Legal Scope (class 11) Flashcards
LPN scope
limited assessment privileges.
limited in interpretation of clinical data.
typically do not have authority to alter nursing care plans.
LPN role responsibilities
be licensed.
be supervised by RN, Physician, or dentist.
Be trained to perform the nursing tasks he/she does.
Not delegate LPN tasks or functions to UAP.
duties of LPN
assist with ADLs.
assist in development & modification of patient care plans.
observe patients, chart, and report problems to RN or DR in charge.
Taking vital signs, administering meds.
Implementing plan of care.
evaluating whether identifited expected outcomes are met.
documentation and reporting patient condition/problem.
following approved institutional procedures.
catheters, dressings, trach care & suctioning, tube feeding, irrigating wounds.
assist in teaching of patient & family.
emotional support.
perform simple diagnostic tests.
postmortem care.
observe patient monitoring equipment.
Delegation
only delegate tasks down the chain of command. cant delegate nursing interventions RT: critical thinking, professional judgement.
Assistive personel fucntion under RN.
5 rights of delegation
- right task- can i delegate it?
- right circumstances- should i delegate it?
- right person-who is best prepared to do it.
- right direction/communication- what does the NAP need to know?
- right supervision- how will i follow up?
PRIORITIES
- life threatening-STAT action.
- High risk to patient if no action.
- lower risk, but could cause paitent harm if no action.
- health maintenance: exercise, diet.
- self-actualization.
Abuse
elder mistreatment. signs often missed by people r/t lack of training. only 1 in 14 cases ever come to attention of authorities. females more likely to be abused. abuse risk rise as persons age increases. majority of abusers are family members.
physical abuse
use of force to threaten or injure, force feeding.
emotional abuse
verbal attacks, threats, isolation, silent treatment, treat like child
sexual abuse
contact without consent
exploitation
theft, fraud, misuse, undue influence over money or property
neglect
caregiver refusal to meet needs
abandonment
desertion of vulnerable person by anyone with duty of care
self-neglect
mentally competent elder willingly engages in acts that threaten their safety- personal choice.
risk factors of elder abuse
advanced age. physical, functional, or cognitive impairment. mental illness. subastance abuse social isolation or poor social netowrk. dependence on others. past history of abusive relationships. low income. depression/low self-esteem. financial or unsafe housing. poor health. caregiver stress/frustration.
perpetrator characteristics
family members who:
abuse drugs or ETOH, have mental/emotional illness, feel burdened,.
assessment findings of physical abuse
bruises, fractures, sprains, dislocations. broken eyeglasses, signs of restraints, med overdose or underuse.
assessment findings of sexual abuse
torn stained or blood underclothes. unexplained vaginal dischaged, anal bleeding, infections.
assessment findings of neglect
dehydration, malnourished, poor hygiene, bed sores, unsafe/unclean living environment.
assessment findings of abandonment
desertion at facility, shopping center, hospital.
assessment findings of exploition
abrupt will changes, large amount of $ withdrawn, forged elder signatures, sudden appearance of family not usually involved claiming rights to assets.
assessment findings of emotional abuse
extremely withdrawn/non communicative. unusual behavior (rocking, sucking, biting), emotionall upset or agitated.
advanced directives
legal document that allow an individual to plan their healthcare. they include: living wills, durable power of atorney, healthcare surrogate, physician orders for life-sustaining treatment.
living will
- legal document that expresses pt wishes regarding life-sustaining tx in terminal illness or permanent unconsciousness.
- does not delegate a substitute decsion maker.
- responsibility of the nurse to advocate Y record plan of care
DPOA
document that delegates authority to make health, financial, and legal decisions.
-must be in writing and state that the person is authorized to make healthcare decisions.
full code
presumed status unless documentation/orders to limit interventions
DNR
order written by Dr based on patient/family wishes. No CPR performed for respiratory or cardiac arrest. DNAR means same thing
comfort measures
a Dr order that means no further life-sustaining interventions are necessary. goal of care is comfortable, dignified death.
euthanasia
a deliberate ending of a life of someone suffering from terminal illness.
slow codes- considered malpractice
voluntary euthanasia
competent adult patient makes decisions to terminate life.
involuntary euthanasia
mercy killing performed without the patients consent.
NI for comfort care
clean skin & linens. comfort positioning. foley or bed pads for incontinence. gentle massage to improve circulation & shift edema. small frequent sips of fluids. oral care. clear secretions from eyes & nose. administer ordered pain meds prn. oxygen as rx'd to relieve dyspnea.
