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Nurse 111
Health Care Systems
| Question | Answer |
|---|---|
| level of health care | Primary care: consult with your primary care provider. Secondary care: see a specialist such as an oncologist or endocrinologist Tertiary care: hospital setting such as dialysis or heart surgery Quaternary care is an advanced level of specialized care |
| What were some of the goals of the Patient Protection and Affordable Care Act? | ACA was intended to improve health care quality while lowering costs and increasing access to care. Eligibility for the Medicaid program adults with incomes below 138% of the federal poverty level. |
| Another focus on ACA | Disease prevention |
| Levels of Prevention | 1. Primary prevention 2. Secondary prevention 3. Tertiary prevention |
| Accreditation | meeting those standards through self-evaluation and an on-site visit by evaluators. organization that assures they have policies and procedures in place to maintain the quality of services and the safety of clients. |
| Accreditation organization develop into | operational standards, policies, and procedures that relate to everyday practice, such as environmental policies, human resources, client safety, and documentation. |
| The Joint Commission | nonprofit organization that accredits health care organizations in multiple types of health care settings, ranging from inpatient hospitals to pharmacies. Full accreditation from TJC is valid for three years. |
| The Joint Commission is conducting a site visit at a facility and will be assessing client records for compliance with standards. Which of the following should the nurse be able to discuss with TJC surveyors? | Facility policies that address administration of medications |
| sentinel event | resulted in a client’s death or harm that is determined to be permanent or severe |
| what is the examples of sentinel events | include administration of blood products with the incorrect blood type to a client, an infant death, and a surgical procedure performed on the incorrect arm or leg. |
| National Committee for Quality Assurance | nonprofit, an organization that focuses on improving the quality of health care through the development of evidence-based standards for care. |
| American Nurses Credentialing Center (ANCC) | An organization that supports nurses to improve client care through education, certifications, and professional designations. |
| what program American Nurses Credentialing Center (ANCC) developed into | developed two programs, the Magnet Recognition Program and the Pathway to Excellence, to recognize quality nursing practice. |
| what is the main goal of Magnet Recognition | promoting quality in a setting that supports professional practice, identifying excellence in the delivery of nursing services to clients, and disseminating “best practices” in nursing service |
| what are components of the Magnet Program model? | Structural empowerment Exemplary professional practice New knowledge, innovations, or improvements Transformational leadership Empirical outcomes |
| Pathway to Excellence Program | health care organizations that demonstrate a commitment to providing a healthy workplace for their staff EX: turnover, workplace engagement, productivity, teamwork, and job satisfaction |
| Press Ganey | survey tool to evaluate health care delivery and client satisfaction. EX: After visit, Every client, Email, Health care delivery Client satisfaction |
| Hospital Consumer Assessment of Healthcare Providers and Systems ( | measure client satisfaction. EX:48 hr to 6 weeks after visit, Random sample of clients< Phone call, Mail, Automated voice message, Mail with phone call |
| Medicare | the client must be age 65 or older, younger than age 65 with disabilities, or any age with end-stage renal disease (ESRD) |
| Medicare consists of three separate parts | Part A: Hospitalization, skilled nursing facilities, some hospice care, some home health care Part B: Doctor’s services, physical therapy, occupational therapy, some home health care Part D: Prescription drugs |
| Children’s Health Insurance Program (CHIP) | Government health care coverage that provides for children who may not meet Medicaid's requirements but need health coverage. |
| private insurance | Insurance coverage that is not provided by a government agency. |
| Insurance Reimbursements | fee for service (FFS): Reimbursement payments made to service providers based on the volume of services delivered. |
| Diagnosis-Related Groups | A fixed payment system for reimbursement for health care services based upon client diagnosis and procedures performed. Centers for Medicare and Medicaid Services (CMS) |
| Centers for Medicare and Medicaid Services (CMS) | A government agency that oversees the health care delivery of Medicare, Medicaid, and CHIP programs. |
| inpatient prospective payment system (IPPS) | A method of standardized insurance reimbursement based on the client’s diagnosis and procedures performed within the acute care setting. |
| Hospital-Acquired Condition Reduction Program (HACRP), | which links Medicare payments to health care quality this program reduces payments to facilities that have poor outcomes related to five specific hospital-acquired infections (HAIs) |
| hospital-acquired infections (HAIs) | An infection a client develops during an admission to an acute care facility hospital will receive less reimbursement money for poor outcomes than for good outcomes. |
