Chapter_026.pdf

Chapter 26 Key Points Review these Key Points fro each NCLEX Examination Client Needs Category. Safe and Effective Care Environment Supervise care assigned or delegated to licensed practical nurses/licensed vocational nurses (LPNs/LVNs) or assistive personnel (AP) to patients who have risk factors...

Chapter 26 Key Points Review these Key Points fro each NCLEX Examination Client Needs Category. Safe and Effective Care Environment Supervise care assigned or delegated to licensed practical nurses/licensed vocational nurses (LPNs/LVNs) or assistive personnel (AP) to patients who have risk factors for airway obstruction. QSEN: Safety Document any direct observations of obstructive sleep apnea (OSA). QSEN: Safety Instruct patients using CPAP to manage OSA to avoid sharing the mask device or tubing with others to prevent infection. QSEN: Safety Apply knowledge of anatomy to prevent aspiration in a patient with a tracheostomy. QSEN: Safety Health Promotion and Maintenance Teach patients using CPAP how to correctly use and care for the equipment. QSEN: Patient-Center Care Remind patients using CPAP to use it daily whenever they sleep in a bed. QSEN: Evidence-Based Practice Assess the airway patency of any patient who experiences facial or nasal trauma. QSEN: Safety Assess the patient for risk factors for head and neck cancer. QSEN: Patient-Centered Care Encourage adults who smoke to quit smoking or using tobacco in any way. QSEN: Patient-Centered Care Teach patients who have had radiation therapy to the oral cavity to have dental examinations at least every 6 months. QSEN: Patient-Centered Care Teach the patient and family about home management of a laryngectomy stoma or tracheostomy. QSEN: Patient-Centered Care Psychosocial Integrity Encourage patients prescribed CPAP therapy for OSA to use the equipment for at least 2 weeks to give them time to adjust to a new and somewhat intrusive sleep routine. QSEN: Patient-Centered Care Encourage patients with permanent tracheostomies or laryngectomies to become involved in self-care and to look at the wound and touch the affected area. QSEN: Patient-Centered Care Allow time to communicate with the patient who has voice loss. QSEN: Patient-Centered Care Teach family members ways to communicate with a patient who cannot speak after surgery for head and neck cancer. QSEN: Patient-Centered Care Physiological Integrity Assess comatose, cognitively impaired, or noncommunicative patients every shift for the need for oral care to prevent a mucoid impaction. QSEN: Patient-Centered Care Remind patients that CPAP is only effective if the mask is tight enough to prevent air leaks. QSEN: Patient-Centered Care Perform a focused upper respiratory assessment and reassessment to determine adequacy of gas exchange and tissue perfusion. QSEN: Patient-Centered Care Check the airway and packing at least every hour for a patient who has posterior nasal packing placed after nasal surgery or posterior epistaxis. QSEN: Evidence-Based Practice Instruct patients who have had mandibular immobilization or fixation after a mandibular fracture to keep wire cutters with them at all times. QSEN: Safety Apply oxygen to any patient who develops stridor. QSEN: Safety Assess the incisions and wounds of a patient who has undergone radical neck surgery for indications of loss of tissue integrity, graft perfusion insufficiency, and carotid artery leak or rupture. QSEN: Patient-Centered Care Copyright © 2021 by Elsevier Inc. All rights reserved.