VATI RN Comprehensive Predictor
Private rooms - ANSare required for clients who have an infectious disease that requires
airborne precautions, or clients who require a protective environment._______ _____ are
preferred for clients who are on droplet and contact precautions. These clients can cohort if no
_______ ______ are available and if all of the following are true. ●The clients have the same
active infection with the same micro-organisms. ●The clients remain at least 3 feet away from
each other. ●The clients have no other existing infection. ______ _______ is also preferred for
the following clients. ●Client who are agitated ●Client who have dementia and a history of
wandering ●Clients who require a quiet environment (those at risk for increased intracranial
pressure [stroke, traumatic brain injury]) ●Clients who are at risk for sensory overload (those
who are having pain, are acutely ill, have invasive tubes [nasogastric, IVs, endotracheal], or
have reduced cognitive function [head injury]) ●Clients who require privacy (those who are near
death)
Prior to delegating client care, consider the following. - ANSPredictability of outcome ●Will the
completion of the task have a predictable outcome? ●Is it a routine treatment? ●Is it a new
treatment? Potential for harm ●Is there a chance that something negative can happen to the
client (risk for bleeding, risk for aspiration)? ●Is the client unstable? Complexity of care ●Are
complex tasks required as a part of the client's care? ●Is the delegatee legally able to perform
the task and do they have the skills necessary? Need for problem solving and innovation ●Is
nursing judgment required while performing the task? ●Does it require nursing assessment
skills? Level of interaction with the client ●Is there a need to provide psychosocial support or
education during the performance of the task?
Examples of tasks nurses can delegate to practical nurses and assistive personnel - ANSTO PN
Monitoring findings (as input to the RN's ongoing assessment)Reinforcing client teaching from a
standard care planPerforming tracheostomy careSuctioningChecking NG tube
patencyAdministering enteral feedingsInserting a urinary catheterAdministering medication
(excluding IV medication in some states). TO AP Activities of daily living (ADLs) Bathing
Grooming Dressing Toileting Ambulating Feeding (without swallowing precautions). Positioning
Routine tasks. Bed making. Specimen collection Intake and output Vital signs (for stable
clients).
Right direction/communication (five rights of delegations) - ANSData that needs to be collected
●Method and timeline for reporting, including when to report concerns/findings ●Specific task(s)
to be performed; client-specific instructions ●Expected results, timelines, and expectations for
follow-up communication
RIGHT DIRECTION AND COMMUNICATION: Delegate an AP to assist the client in room 312
with a shower before 0900 and to notify the nurse when complete.
, WRONG DIRECTION AND COMMUNICATION: Delegate an AP to assist the client in room 312
with morning hygiene.
Steps in providing educational programs - ANS1. Identify and respond: Determine the need for
knowledge or skill proficiency 2. Analyze: Look for deficiencies, and develop learning objectives
to meet the need 3. Research: Resources available to address learning objectives based on
evidence-based practice 4. Plan: Program to address objectives using available resources 5.
Implement: Program(s) at a time conducive to staff availability; consider online learning modules
6. Evaluate: Use materials and observations to measure behavior changes secondary to
learning objectives
Tetralogy of Fallot. - ANSFour defects that result in mixed blood flow: Pulmonary stenosis,
ventricular septal defect, overriding aorta, right ventricular hypertrophy. Cyanosis at birth:
progressive cyanosis over the first year of life. Systolic murmur. Episodes of acute cyanosis and
hypoxia (blue or "Tet" spells knee chest position or squating). SURGICAL PROCEDURES Shunt
placement until able to undergo primary repair. Complete repair within the first year of life.
Defects that increase pulmonary blood flow - ANSVentricular septal defect (VSD) (20.1) Atrial
septal defect (ASD), Patent ductus arteriosus (PDA),
Defects that increase pulmonary blood flow Ventricular septal defect (VSD) - ANS_______ A
hole in the septum between the right and left ventricle that results in increased pulmonary blood
flow (left‑to‑right shunt) ●Loud, harsh murmur auscultated at the left sternal border ●Heart
failure ●Many VSDs close spontaneously early in life.
Defects that increase pulmonary blood flow Atrial septal defect (ASD) - ANSA hole in the
septum between the right and left atria that results in increased pulmonary blood flow
(left‑to‑right shunt) ●Loud, harsh murmur with a fixed split second heart sound ●Heart failure
●Asymptomatic (possibly)
Defects that increase pulmonary blood flow Patent ductus arteriosus (PDA) - ANSA condition in
which the normal fetal circulation conduit between the pulmonary artery and the aorta fails to
close and results in increased pulmonary blood flow (left‑to‑right shunt) ●Systolic murmur
(machine hum) ●Wide pulse pressure ●Bounding pulses ●Asymptomatic (possibly) ●Heart
failure ●Rales
Obstructive defects - ANSinclude those where blood flow exiting the heart meets an area of
narrowing (stenosis), which causes obstruction of blood flow. ●The pressure that occurs before
the defect is increased (ventricle) and the pressure that occurs after the defect is decreased.
This results in a decrease in cardiac output. ●These children can present with manifestations of
heart failure. Pulmonary stenosis (20.2), Aortic stenosis, Coarctation of the aorta (20.3)
Pulmonary stenosis (20.2) - ANSA narrowing of the pulmonary valve or pulmonary artery that
results in obstruction of blood flow from the ventricles ●Systolic ejection murmur ●Asymptomatic
Private rooms - ANSare required for clients who have an infectious disease that requires
airborne precautions, or clients who require a protective environment._______ _____ are
preferred for clients who are on droplet and contact precautions. These clients can cohort if no
_______ ______ are available and if all of the following are true. ●The clients have the same
active infection with the same micro-organisms. ●The clients remain at least 3 feet away from
each other. ●The clients have no other existing infection. ______ _______ is also preferred for
the following clients. ●Client who are agitated ●Client who have dementia and a history of
wandering ●Clients who require a quiet environment (those at risk for increased intracranial
pressure [stroke, traumatic brain injury]) ●Clients who are at risk for sensory overload (those
who are having pain, are acutely ill, have invasive tubes [nasogastric, IVs, endotracheal], or
have reduced cognitive function [head injury]) ●Clients who require privacy (those who are near
death)
Prior to delegating client care, consider the following. - ANSPredictability of outcome ●Will the
completion of the task have a predictable outcome? ●Is it a routine treatment? ●Is it a new
treatment? Potential for harm ●Is there a chance that something negative can happen to the
client (risk for bleeding, risk for aspiration)? ●Is the client unstable? Complexity of care ●Are
complex tasks required as a part of the client's care? ●Is the delegatee legally able to perform
the task and do they have the skills necessary? Need for problem solving and innovation ●Is
nursing judgment required while performing the task? ●Does it require nursing assessment
skills? Level of interaction with the client ●Is there a need to provide psychosocial support or
education during the performance of the task?
Examples of tasks nurses can delegate to practical nurses and assistive personnel - ANSTO PN
Monitoring findings (as input to the RN's ongoing assessment)Reinforcing client teaching from a
standard care planPerforming tracheostomy careSuctioningChecking NG tube
patencyAdministering enteral feedingsInserting a urinary catheterAdministering medication
(excluding IV medication in some states). TO AP Activities of daily living (ADLs) Bathing
Grooming Dressing Toileting Ambulating Feeding (without swallowing precautions). Positioning
Routine tasks. Bed making. Specimen collection Intake and output Vital signs (for stable
clients).
Right direction/communication (five rights of delegations) - ANSData that needs to be collected
●Method and timeline for reporting, including when to report concerns/findings ●Specific task(s)
to be performed; client-specific instructions ●Expected results, timelines, and expectations for
follow-up communication
RIGHT DIRECTION AND COMMUNICATION: Delegate an AP to assist the client in room 312
with a shower before 0900 and to notify the nurse when complete.
, WRONG DIRECTION AND COMMUNICATION: Delegate an AP to assist the client in room 312
with morning hygiene.
Steps in providing educational programs - ANS1. Identify and respond: Determine the need for
knowledge or skill proficiency 2. Analyze: Look for deficiencies, and develop learning objectives
to meet the need 3. Research: Resources available to address learning objectives based on
evidence-based practice 4. Plan: Program to address objectives using available resources 5.
Implement: Program(s) at a time conducive to staff availability; consider online learning modules
6. Evaluate: Use materials and observations to measure behavior changes secondary to
learning objectives
Tetralogy of Fallot. - ANSFour defects that result in mixed blood flow: Pulmonary stenosis,
ventricular septal defect, overriding aorta, right ventricular hypertrophy. Cyanosis at birth:
progressive cyanosis over the first year of life. Systolic murmur. Episodes of acute cyanosis and
hypoxia (blue or "Tet" spells knee chest position or squating). SURGICAL PROCEDURES Shunt
placement until able to undergo primary repair. Complete repair within the first year of life.
Defects that increase pulmonary blood flow - ANSVentricular septal defect (VSD) (20.1) Atrial
septal defect (ASD), Patent ductus arteriosus (PDA),
Defects that increase pulmonary blood flow Ventricular septal defect (VSD) - ANS_______ A
hole in the septum between the right and left ventricle that results in increased pulmonary blood
flow (left‑to‑right shunt) ●Loud, harsh murmur auscultated at the left sternal border ●Heart
failure ●Many VSDs close spontaneously early in life.
Defects that increase pulmonary blood flow Atrial septal defect (ASD) - ANSA hole in the
septum between the right and left atria that results in increased pulmonary blood flow
(left‑to‑right shunt) ●Loud, harsh murmur with a fixed split second heart sound ●Heart failure
●Asymptomatic (possibly)
Defects that increase pulmonary blood flow Patent ductus arteriosus (PDA) - ANSA condition in
which the normal fetal circulation conduit between the pulmonary artery and the aorta fails to
close and results in increased pulmonary blood flow (left‑to‑right shunt) ●Systolic murmur
(machine hum) ●Wide pulse pressure ●Bounding pulses ●Asymptomatic (possibly) ●Heart
failure ●Rales
Obstructive defects - ANSinclude those where blood flow exiting the heart meets an area of
narrowing (stenosis), which causes obstruction of blood flow. ●The pressure that occurs before
the defect is increased (ventricle) and the pressure that occurs after the defect is decreased.
This results in a decrease in cardiac output. ●These children can present with manifestations of
heart failure. Pulmonary stenosis (20.2), Aortic stenosis, Coarctation of the aorta (20.3)
Pulmonary stenosis (20.2) - ANSA narrowing of the pulmonary valve or pulmonary artery that
results in obstruction of blood flow from the ventricles ●Systolic ejection murmur ●Asymptomatic
