Admissions, Transfers, and Discharge - ATI - Chapter 9

Question 1

Responsibilities of nurses include enuring continuity of care and information sharing throughout the processes of admission, transfers, and _____.

Answer 1

discharge

Question 2

The admission assessment provides baseline data to use in the development of the _____.

Answer 2

nursing care plan

Question 3

Comparisons with future assessments help monitor client status and response to ________.

Answer 3

treatment

Question 4

Many clients experience anxiety, fear of the unknown, and loss of independence and ______ at the time of admission to the hospital or health care facility.

Answer 4

self-identity

Question 5

Children can experience _______ if parents are not present during the hospitalization. When nurses recognize client’s concerns and provide respectful, culturally sensitive care, the clients’ experiences will be more positive.

Answer 5

separation anxiety

Question 6

_____ planning is an interprofesional process that starts at admission.

Answer 6

discharge

Question 7

Nurses conduct discharge planning with clients and _____ for optimal results.

Answer 7

families

Question 8

Nurses establish the ability of clients to participate in the ____ assessment.

Answer 8

admission

Question 9

Clients in distress or who have ______ changes might need to have a family member provide necessary information.

Answer 9

mental status

Question 10

Nurses begin establishing the therapeutic relationship with clients and _____ during the admission process.

Answer 10

families

Question 11

Nurses promote _______ communication between providers.

Answer 11

professional

Question 12

Nurses use the nursing process as a guide to plan _____ and interventions for clients during discharge.

Answer 12

teaching

Question 13

Nurses use standard hand-off communication tools, such as Introduction, Situation, Background, Assessment, Recommendation (ISBAR) to facilitate _____ and discharges.

Answer 13

transfers

Question 14

Prior to arrival of the client, bring necessary _____ into the room. This should include appropriate documentation forms, equipment to measure vital signs, a pulse oximeter and hospital attire for the client.

Answer 14

equipment

Question 15

Admission Procedure:

Answer 15

Introduce yourself and identify your role.

Explain the roles of other care delivery staff.

If in a semiprivate room, introduce the client to his roommate.

Provide hospital attire and assist as necessary.

Position the client comfortably.

Apply the id bracelet and allergy band if needed.

Provide facility-specific brochures and info material

Provide info about advance directives.

Document the client’s advance directives status in the medical record. Place a copy in the medical record if it is available.

Question 16

During the admission process collect ____ data which would include vital signs, height, weight, and allergy status.

Answer 16

baseline data

Question 17

During the admission process collect _____ information about the patient.

Answer 17

biographical

Question 18

During the admission process data collection the client’s reason for seeking _______.

Answer 18

health care

Question 19

During the admission process collect data on the client’s present illness and ______.

Answer 19

symptoms

Question 20

During the admission process collect data on the _______ which should include: current illness, current medications (prescription and OTC), prior illnesses, chronic disease, surgeries, previous hospitalizations, and other relevant data.

Answer 20

health

Question 21

During the admission process collect data about the _______.

Answer 21

family history

Question 22

During the admission process do a _______ assessment and determine if the patient’s use of alcohol, tobacco, drug, and caffiene use; recent weight gain/loss, use of nutritional or herbal supplements and dentures.

Answer 22

psychosocial

Question 23

During the admission process assess the _______ of patient by looking at the current diet, any chewing or swallowing problems, recent weight gain/loss, use of nutritional or herbal supplements, and dentures.

Answer 23

nutrition

Question 24

During the admission process collect data on the _____ which includes religion, advance directives, and living wills.

Answer 24

spiritual health/quality of life concerns

Question 25

During the admission process collect data on the _____ also known as the ROS.

Answer 25

systems

Question 26

During the admission process do a _____ assessment and find out about their history of falls, sensory deficits (vision, hearing), and use of assistive devices (walker, cane, crutches, wheelchair)

Answer 26

safety

Question 27

During the admission process, you also start the ____ process. You will need to know what family members are in the home, transportation for discharge, relevant phone numbers, medical equipment needs at home and home health care needs at home.

Answer 27

discharge

Question 28

During the admission process _____ personal items.

Answer 28

inventory

Question 29

Examples of personal items to inventory include clothing, jewelry, money, credit cards, _____ (eyeglasses, contacts, hearing aids, cane, dentures), medications, cell phones, and other technology devices and religious articles.

Answer 29

assistive devices

Question 30

During the admission process you should discourage keeping valuable at the _____ .

Answer 30

bedside

Question 31

During the admission process you should document communication with client related to items left within the room, and valuables locked in the ______.

Answer 31

facility’s safe

Question 32

______ the client and family to the room and the facility.

Answer 32

orient

Question 33

During the client and family’s orientation to the facility share the following information.

Answer 33

Call light operation
Electric bed operation
Telephone services/television controls
overhead lighting operation
smoking policy
restroom locations
waiting areas
meal times
usual time for providers' visits
dining/vending services
visiting policies

Question 34

If the _____ changed (i.e. health status improved so a client no longer needs intensive care) it is an indication for transfer and/or discharge.

Answer 34

level of care

Question 35

______ is required to provide necessary care (i.e. transfer form medical unit to surgical suite) is an indication for transfer and/or discharge.

Answer 35

Another setting

Question 36

If the facility does not ____the type of care a client now requires (i.e. after the acute phase of a stroke, the client requires care in a skilled facility) is an indication for transfer and/or discharge.

Answer 36

offer

Question 37

The client no longer needs _____ care and is ready to return home is an indication for transfer and/or discharge.

Answer 37

inpatient

Question 38

_____ planning should begin on admission for every patient.

Answer 38

discharge

Question 39

In discharge planning assess whether the client will be able to ____ too his previous residence.