| Which of the following is an example of a hospital-acquired infection (HAI)? | Catheter-associated urinary tract infection (CAUTI) |
| Resource Utilization Groups (RUGs) | A fixed payment system for reimbursement of health care services provided in the long-term care setting based upon client diagnosis and services required. payment system is used only in the long-term care setting |
| Seven major RUG categories | rehabilitation, extensive services, special care, clinically complex, impaired cognition, behavior problems, and reduced physical function. |
| Minimum Data Set (MDS) . | A clinical assessment of a client s physical and cognitive status required to be conducted on nursing home residents who receive Medicare and Medicaid benefits |
| Health Care Disparities | social, economic, and environmental differences, all of which affect health status. |
| social determinants of health (SDOH) | Factors that impact health other than health care services, including location, environment, genetics, income, relationships, and gender. |
| Example of physical determinants | Apartment buildings built close together and a lack of green space are |
| Example of social determinants | Difficulty accessing food that supports healthy eating, including a local store that does not sell fresh produce, working two jobs to pay bills, and lack of transportation to medical visits |
| Public Health Nurse Role | nurse cares for the community, intending to improve the health of that entire population. |
| Health Care Access | Implementation of the ACA, insurance coverage available to all, and broader availability of Medicaid coverage were all efforts aimed at reducing racial/ethnic and gender disparities. |
| skilled nursing facility (SNF) | Sometimes referred to as a nursing home or long-term care, may provide for short term rehabilitation care such as occupational and physical therapy as well as oversight for activities of daily living. |
| Ms. Jones is an 86-year-old female admitted to the acute care setting after sustaining a hip fracture. There is one flight of stairs to go up to access her home. What level of care would you recommend for a discharge plan for Ms. Jones? | Skilled nursing facility |
| long-term care hospital (LTCH) | A facility that specializes in providing care for stable clients who require a lengthy period of treatment such as for severe burns, trauma, or ventilation needs. |
| Assisted living | Provides services for clients who are mostly independent in their living but need assistance with some part of their daily life—for example, with meals, medication management, laundry, housekeeping, or transportation. |
| Hospice care | Services provided to clients when it is determined the client has less than six months to live. The goal is comfort and support services for the client and family, not curative |
| palliative care | Services provided to clients to promote comfort while in the last stages of life. A treatment focused on the management of symptoms of chronic or life-threatening illnesses while maintaining the highest level of quality of life possible for the client. |
| Respite care | Allows the client to be cared for apart from the caregiver, to allow the caregiver a break from the responsibilities of client care for a short time for vacations to travel or to simply stay at home without caring for the client. |
| Home care | The delivery of continued health care services within the client s home. Services can include nurse visits as well as occupational therapy, physical therapy, and social work. |
| Advanced Practice Registered Nurse | nurse practitioner, is a registered nurse who has completed advanced education in a specialty and passed the associated certification examination. |
| The interprofessional team is collaborating to address Mr. Marino’s needs. What sequence of actions should the team take when applying the nursing process to Mr. Marino’s situation? | 1. Mr. Marino’s health history 2. Identify which of Mr. Marino’s health problems is the highest priority and should be addressed first 3. Panning step the team determines a goal 4. achieve his goal of care. 5. if he ready to be discharged to his home |
| health promotion | The process of enabling people to increase control over and improve their health. |
| wellness | A positive state of health. |
| disease prevention | Specific, population-based and individual-based interventions for primary and secondary (early detection) prevention, aiming to minimize the burden of diseases and associated risk factors. |
| health education | Learning experiences that are designed to improve the health of an individual or community through increased knowledge or by influencing attitudes. |
| Healthy People Initiative | established by the U.S. Department of Health and Human Services (DHHS), with the intention of improving the overall health of Americans. |
| Health Promotion Strategies | the process of enabling people to increase control over, and to improve their health |
| foundational principles which guide Healthy People 2030 include | -Provide a framework that focuses on foundational principles -Provide public access to a collection of data on American health trends and issues for the past 10 years. -Provide tools for health professionals -Offer interactive access |
| A nurse is preparing to give a presentation to a group of clients in the community about Healthy People. The nurse knows that which of the following options should be included? | Goals and objectives for healthy habits |
| Self-care | important concept that clients can implement to promote and maintain their own health and well-being. |
| health outcomes | The result of health promotion and disease prevention measures. Individuals are empowered to make healthier decisions to reduce the likelihood of developing disease and disability through health promotion and disease prevention programs. |
| Nurses can educate and reinforce these concepts with clients to improve health outcomes by | -Knowledge and health literacy -Mental well-being and self-awareness -Physical activity -Healthy eating -Risk avoidance: Receive vaccinations, practice safe sex -Good hygiene |
| Nurse Self-Care | create healthy habits, making time for daily exercise and adequate sleep, using stress-reducing apps and resources, connecting with others, improving positivity at work |
| modifiable risk factors | Behaviors and actions that can affect a client’s risk for developing a disease. For example, tobacco use, eating a diet high in unhealthy fats, sedentary lifestyle, and excessive alcohol consumption |
| nonmodifiable risk factors | Risk factors that cannot be changed. age, gender, ethnicity/race, and family history. |
| Strategies to promote health | a. Health beliefs b. Exemplar: Physical fitness c. Exemplar: exercise d. Exemplar: Oral health e. Exemplar: Nutrition f. Exemplar: Screening g. Normal sleep/rest patterns h. Exemplar: Lifestyle choices i. Exemplar: Self Management |
| Health Literacy | The term “literacy” refers to the ability to read and comprehend written text. Some clients may be literate, yet have a low level of health literacy. |
| Socioeconomic Factors | Poverty has long been established as a factor negatively affecting health outcomes. |
| Environmental Factors | can affect health and well-being include air and water quality; exposure to toxic pollutants, hazards, and waste; and the safety of homes, work environments, and schools. |
| culture | The learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular group that guides their thinking, decisions, and actions in patterned ways. |
| primary prevention | The act of intervening before negative health effects occur. Vaccinations, changing risky behaviors such as tobacco use, and banning harmful substances |
| secondary prevention | To reduce the impact of disease or injury, and limit disability. Early detect ex: Screening tests such as blood pressure measurement to detect hypertension, blood cholesterol levels, and cancer screening tests |
| Tertiary Prevention | controlling the chronic effects of a health issue that has already occurred and on restoring the individual to optimal functioning ex: cardiac rehabilitation for clients following a heart attack and physical and occupational therapy |
| Quaternary Prevention | focuses on protecting clients from the excessive use of medical interventions that can cause more harm than good. medical tests, medications, and treatments that do not benefit the client. |
| In the scenario, the nurse identifies that the client’s blood pressure is elevated. Which of the following actions should the nurse take? (Select all that apply.) | Ask the client about a family history about bp follow-up with their primary care provider. Provide the information about high blood pressure. Identify if the client has risk factors for heart disease. Discuss a heart-healthy lifestyle |
| Telehealth | The provision of both clinical and nonclinical aspects of health care delivery through the use telecommunication devices such as the internet and telephone. |
| Endorsement | Being granted single state licensure based on reciprocity for nurses who have passed the National Council Licensing Exam (NCLEX). |
| Advocacy | Speaking up for clients' needs when the clients are unable to speak for themselves and supporting clients to make choices for their own health. |
| Nurse staffing | The process of determining the correct number and skill mix of nurses for the number and acuity of patients needing care. Affects the ability of nurses to deliver safe care. |
| Nurse-to-patient ratio | The number of clients each nurse is assigned. The ratio is based on the service area and client acuity. |
| P&P manuals | Policies and procedures that provide the standard of care that meets regulatory and accreditation requirements and promote safety. |
| Regulatory law | protecting nurses is the Occupational Safety and Health Administration (OSHA) requirement that employers provide protection for employees who may be exposed to blood and body fluids. |
| Professional nursing organizations | Grouped by nurse interest such as specialty area or nurse role; provide collegiality, access to scholarly literature, and potential monies to support education and research. |
| Nurse Practice Act | Law that defines the authority of the state board of nursing, identifies the types of nursing licenses and titles, and regulates nursing scope and standards of practice. |
| determinants of health | Factors that impact health other than health care services, including location, environment, genetics, income, relationships, and gender. |
| Health in All Policies | An approach to public policy making that systematically accounts for the health implications of all decisions. |
| Patient Protection and Affordable Care Act: Essential Health Benefits | Ambulatory (outpatient) patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services, including behavior health treatment Prescription drugs Rehabilitative |
| Health Insurance Portability and Accountability Act (HIPAA) | 1996, also known as the Privacy Act, legislation to protect insurance coverage and private information of clients. |
| The nurse in the scenario is determining how to respond to the primary care provider’s request for information about Mr. Alvarez. Which of the following actions should the nurse take? (Select all that apply.) | Review the policies and procedures of the facility before disclosing Mr. Alvarez’s information. |
| Administrative safeguards | The facility provides annual HIPAA training to all employees. |
| Physical safeguards | Electronic health information data are backed up on a routine schedule. Computers are placed in locations where access is restricted. |
| Technical safeguards | Employees are required to enter a login ID and password to access protected information. Electronic protected information is encrypted. |
| determinants of health | Factors that impact health other than health care services, including location, environment, genetics, income, relationships, and gender. |
| living wills | Legal document that allows individuals to decide what lifesaving measures they desire towards the end of life. |
| durable power of attorney for health care | Legal document that allows an individual to choose a designated person, a proxy, to make health care decisions on their behalf. |
| A nurse is caring for a client who has terminal cancer and wishes to stop further treatment. The client’s family does not support this decision. Which of the following actions should the nurse take? | Inform the family that the client has the right to immediately stop treatment. |
| Concept of Safety | state in which hazards and conditions leading to physical, psychological or material harm are controlled in order to preserve the health and well-being of individuals and the community. |
| Schedule I | No accepted medical use High potential for abuse Not prescribed ex: Heroin Lysergic acid diethylamide (LSD) |
| Schedule II | High potential for abuse and severe physical or psychological dependence ex:Amphetamine Fentanyl Hydromorphone Methamphetamine |
| Schedule III | Potential for abuse, but less than substances in Schedules I and II Abuse may lead to moderate or low physical or high psychological dependence ex: Anabolic steroids Buprenorphine Codeine Ketamine |
| Schedule IV | Lower potential for abuse EX;Alprazolam Carisoprodol Diazepam Lorazepam Midazolam Temazepam Triazolam |
| diversion | When a health care professional replaces a controlled substance with another and takes the substance for personal use. |
| mortality | The number of deaths due to a specific illness or injury. |
| chemical restraints | The use of antipsychotic medications to control uncooperative behavior rather than for a specific medical condition. |
| Requires that health care organizations that offer emergency services provide a medical screening examination and stabilizing treatment to anyone who presents for care, regardless of the individual’s insurance status or ability to pay. | Emergency Medical Treatment and Active Labor Act (EMTALA) |
| Regulates medications with a potential for abuse by placing them in categories called schedules and requiring health care organizations to ensure scheduled drugs are stored with additional locking mechanisms. | Controlled Substances Act |
| Requires insurers to cover a minimum stay for mothers and neonates for at least 48 hr after giving birth vaginally and 96 hr after cesarean birth. | Newborns’ and Mothers’ Health Protection Act |
| Requires insurers and federal payers to reimburse for mental illness and substance use disorder care equally to medical illness or surgical intervention and mandates no lifetime or annual dollar limit for services. | Mental Health Parity and Addiction Equity Act |
| health disparities | Preventable differences in incidence and prevalence of disease, injury, or violence among populations, based on race, ethnicity, gender, gender identity, LGBT, age, or socioeconomic status. |
| health equity | Valuing all individuals equally and removing obstacles to optimal health and health care across different populations. |
| social justice | Change in health policy aimed at analysis and critique of social structures, laws, and customs that harm groups through exclusion. Every individual has the right to quality health care. |
| culture of safety | Systems approach to change that leads to safer procedures taking blame away from individuals who make errors based on systems issues. |
| epidemiology | The incidence and prevalence of illness and injury. |
| incidence | The number of individuals newly afflicted with an illness or injury, expressed as a percent of a larger population. |
| prevalence | The number of individuals who have an illness or injury at a given point in time, expressed as a percent of a larger population. people who have the illness or injury at a specific period in time. |
| Standard precautions | set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes. |
| hand-off communication in nursing | use clear language and avoid use of abbreviations or term that can be misinterpreted |
