TEST 2 - UNIT B - EF - MANAGING CLIENT CARE Flashcards
Time management is an
essential nursing skill that affects both
Time management effects both
nurse and client satisfaction and safety.
The nurse can use many time management strategies to
help plan the day, such as a time management matrix or lists.
Organizational skills are also necessary to achieve
effective time management.
Tools such as SBAR reportingand SOAP notes can help nurses
organize client information.
Nurses can use SMART goals to establish
plans for the day that are realistic and achievable.
Making client assignments can be difficult for nurses because
client acuity,
nurse skill, and
scope of practice must all be taken into consideration.
If client care tasks are delegated, the delegator must ensure the delegatee is
competent and legally able to complete the task.
The delegator should continue to supervise the delegate to ensure
the task is completed correctly and safely.
Toolkits such as the IDEAL framework can help health care providers improve
client discharge planning and support the client’s family.
Numerous client-specific challenges can affect the
care and safety of the client as well as the health and safety of the nurse.
The nurse must be prepared to deal w/
abusive or impaired clients as well as noncompliant clients.
The use of interprofessional collaboration and continuity of care can help all health care providers achieve the
most effective client care, good communication, and positive
· acuity level
o The requirement of nursing services and the amount of nursing time to meet those requirements. Complexity of a client’s condition.
· advocate
o A person who pleads on another’s behalf.
· client assignments
o Process of dividing responsibility for care of multiple clients among the nursing staff.
· delegatee
o A person whom a task is entrusted to.
· delegator
o A person who entrusts a task to another.
· discharge planning
o Procedure for determining what additional support a client needs in order to be transferred from one care facility to another or home. Coordinating detailed planning for client’s discharging, or leaving a facility, or level of careto alleviate gapsor oversights in treatments or care.
· managing a group of clients
o Nursing process of organizing delivery of client’s care tasks among a group of people.
· organizational skills
o Activities that allow the nurse to be efficient and accurate in delivering client care such as making a to-do list.
· SBAR
o Acronym for a communication tool to relay relevant client information to other medical professionals: situation, background, assessment, recommendation.
· SMART
o Acronym for goal setting: specific, measurable, attainable, realistic, timely.
· SOAP
o Acronym for a documentation tool: subjective, objective, assessment, plan.
· teach back
o A technique to determine the client’s level of understanding by having the client explain back to the nurse the information that was taught.
· team nursing
o A group of nurses working together to achieve client care tasks.
· teamwork
o The combined action of a group.
· time management matrix
o A tool that divides activities into four quadrants: important, not important, urgent, not urgent.
- A charge nurse is teaching a newly licensed nurse about the concept of team nursing. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?
Nurses will pair together to care for an assigned group of clients.”
- A nurse is precepting a newly licensed nurse and suggests using the IDEAL method to structure the client’s discharge planning. The client’s caregiver is also in the room. Which of the following statements made by the newly licensed nurse demonstrates the correct the use of the IDEAL method?
I will include the client and caregivers in the discharge discussion
- A nurse is teaching the SMART goal method to a client who has diabetes mellitus and is setting nutrition and weight loss goals. Which of the following client statements should indicate to the nurse an understanding the teaching?
“I will reduce my sugar intake by 10 grams each week for one month until I reach the desired level.”
- A nurse is speaking with a client who is noncompliant in performing a daily blood glucose testing regimen. Which of the following responses should the nurse make?
“What is preventing your consistency with your daily blood glucose checks?”
- A charge nurse is reviewing client acuities and tasks to make the nursing staff’s daily assignments. When using the Five Rights of Delegation, which of the following should the charge nurse use to ensure client safety?
Right task
- A charge nurse is teaching a group of nurses about protecting themselves from an abusive client. Which of the following statements by a nurse within the group demonstrates an understanding of the teaching?
I should try to escape or put a barrier between myself and the client
- A nurse is giving change-of-shift report to an oncoming nurse using SBAR reporting. Which of the following entries by the nurse demonstrates the correct use of SBAR?
The client in room 1 has been experiencing breakthrough pain following an exploratory surgery yesterday. Vital signs are stable. Recommend calling the provider for a breakthrough dose if pain continues.
- A nurse is caring for a client who is being transferred to another unit, but the receiving nurse is unavailable to take report. Which of the following concepts is being violated that could place the client at risk?
Continuity of care
- A newly licensed nurse is reviewing the client assignments for a shift and determining tasks to complete. Which of the following is a time management strategy the nurse should use?
Make a list and prioritize a plan
All licensed nurses and assistive personnel (AP) have a personal responsibility to
know what their role and scope of practice entails.
The nurse should never assign a task _____the AP’s scope of practice.
outside
Managing multiple clients can be difficult for a new nurse. Making a list of all tasks to accomplish and then prioritizing a plan can
help the nurse stay organized and efficient.
