Ethics Schmethics
The act of threatening an individual with harm.
What is Assault?
The nurse is in a contact precautions room when a healthcare provider walks in without using personal protective equipment (PPE). What action should the nurse take?
A- Ask the healthcare provider to leave the client's room
B- Tell the charge nurse
C- Remind the healthcare provider that they need a gown
D- Discretely hand the required PPE to the provider.
What is D?
The type of communication that should occur between the patient and the nurse to develop a nurse-client relationship and provide patient centered care.
What is therapeutic communication?
Term used to describe activity of a person, often an employee, revealing information about activity within a private or public organization that is deemed illegal, immoral, illicit, unsafe or fraudulent.
What is Whistleblowing?
(What should be done/not done?)
A client is admitted to the ED for anaphylactic shock. What data may indicate the client is improving?
What is they will see an improvement in the client's BP, HR, HGB/HCT, BUN, creatinine, pulse, skin temperature, LOC, oxygen, distal pulses, airway, breathing.
What steps does the RN do when a patient chooses to change their code status to a DNR?
What is:
Get a copy of the patients advanced directives
Notify the provider/any applicable staff
Place a DNR band/chart/door signage on patient
This ethical framework is focused on providing the most good for the greatest number of people.
What is utilitarian framework?
Others-Duty based, rights based, Institutionist (case by case).
The nurse can delegate the following tasks to which member of the healthcare team:
Wound dressing change, Administer PO antibiotics, Obtain vitals on a patient with tachycardia, Complete oral care on a client before bed.
Who is the LPN?
What is scope of each RN/LPN/UAP?
What does a leader need to ensure is available for employees that is regulated by the Fair Labor Standards Act?
What is:
Minimum wage, overtime pay, breast feeding accommodations, break times.
A nurse manager is facilitating conflict resolution among two staff members. Which priority action should the nurse manager take to manage the conflict effectively?
A- Ignore the conflict and hope it will resolve on their own
B- Provide opportunities for collaborative problem-solving
C- Focus solely on the differences among team members
D- Seek input from external parties before internal discussions
What is B?
A nurse informing a patient about the potential side effects of a medication they are about to receive, even if the side effects are unpleasant is an example of what ethical term?
What is veracity?
The obligation to tell the truth.
What other terms are there for ethics?
Name one area of a personal/professional development the nurse leader should assess during an interview.
What is:
Emotional Intelligence/working through conflicts, Self-awareness, Self-regulation, Motivation, Empathy, Social Skills.
Which patient should the nurse see first?
A-Client just admitted needing initial assessment
B- Client that has a BP of 210/107 and STAT labetalol
C- Client needing orientation to their room and unit
D-Client needing ordered albuterol with audible wheezing
Who is patient D?
During an interview of a potential new nurse candidate, which question topic should be avoided to reduce the risk of violating employment laws?
What is do you have any children, or are you pregnant?
Will also take questions about gender identity, sexual preference, race, color, religion, National origin.
A client was in an emergent event where they received a lidocaine 100mg mg bolus and then another 400 mg bolus. The client was stabilized and sent to the intensive care unit where they were continued on an infusion of lidocaine at 2 mg/min for the next 5 hours. The infusion was then decreased to 0.5 mg/min for the next 3.5 hours. The maximum dose of lidocaine a client can receive in 24 hours to be safe is 1000 mg. How many mg of lidocaine has this client received?
What is 1205?
100+400=500
5*60=300*2=600
3.5*60=210*0.5=105
500+600+105=1205
A new graduate nurse is given an assignment that the nurse feels may be unsafe and will not allow for care that meets the Nurse Practice Act standards of care. What is the nurse's priority?
What is refuse unsafe assignment for patient safety, work with charge or management to negotiate safer assignment. Consult Risk or legal team/malpractice representative.
Abandonment may be cited if any portion of patient report is taken.
What is one strategy the nurse manager can implement to decrease staff resistance to change?
What is:
Strive for a collaborative relationship, include in the decision-making process, elicit feedback, include honesty and transparency in rationale for change, create a safe space for feedback, have an open-door policy for questions.
A client is admitted for confusion, left sided weakness, and abnormal MRI showing a right sided infarct. Which of the following tasks can the client delegate to the LPN?
Vital signs, application of the ECG monitor, apply oxygen to keep sats above 94%, administration of TNK, hourly NIH assessments, Evaluate coag labs.
What is:
Vital signs, ECG monitor, oxygen
Examples of colleague impairment that may indicate drug or ETOH abuse.
What are: Periods of absence, missing/incorrect counts, frequent medication errors, frequent extra shifts in certain areas, S/S of impairment.
A low BP and high heart rate could indicate this priority complication:
What is fluid volume deficit?
(Would also take Altered Perfusion or Infection)
Which ethical framework model should the nurse use when facing an ethical dilemma and what are the steps of this model?
What is MORAL decision-making process
M-Massage the dilemma (Gather Data/Who involved)
O- Outline option (Consider all options/Key people)
R- Review (Weigh Positive and Negatives)
A- Affirm and Act (Agree on Plan and Implement)
L- Look back (Evaluate process/Outcomes)
This type of leadership style is described as a hands-off style that provides minimal direction and feedback.
What is Laissez-Faire style?
Other styles-Authoritative, Servant style, Democratic, Transformational, Transactional.
The registered nurse updates the plan of care for a client admitted for Cdiff. Which priority intervention should the nurse plan to delegate to the licensed practice nurse (LPN)?
A- Place the client on contact precautions.
B- Monitor trends in stool samples
C- Initiate intravenous antibiotics as prescribed.
D- Walk the patient to the bathroom every four hours
What is A?
What method to reduce new grad burnout should the nurse leader participate in when listening to feedback?
Think (GRRRRR)
What is:
G-Greeting
R-Respectful listening
R-Review
R-Recommend
R- Request information
R-Reward
A client is admitted with confusion, hypotension, and hyperglycemia. Diagnosed with DKA. The client's labs are: BG-850, K-2.5, PH-7.2, HCO3-16, Co2-32, NA-136. Vitals are BP-89/56, HR-125, Temp-98.6, O2-95 RA, R-26. Which of the following orders are appropriate for the nurse to complete?
Administer 1L IV 0.9% NS bolus
Administer 10U regular insulin bolus, then start patient on IV regular insulin drip.
Check blood glucose levels hourly
Call provider for any abnormal labs
What is: Administer IV bolus, check BG, call provider for potassium level. Would hold Insulin.