NCSBN Management of Care
NCSBN Management of Care
Study online at https://quizlet.com/_8bc6pk
1. CLIENTS HAVE A Be informed of their treatment options
RIGHT TO:
Accept treatment options or refuse treatment, even life-sustaining treatments
2. advance directive A written document intended to guide medical treatment decisions when a
person becomes unable to make decisions for him/herself. Two types of advance
directives are living wills and medical powers of attorney. A living will, or treat-
ment directive, states an individual's personal wishes about end-of-life medical
treatment in the event that he or she loses the ability to communicate or to make
decisions. In a medical power of attorney, an individual appoints someone (often
called a health care agent) to make treatment decisions for him or her.
3. living will An advanced directive in which a client can spell out specifics about what care
can or cannot be provided. This document often addresses end-of-life decisions.
4. DNR (do not resus- Do not resuscitate (DNR) is a medical order, usually written by a physician. It
citate) instructs health care providers not to perform cardiopulmonary resuscitation
(CPR) if a client's breathing stops or if the client's heart stops beating. The DNR
order may also include identification of medications that may be given without
any defibrillation attempts.
The client or health care proxy can withdraw the order at any time.
5. Allow natural Allow natural death (AND) is a medical term limiting or prohibiting the use of
death (AND) life-extending measures.
This order acknowledges that the client is dying and everything that is being
done for the client, including the withdrawal of nutrition and hydration, will allow
the dying process to occur as comfortably as possible.
6. Organ Donation Nurses advocate for and support families throughout the organ and tissue
donation process.
1 of 48
, NCSBN Management of Care
NCSBN Management of Care
Study online at https://quizlet.com/_8bc6pk
Nurses involved in the process of organ and tissue donation should be knowl-
edgeable of the ethical, cultural, religious and social issues related to organ and
tissue donation.
7. Informed Consent Grants permission to perform a test or procedure. The health care provider is
legally obligated to provide a complete description of the test or procedure, as
well as the possible risks and benefits. Informed consent is also important for
clients who wish to leave a health care facility against medical advice (AMA).
The client must have the capacity to understand:
The purpose of the procedure and expected results
Anticipated risks and discomforts
Potential benefits
Any reasonable alternative treatments
The informed consent form must be signed by a competent adult. The person
signing the document must be able to understand the information given by the
health care professional. If the person is unable to understand the information
due to a language barrier or hearing impairment, a trained medical interpreter
must be present.
Nurses will cosign the document, attesting that they witnessed the client or
designated person sign the consent form.
The client and/or designated proxy can withdraw consent at any time
8. Client's role in In- A client needs to understand the following information before giving consent:
formed Consent The diagnosis
The nature and purpose of the treatment or procedure
Any reasonable alternatives, regardless of the cost or whether or not the alter-
native is covered by insurance
Risks, consequences and benefits of the procedure and the alternative(s)
Risks and consequences if the treatment or procedure is refused
9.
2 of 48
, NCSBN Management of Care
NCSBN Management of Care
Study online at https://quizlet.com/_8bc6pk
nurses role in in- The nurse's role is:
formed consent To be the client's advocate
To protect the client's dignity
To identify any fears
To determine the client's degree of comprehension and approval of the care he
or she is to receive
The nurse may be assigned the task of obtaining and witnessing the client's
signature
The nurse who is concerned about the validity of an informed consent has a legal
obligation to tell the physician and the nursing supervisor about the concern
The nurse is not responsible for providing details about the treatment or proce-
dure
10. Freedom from re- A restraint is a measure or condition that limits a client's movement. Restraints
straint can also help keep a client from getting hurt or doing harm to others.
11. professional mis- Professional accountability can be defined as a condition in which nurses main-
conduct tain the established standards of practice in order to provide safe, appropriate
and ethical care.
Professional misconduct involves an act of breaking or failing to observe a
law, agreement or ethical code of conduct. This conduct may involve deceiving,
defrauding or harming the public.
Professional negligence (also known as malpractice) is failing to act as other
prudent nurses with a similar background, knowledge and education would
act under similar circumstances. It involves an action or inaction that results in
unintended harm to the client.
Common situations that require incident reports include, but are not limited to:
Medication errors
Complications from diagnostic or treatment procedures
Incorrect sponge counts in surgery
3 of 48
, NCSBN Management of Care
NCSBN Management of Care
Study online at https://quizlet.com/_8bc6pk
Failure to report a client's change in condition
Falls
Burns
Aseptic technique
Refusal of treatment/client
Family is dissatisfied with care
12. Substance use dis- Substance use disorder (SUD) encompasses a pattern of behaviors that range
order (SUD) from misuse to dependency or addiction to alcohol or (legal and/or illegal)
drugs. SUD is a treatable illness or chronic brain disease, not an "impairment"
or a personal failure.
SUD may be manifested by behavior changes, physical signs of the disease and
drug diversion.
The impaired nurse compromises client care. If you observe or suspect a nurse
is working impaired, it is your professional and ethical responsibility to protect
the client and communicate concerns to the nurse manager or other first line
manager in the chain of command. In some states/jurisdictions, you are legal-
ly obligated to report this behavior to the board of nursing/regulatory body
(BON/RB)
13. Professional A therapeutic relationship is one that allows nurses to apply their professional
Boundaries knowledge, skills, abilities, and experiences towards meeting the health needs
of the client. This relationship is dynamic, goal-oriented and client-centered
because it is designed to meet the needs of the client.
The therapeutic nurse-client relationship protects the client's dignity, autonomy,
privacy and allows for the development of trust and respect.
