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Concepts II: Ch. 2
Health-Care Delivery, Settings, and Economics
| Question/Term | Answer/Definition |
|---|---|
| Question: The health-care organization uses a system of health-care delivery aimed at managing the cost and quality of access to health care. Which type of delivery system should the nurse review prior to arriving for an interview for a position? | Answer: Managed care |
| Question: A client has a federal government’s health insurance program for people older than 65 years. Which type of health insurance should the nurse expect to see documented in the client’s medical record? | Answer: Medicare |
| Question: The instructor reviews the delivery approach of client-centered care before taking the students to the clinical area. For which student statement should the instructor review the information again? | Answer: “It fosters a feeling of dependence.” |
| Question: The nurse is working in a critical care unit where the focus is on primary care nursing. Which action will the nurse take to demonstrate understanding of this care delivery approach? | Answer: Provide all aspects of nursing care for assigned patients. |
| Question: The instructor is reviewing the scope of practice for the licensed practical/vocational nurse (LPN/LVN) with a group of students. For which student statement should the instructor provide more information about the role? | Answer: “The LPN/LVN can practice independently.” |
| Question: The nurse is caring for a client with increasing difficulty breathing. With which health-care worker should the nurse collaborate to address this client’s health problem? | Answer: Respiratory therapist (RT) |
| Question: The nurse manager is reviewing risk management data collected for the care area after the staff attended an educational program on health-care collaboration. Which outcome indicates that this program has been successful? | Answer: Number of client falls reduced by 85% |
| Medical doctor (MD) Doctor of osteopathy (DO) | Responsible for diagnosing and treating disease, illness, and injury; ordering diets, tests, medications, treatments, therapies, and procedures; and directing overall care of patients |
| Physician’s assistant (PA) | Employed by a physician or hospital to work closely with the physician and assist in directing patient care |
| Nurse practitioner (NP) | Masters-prepared registered nurse certified in a specific area of practice and identified with advanced practice license who diagnoses illnesses and prescribes medications and treatments |
| Registered nurse (RN) | Practices nursing within a defined scope under the direction of a physician; provides direct patient care, manages departments, and supervises other nurses and assistive personnel |
| Licensed practical/vocational nurse (LPN/LVN) | Practices within a defined scope under the supervision of a physician, dentist, or RN; provides direct patient care and supervises assistive personnel |
| Unlicensed assistive personnel (UAP) | Performs more complicated tasks than the certified nursing assistant, including sterile procedures, in some states |
| Certified nursing assistant (CNA) | Performs patient care duties and assists nursing staff |
| Respiratory therapist (RT) | Evaluates, treats, and cares for patients with breathing problems due to heart and lung disease |
| Respiratory therapy technician (RTT) | generally works under the supervision of an RT |
| Physical therapist (PT) | Provides services to help improve or restore function and mobility, relieve pain, and prevent or limit permanent physical disabilities for patients suffering from injuries and disease |
| Physical therapy assistant (PTA) | generally works under the supervision of a PT and carries out the PT’s orders |
| Speech and language therapist (ST) | Assesses, diagnoses, treats, and helps to prevent disorders related to speech, language, voice, swallowing, and fluency |
| Occupational therapist (OT) | Assists patients with disabilities to develop, recover, or maintain their skills for daily activities and work |
| Certified occupation therapy assistant (COTA) | generally works under the supervision of a OT and carries out the OT’s orders |
| Pathologist (MD) | Medical doctor who examines tissue and blood samples to determine the origin or existence of disease |
| Medical laboratory technologist (MLT) Medical technician (MT) | Examines and analyzes body fluids and tissues, matches blood for transfusions, and tests for blood levels of medications |
| Phlebotomist | Draws blood specimens from patients for testing |
| Radiologist (MD) | Medical doctor who specializes in procedures involving x-rays and radiation therapy; reads radiographs and other radiological films |
