Foundations of Nursing Care (ATI RN
Fundamentals)
⫸ Medicare. Answer: public federally funded programs. clients over age
65 and/or with permanent disabilities.
⫸ Medicaid. Answer: for clients with low income. is federally funded
and individual states determine eligibility requirements.
⫸ Traditional Insurance. Answer: reimburses for services on fee-for-
service basis.
⫸ Managed Care Organizations (MCOs). Answer: comprehensive care
is overseen by a primary care provider & focuses on prevention and
health promotion
⫸ Preferred Provider Organizations (PPOs). Answer: client chooses
from a list of contracted providers. using non-contracted providers
increases the client's out of pocket costs
⫸ Exclusive Provider Organizations (EPOs). Answer: the client chooses
from a list of providers within a contracted organization
⫸ Long-Term Care Insurance. Answer: provides for long-term care
expenses not covered by Medicare
,⫸ Preventive health care. Answer: focuses on educating and equipping
clients to reduce and control risk factors of disease. Examples include
immunizations, stress management programs, and seat belt use
⫸ Primary health care. Answer: emphasizes health promotion, and
includes prenatal and well-baby care, nutrition counseling, and disease
control. is based on a sustained partnership between client and provider.
examples include office or clinic visits and scheduled school/work
centered screenings (vision, hearing, obesity)
⫸ Secondary health care. Answer: includes the diagnosis and treatment
of emergency, acute illness, or injury. examples include care given in
hospital settings (inpatient and EDs), diagnostic centers, or emergent
care centers
⫸ Tertiary health care. Answer: involves the provision of specialized
highly technical care. examples include oncology centers and burn
centers
⫸ Restorative health care. Answer: involves intermediate follow-up
care for restoring health. examples include home health care, rehab
centers, and skilled nursing facilities
⫸ Continuing health care. Answer: designed to address long-term or
chronic health care needs. examples include hospice, adult day care, and
in-home respite care
,⫸ Health care regulatory agencies include:. Answer: -US Dept of
Health and Human Srvcs
-US FDA
-State and local public health agencies
-State licensing boards (to ensure providers & agencies comply with
state regulations)
-the Joint Commission/JCAHO (set quality standards for accreditation of
health care facilities)
-Professional Standards Review Organizations (PSROs)
-Utilization review committees (monitor for appropriate diagnosis and
treatment of hospitalized clients)
⫸ Clergy. Answer: Job: provide spiritual care to client (pastors, rabbis,
priests)
Refer to when: the client requests communication or the family asks for
prayer prior to client undergoing a procedure
⫸ Registered dietitian. Answer: Job: assess, plan for, and educate the
client reg. nutritional needs; direct care of nutritional aids
Refer to when: ex- the client has low nutrient levels and/or experienced
a recent unexplained weight loss
, ⫸ Lab tech. Answer: Job: obtain specimens of the client's body fluids
and perform the necessary diagnostic tests
Refer to when: ex- the provider orders a CBC to be performed
immediately
⫸ Occupational therapist. Answer: Job: assess and plan for the client to
regain ADLs, esp motor skills of the upper extremities; direct care of
occupational therapy assistants
Refer to when: ex- client has difficulties using an eating utensil with
dominate hand following a stroke
⫸ Pharmacist. Answer: Job: provide & monitor meds for the client as
prescribed by the provider; supervises pharm techs in states in which the
practice is allowed
Refer to when: client concerns over meds; dosage concerns; etc
⫸ Physical Therapist. Answer: Job: assess and plan for client to
increase musculoskeletal functions, esp of lower extremities, to maintain
mobility; direct care of physical therapy assistants
Refer to when: ex- following a hip replacement, a client requires
assistance learning to ambulate and regain strength
Fundamentals)
⫸ Medicare. Answer: public federally funded programs. clients over age
65 and/or with permanent disabilities.
⫸ Medicaid. Answer: for clients with low income. is federally funded
and individual states determine eligibility requirements.
⫸ Traditional Insurance. Answer: reimburses for services on fee-for-
service basis.
⫸ Managed Care Organizations (MCOs). Answer: comprehensive care
is overseen by a primary care provider & focuses on prevention and
health promotion
⫸ Preferred Provider Organizations (PPOs). Answer: client chooses
from a list of contracted providers. using non-contracted providers
increases the client's out of pocket costs
⫸ Exclusive Provider Organizations (EPOs). Answer: the client chooses
from a list of providers within a contracted organization
⫸ Long-Term Care Insurance. Answer: provides for long-term care
expenses not covered by Medicare
,⫸ Preventive health care. Answer: focuses on educating and equipping
clients to reduce and control risk factors of disease. Examples include
immunizations, stress management programs, and seat belt use
⫸ Primary health care. Answer: emphasizes health promotion, and
includes prenatal and well-baby care, nutrition counseling, and disease
control. is based on a sustained partnership between client and provider.
examples include office or clinic visits and scheduled school/work
centered screenings (vision, hearing, obesity)
⫸ Secondary health care. Answer: includes the diagnosis and treatment
of emergency, acute illness, or injury. examples include care given in
hospital settings (inpatient and EDs), diagnostic centers, or emergent
care centers
⫸ Tertiary health care. Answer: involves the provision of specialized
highly technical care. examples include oncology centers and burn
centers
⫸ Restorative health care. Answer: involves intermediate follow-up
care for restoring health. examples include home health care, rehab
centers, and skilled nursing facilities
⫸ Continuing health care. Answer: designed to address long-term or
chronic health care needs. examples include hospice, adult day care, and
in-home respite care
,⫸ Health care regulatory agencies include:. Answer: -US Dept of
Health and Human Srvcs
-US FDA
-State and local public health agencies
-State licensing boards (to ensure providers & agencies comply with
state regulations)
-the Joint Commission/JCAHO (set quality standards for accreditation of
health care facilities)
-Professional Standards Review Organizations (PSROs)
-Utilization review committees (monitor for appropriate diagnosis and
treatment of hospitalized clients)
⫸ Clergy. Answer: Job: provide spiritual care to client (pastors, rabbis,
priests)
Refer to when: the client requests communication or the family asks for
prayer prior to client undergoing a procedure
⫸ Registered dietitian. Answer: Job: assess, plan for, and educate the
client reg. nutritional needs; direct care of nutritional aids
Refer to when: ex- the client has low nutrient levels and/or experienced
a recent unexplained weight loss
, ⫸ Lab tech. Answer: Job: obtain specimens of the client's body fluids
and perform the necessary diagnostic tests
Refer to when: ex- the provider orders a CBC to be performed
immediately
⫸ Occupational therapist. Answer: Job: assess and plan for the client to
regain ADLs, esp motor skills of the upper extremities; direct care of
occupational therapy assistants
Refer to when: ex- client has difficulties using an eating utensil with
dominate hand following a stroke
⫸ Pharmacist. Answer: Job: provide & monitor meds for the client as
prescribed by the provider; supervises pharm techs in states in which the
practice is allowed
Refer to when: client concerns over meds; dosage concerns; etc
⫸ Physical Therapist. Answer: Job: assess and plan for client to
increase musculoskeletal functions, esp of lower extremities, to maintain
mobility; direct care of physical therapy assistants
Refer to when: ex- following a hip replacement, a client requires
assistance learning to ambulate and regain strength
