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Questions and Answers
What should the RN do daily?
Assess clients and report acuity daily
In what order should the RN see the following clients? Place the options in order.
A 54-year-old client 4 hours post-cardiac catheterization who has mild discomfort at the access site = 4 A client newly diagnosed with diabetes mellitus who needs reinforcement of sick day management guidelines = 2 A client who arrived 30 minutes ago from the post-anesthesia care unit = 1 A client who is ready for discharge but will not have transportation home available until 5pm = 5 A client with pneumonia who has received two doses of IV antibiotics and has an oxygen saturation of 93% = 3
Which task should the nurse delegate to the charge nurse when a client is experiencing respiratory distress?
What is the nurse's best and first action when a client in room 3 requests pain medication while assisting another client with lunch?
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Which tasks can the nurse delegate to an unlicensed person (UAP)? Select all that apply.
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Which tasks are best delegated to the licensed practical/vocational nurse (LPN)? Select all that apply.
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Which tasks would be best delegated to the LPN for a team nursing approach?
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Which tasks should the nurse assign to the CNA and LPN?
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Which task should the nurse delegate to the UAP?
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Which client should be assigned to the licensed practical nurse (LPN)?
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Which assignment is appropriate for the staff nurse in charge of the medical-surgical unit?
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Which group of clients should be assigned to the float nurse?
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Which task should the nurse delegate to the LPN?
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What elements of delegation have been breached in the case of a hematoma from a venipuncture? Select all that apply.
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Which tasks should the nurse delegate for a client with 'heartburn' and related symptoms? Select all that apply.
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What is the first action the registered nurse (RN) should take at the beginning of the work shift? Place in order.
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Prioritize the tasks a nurse should complete at the beginning of a busy shift, placing the options in order.
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Study Notes
Ethical Principles in Nursing
- Autonomy allows clients to make their own treatment decisions, even when nurses disagree.
- Negligence is characterized by unintentional failure to perform duties; purposeful actions are not classified as negligence.
- Fidelity involves keeping promises and being trustworthy in client relationships.
- A nurse has a duty to provide care only when a professional relationship exists, which is not applicable if off-duty.
Malpractice and Legal Considerations
- In malpractice cases, there must be a duty owed, a breach of that duty, causation, and injury.
- Intent to cause harm is not a requirement for establishing malpractice; unintended errors can also result in litigation.
- The Nurse Practice Act protects the public by establishing nursing scope of practice and minimum qualifications.
- Reporting unsafe staffing conditions is essential in mitigating malpractice risks.
Delegation and Task Management
- When delegating tasks, consider the complexity and unpredictability of the client's condition.
- A stable client who is ambulatory is most suitable for delegation to an unlicensed assistive personnel (UAP).
- Some tasks, such as assessing responses to medication or providing detailed patient education, should remain with licensed nurses.
Quality Improvement and Documentation
- Regular audits of electronic medical records are necessary to determine staff acceptance and effectiveness.
- Engaging nursing staff in initiatives can lead to improvements in care delivery and quality of service.
Patient Care Prioritization
- In patient care, prioritize clients based on their medical conditions, with the most urgent cases receiving immediate attention.
- The nurse's actions should always align with the principle of patient safety and the need for timely intervention.
Emergency Situations
- In cases of respiratory distress or other urgent conditions, the nurse must quickly delegate important tasks, emphasizing the importance of effective communication and team collaboration.
General Nursing Responsibilities
- Maintaining confidentiality of patient information while sharing necessary details for care is paramount.
- Continuous education and skill maintenance are crucial components of reducing malpractice risk and ensuring high-quality nursing practice.### Delegation in Nursing
- Delegation is a crucial aspect of nursing practice, involving assigning tasks based on the level of licensure and competencies of the staff.
- Understanding which tasks can be delegated to unlicensed assistive personnel (UAP) and licensed practical nurses (LPN) ensures efficient patient care.
Tasks Suitable for UAP Delegation
- Basic Care Tasks: UAP can be assigned basic tasks like measuring vital signs and recording intake/output.
- Feeding: UAP may feed clients who are stable except for those with swallowing difficulties.
- Routine Monitoring: Tasks like rechecking vital signs on stable patients can be delegated.
LPN Delegation Tasks
- Complex Care: LPNs can handle more complex tasks such as dressing changes on non-complicated wounds, administering oral medications, and performing basic assessments.
- Postoperative Care: LPNs may manage basic care needs of postoperative clients but not critical assessments.
Prioritization in Patient Care
- Nurses need to prioritize tasks based on client needs and the urgency of care, especially during shift changes.
- Key tasks often include reviewing medication orders, checking client conditions, and addressing immediate safety concerns.
Delegation Considerations
- Task: Ensure the task is within the delegatee’s scope of practice.
- Circumstance: Proper context must be provided regarding the client’s condition and task requirements.
- Communication: Clear instructions must be communicated to avoid misunderstandings.
- Supervision: Adequate supervision must be maintained, especially during complex procedures.
Assignment of Clients
- Nurses must assess the acuity of clients when assigning tasks and groups to ensure experienced staff manage complex cases.
- New staff, including orienting RNs, may be assigned to less complex clients to ensure safety and support.
Key Medications and Orders
- Nurses may be involved in administering critical medications like anticoagulants or managing vital diagnostic tests, such as EKGs, depending on the urgency of the patient's condition.
Hematoma and Delegation Breaches
- A hematoma at a venipuncture site indicates potential issues with the delegation process, highlighting the need for proper training and supervision in procedures that involve patient safety.
Daily Work Shift Management
- Efficient time management at the beginning of a shift includes listening to hand-offs, checking essential patient information, reviewing lab results, and ensuring medication readiness, especially in a busy environment.
Incorporating Prioritization Rounds
- Prioritize urgent interventions, from vital stabilization tasks to routine care, ensuring critical patient safety and effective use of nursing resources on the unit.
Continuous Assessment
- Regular reassessment of delegated tasks ensures that patient needs are continuously met and adjustments to care plans are made promptly as needed.
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Description
Test your knowledge with NCLEX-RN practice questions! This quiz focuses on ethical principles in nursing, designed to help you prepare for your nursing exams. Enhance your understanding of concepts like autonomy and beneficence through interactive flashcards.