| National Patient Safety Goals | Goals designed to focus on client safety, safe and effective delivery of health care, and recommendations to avoid adverse outcomes. |
| The goal of identifying clients accurately has two components | use two client identifiers and ensure that the medication, treatment, procedure, or care is intended for that specific client. |
| two client identifiers | identify every client using two identifiers accurately. These may consist of the client's name, date of birth, hospital ID number, telephone number, or alternate client-specific documentation. |
| barcode scanning | Used at the time of medication administration when both the medication and the client's facility-issued identification band are scanned to ensure the right medication is being administered to the right client. |
| The goal of improving staff communication refers to reporting | critical results promptly |
| critical results | Lab or diagnostic procedure results that are outside the expected reference range and can be life-threatening or potentially fatal if not immediately improved |
| Each facility creates guidelines and standards | The facility’s definition of a critical result A defined time frame from when the results are available to when they are reported to the provider Written documentation of the notification of results to the provider |
| Medications Safely 3 goals | label all medications, before a procedure; decrease the possibility of medication errors with anticoagulant; and establish an accurate and current medications list for the client and have the provider reconcile the list with the new drugs ordered. |
| clinical alarm systems | Audible alert devices that are built into medical equipment function is to provide a warning of a potentially serious event that is occurring. The other feature is that they warn when there is a machine malfunction |
| alarm fatigue | Sensory overload from noise pollution created in part by the numerous distress alerts. |
| Prevent Hospital-Acquired Infections | Nosocomial infections, also known as hospital–associated infections (HAIs) |
| hospital–associated infections (HAIs) | Nosocomial infections. Infections that occurred while the client was in the hospital. |
| The Centers for Disease Control and Prevention monitors and has developed evidence-based protocols for health care facilities to help prevent four types of HAIs: | Central line–associated bloodstream infection (CLABSI) Catheter-associated urinary tract infection (CAUTI) Surgical-site infection (SSI) Ventilator-associated pneumonia (VAP) |
| medication reconciliation | The process when the physician assesses the current home medications with the newly prescribed drugs. It must be completed on client admission, transfer, or discharge from the hospital. |
| adverse event | Any event that is not consistent with the desired or normal operation. |
| time-out | A joint commission mandated pause taken by all personnel in the procedure or operating room. This brief suspension allows identifying the correct patient, site, the procedure to be performed. |
| surgery centers, and diagnostic centers perform a series of safety checks before beginning any invasive procedure or surgery | Use two client identifiers to establish the client’s identity. Mark the surgical site if possible. Perform a time-out in the operating/procedure room. |
| Standards of Compliance | Former National Safety Goals that have been routinely adopted by healthcare professionals and are now retired. |
| A nurse is educating a newly licensed nurse about The Joint Commission’s National Patient Safety Goals. Which of the following goals does the nurse include when providing the education? | Preventing surgical-site infections |
| hourly rounding | The practice of scheduling (every 1 hour) a member of the nursing staff to see the client and proactively address their needs such as toileting, positioning, pain, and safety checks (siderail and bed position, proximity of call bell to the client, etc) |
| The Transforming Care at the Bedside plan includes the following components | Have nurses spend 70% of their time at the bedside performing direct client care hourly roundly Strengthen management through leadership development program rapid response team for the facility’s medical–surgical units standardized communication |
| rapid response team (RRT) | A dedicated group whose responsibility is to bring proactively critical care to the bedside. |
| Conditions that may warrant a callout of the RRT may include the following: | A sudden change in vital signs Low oxygen saturation Chest pain despite the administration of nitroglycerine Seizure Medical professional has a deep concern about the client’s condition Sudden variation in the client’s mental status |
| utilize a standardized communication tool | ISBARR (identity, situation, background, assessment, recommendation and read back) is one such tool that aids in nurse-to-nurse or nurse-to-provider communication. |
| ISBARR Communication Tool | Identity: Introduce yourself and where you are calling from. Situation: Client name and age, admitting diagnosis, and chief complaint or urgent need for the rapid response to be called. Background: Medical history |
| ISBARR Communication Tool 2 | Assessment: diagnostic tests, lab work, and vital signs. Recommendations: Treatment provided and the client’s response to the treatment. Read back: Read back the message or prescription from the provider, clarification of any miscommunication |
