Ch. 11: Admission, Transfer, and Discharge

Question 1

Admission to a hospital or other health care facilities

Answer 1

Is an anxious time for patients

Question 2

The nurse’s responsibility is to

Answer 2

Assist the patient in maintaining dignity and a sense of control and in becoming comfortable in the new environment

Question 3

Upon admission, some patients may experience

Answer 3

Disorientation, fear of the unknown, loss of identity, or separation anxiety

Question 4

What can help alleviate a patient’s fear and anxiety?

Answer 4

Orienting the patient to the new environment

Question 5

Only address a patient’s first name

Answer 5

At the patient’s request

Question 6

Empathy

Answer 6

Ability to recognize and to some extent share the emotions and significance of that person’s behavior

Question 7

If the patient does not speak English, and is not accompanied by a bilingual family member on admission

Answer 7

contact the social services department to secure an interpreter

Question 8

Medicare and Medicaid reimbursements are required to present information on

Answer 8

patient’s right to refuse or accept medical treatment and information regarding advance directives

Question 9

Some hospitals have telephone admitting

Answer 9

the day before a planned admission, a representative from the admitting office calls the patient at home and gathers all the information needed to begin the records

Question 10

Patient room orientation

Answer 10

Explanation of policies applicable to the patient, how to adjust the bed and the lights, how to call the nurse form the bed and the bathroom, how to operate the telephone and the radio, how to operate the television, how to use the intercom system if one is present, the location of lounge areas, the locations of shower and bathroom facilities, the relationship of the room to the nurses’ station

Question 11

To introduce yourself

Answer 11

give your name and title, a person who is warmly welcomed is more at ease in a new enviorment

Question 12

What expedites the admission process in the admitting department and on the nursing unit?

Answer 12

The EHR

Question 13

The admitting procedure on the patient care unit is much more extensive than that in the

Answer 13

admitting department

Question 14

The nurse must verify information

Answer 14

found in the EHR

Question 15

Assess immediate needs

Answer 15

such as pain, shortness of breath, or severe anxiety

Question 16

Steps associated with patient admission

Answer 16

1. Perform hand hygiene
2. Prepare the room before the patient arrives
3. Courteously greet the patient and family
4. Check the ID band and verify its accuracy
5. Assess immediate needs
6. Orient the patient to the unit, the lounge and the nurse’s station
7. Orient the patient to the room. Explain the use of equipment, call system, bed, telephone, and television
8. Explain facility routines, such as visiting hours and meal times
9. Provide privacy if the patient desires or if abuse is suspected
10. Follow facility policy for care of valuables, clothing and medications
11. Obtain the patient’s health history and perform the initial nursing assessment.
12. Provide for safety
13. Begin care as ordered by the health care provider
14. Invite family back into the room if they left earlier
15. Perform hand hygiene
16. Record the information on the patient’s health care record according to agency policy
17. Allow patient and family time alone together, if desired
18. Perform patient teaching

Question 17

TJC requires each hospitalized patient to have an admission assessment prepared by a registered RN within

Answer 17

24 hours of admission

Question 18

The initial assessment includes

Answer 18

level of consciousness, vital signs, height, weight, and a review of body systems

Question 19

When is a hospitalist assigned to the patient’s care?

Answer 19

If the primary health care provider chooses not to follow patient care in the hospital setting

Question 20

The role of the LPN/LVN in the nursing process

Answer 20

participate in planning care for patients based on patient needs, review patient’s plan of care for patients based on patient needs, review and follow defined prioritization for patient care, use clinical pathways, care maps, or care plans to guide and review patient care

Question 21

Assessment of the patient begins at

Answer 21

admission

Question 22

Subjective and objective data are collected

Answer 22

during the assessment

Question 23

The patient being admitted to most health care facilities is required to have a nursing care plan initiated by the RN within

Answer 23

the first 24 hours of admission

Question 24

Common patient problems for a newly admitted patient include

Answer 24

anxiousness and potential for injury, insufficient knowledge regarding admission process/illness, and fearfulness, related to admission to health care facility