| Radiologic technologist (Rad Tech) | Operates x-ray machines and other radiological equipment (CT) scanners, as well as magnetic resonance imaging (MRI) and ultrasound equipment; assists the radiologist by performing ordered tests to determine diagnoses and treat certain diseases |
| Pharmacist | Pharmacist distributes prescription medications and advises patients and prescribers on the selection, dosages, interactions, and side effects of medications |
| Pharmacy technician | assists pharmacist by helping to prepare prescribed medications, answering phones, and stocking shelves |
| Registered dietitian (RD) | plans regular menus and develops special menus to meet the dietary needs of patients, works with health- care providers to meet special dietary needs, and instructs patients on special diets |
| Dietary technician | assists the RD by distributing and picking up selective menus and monitoring patient food intake |
| Medical social worker Public health social worker | Provides psychosocial support to patients, families, or vulnerable populations; advises caregivers; counsels patients; plans for patients’ needs after discharge; and arranges for needed care such as home health care |
| Chaplain | Provides spiritual care for patients in hospitals and hospice settings, meets the spiritual needs of families and patients when diagnosis is terminal or when death occurs, and provides spiritual care for hospital staff |
| Managed Care | Any method of financing and organizing the delivery of health care in which costs are contained by controlling the provision of benefits and services |
| Medical Necessity | Patient’s clinical/medical information versus accepted medical review criteria; Must seem reasonable and necessary |
| Inpatient Settings | 1. Acute care hospital or medical setting 2. Long-term acute care hospital 3. Skilled nursing facility 4. Rehabilitation facility 5. Residential care facilities |
| Outpatient Care | 1. Hospital outpatient department 2. Outpatient mental health services 3. Cardiac rehabilitation 4. Pulmonary rehabilitation 5. Ambulatory care clinics 6. Health departments 7. Medical office 8. Home health care 9. Hospice |
| Client-centered care | Empowers the patient to take control of and manage their care; Allows patients to achieve independence within the limits of their disability by permitting them to have a voice in their rehabilitation, schedule, goals, and method of attaining those goals |
| Primary care nursing | One nurse is responsible for all aspects of nursing care for their assigned patients; A disadvantage of this type of nursing delivery is that it works best when the number of patients assigned to the nurse is very limited. |
| Case management | Assist patients who are vulnerable, at risk, or cost-intensive so that care is coordinated, meets specific needs, and is cost-effective while still promoting optimum health |
| Question: In which nursing care delivery system is one nurse responsible for all aspects of nursing care for his or her assigned patients? | Answer: Primary care |
| The Affordable Care Act (ACA) | Works to address four major issues: 1. Cost containment 2. Pre-existing conditions 3. Small business premiums 4. Lifetime benefit caps |
| Question: Young adults can stay on their parents’ insurance policy until what age to help them pay for the cost of insurance under which act? | Answer: 26 years old, Affordable Care Act (ACA) |
| Medicare | Over 65, or those younger with end-stage renal disease (ESRD), or other debilitating diseases; Diagnosis-related groups (DRGs)-payment based on a client’s particular illness or disease |
| Medicaid | Income below poverty level; benefits differs by state; pregnant women, children, and the disabled with an income below poverty levels |
| Indian Health Service | Provides govt funding for health care for qualified Native American individuals; a “certificate of degree of Indian blood” (CDIB) to be eligible to receive care; enables the individual to receive health-care services at tribal and IHS facilities |
| Private health insurance (Third-party payers) | 1. Health maintenance organization (HMO) 2. Preferred provider organization (PPO) 3. Point-of-service plans (POS) |
| TRICARE | -Active and retired military and their families |
| CHAMPVA | Veterans insurance |
| Worker’s compensation | People injured on the job |
| Disability | Insurance for those who become disabled |
| Charitable organizations | 1. Catholic and Jewish health systems 2. Shriners 3. Kaiser family 4. Robert Wood Johnson Foundation |
| Question: Which type of health insurance program uses a schedule based on diagnosis-related groups (DRGs)? | Answer: Medicare |
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