| Types of Unexpected Events | near misses, client safety events, and sentinel events |
| near miss | A potential error or close call that could have caused harm, but was caught and avoided. |
| client safety event | An unexpected event or circumstance that occurred that did not cause harm to the patient but had the potential to. |
| sentinel event (never event) | A critical, unexpected adverse event or circumstance that caused severe physical or psychological harm to the patient. |
| occurrence (incident) report | tool used to report an adverse event, sentinel event, client safety event, or near miss. |
| A client who is NPO (nothing by mouth) prior to a procedure is delivered a food tray, which the client consumes. The procedure is delayed. | Client Safety Event |
| A client has signed an operative consent for a lumpectomy of the right breast but receives mastectomy of the left breast. | Sentinel Event |
| A nurse is performing medication reconciliation and notices that a client who routinely takes Celebrex (a nonsteroidal anti-inflammatory drug) at home is prescribed Celexa (an antidepressant) instead. The client does not have a history of depression. | Near Miss |
| A client falls out of bed and sprains a wrist. | Adverse Event |
| three factors that the nurse must check when using electrical devices: | Check for faulty electrical equipment Check for ground fault circuit interrupter (GFCI) receptacle damage Use safe work practices |
| nurses should implement safe practices when working with electrical devices and equipment to prevent injury to both the nurse and the client: | Avoid plugging or unplugging a device when hands are wet Unplugging the equipment by pulling on the cord can cause damage to the equipment or injury to the nurse or client. Avoid using extension cords. |
| A chemical can enter the body in four ways: | Inhalation: Breathing in the fumes or air that has been contaminated Contact with skin or eyes Ingestion: Direct (swallowing of the chemical) or indirect (contamination of the hands, which then contact a food Injection: Due to needlestick injury |
| personal protection equipment (PPE) | Specially designed equipment that is meant to protect the healthcare worker from contamination, blood or body fluids. This equipment may include masks, eye protection, gown, gloves, and hair caps. |
| Radiation Safety | exposure to high doses of radiation causes cellular damage that can lead to cancer. Also, children are at much greater risk from radiation exposure due to the rapid rate at which their cells are dividing. |
| radiology studies, three major principles must be followed to assure safety: | Reduce time Increase distance Use shielding. Using a protective shield will help to decrease the dose of radiation. |
| Infants and Preschoolers (0–4 Years) safety | helmets and eye protection |
| Hospital-Acquired Injury | when harm directly affects a client while in the hospital, with the injury not having been present on the client’s admission to the hospital. |
| Some conditions that a client may suffer while in a health care facility include: | SSIs. CAUTIs. CLABSIs. Burn or electrical shock. Blood transfusion incompatibility. Injury related to a fall or trauma. Ineffective and unsafe insulin usage. Deep vein thrombosis (DVT). Pressure injury (decubitus ulcer or bedsore) |
| clients at high risk | Clients with an increased safety risk. This population can vary in age, medical, or behavioral conditions. It may also include persons with disabilities. disabling medical conditions that increase the risk of hospital-acquired injuries include stroke, ne |
| Communication disability | defined as a person’s inability to interact with others in ways that staff will understand hearing impairment, autism, or aphagia secondary to a stroke or other neurologic conditions. dementia Alzheimer’s |
| Screening Tools | developed to identify early in the care of a client those risk factors that may contribute to the client developing a disease or a hospital-acquired injury. |
| R.A.C.E. | Acronym that stands for Rescue, Alarm, Contain, and Extinguish in the event of a fire. |
| P. A.S.S. | An acronym that stands for Pull, Aim, Squeeze, and Sweep. It is used to described the steps to activate and use a fire extinguisher appropriately. |
| Types of Fire Extinguishers | Class A: water wood, plastics, rubber, and cloth. Class B: A carbon dioxide (CO2)– oils, gasoline, paints, grease Class C: A dry chemical-based fire fuse boxes, computers Class D: A fire extinguisher for fires involving metals Class K: kitchen fires |
| Class A, B, C | A multipurpose fire extinguisher that contain a dry chemical suitable for use on flammable materials and liquids or electric equipment. |
| lateral evacuation | Clients, visitors and staff who are threatened by fire are moved on the same floor to a safe location. |
| vertical evacuation | Clients, visitors and staff threatened by fire are relocated to a different floor. |
| There are three categories of radiation: | Alpha: The least amount of risk. Beta: The middle level of risk Gamma: The most serious of the three types. |
| Biological Exposure | anthrax, smallpox, Ebola, or, most recently, COVID-19. |
| elopement | client leaves or wanders away from a health care facility. Usually due to a diminished mental capacity such as a traumatic brain injury or dementia. |
| Factors that may contribute to a client falling include physical disorders | Stroke Amputation Recent surgery Multiple sclerosis Visual impairment Chronic pain Malnutrition Weakness Unsteady gait |
| Cognitive influences that may contribute to a client falling include: | Sleep disorders Impulsiveness Disorientation Dementia Depression |
| Environmental factors that may contribute to a client falling include: | Room clutter Poor lighting Slippery floors |
| Still other factors that may contribute to a client falling include: | The use of certain medications—such as antidepressant, antihypertensive, and anticonvulsant drugs—that have a strong correlation with client falls Age Bathroom frequency, with or without incontinence The staffing levels on the unit |
| fall safety champions | The champions are fall safety experts within the facility that promote strategies aimed at fall prevention. |
| Medical Conditions | Use of anticoagulant medications Multiple sclerosis |
| Mental Health and Behavioral Disorders | Schizophrenia Alcohol use disorder Attention-deficit/hyperactivity disorder Depression |
| Vision, Communication, and Cognitive Disability Conditions | Dementia Alzheimer’s disease Macular degeneration Hearing impairment |
| movement alarms | fall prevention tool that can attach to the bed, chair, or person. The alarm will ring when the client attempts to move from their current environment. |
| restraints | Used to decrease the client’s movement and function for their safety as well as other clients and staff. There are five types of restraints that include physical, mechanical, chemical, barrier, and seclusion. |
| Fall Risk | An infant who has diarrhea An adolescent who is receiving opioids for pain management A toddler who is preoperative for placement of tubes in the ears An adult who has a nasogastric tube to suction An older adult who has an indwelling urinary catheter |
| physical restraint | The manual holding or immobilizing the client using physical strength. |
| mechanical restraint. | A physical device that is applied to a person to restrict their movement. It may consist of the use of materials such as straps, fabric, leather devices that can fasten around the client s wrists or ankles. Other items that may be used as a mechanical res |
| chemical restraint | The administration of medications (including benzodiazepines, antipsychotics, and neuromuscular blocking agents) to reduce the client's movement or control behavior. |
| barrier restraint | Restrain a client’s movement within a setting through the use of barriers to limit movement such as concave mattresses and lapboards that are attached to chairs. |
| seclusion | Placing the client alone in a securely locked room. |
| nurse is preparing to apply wrist restraints to a client. Which of the following actions should the nurse take? | Pad bony prominences before applying the restraint. Use a quick-release knot when securing the restraint Apply the restraint so that two fingers can be inserted between the restraint the client’s wrist. |
| Code of Ethics | refers to the ideals, duties, and obligations that nurses are expected to uphold as members of the nursing profession. |
| Provisions 1 to 3 of the Code refer to the fundamental values of the nursing profession and the nurse’s commitment to those that they care for. | provide compassionate care and respect for the client. The nurse should recognize that each client is unique, has worth, and deserves to be treated with dignity. advocate for each client’s rights and needs. promote and protect the health and safety |
| Provisions 4 to 6 of the Code refer to the duty and loyalty that the nurse is expected to show | demonstrate authority, accountability, and responsibility for promoting best practices. maintain competence, practice the accepted values of the nursing profession, The nurse should adhere to the ethical principles of the nursing profession. |
| Provisions 7 to 9 of the Code refer to the duty and loyalty expected to show beyond direct client encounters and to the nursing profession as a whole. | The nurse should promote the profession of nursing through research and inquiry. The nurse should participate in the development of standards of practice and policies governing nursing and health care. |
| autonomy | Independence or freedom, ability to make one's own decisions. |
| beneficence | Doing good and acting in the best interest of a client by providing care that benefits them. |
| nonmaleficence | Doing no harm, or the least amount of harm to the client, while trying to achieve the best possible outcome. |
| veracity | Telling the truth. |
| fidelity | Keeping promises or commitments. |
| Justice | The ethical principle of justice refers to the nurse’s obligation to provide treatment, care, and resource allocation that is impartial, fair, and equitable to all clients regardless of age, sex, race, or economic status. |
| altruism | To do something, or take action, for the sake of benefiting someone else. nurse rushing to help someone in need, sometimes ignoring risk to themselves and putting the needs of the client first. |
| human dignity | Implies that each individual, regardless of things such as race, religion, sex, gender, etc., has value and shall be respected simply because human beings are all equal. |
| integrity | The quality of being honest and having strong moral principles. |