Answer 39

return

Question 40

In discharge planning determine whether the client needs or has someone to assist him at ____.

Answer 40

home

Question 41

In discharge planning make a referral too the social worker to arrange for _____.

Answer 41

community services

Question 42

In discharge planning communicate _____ and needs to community service providers.

Answer 42

health status

Question 43

In discharge planning the provider documents that the client may be discharged. However, a client who is legally competent has the right to _____ the facility at any time. The nurse notifies the client’s provider, has the client sign the proper forms if possible, and provides discharge instructions.

Answer 43

leave

Question 44

You should involve the client and family as much as possible in the _____.

Answer 44

discharge planning

Question 45

______ is when the nurse discusses the discharge instructions with the client and provides a printed copy.

Answer 45

discharge education

Question 46

When nurses are giving discharge education they should verify _____ of the instructions by the client.

Answer 46

instructions

Question 47

Identifying ____ concerns at home is a part of the standards for discharge education.

Answer 47

safety

Question 48

Reviewing symptoms of potential _____ and when to contact emergency care or the provider is a part of the standards for discharge education.

Answer 48

complications

Question 49

Providing the _____ of the provider is a part of the standards for discharge education.

Answer 49

phone number

Question 50

Providing the names and phone number of ______ that give care at the client’s residence is a part of the standards for discharge education.

Answer 50

community resources

Question 51

Step by step instructions for performing continuing _____, such as dressing changes is a part of the standards for discharge education.

Answer 51

treatments

Question 52

______ restrictions and guidelines, including those that pertain to medication administration is a part of the standards for discharge education.

Answer 52

dietary

Question 53

The amount and frequency of _____ to perform to support continued independence at home is a part of the standards for discharge education.

Answer 53

therapies

Question 54

Directions how to take medications, potential interactions, and ____ adherence is important is a part of the standards for discharge education.

Answer 54

why

Question 55

________ at the bedside and from dresser drawers and closets (flowers, books, clothing, personal care items) should be transferred/discharged with the client.

Answer 55

Personal belongings

Question 56

_____ from the safe (if leaving the facility) should be transferred/discharged with the client.

Answer 56

valuables

Question 57

______ (especially that belong to the client or that cannot be returned to the pharmacy for credit) should be transferred/discharged with the client.

Answer 57

medications

Question 58

______ devices should be transferred/discharged with the client.

Answer 58

assistive

Question 59

_______ or a transfer form should be transferred/discharged with the client.

Answer 59

medical records

Question 60

A responsibility of the nurse on the day and time of transfer is to confirm that the receiving facility or unit is _____ the client and that the room or bed is available when transferring/discharging a client.

Answer 60

expecting

Question 61

A responsibility of the nurse is to communicate the ____ the client will transfer to the receiving facility or unit when transferring/discharging a client.

Answer 61

time

Question 62

A responsibility of the nurse is to complete the _______ (medial records, transfer forms) when transferring/discharging a client.

Answer 62

documentation

Question 63

A responsibility of the nurse is to give a ____ transfer report in person or via telephone when transferring/discharging a client.

Answer 63

verbal

Question 64

A responsibility of the nurse is to confirm the ______ the client will use to complete the transfer or discharge (care, wheelchair, ambulance) when transferring/discharging a client.

Answer 64

mode of transportation

Question 65

A responsibility of the nurse is to make sure the client is dressed _____ if going outside of the facility when transferring/discharging a client.

Answer 65

appropriately

Question 66

A responsibility of the nurse is to account for all of the client’s _____ when transferring/discharging a client.

Answer 66

valuables

Question 67

A responsibility of the nurse is to have any _____ ready when receiving a transferred client.

Answer 67

specialized equipment

Question 68

A responsibility of the nurse if appropriate, inform the client’s _____ of the impending admission or transfer when receiving a transferred client.

Answer 68

roommate

Question 69

A responsibility of the nurse is to ____ other health care team members of the client’s arrival and needs when receiving a transferred client.

Answer 69

inform

Question 70

A responsibility of the nurse is to meet with the client and family on arrival to complete the _____ and orient the client and family to the new facility or unit when receiving a transferred client.

Answer 70

admission process

Question 71

A responsibility of the nurse is to assess how the client _____ the transfer when receiving a transferred client.

Answer 71

tolerates

Question 72

A responsibility of the nurse review _______ when receiving a transferred client.

Answer 72

transfer documentation

Question 73

A responsibility of the nurse is to implement appropriate nursing interventions in a ______ when receiving a transferred client.

Answer 73

timely manner

Question 74

Transfer documentation includes

Answer 74

medical diagnosis and care providers
demographic info
overview of health status, plan of care, and recent progress
alterations that can precipitate and immediate concern
notification of assessments or care essential within the next few hours
most recent vital signs and medications, including PRN
allergies
diet and acitivity orders
specific equipment or adaptive devices (oxygen, suction, wheelchair)
advance directives and emergency code status
family involvement in the care and health care proxy, if applicable

Question 75

Discharge documentation includes

Answer 75

Types of discharge (provider prescription or against Medical advise (AMA)
Date and time of discharge, who went with the client, and Transportation (wheelchair to car, gurney to ambulance)
Where the client went (home, long-term care, etc)
Summary of the client’s condition at discharge (steady gait, ambulating independently, in no apparent distress)
Description of any unresolved difficulties and procedures for follow up
Disposition of valuables, meds brought form home, and prescriptions

Question 76

Discharge instructions should include documentation of _____ of instructions by the client.

Answer 76

understanding

Question 77

Discharge instructions

Answer 77

written instructions in the client’s language
diet at home
step by step instructions for procedures at home
precautions to take when performing procedures or administering meds
signs and symptoms of complications to report
names and numbers of providers and community services to contact
plans for follow up care and therapies.