1
NCSBN REVIEW
Author: Kevin Begay — Nursing Tutor &
Study Coach
Management of Care:
o Advance Directive is AKA a living will
- Legal document where one specifies their wishes concerning medical tx./ end of life care
once they are unable to.
, 2
- Advance care planning: sharing personal values/wishes with loved ones and selecting a
medical power of attorney or health care proxy who will make medical decisions on the
client’s behalf once they are unable to do so.
- This document does not expire
- Does not include info. Regarding assets or the client’s estate.
- Includes: health care power of attorney, living will, DNR order, &/or POLST (phys. Order for
life-sustaining tx.)
o Code of Ethics
- Nonmaleficence à to “do no harm”. This is directly tied to the nurse’s duty to protect the
client’s safety.
- Beneficence à doing good and the right thing for the patient
- Autonomy à nurses encourage pt. to make their own decision without any judgment. The
pt. has the right to accept or reject tx.
- Justice à fairness.
- Accountability à accepting responsibly for one’s own actions.
- Fidelity à keeping one’s promise.
- Veracity à being completely truthful with patients. Nurses must not withhold the whole
truth from pt. even when it may upset them.
- Negligence à aka malpractice. Failing to act on behalf of the pt. involving an action or
inaction that results in untended harm to the pt.
o DNR – Do Not Resuscitate. A medical order by the physician.
o AND – Allow Natural Death. Limiting or prohibiting the use of life-extending measures. This
order acknowledges that pt. is dying and everything has been withdrawable including
food/water allowing the dying process to occur as comfortably as possible. Comfort measures
applied.
o Informed Consent – grants permission to perform a test or procedure. HCP explains the
procedure/test along with the risk and benefits. The nurse’s job is to cosign the document,
witnessing the signature by the client. If the pt. does not understand the procedure the nurse
must advocate for the client and have the HCP come and explain the procedure. Test again
before the signature is made.
, 3
o Common situations that require incident reports:
- Medication errors
- Complications from dx. Or tx. procedures
- Incorrect sponge counts in sx.
- Failure to report pt. change in condition
- Falls
- Burns
- Aseptic technique
- Refusal of tx./patient
- Family dissatisfied with care
o RN
- Assess pt. physical condition
- Analyze/interpret data
- Intervene based on important data and evaluate
- Health promotion and maintenance
- Provide pt. education
- Offer counsel and support
- Help pt. restore optimal function and comfort
- Nursing Process: ADPIE *** (assess, dx., plan, implement, evaluate)
o LPN/LVN
- Assist with implementation
- Provide care for STABLE pt. with PREDICTABLE OUTCOMES
- Collect data for assessment
- Differentiate abnormal – normal to report to the RN
, 4
- Maintain knowledge of asepsis and dressing changes
- Admin. Some meds
o UAP
- Provide basic care
- Assist with ADL’s
- Examples: bathing, feeding, toileting, obtaining vitals, I&Os, recording height and
weight.
o 5 Rights of Delegation
- Right Task
- Right Circumstance
- Right Person
- Right Directions & Communication
- Right Supervision & Evaluation
o Establishing Priorities:
- Life – threatening needs or ones that could result in harm to the pt. if left untreated
are high priority
- Actual problems trump potential problems or needs
- ABC&P = airway, breathing, circulation, pain
- Maslow’s = physiological, safety, social, esteem, self-actualization (that order)
o Communication:
NCSBN REVIEW
Author: Kevin Begay — Nursing Tutor &
Study Coach
Management of Care:
o Advance Directive is AKA a living will
- Legal document where one specifies their wishes concerning medical tx./ end of life care
once they are unable to.
, 2
- Advance care planning: sharing personal values/wishes with loved ones and selecting a
medical power of attorney or health care proxy who will make medical decisions on the
client’s behalf once they are unable to do so.
- This document does not expire
- Does not include info. Regarding assets or the client’s estate.
- Includes: health care power of attorney, living will, DNR order, &/or POLST (phys. Order for
life-sustaining tx.)
o Code of Ethics
- Nonmaleficence à to “do no harm”. This is directly tied to the nurse’s duty to protect the
client’s safety.
- Beneficence à doing good and the right thing for the patient
- Autonomy à nurses encourage pt. to make their own decision without any judgment. The
pt. has the right to accept or reject tx.
- Justice à fairness.
- Accountability à accepting responsibly for one’s own actions.
- Fidelity à keeping one’s promise.
- Veracity à being completely truthful with patients. Nurses must not withhold the whole
truth from pt. even when it may upset them.
- Negligence à aka malpractice. Failing to act on behalf of the pt. involving an action or
inaction that results in untended harm to the pt.
o DNR – Do Not Resuscitate. A medical order by the physician.
o AND – Allow Natural Death. Limiting or prohibiting the use of life-extending measures. This
order acknowledges that pt. is dying and everything has been withdrawable including
food/water allowing the dying process to occur as comfortably as possible. Comfort measures
applied.
o Informed Consent – grants permission to perform a test or procedure. HCP explains the
procedure/test along with the risk and benefits. The nurse’s job is to cosign the document,
witnessing the signature by the client. If the pt. does not understand the procedure the nurse
must advocate for the client and have the HCP come and explain the procedure. Test again
before the signature is made.
, 3
o Common situations that require incident reports:
- Medication errors
- Complications from dx. Or tx. procedures
- Incorrect sponge counts in sx.
- Failure to report pt. change in condition
- Falls
- Burns
- Aseptic technique
- Refusal of tx./patient
- Family dissatisfied with care
o RN
- Assess pt. physical condition
- Analyze/interpret data
- Intervene based on important data and evaluate
- Health promotion and maintenance
- Provide pt. education
- Offer counsel and support
- Help pt. restore optimal function and comfort
- Nursing Process: ADPIE *** (assess, dx., plan, implement, evaluate)
o LPN/LVN
- Assist with implementation
- Provide care for STABLE pt. with PREDICTABLE OUTCOMES
- Collect data for assessment
- Differentiate abnormal – normal to report to the RN
, 4
- Maintain knowledge of asepsis and dressing changes
- Admin. Some meds
o UAP
- Provide basic care
- Assist with ADL’s
- Examples: bathing, feeding, toileting, obtaining vitals, I&Os, recording height and
weight.
o 5 Rights of Delegation
- Right Task
- Right Circumstance
- Right Person
- Right Directions & Communication
- Right Supervision & Evaluation
o Establishing Priorities:
- Life – threatening needs or ones that could result in harm to the pt. if left untreated
are high priority
- Actual problems trump potential problems or needs
- ABC&P = airway, breathing, circulation, pain
- Maslow’s = physiological, safety, social, esteem, self-actualization (that order)
o Communication:
