ATI VATI LEADERSHIP AND MANAGEMENT REMEDIATION

1.A client asks the nurse what the difference is between a durable power of attorney for health care and a living will. What should the nurse teach the client to differentiate the two components of advanced directives? a.A living will is a legal document that expresses the clients wishes regarding medical treatment in the event the client becomes incapacitated and is facing end- of-life issues. Types of treatments that often addressed in a living will are those that have the ability to prolong life, for example cardiopulmonary resuscitation, mechanical ventilation, and feeding by artificial means. Whereas a durable power of attorney for health care or a healthcare proxy is a legal document that designates a health care surrogate which is an individual authorized to make health care decisions for a client who is unable to. The person who serves in this role of the health care surrogate to make decisions for the client should be very familiar with the client’s wishes. Living wills can be difficult to interpret, especially in the face of unexpected circumstances. A durable power of attorney for health care, as an adjunct to a living will, can be a more effective way of ensuring that the client’s decisions about their health care are honored. 2.Describe the steps a nurse should take when preparing to administer a blood transfusion. a.The steps a nurse should take when preparing to administer a blood transfusion involve explaining the procedure to the client, in addition to, assessing the client’s vital signs and lab values. The nurse should review lab values to ensure the client still requires transfusion and to compare to post-transfusion values. The nurse should also obtain consent for the procedure as well as blood samples for compatibility determination such as a type and cross match. Other steps include starting a large bore 18 or 20-gauge IV, obtaining blood products from the blood bank, and inspecting that blood for discoloration, excessive bubbles, or cloudiness. Prior to transfusion two RN’s (Or an RN and a PN, depending on facility policy) must identify the correct blood product and client by looking at the hospital identification number (noted on the blood product) and the number identified on the client's identification band to makes sure the numbers match. The nurse completing the blood product verification must be one of the nurses who administers the blood product. The nurse should prime the blood administration set with 0.9% sodium chloride only. Medications should also never be added to blood products. Lastly, nurse should start the transfusion within 30 minutes of obtaining the blood product to reduce to risk of bacterial growth, and remain with the client during the initial 15-30 minutes of the transfusion. Most severe reactions occur within this time frame for blood products.