Name
Chamberlain University
NR-226: Fundamentals – Patient Care
Prof. Name
Date
Prioritizing patient care is vital for nurses as it enables them to identify relationships among various patient problems. This approach helps avoid delays in taking necessary actions that could prevent serious complications. Immediate action is essential to stabilize patients’ conditions, following the ABC rule: airway, breathing, and circulation should always be the top priority.
The categorization of patient care prioritization is as follows:
Priority Level | Description | Examples |
---|---|---|
High | Emergency situations posing immediate threats to survival or safety. | Obstructed airway, anxiety attack |
Intermediate | Non-emergency but important needs experienced by patients and families. | Anticipating patient education on new medications, managing post-operative pain. |
Low | Issues not directly related to the patient’s current illness, focusing on developmental or long-term health needs. | Patient education required before discharge. |
Nursing models play a significant role in the delivery of care. Various models include:
Nursing Model | Description | Cons |
---|---|---|
Primary Nursing | A single RN takes responsibility for a patient’s care, with limited patient assignments. | Does not necessarily reduce costs; care plans require approval for changes. |
Total Patient Care | The RN oversees all aspects of patient care, working directly with the patient and healthcare team. | High RN demand makes it less cost-effective; communication lapses can affect continuity. |
Functional Nursing | Care is divided among team members by function. | Potential fragmentation of care; may not provide holistic care. |
Case Management | Coordinates healthcare services to streamline costs and enhance quality. | Direct care may not always be provided. |
Team Nursing | An RN leads a team of RNs, LPNs, and MAs to provide care under supervision. | Delegation takes time, and RNs may not have adequate patient contact. |
Magnet hospitals are recognized for their clinical promotion systems, research initiatives, and commitment to evidence-based practice. Nurses within these organizations maintain professional autonomy and control over their practice environment. This empowerment fosters innovation and collaborative relationships, ultimately improving the quality of patient care.
Delegation involves transferring the responsibility for a task while retaining accountability for the outcome. Key aspects of delegation include assessing the knowledge and skills of team members and matching tasks appropriately. Effective communication is critical, requiring clear directions, active listening, and feedback. The Five Rights of Delegation include:
Rights of Delegation | Description |
---|---|
Task | Routine, non-invasive tasks requiring minimal supervision. |
Circumstance | Appropriate patient settings and available resources. |
Person | Matching the right person to perform the task and the right person to receive it. |
Direction | Clear instructions about the task, including objectives and limits. |
Supervision | Providing ongoing monitoring and support for the delegated task. |
Effective communication is essential, particularly for patients with special needs such as cognitive impairments, hearing loss, or vision loss. Strategies include:
Condition | Techniques |
---|---|
Cognitive Impairment | Use simple sentences, ask one question at a time, allow response time, and include family in conversations. |
Hearing Impaired | Reduce noise, gain the patient’s attention before speaking, and ensure visibility of the speaker’s mouth. |
Visually Impaired | Maintain a normal tone, use indirect lighting, and ensure print size is adequate. |
Cannot Speak | Listen attentively, ask yes/no questions, and utilize visual aids. |
Various communication techniques enhance interactions, including:
Technique | Description |
---|---|
Parroting | Repeating what the patient has said without paraphrasing. |
Clarifying | Restating unclear questions to ensure understanding. |
Focusing | Directing the conversation to key elements without interrupting. |
Paraphrasing | Briefly restating the patient’s message in the nurse’s own words to confirm understanding. |
The SBAR method standardizes communication about significant patient events. It encompasses:
Therapeutic Communication | Non-therapeutic Communication |
---|---|
Encourages the expression of feelings and conveys respect. | Can hinder professional relationships and block expression. |
Understanding personal space is crucial for patient interactions:
Zone | Distance | Examples |
---|---|---|
Intimate | 0-18 inches | Performing assessments, changing dressings. |
Personal | 18 inches-4 ft | Sitting at a bedside, taking patient history. |
Social | 4-12 ft | Making rounds, teaching classes. |
Public | 12 ft and greater | Speaking at community events, lecturing. |
Surgical procedures are categorized based on urgency and purpose:
Classification | Description | Examples |
---|---|---|
Urgent | Needed to prevent health deterioration; not emergent. | Excision of a cancerous tumor. |
Elective | Patient choice; not essential for health. | Hernia repair. |
Emergency | Immediate action required to save life or function. | Control of internal bleeding. |
Major | Extensive alterations; higher risk. | Coronary artery bypass graft (CABG). |
Minor | Minimal alterations; low risk. | Tooth extraction. |
Diagnostic | Surgical exploration for diagnosis. | Exploratory laparotomy. |
Ablative | Removal of a body part. | Gallbladder removal. |
Palliative | Relieves symptoms; does not cure. | Colostomy. |
Reconstructive | Restores function or appearance. | Scar revision. |
Procurement | Removal of organs for transplant. | Kidney transplant. |
Constructive | Restores lost function due to congenital issues. | Repair of cleft palate. |
Cosmetic | Improves personal appearance. | Rhinoplasty. |
Malignant hyperthermia is a life-threatening genetic disorder associated with anesthesia, characterized by symptoms like hypercarbia and muscular rigidity. Close monitoring of temperature is essential, especially when anesthesia is introduced.
In the pre-operative unit, several steps ensure patient readiness for surgery, including:
In the PACU, the following parameters are assessed:
Understanding the various types of anesthesia is crucial for managing patient care:
Anesthesia Type | Purpose | Complications | Nursing Implications |
---|---|---|---|
General | Induces immobility and lack of memory during surgery. | Cardiovascular and respiratory depression, organ damage. | Monitor vital signs and recovery status. |
Regional | Loss of sensation in a specific area without loss of consciousness. | Sudden drops in blood pressure and impaired breathing. | Assess respiratory status and position of limbs. |
Local | Loss of sensation at a specific site. | Limited motor function depending on injection site. | Monitor for adverse reactions and functional abilities. |
Conscious Sedation | Provides sedation while maintaining patient responsiveness. | Similar risks as other anesthetics. | Ensure airway maintenance and monitor response to stimuli. |
The Time Out protocol occurs prior to surgery when all healthcare personnel convene to confirm the surgical plan and patient details, ensuring patient safety.
The roles in the operating room include:
Circulating Nurse | Scrub Nurse |
---|---|
Must be an RN; oversees intraoperative care and documentation. | Maintains the sterile field and assists the surgeon. |
Evaluates patient care and verifies instrument counts. | Assists with draping and instrument handoff. |
American Nurses Association. (2021). Nursing: Scope and standards of practice. American Nurses Association.
Black, J. M., & Hawks, J. H. (2016). Medical-surgical nursing: Clinical management for positive outcomes. Elsevier.
Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., & Bucher, L. (2017). Medical-surgical nursing: Assessment and management of clinical problems. Elsevier.
Potter, P. A., & Perry, A. G. (2022). Fundamentals of nursing. Elsevier.
Smeltzer, S. C., & Bare, B. G. (2020). Textbook of medical-surgical nursing. Pearson.
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