Capstone A/B

Capstone A/B l



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1. Home safety: l a. Remove throw rugs, loose carpets. l l l l



Planningcarefor
l l l b. Electrical cord/ extension against the wall behind the l l l l l l l



a client who has
l l l l furniture
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vision loss
l l c. Monitor gait l



d. Steps/ sidewalks are in good repair l l l l l



e. Grab bar near toilet/tub, stool riserl l l l l



f. Non skid mat in tub.shower
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g. Shower chair and Bedside commode l l l l



h. Proper lightning l




2. Cystic Fibrosis: Assess lung sounds and respiratory status.
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Priority Assess- 12 yr old child has difficulty swallowing secretion
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mentforaGroup
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of children
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3. InfectionControl:Reportanycommunicable diseases(TB,STI,communi-
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InfectiousDis- cabledisease) l l



eases to
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4. Legal Respon- l Fall risk data, advance directives (living will, POA)
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sibilities: Docu-
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mentingAdmis-
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sion Data
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5. Disordersofthe l l Provider will remove lens and use replacement lense, sand
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Eye: Evaluating
l l grains in the eye is normal, wear sunglasses, in-
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a Client's Un-
l l l creaselightinroom,preventIOP,preventinfection,pro- vide
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derstanding of
l l pain relief, fall prevention
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Cataract Re-
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moval
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6. Crisis Manage- l Safetyfirst.Precautions of safeguard on the client
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ment: Crisis In-
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terventionforIn-
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timate Partner
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Abuse
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7. Delegationand l a. Providesupervision,eitherdirectlyorindirectly(assign- l l l l l l



Supervision:
l ing supervision to
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1 l/ l20

, Capstone A/B l



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Scope of l anotherlicensed nurse) l l



Practiceof
l l b. Monitorperformance.Interveneifnecessary(forunsafe l l l l l l



Registere
l clinical practice).
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d Nurses
l c. Providefeedback l



d. Evaluate the client and determine the client's outcome l l l l l l l



status.
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e. Evaluate task performance and identify needs for per- l l l l l l l



formance improvement
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activities and additional resources. l l l




8. Facility Proto- a. 1st assess client
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cols:Discovering
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a Medication Er- b. then call hcp
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rors
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c. Then do an incident report within 24 hrs (AVOID telling l l l l l l l l l



client or place in client's chart) l l l l l l




d. Submit to risk manager l l l




9. Managing Client l a, Assist with breakfast with client who has vision loss
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Care: Evaluating
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anAssistivePer-
l l l b. AP can do ADL, feeding without swallow precaution,
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sonnel Perfor-
l l positioning, routine task, i/o,specimen collection, vitals (if
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mance
l client is stable)
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10. Continuity of l Ïhome health nurse:nursing home, traditional home, as- sisted
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Care: Interven-
l l living
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tionsPromoting
l l Ï-work as part of team, holistic care.nurses, pt, OT, home
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Independence
l health aids, social workers and dieticians part of the care Ï-
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provideskilledassessment,woundcare,labdraws,med l l l l l l l



education, parenteral nutrition, IV fluids & meds, central line
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care, urinary catheter insertion and maintenance, co-
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ordination of other participants in health
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Ï -evaluate living environment for safety- older adults=
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increase fall risk
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Ï -ask about food in home, help with household activities,
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living alone, support system, set up and dispense of med-
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ications, access to health care
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Ï -encourage clients to be independent and involved
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2 l/ l20

, Capstone A/B l



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11. Legal and Ethi- l l a. Veracity-honest,justice-beingfair,fidelity-loyal/faithful, l l l l l l l



lcal Issues: Re-
l l beneficence- doing good, nonmaleficence- no harm
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lspectingClients l b. A voluntarily admitted client has the right to apply for
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lRights release at any time.This client is considered competent,
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and so has the right to refuse medication and treatment.
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12. Managing Client l a. Structure audits evaluate the influence of elements that l l l l l l l



lCare: Planning l exist separate from or outside of the client
l l staffinteraction. l l l l l l l



lanAuditofQuali-
l l l b. Process audits review how care was provided and as- l l l l l l l l



lty Control
l sumearelationshipexistsbetweennursesandthequality of
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care provided.
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c. Outcomeauditsdetermine what results,ifany,occurred as l l l l l l l l



a result of the nursing care provided.
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d. Retrospectiveaudits occuraftertheclient receives care. l l l l l l l



e. Concurrent audits occur while the client is receiving l l l l l l l



care.
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f. Prospective audits predict how future client care will be l l l l l l l l



affected by current level of services.
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13. Cancers Disor- l a. D/cteachingincludesincisioncareanddrainagetubes.
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lders: Planning l (Drains are usually left in for 1 to 3 weeks.)
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ldischargeTeach- l b. AVOID placing her arm in a dependent position. l l l l l l l



ling for a client
l l l c. Encourage early arm and hand exercises (squeezing l l l l l l



lwhoispostoper- l l a rubber ball, elbow flexion and extension, and hand
l wall l l l l l l l



lative following a l l climbing) to prevent lymphedema and to regain full range of
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lmodified radical l motion.
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lmastectomy d. AVOIDtightclothing. l l



e. Teach BSE. l



f. Report numbness, pain, heaviness, or impaired motor l l l l l l



function of the affected arm to the surgeon.
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g. Encourage discuss breast reconstruction alternatives l l l l



with the surgeon (Reconstruction can begin during the
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original breast removal procedure or after some healing
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hasoccurred,Nipplereconstructionfromlabia,abdomen, or
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inner thigh)
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h. Genetic counseling for BRCA 1 and 2 l l l l l l



i. Recommendationofbilateralmastectomy,oophorec- l l l l



tomyto prevent cancer occurrence.Clients who do not
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3 l/ l20