Question 25

Examples of patient-centered goals

Answer 25

Patient will voice understanding of care planned while in facility
Patient will not suffer accidental injury while in facility

Question 26

Examples of nursing intervention/implementation

Answer 26

orient or acquaint the patient to the facility to ease the patient’s anxiety, establish nurse-patient rapport directed at fostering a therapeutic nurse-patient relationship, identify risk behaviors or limitations to assist the staff in making the environment safe, confirm though discussion and questions that the patient understands the diagnostic tests and procedures, monitor the patient’s ability to ambulate alone, monitor the patient’s ability to operate the hospital bed, the call light, and the emergency button

Question 27

Determine whether the patient has met the previously established goals

Answer 27

Patient demonstrates understanding of procedure, Patient has remained injury free

Question 28

The changing condition of a patient, whether improving or becoming more critical, frequently necessitates

Answer 28

transfer

Question 29

Documentation of the patient’s condition before and during transfer and adequate communication among nursing staff ensures

Answer 29

continuity of care

Question 30

Transfer combines

Answer 30

admission and discharge

Question 31

Assessment for transfer

Answer 31

the patient’s condition must be assessed before transfer to determine the necessary method of transfer

Question 32

Patient problems that the patient had before the transfer

Answer 32

may still be current after the transfer, the nurse’s assessment helps in determining whether revisions to the care plan are necessary

Question 33

Examples of patient-centered goals with transferring

Answer 33

Patient will voice an understanding of the reason for and the process involved with the transfer
Patient will incur no injury during or after transfer

Question 34

Implementation for transfer

Answer 34

explain to patient and family the reason for the transfer, when it is to occur, and what procedures are planned
encourage questions
confirm the patient understands the transfer and procedures through discussion and questions
inspect the patient’s positioning in or on transport vehicle
during final assessment, compare present data with previous findings

Question 35

Evaluation for transfer

Answer 35

Patient state the reasons for the transfer

Patient is secured into wheelchair or gurney and remains injury free

Question 36

Discharge planning

Answer 36

is defined as the systematic process of planning for patient care after discharge from a hospital or health care facility

Question 37

Effective discharge requires

Answer 37

careful planning and continued assessment of the patient’s needs during the stay in the facility

Question 38

The Joint Commission suggest the following instructions be given to patients upon discharge from a health care facility

Answer 38

reason for the admission, safe and effective use of medications and medical equipment, instruction on nutrition and modified diets, rehabilitation techniques to support adaptation to or functional independence in the environment, access to available community resources as needed, when and how to obtain further treatment, the patient’s and family’s responsibilities in the patient’s ongoing health care needs, maintenance of good standards for personal hygiene and grooming

Question 39

The social worker is often in charge of

Answer 39

discharge planning for the long-term care resident

Question 40

Another approach to discharge planning is to perform

Answer 40

transitional care with transition specialists

Question 41

A discharge summary is part of the

Answer 41

discharge plan

Question 42

A discharge summary includes

Answer 42

the patient’s learning needs, how well they have been met, the patient teaching completed, short-term and long-term goals of care, referrals made, and coordinated care plan to be implemented after discharge

Question 43

Referrals should be made

Answer 43

as soon as possible after the patient’s need is identified

Question 44

The nurse is responsible to ascertain

Answer 44

whether the patient or family is able to provide any care still needed

Question 45

AMA

Answer 45

when a patient leave a health care facility without a health care provider’s order for discharge

Question 46

If the health care provider fails to convince the patient to remain in the facility

Answer 46

the provider asks the patient to sign an AMA form

Question 47

Patient problem on discharge example

Answer 47

Compromised Maintenance of Health and Inability to Bathe Self.

Question 48

Patient planning at discharge examples

Answer 48

Patient or family member will be able to care for individual needs
Health care resources regarding bathing and hygiene will be available at home

Question 49

Evaluation at discharge examples

Answer 49

Home health agency has been notified of a patient’s needs on arrival at home
Home health agency’s initial visit is completed before discharge or soon thereafter