The guiding principles of professional boundaries in nursing include:
The nurse-client relationship is professional, not personal
The nurse is responsible for setting and keeping boundaries
Once a nurse becomes involved in the client's personal life, professional objec-
4 of 48
NCSBN Management of Care
Study online at https://quizlet.com/_8bc6pk
1. CLIENTS HAVE A Be informed of their treatment options
RIGHT TO:
Accept treatment options or refuse treatment, even life-sustaining treatments
2. advance directive A written document intended to guide medical treatment decisions when a
person becomes unable to make decisions for him/herself. Two types of advance
directives are living wills and medical powers of attorney. A living will, or treat-
ment directive, states an individual's personal wishes about end-of-life medical
treatment in the event that he or she loses the ability to communicate or to make
decisions. In a medical power of attorney, an individual appoints someone (often
called a health care agent) to make treatment decisions for him or her.
3. living will An advanced directive in which a client can spell out specifics about what care
can or cannot be provided. This document often addresses end-of-life decisions.
4. DNR (do not resus- Do not resuscitate (DNR) is a medical order, usually written by a physician. It
citate) instructs health care providers not to perform cardiopulmonary resuscitation
(CPR) if a client's breathing stops or if the client's heart stops beating. The DNR
order may also include identification of medications that may be given without
any defibrillation attempts.
The client or health care proxy can withdraw the order at any time.
5. Allow natural Allow natural death (AND) is a medical term limiting or prohibiting the use of
death (AND) life-extending measures.
This order acknowledges that the client is dying and everything that is being
done for the client, including the withdrawal of nutrition and hydration, will allow
the dying process to occur as comfortably as possible.
6. Organ Donation Nurses advocate for and support families throughout the organ and tissue
donation process.
1 of 48
, NCSBN Management of Care
NCSBN Management of Care
Study online at https://quizlet.com/_8bc6pk
Nurses involved in the process of organ and tissue donation should be knowl-
edgeable of the ethical, cultural, religious and social issues related to organ and
tissue donation.
7. Informed Consent Grants permission to perform a test or procedure. The health care provider is
legally obligated to provide a complete description of the test or procedure, as
well as the possible risks and benefits. Informed consent is also important for
clients who wish to leave a health care facility against medical advice (AMA).
The client must have the capacity to understand:
The purpose of the procedure and expected results
Anticipated risks and discomforts
Potential benefits
Any reasonable alternative treatments
The informed consent form must be signed by a competent adult. The person
signing the document must be able to understand the information given by the
health care professional. If the person is unable to understand the information
due to a language barrier or hearing impairment, a trained medical interpreter
must be present.
Nurses will cosign the document, attesting that they witnessed the client or
designated person sign the consent form.
The client and/or designated proxy can withdraw consent at any time
8. Client's role in In- A client needs to understand the following information before giving consent:
formed Consent The diagnosis
The nature and purpose of the treatment or procedure
Any reasonable alternatives, regardless of the cost or whether or not the alter-
native is covered by insurance
Risks, consequences and benefits of the procedure and the alternative(s)
Risks and consequences if the treatment or procedure is refused
9.
2 of 48
, NCSBN Management of Care
NCSBN Management of Care
Study online at https://quizlet.com/_8bc6pk
nurses role in in- The nurse's role is:
formed consent To be the client's advocate
To protect the client's dignity
To identify any fears
To determine the client's degree of comprehension and approval of the care he
or she is to receive
The nurse may be assigned the task of obtaining and witnessing the client's
signature
The nurse who is concerned about the validity of an informed consent has a legal
obligation to tell the physician and the nursing supervisor about the concern
The nurse is not responsible for providing details about the treatment or proce-
dure
10. Freedom from re- A restraint is a measure or condition that limits a client's movement. Restraints
straint can also help keep a client from getting hurt or doing harm to others.
11. professional mis- Professional accountability can be defined as a condition in which nurses main-
conduct tain the established standards of practice in order to provide safe, appropriate
and ethical care.
Professional misconduct involves an act of breaking or failing to observe a
law, agreement or ethical code of conduct. This conduct may involve deceiving,
defrauding or harming the public.
Professional negligence (also known as malpractice) is failing to act as other
prudent nurses with a similar background, knowledge and education would
act under similar circumstances. It involves an action or inaction that results in
unintended harm to the client.
Common situations that require incident reports include, but are not limited to:
Medication errors
Complications from diagnostic or treatment procedures
Incorrect sponge counts in surgery
3 of 48
, NCSBN Management of Care
NCSBN Management of Care
Study online at https://quizlet.com/_8bc6pk
Failure to report a client's change in condition
Falls
Burns
Aseptic technique
Refusal of treatment/client
Family is dissatisfied with care
12. Substance use dis- Substance use disorder (SUD) encompasses a pattern of behaviors that range
order (SUD) from misuse to dependency or addiction to alcohol or (legal and/or illegal)
drugs. SUD is a treatable illness or chronic brain disease, not an "impairment"
or a personal failure.
SUD may be manifested by behavior changes, physical signs of the disease and
drug diversion.
The impaired nurse compromises client care. If you observe or suspect a nurse
is working impaired, it is your professional and ethical responsibility to protect
the client and communicate concerns to the nurse manager or other first line
manager in the chain of command. In some states/jurisdictions, you are legal-
ly obligated to report this behavior to the board of nursing/regulatory body
(BON/RB)
13. Professional A therapeutic relationship is one that allows nurses to apply their professional
Boundaries knowledge, skills, abilities, and experiences towards meeting the health needs
of the client. This relationship is dynamic, goal-oriented and client-centered
because it is designed to meet the needs of the client.
The therapeutic nurse-client relationship protects the client's dignity, autonomy,
privacy and allows for the development of trust and respect.
The guiding principles of professional boundaries in nursing include:
The nurse-client relationship is professional, not personal
The nurse is responsible for setting and keeping boundaries
Once a nurse becomes involved in the client's personal life, professional objec-
4 of 48
