Prioritization
What are the ABC's of Prioritization in Emergency ?????????
Airway
Breathing
Circulation
The client's nursing diagnosis is Deficient Fluid Volume related to excessive fluid loss. Which action related to fluid management should be delegated to a UAP?
A. Administering IV fluids as prescribed by the physician
B. Providing straws and offering fluids between meals
C. Developing a plan for added fluid intake over 24 hours
D. Teaching family members to assist the client with fluid intake
B
What are 2 ways an RN can supervise the delegatee???
Directly and Indirectly
What is Principle 1???
(Prioritization video)
SAFETY FIRST
What cannot be DELEGATED?
(UEAT)
Unstable patients
Evaluations
Assessments
Teaching
Nurse Caitlynn has received the assignment for the day shift. After making initial rounds and checking all of the assigned clients, which client should the nurse plan to care for first?
a. A client who is ambulatory
b. A client scheduled for physical therapy at 1 pm
c. A client with a fever who is diaphoretic and restless
d. A postoperative client who has just received pain medication
C
Nurse Morgan is caring for a patient with esophageal cancer. Which task could she delegated to her CNA?
A. Assisting the patient with oral hygiene
B. Observing the patient's response to feedings
C. Facilitating expression of grief or anxiety
D. Initiating daily weights
A
An RN is counseled by the nurse manager regarding inappropriate delegation when the:
A. RN instructs the nursing assistant to greet ambulatory surgery patients and show them to their rooms.
B. nursing assistant informs the RN that she has not been trained to collect a sputum specimen and the RN states, "I will show you this time and you can show me the next time."
C. RN assigns the float LPN/LVN the task of completing a plan of care for a stable patient who was admitted for routine replacement of a feeding tube.
D. LPN/LVN who has demonstrated competence is asked to perform a dressing change for a patient before she is discharged home.
C
What did the male nurse do wrong in the beginning?
Delegation video
Not give report before leaving
What does each letter in S.M.A.R.T. goals mean?
Specific
Measurable
Achievable
Relevant
Time-bound
Nurse Caitlynn is caring for four clients and is preparing to do his initial rounds. Which client should the nurse assess first?
A. A client with diabetes is being discharged today.
B. A 35-year-old male with tracheostomy and copious secretions.
C. A teenager is scheduled for physical therapy this morning.
D. A 78-year-old female client with a pressure ulcer that needs a dressing change.
B
New grad RN Morgan is very busy in the inpatient unit with her 15 patients. The MD has ordered a removal of an indwelling urinary catheter and a bladder scan. RN Morgan is unable to d/c the foley because she is too busy. Her UAP tells her that he knows how to do it and offers to do so. Which of these is the best action for Nurse Morgan?
A. Tell him it is not in his scope of practice
B. Allow him to do it because he knows how to
C. Call the Charge RN and ask if he's allowed to
D. Call the MD and tell him you don't have enough time
C
Name one of the 4 Main Principles of Supervision
Constructive Feedback
Positive Attitude
Plan for Future Delegation
Supervision Importance
Why is delegation so important, according to the charge nurse at the end of the delegation video?
Enhances patient outcomes.
Can LPN/LVN give IV piggyback medications?
YES
not push
RN Caitlynn is monitoring a 53-year-old client who is undergoing a treadmill stress test. Which client-finding will require the most immediate action?
A. Blood pressure of 152/ 88 mm Hg
B. Heart rate of 134 beats/ min
C. Oxygen saturation of 91%
D. Chest pain level of 3 (on a scale of 10)
D
When care assignments are being made for patients with alterations related to gastrointestinal (GI) cancer, which patient would be the most appropriate to assign to an LPN/ LVN under the supervision of a team leader RN?
A. A patient with severe anemia secondary to GI bleeding
B. A patient who needs enemas and antibiotics to control GI bacteria
C. A patient who needs preoperative teaching for bowel resection surgery
D. A patient who needs central line insertion for chemotherapy
B.
Charge RN Chloe is reviewing the charts of clients who were assigned to the care of a newly graduated RN. The RN has correctly charted dose and time of medication, but there is no documentation regarding nonpharmaceutical measures. What action should you take first?
A. Make a note in the nurse's file and continue to observe clinical performance.
B. Refer the new nurse to the in-service education department.
C. Quiz the nurse about knowledge of pain management and pharmacology.
D. Give praise for correctly charting the dose and time and discuss the deficits in charting
D
What is Principle 2???
(Prioritization video)
Start with what takes the least amount of time!!!
A patient with a pulmonary embolism is receiving anticoagulation with IV heparin. What instructions would you give the nursing assistant who will help the patient with activities of daily living? Select all that apply.
A. Use a lift sheet when moving and positioning the patient in bed.
B. Use an electric razor when shaving the patient each day.
C. Use a soft-bristled toothbrush or tooth sponge for oral care.
D. Use a rectal thermometer to obtain a more accurate body temperature.
E. Be sure the patient's footwear has a firm sole when the patient ambulates.
A B C E
A newly admitted client is suspected to have avian influenza ("bird flu") due to increasing dyspnea and dehydration. Which of these prescribed actions will nurse Caitlynn implement first?
• A. Give first dose of oseltamivir (Tamiflu)
• B. Instill 5% dextrose in water at 100 mL/hr
• C. Collect blood and sputum specimens for testing
• D. Start oxygen using a non-rebreather mask
D
What are the 5 rights of Delegation????????
Right Task
Right Circumstance
Right Person
Right Direction/Communication
Right Supervision
The active process of directing, guiding, and influencing the outcome of an individual's performance of an activity or task is referred to as ___________________.
Supervision
What should the female nurse that was left the patients have done before letting the male nurse go to lunch?
Get report
What 5 Needs are included in Maslow's Hierarchy of Needs?!?
Self Actualization
Self Esteem
Love and belonging
Safety and security
Psychological needs