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The home health nurse is visiting the home of a client that has been diagnosed with a brain
tumor. The family states that the client has been having more frequent seizures. What nursing
care should be provided? (Found in Adult Med Surg Review Module)
• Maintain airway (monitor oxygen levels, administer oxygen as needed, monitor lung
sounds).
• Monitor neurological status — in particular, assessing for changes in level of
consciousness, neurological deficits, and occurrence of seizures.
• Maintain client safety. (Assist with transfers and ambulation, provide assistive devices as
needed.)
• Implement seizure precautions.
• Administer medications as prescribed.
The nurse is collaborating with the health care team to create a plan of care for a client following
a stroke. Explain the nurse’s role in continuity of care. The nurse role in continuity care is a
coordinator, documentation, communication, consultations, referrals, transfer and discharge
planning.
An elderly client is being discharged from the hospital to home following a long hospitalization.
What are some community resources that the nurse should initiate referrals for this client?
• Specialized equipment (cane, walker, wheelchair, grab bars in bathroom)
• Specialized therapists (physical, occupational, speech)
• Care providers (home health nurse, hospice nurse, home health aide
What behaviors would indicate to the charge nurse that one of the nurses could be experiencing
countertransference? (Found in the Mental Health Review Module)
• Nurse overly identifies with client
• Nurse competes with client
• Nurse argues with client
List the six (6) Quality and Safety Education for Nurses (QSEN) competencies and explain their
, importance.
1. PATIENT-CENTERED CARE: The provision of caring and compassionate, culturally
sensitive care that addresses clients’ physiological, psychological, sociological, spiritual,
and cultural needs, preferences, and values.
2. TEAMWORK AND COLLABORATION: The delivery of client care in partnership with
multidisciplinary members of the health care team to achieve continuity of care and
positive client outcomes.
3. EVIDENCE-BASED PRACTICE: The use of current knowledge from research and other
credible sources on which to base clinical judgment and client care.
4. QUALITY IMPROVEMENT: Care-related and organizational processes that involve the
development and implementation of a plan to improve health care services and better
meet clients’ needs.
5. SAFETY: The minimization of risk factors that could cause injury or harm while
promoting quality care and maintaining a secure environment for clients, self, and others.
6. INFORMATICS: The use of information technology as a communication and
information-gathering tool that supports clinical decision-making and scientifically-based
nursing practice
A client's wife calls the charge nurse to the room and states she is very angry with the nursing
staff because her husband is "not receiving adequate nursing care". What problem solving
strategies should the charge nurse use in this situation?
• Conflict Management Strategies: Identify the problem – State it in objective terms,
minimizing emotional overlay.
• Discuss possible solutions – Brainstorming solutions as a group may stimulate new
solutions to old problems. Encourage individuals to "think outside the box. "Analyze
identified solutions – The potential pros and cons of each possible solution should be
discussed in an attempt to narrow down the number of viable solutions. Select a solution
– Based on this analysis, select a solution for implementation. Implement the selected
solution – A procedure and timeline for implementation should accompany the
implementation of the selected solution. Evaluate the solution's ability to resolve the
original problem – The outcomes surrounding the new solution should be evaluated
according to the predetermined timeline. The solution should be given adequate time to
become established as a new routine before it is evaluated. If the solution is deemed
unsuccessful, the problem-solving process will need to be reinstituted and the problem
discussed again.
Upon admission to a healthcare facility, what are the nurse’s responsibilities regarding a living
will?
• Providing written information regarding advance directives
• Documenting the client’s advance directives status
• Ensuring that advance directives are current and reflective of the client’s current
decisions
• Recognizing that the client’s choice takes priority when there is a conflict between the
client and family, or between the client and the provider