurse to see relationships among patient problems &
avoid delays in taking action that can potentially prevent serious complications for a patient.
act immediately to stabilize conditions
remember ABC: airway, breathing, circulation as top priority
High Emergency; immediate threat to survival or safety
Example: obstructed airway, anxiety attack
Intermediate non-emergency, non life threatening actual or potential needs the
patient & family members are experiencing
Example: anticipating teaching needs of patient related to a new drug,
taking measures to decrease post-op pain
Low actual or potential problems that are not directly related to a patient's
illness or disease (developmental or long-term health needs)
example: patient at admission that will need patient teaching prior to
discharge
2. Types of Nursing:
Primary Nursing One RN assumes responsibility for the caseload Cons: model does not
lateral communication from nurse to nurse always decrease costs,
RNs have limited # of patients associate nurse cannot
RN assesses patients & develops care plans change care plan without
variety of staffing levels & mixes approval
Total Patient Care RN in charge of all aspects of care Cons: not cost effective due
delegation allowed to high # of RNs needed,
RN works directly with patient & family, other continuity of care a
healthcare team members problem if communication
RN plans care lacks
Functional Nursing
Case Management coordinates & links health care services to patients Cons: do not always
& their families while streamlining costs & provide direct care
maintaining quality
collaborative process of assessment, planning,
facilitation & advocacy
clinicians oversee management of patients with
specific healthcare problems & are held accountable
for costs management & quality
Team Nursing RN leads team of other RNs, LPNs, and MA Cons: TL takes time to
Team provides direct patient care under RN delegate, RN does not
supervision spend time with patients
, Leader develops care plans & provides complex
nursing skills
Hierarchy in communication
3. Magnet Hospital
clinical promotion systems, research & evidence-based practice
nurses have professional autonomy over their practice; control over their practice\environment
empower nursing team to make changes & be innovative
strong collaborative relationship amongst team & improved patient quality of care
4. Delegation including to medical assist and LPN: as transferring responsibility for the performance of
an activity or task while retaining accountability for the outcome.
Assess knowledge & skills, then match tasks
communicate clearly, listen, & give feedback
5 Rights of Delegation
Task things that are repetitive * relatively noninvasive
require little supervision * have predictable results
potential for minimum risk
Circumstance patient setting
available resources & other relevant factors
Person correct person performing
correct person receiving
Direction clear, concise description of task (objectives, limits, expectations)
ongoing communication is vital between NAP & RN
Supervision provide appropriate monitoring, evaluation & intervention as needed
NAP should be comfortable asking ?s & seeing assistance
Chapter 24: Communication
1. Communication techniques for special needs (i.e. cognitive, hearing loss, vision loss)
Cognitive use simple sentences
Impairment
