ATI Fundamentals for
Nursing ATI
Medicare - for clients over age 65 and/or with permanent disabilities. premiums
applied as insurance program reimburses providers based on DRGs. Premiums
applied as Managed Care Organizations (MCOs) provide enrolled clients with
comprehensive care overseen by a primary care provider. Is federally funded.
Medicaid - for clients with low income. is federally funded and individual states
determine eligibility requirements.
Traditional Insurance - reimburses for services on fee-for-service basis.
Managed Care Organizations (MCOs) - comprehensive care is overseen by a
primary care provider & focuses on prevention and health promotion
Preferred Provider Organizations (PPOs) - client chooses from a list of contracted
providers. using non-contracted providers increases the client's out of pocket costs
Exclusive Provider Organizations (EPOs) - the client chooses from a list of providers
within a contracted organization
Long-Term Care Insurance - provides for long-term care expenses not covered by
Medicare
Preventive health care - 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 - 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 - 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 - involves the provision of specialized highly technical care.
examples include oncology centers and burn centers
Restorative health care - involves intermediate follow-up care for restoring health.
examples include home health care, rehab centers, and skilled nursing facilities
Continuing health care - 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: - -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 - 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 - 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 - 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 - 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 - 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 - 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
, Provider - Job: assess, diagnose, and treat cllient for disease and/or injury; includes
MDs, DOs, APNs, and PAs
Refer to when: ex- client experiences change in vital signs
Rad Tech - Job: position client and perform x-rays and other imaging procedures
for providers to review for diagnosis of disorders of various body parts
Refer to when: ex- provider orders x-ray of client's hip after a fall
Respiratory therapist - Job: evaluate resp status and provide prescribed resp
treatments including O2 therapy, chest physiotherapy, inhalation therapy, and
artificial mechanical ventilation
Refer to when: ex- client with resp disease experiences SOB and requests nebulizer
treatment that is ordered PRN
Social Worker - Job: work with client and client's family by coordinating inpatient
and community resources to meet psychosocial and environmental needs that are
necessary for recovery and/or discharge
Refer to when: ex- client dying of cancer wishes to go home but is unable to
perform ADLs; the spouse needs med equipment in the home to care for client
Speech therapist - Job: evaluate and make recommendations regarding the
functions of speech, language, and swallowing impacted by various client disorders
or injuries; teach client techniques and exercises to improve function when
possible
Refer to when: ex- a client is having difficulty swallowing a regular diet after
trauma to the head and neck
Nursing ATI
Medicare - for clients over age 65 and/or with permanent disabilities. premiums
applied as insurance program reimburses providers based on DRGs. Premiums
applied as Managed Care Organizations (MCOs) provide enrolled clients with
comprehensive care overseen by a primary care provider. Is federally funded.
Medicaid - for clients with low income. is federally funded and individual states
determine eligibility requirements.
Traditional Insurance - reimburses for services on fee-for-service basis.
Managed Care Organizations (MCOs) - comprehensive care is overseen by a
primary care provider & focuses on prevention and health promotion
Preferred Provider Organizations (PPOs) - client chooses from a list of contracted
providers. using non-contracted providers increases the client's out of pocket costs
Exclusive Provider Organizations (EPOs) - the client chooses from a list of providers
within a contracted organization
Long-Term Care Insurance - provides for long-term care expenses not covered by
Medicare
Preventive health care - 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 - 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 - 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 - involves the provision of specialized highly technical care.
examples include oncology centers and burn centers
Restorative health care - involves intermediate follow-up care for restoring health.
examples include home health care, rehab centers, and skilled nursing facilities
Continuing health care - 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: - -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 - 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 - 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 - 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 - 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 - 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 - 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
, Provider - Job: assess, diagnose, and treat cllient for disease and/or injury; includes
MDs, DOs, APNs, and PAs
Refer to when: ex- client experiences change in vital signs
Rad Tech - Job: position client and perform x-rays and other imaging procedures
for providers to review for diagnosis of disorders of various body parts
Refer to when: ex- provider orders x-ray of client's hip after a fall
Respiratory therapist - Job: evaluate resp status and provide prescribed resp
treatments including O2 therapy, chest physiotherapy, inhalation therapy, and
artificial mechanical ventilation
Refer to when: ex- client with resp disease experiences SOB and requests nebulizer
treatment that is ordered PRN
Social Worker - Job: work with client and client's family by coordinating inpatient
and community resources to meet psychosocial and environmental needs that are
necessary for recovery and/or discharge
Refer to when: ex- client dying of cancer wishes to go home but is unable to
perform ADLs; the spouse needs med equipment in the home to care for client
Speech therapist - Job: evaluate and make recommendations regarding the
functions of speech, language, and swallowing impacted by various client disorders
or injuries; teach client techniques and exercises to improve function when
possible
Refer to when: ex- a client is having difficulty swallowing a regular diet after
trauma to the head and neck
