Comprehensive ATI NCLEX-RN Review

Comprehensive ATI NCLEX-RN Review Leave the first rating Students also studied Terms in this set (223) Science MedicineNursing Save ATI comprehensive predictor STUDY...198 terms h_trtPreview module 5- delegation 30 terms mackenziolger Preview

Virtual ati: Priority- Setting Framew...

10 terms Antonio_Acosta6 Preview Adult M 22 terms jenn Conflict Management Strategies▪ Avoiding/withdrawing: both parties aware of conflict but refusing to face it - lose/lose situation ▪ Smoothing: one party satisfies other to maintain peace - lose/lose situation

▪ Cooperating/accommodating: one party sacrifices something to give other

party what they want - lose/win situation

▪ Competing/coercing: one party pursues soln at expense of other party -

lose/win situation ▪ Compromising/negotiating: each party gives up something - can be win/lose if someone gives up something less important

▪ Collaborating: work together to achieve common goal - win/win

Leadership Styles▪ Authoritative: make decisions for group, motivates w/ coercion, communication occurs down chain of command

▪ Democratic: includes group in decisions, motivates by supporting staff's

achievements, communication occurs up & down chain of command; MOST EFFECTIVE manager in health care environment!▪ Laissez-faire: makes few decisions, motivation largely responsibility of individual, communication occurs up & down chain of command and btwn others Steps in Discipline▪ First infraction → informal reprimand, meet w/ manager, verbal admonishment, discuss issue, identify ways to improve ▪ Second infraction → formal reprimand, written warning given in person by manager, review specifics of infraction, discuss potential consequences ▪ Third infarction → suspended w/ or w/o pay, employee has time to think about issues and consider alternatives ▪ Fourth infraction → involuntary termination, consequence after repeated warnings Steps in quality/performance improvement1. Standard is developed and approved by facility committee

• Standards are made available to employees via policies/procedures
• Quality issues are identified by staff
• Interprofessional team is developed to review issues
• Current state of issue is analyzed
• Data collection methods determined
• Data collected, analyzed, compared to established benchmark
• If benchmark not met → root cause analysis
• Potential solutions are analyzed, one selected for implementation
• Issue is re-evaluated to determine efficacy of the solution

Rights of Delegationright person, right task, right circumstances, right direction, right communication Delegation▪ RN CANNOT delegate: nursing process, client education, tasks requiring nursing judgements w/ unstable clients, initial assessments ▪ UAP: ADLs, hygiene/grooming, report to LPN/RN, VS, I&Os, maintaining safe environment, noninvasive skills ▪ LPN: varies by state; stable patients, patients w/ expected outcomes, reinforce teaching, contribute to care plan by discussing w/ RN, calculates and monitors IV flow rate, admin IVPB meds (IF not first dose, IF not titrated, or IF pre-mixed), PO meds

Prioritization principles▪ Systemic before local "life before limb" ▪ Acute before chronic ▪ Actual problems before potential future problems ▪ Maslow's hierarchy ▪ Trends vs. transient findings ▪ Emergencies/complications vs expected ▪ Clinical knowledge about priority actions (i.e. insulin more of priority than other meds)

Ethical Principles▪ Autonomy: right to make one's own decisions

▪ Beneficence: obligation to do good for others

▪ Fidelity: keep promises

▪ Justice: be fair to all people

▪ Nonmaleficence: do no harm

▪ Veracity: obligation to tell truth

▪ Paternalism: make decision for another

Advance Directives▪ Document in which a client who is competent is able to express wishes regarding future acceptable health care ▪ Patient-Self Determination Act: requires all clients admitted to health care facility to be asked if they have advance directives ▪ Living will: legal document that instructs what life-sustaining treatments an individual wants if they become unable to make decisions

▪ Durable power of attorney for healthcare: legal document that documents

another person to make health care decisions for a client when they become unable to make decisions Informed consent▪ Obtained after client receives complete disclosure of all pertinent info provided by provider ▪ Must fully understand procedure, risks/benefits, expected complications/side effects, alternate treatments or therapies available ▪ Consent can be given by a competent adult, legal guardian, or designated power of attorney, emancipated/married minor, parents of minor, or court order ▪ Nurse's role = WITNESS signature and ENSURE client understands procedure and is competent to sign HIPAA▪ Provides clients with control over how their personal health info is used and disclosed ▪ Outlines limited circumstances in which personal health info can be disclosed w/o obtaining consent first: suspicion of child or elder abuse, criminal activity, or reportable communicable disease

Torts▪ Legal wrongs committed against a person

TYPES:

▪ Intentional: assault (threat), battery (physical), false imprisonment (restraining w/o justification) ▪ Quasi-intentional: defamation of character (slander - verbal, libel - written), invasion of privacy/breach of confidentiality (violate HIPAA) ▪ Unintentional: malpractice (nurse did not carry out owed duty to pt), negligence (omit something reasonable person would do/do something reasonable person wouldn't do) Good Samaritan LawHealth care providers are protected from potential liability if volunteering away from their place of employment, as long as the nurse is not grossly negligent Mandatory reporting▪ Abuse (elder, child, domestic)

▪ Communicable diseases (ex: TB)

Disaster▪ Serious disruption of a functioning community; losses exceed ability of affected community to cope with its own resources ▪ Internal disaster: events in health care facility - structural or personnel-related ▪ External disaster: events outside of health care facility - human-made or natural Mass casualty disaster triage▪ Emergent/Class 1 - Red Tag: immediate threat to life; do not delay tx ▪ Urgent/Class 2 - Yellow Tag: major injuries requiring tx, can delay tx for 30 min-2 hr ▪ Nonurgent/Class 3 - Green Tag: minor injuries not requiring immediate tx, can delay tx for 2-4hr

▪ Expectant/Class 4 - Black Tag: expected and allowed to die, prepare for

morgue Greatest good for greatest # of people

Critical incident stress debriefing process: defusing &

formal debriefing ▪ Defusing: discussion of feeling shortly after disaster/critical incident i.e. end of shift ▪ Formal debriefing: discussion hours or days after disaster/critical incident, in large group setting, w/ mental health teams serving as leaders ▪ Both are designed to prevent development of PTSD among first responders & health care professionals Categories of Bioterrorism▪ Category A: highest-priority - smallpox, botulism, anthrax, tularemia, hemorrhage viral fevers (ebola), plague ▪ Category B: second-highest priority - typhus fever, ricin toxin, diarrheagenic E.coli, West Nile Virus ▪ Category C: third-highest priority - hantavirus, influenza virus, TB, rabies virus