| social justice | Change in health policy aimed at analysis and critique of social structures, laws, and customs that harm groups through exclusion. Every person has the right to quality health care. |
| ethical dilemmas | Situation where a critical choice must be made, but the solution may not be ethically acceptable. |
| decision-making process uses eight sequential steps. | Is There an Ethical Dilemma? Clearly Identify Identify Possible Solutions Apply Ethical Principles Include All Relevant Individuals and Factors Decide on a Solution Put the Decision into Action |
| Emergency Medical Treatment and Labor Act (EMTALA) | Ensures that all individuals, regardless of their insurance or financial status, have equal access to emergency medical care. |
| Health Insurance Portability and Accountability Act of 1996 (HIPAA) | The Health Insurance Portability and Accountability Act, also known as the Privacy Act, is legislation to protect insurance coverage and private information of clients. |
| A nurse is caring for a client who doesn’t want her family to know she is in the hospital. The nurse receives a phone call from the client’s neighbor asking if the client had been admitted and how they are doing. The nurse should recognize that ? | D The client and health care workers involved in their care are the only people who have access to the health information |
| In the video the charge nurse is informed that the client’s protected health information (PHI) is displayed on a computer. Which of the following actions should the nurse take first? | Log out the client’s nurse from the computer. |
| tort | Carrying out an act, or failing to carry out an act, which results in injury or harm to a client. |
| informed consent | Formal permission granted with the knowledge of the possible consequences and alternatives. Colonoscopy to screen for colon cancer Scheduled cesarean section Elective cosmetic surgery |
| implied consent | Agreement by the client to the administration of care as demonstrated by the client’s actions rather than by formal verbal or written consent. Insertion of a urinary catheter Initiation of an IV site Administration of pain medication |
| the video, the nurse assists in obtaining informed consent from Mr. Aniston prior to his surgical procedure. Which of the following tasks is the nurse’s responsibility when assisting in this process? | Witness Mr. Aniston’s signature on the consent form. |
| advance directives | A written statement of a person's wishes regarding medical treatment. |
| Which of the following would be included in advance directives? | Living will Durable power of attorney for health care Organ donation form Do not intubate (DNI) order |
| Good Samaritan laws | Provides for protection from claims of negligence for those who provide care without expectation of payment. |
| whistleblowing | Reporting private information about an organization's wrongdoing or illegal activity. |
| Maltreatment may present itself in many forms, including but not limited to the following: | Physical maltreatment or denying food, shelter, or comfort Neglect, denial or delaying of care Verbal or emotional maltreatment Sexual maltreatment Financial exploitation Educational maltreatment or neglect Lack of protection from harm |
| Reporting of Incidence of Disease | Anthrax Botulism Chlamydia Foodborne disease outbreak Hepatitis A–C HIV Influenza Measles Rubeola Tuberculosis Zika virus |
| nurse in a public health department is reviewing the medical records of a group of clients. Which of the following diseases should the nurse identify as a reportable condition? (Drag each description to the desired category.) | Reportable conditions Measles Influenza Nonreportable conditions Pneumonia Methicillin-resistant Staphylococcus aureus (MRSA) infection |
| Incident, or occurrence, reporting should occur in the following instances. | medication error or a missed provider prescription Incidents involving workplace violence Any near-miss event, such as an expired medication that is identified before it is administered to a client fall Any sentinel event |
| just culture | Values-supportive model of shared accountability and mindfulness. An example of a just culture in nursing is when nurses experience missed nursing care due to circumstances such as understaffing, being overworked or experiencing undue stress, and other w |
| Client Abandonment | leaving the unit without arranging for another nurse to provide care for assigned clients, failure to provide report to another nurse prior to leaving the unit, and sleeping while assigned to provide care for a client. |
| Client-to-Nurse Staffing Ratios | best described as the number of clients that the nurse is responsible for providing care to during their shift. |
| Delegation | Nurses have the responsibility to provide safe and effective care to their clients; this includes the use of delegation of some tasks |
| Five Rights of Delegation | Right task Right circumstance Right person Right directions and communications Right supervision and evaluation |
| Standards of Practice | Explanatory statements that describe a competent level of care for all nurses, using the critical thinking model known as the nursing process |
| Standards of Professional Performance | Defines competent behavior of all registered nurses where professional care is provided. |
Created by:
Nweylay