Administering medications should be as prescribed and according to a
schedule
. It may be necessary to _____ if several clients have medications due at the same time, but the nurse would not give the entire day’s medications at the same time.
prioritize
A nurse should document tasks as
performed throughout the workday.
Leaving documentation to
the end of the day is a safety issue as well as poor time management.
The right scope, referring to scope of practice or range of function (for an assistive personnel), is a consideration for choosing the
right person. It is not a defined right of delegation by itself.
The charge nurse should provide the right directions via
effective communication to the health care worker completing an assignment or task.
It is unsafe both for the nurse and the client if the nurse is
not clear on what to do for the task.
The charge nurse is responsible for supervising assignments and
task delegation during the shift.
The charge nurse should delegate an assignment or task that is
safe for a health care worker to carry out.
Safety includes
right training, competency, or within the health care worker’s scope of practice.
The nurse should always try to escape a dangerous situation. If escape is not possible, do what
creating a barrier where the client cannot reach them until help arrives is the next acceptable action.
The nurse has the right to
protect and defend themself. The nurse should report the incident and not let abuse from a client go unnoticed.
The nurse should identify that verbal abuse is also
abuse. Even if the client does make physical contact but the nurse is unharmed, it is still abuse.
The nurse should identify that abuse or assault occurs in
1 out of 4 nurses. Many nurses do not admit to or report such occurrences.
The nurse should listen to what the client and caregiver want to achieve and let them
set those goals.
The nurse should not assume the client
understands after issuing a printout of the medications.
“D” in IDEAL stands for
“discuss” the 5 key areas
IDEAL 5 key areas
medications,
home life,
warning signs,
test results,
follow-up with the client and caregivers.
The nurse should ensure the client and caregiver understand the diagnosis by having the client use the
teach back method.
in IDEAL “I” stands for
“include” in this model. The nurse should include the client and caregivers to review the discharge instructions.
Research shows including caregivers in the discharge instructions with the client leads to
a safer transition.
quality assessment skills is a method to help ensure
continuity of care.
interprofessional collaboration is an important piece of
client care.
Interprofessional collaboration is related to a
group of providers working together on different aspects of the client’s care.
continuity of care can cause a safety risk of a client when there are
numerous hand-off reports completed during a transfer to another unit. The nurse should wait until the other nurse is available for report.
consistent client monitoring is a method to help ensure
continuity of care.
continuity of care.
??
Team nursing is the concept of nursing that
pairs two or more nurses together to provide care for a group of clients.
Team nursing provides support for
novice nurses and others that are not as skilled in performing more complex tasks.
A positive outcome of team nursing is the
team works together. No one is expected to perform tasks that they are uncomfortable with or not competent to perform.
The nurse who is responsible for total care of the clients is performing the concept of
primary care.
In primary care, the nurse can
have the assistance of another health care professional such as an assistive personnel.
“It is important that you monitor your blood glucose, or you can have more health problems” WHATIS WRONG W/ SAYING THIS TO THE CLIENT
The nurse is using a closed-ended statement that does encourage the client to share reasons for nonadherence of the daily blood glucose testing.
“What is preventing your consistency w/ your daily blood glucose checks” RATE THIS STATEMENT TO CLIENT
The nurse is using an open-ended question to encourage the client to talk more about what is hindering them from the process for daily blood glucose testing.
“Explain why you are not doing you daily checks as prescrtbed” RATE THIS STATEMENT TO CLIENT
The nurse is using a “why” question by asking for an explanation from the client for the reason for not adhering to performing daily blood glucose checks.
Why questions can do what to clients”
This can intimidate the client and cause resentment along with mistrust. The nurse should continue to educate the client to understand and overcome the reasons for the client not adhering to the daily blood glucose testing.
“Do you understand the purpose of the daily checks” RATE THIS STATEMENT TO CLIENT
The nurse is using a closed-ended question, which can act as a barrier to close off communication about why the client is not performing daily blood glucose testing. The nurse should use open-ended questions to encourage the client to communicate.
SOAP OR SBAR EXAMPLE
Client in room 1 states “pain – 4 out of 10” despite pain medications. Vitals signs are stable. No outward manifestations of distress. Plan to call the provider if it continues”
This is a SOAP note example, not SBAR.
SOAP is used for documentation and includes
subjective data, objective data, assessment, and plan.
SOAP
??
SBAR
??
Relevant and needed information for SBAR reporting:
situation, background, assessment, and recommendation.
SMART goals allow the nurse to set goals that are s
pecific (S), measurable (M), attainable (A), realistic (R), and timely (T).
Information needed for SBAR is related to
situation, background, assessment, and recommendation.
SMART goal method: creating goals that are
specific (S), measurable (M), attainable (A), realistic (R), and timely (T).
The client who uses SMART goals can help make goals that are
manageable and provide a sense of accomplishment.
All licensed nurses and assistive personnel (AP) have a personal responsibility to practice.
know what their role and scope of practice entails. The nurse should never assign a task outside the AP’s scope of
Managing multiple clients can be difficult for a new nurse. Making a ___________ can help the nurse stay organized and efficient.
list of all tasks to accomplish and then prioritizing a plan
Administering medications should be as
prescribed and according to a schedule. It may be necessary to prioritize if several clients have medications due at the same time, but the nurse would not give the entire day’s medications at the same time.
A nurse should document tasks as
performed throughout the workday. Leaving documentation to the end of the day is a safety issue as well as poor time management.
The right scope, referring to scope of practice or range of function (for an assistive personnel), is
a consideration for choosing the right person.
The right scope is not a defined right of
delegation by itself.
The charge nurse should provide the right directions via
effective communication to the health care worker completing an assignment or task.
The charge nurse is responsible for
supervising assignments and task delegation during the shift.
The charge nurse should delegate an assignment or task that is
safe for a health care worker to carry out. Safety includes right training, competency, or within the health care worker’s scope of practice.
It is unsafe both for the
nurse and the client if the nurse is not clear on what to do for the task.
The nurse should always try to escape a
dangerous situation.
The nurse has the right to
protect and defend themself. The nurse should report the incident and not let abuse from a client go unnoticed.
The nurse should identify that verbal abuse is also
abuse. Even if the client does make physical contact but the nurse is unharmed, it is still abuse.
The nurse should identify that abuse or assault occurs in
1 out of 4 nurses. Many nurses do not admit to or report such occurrences.
If escape is not possible,
creating a barrier where the client cannot reach them until help arrives is the next acceptable action.
The nurse should not assume the client understands after issuing a printout of the with the client and caregivers.
medications.
D in IDEAL stands for
D stands for “discuss” the 5 key areas: medications, home life, warning signs, test results, follow-up
The nurse should ensure the client and caregiver understand the diagnosis by having the client use
the teach back method.
I stands for in IDEAL
“I” stands for “include” in this model. The nurse should include the client and caregivers to review the discharge instructions. Research shows including caregivers in the discharge instructions with the client leads to a safer transition.
quality assessment skills is a method to
help ensure continuity of care.
interprofessional collaboration is an important piece of
client care.
Interprofessional collaboration is related to a
group of providers working together on different aspects of the client’s care.
continuity of care can cause a ________ of a client when there are numerous hand-off reports completed during a transfer to another unit. The nurse should wait until the other nurse is available for report.
safety risk
consistent client monitoring is a method to help ensure
continuity of care.
Team nursing is the concept of nursing that
pairs two or more nurses together to provide care for a group of clients.
The nurse who is responsible for total care of the clients is performing the concept of
primary care.
Team nursing provides support for
novice nurses and others that are not as skilled in performing more complex tasks.
The nurse is using a closed-ended statement that does encourag
e the client to share reasons for nonadherence of the daily blood glucose testing.
The nurse is using an open-ended question to encourage the client to
talk more about what is hindering them from the process for daily blood glucose testing.
The nurse is using a “why” question by asking for an explanation from the client for the reason for not adhering to performing daily blood glucose checks. This can intimidate the client and cause resentment along with mistrust. The nurse should continue to educate the client to understand and overcome the reasons for the client not adhering to the daily blood glucose testing.
intimidate the client and cause resentment along with mistrust. The nurse should continue to educate the client to understand and overcome the reasons for the client not adhering to the daily blood glucose testing.
The nurse is using a closed-ended question, which can act as a
barrier to close off communication about why the client is not performing daily blood glucose testing. The nurse should use open-ended questions to encourage the client to communicate.
SBAR reporting:
situation, background, assessment, and recommendation.
SOAP is used for documentation and includes
subjective data, objective data, assessment, and plan.
SMART goals allow the nurse to set goals that are assessment, and recommendation.
specific (S), measurable (M), attainable (A), realistic (R), and timely (T).
Team nursing provides support for
novice nurses and others that are not as skilled in performing more complex tasks. A positive outcome of team nursing is the team works together. No one is expected to perform tasks that they are uncomfortable with or not competent to perform.
In primary care, the nurse can
have the assistance of another health care professional such as an assistive personnel.
A positive outcome of team nursing is
that the team works together. No one is expected to perform tasks that they are uncomfortable with or not competent to perform.
The nurse should use open-ended questions to
encourage the client to communicate.
client who uses SMART goals can help make goals that are
manageable and provide a sense of accomplishment.