ATI - NURSING FUNDAMENTALS STUDY
GUIDE-UPDATED 2022
Regulatory agencies - US Dept of Health and Human Services
FDA
State and local public health agencies
State icensing boards
Joint Commission-JCAHO
Professional Standards Review Organizations
Review committees
Healthcare financing mechanisms - publically federally funded progams
-Medicare
-Medicaid
-Private pay
Levels of Healthcare - Preventive Health-immunization, stress management
Primary-nutrition counseling
Secondary-emergency
Tertiary-techincal care, cancer centers
Restorative-home health, rehab
Continuing-long-term, chronic
Interdisplinary Personnel-Non-Nursing - Clergy-spiritual
Registered Dietitian-educate on nutrition
Lab Tech-obtain specimens
Occupational Therapist-regain ADLs
Pharmacist-provide/monitor medications
,Physical Therapist-increase musculoskeletal function
Provider-assess, diagnose, treat client
Radiologic Techs-perform xrays
Respiratory Therapist-evaluate respiratory status
Social Worker-equip client/family with community resources
Speech Therapist-assist with regaining speech
Autonomy (Ethical Responsibilities) - ability of the client to make personal diecisins, even when those
decissions may not be in the clients best interest
Beneficence (Ethical Responsibilities) - agreement that the care given is in the best interest o the client;
taking positive actions to help others
Fidelity (Ethical Responsibilities) - agreement to keep one's promise to the client about care that was
offered
Justice (Ethical Responsibilities) - fair treatment in matters related to physical an psychosocial care and
use of resources
Nonmaleficnce (Ethical Responsibilities) - avoidance of harm of pain as much as possible when giving
treatments
Ethical dilemna (Ethical Responsibilities) - it cannot be solved solely by a review of scientiic data; it
involves a conflict between two moral imperatives; the answer will have a profound effect on the
situation/client
Nurses basic code of ethics (Ethical Responsibilities) - advocacy, responsibility, accountability and
confidentiality
nurses role in ethical decision making (Ethical Responsbilities) - 1. an agent fo the client facing and
ethical decision-helping decision of abortion for adolscent; discussing blood transfusion w/JW;
2. the decison maker in regard to nursing practice-witnessing surgeon provide options but not dangers
,Sources of Law (legal responsibilities) - Health Insurance Portablity and Accountability Act-HIPAA;
The Americans with Disabilities Act-ADA;
The Mental Health Parity Act-MHPA;
The Patient Self-Determination Act-PSDA
Criminal law - subsection of public law and relates to the relationship of an individual with the
govenment-nurse who falsifies medical record
Civil law - protects the individual rights of people-provision of nursing care is tort law
Negligence - Unintentional Torts - nurse fails to implement safety measures for a client who has been
identified as at risk for falls
Malpractice - Unintentional Torts - nurse administers a large dose of medication due to a calculation
error. Client has a cardiac arrest and dies
Breach of Confidentiality - Quasi-Intentional Tort - a nurse release the medical diagnosis of a client to a
member of the press
Defamation of Character - Quasi-Intentional Tort - a nurse tells a coworker that she believes the
clienthas been unfaithful to her spouse
Assault - Intentional Torts - the conduct of one person makes another person fearful-threatening
Battery - Intentional Tort - intentional and wrong physical contact that involves injury or offensive
contact-restraining of a client
False Imprisionment - Intentional Tort - a person is confined/restrained against their will-competent
client put in restraints to prevent leaving facility
, Professional Negligence - failure of a person with professional training to act in a reasonable and
prudent manner
Responsiblities for informed consent - Provider-obtain consent;
Client-give consent;
Nurse-witnesses consent
Types of Advance Directives - Living Will-expressin clients wishes regarding medical treatment;
Durable Power of Attorney for Healthcare-designates a healthcare proxy;
Providers Order-DNR-do not resuscitate; AND-allow natural death; CPR-cardiopulmonary resuscitation
Chart Information - assessments; medication administration; treatments geven and the clients
responses; client education
Chart documentation - subjective data-what the client says in quotation marks;
objective data-what you see;
accurate/concise-info documented must be precise;
complete/current-info is comprehensive and timely;
organized-communicate in logical order
Delegation and Supervision - RNs to RNs, LPNs and Nursing assistants
Delegation Factors - Predictability of outcome; Potential for harm; Complexity of care; need for problem
solving and innovation; level of interaction with the client
Five Rights of Delegation - Right Task-identify task;
Right Circumstance-access health status/complexity of care;
Right person-verify compentencey of delegatee;
Right direction/communication-data to collect;
Right supervision/evaluation-provide direct/indirect supervision
GUIDE-UPDATED 2022
Regulatory agencies - US Dept of Health and Human Services
FDA
State and local public health agencies
State icensing boards
Joint Commission-JCAHO
Professional Standards Review Organizations
Review committees
Healthcare financing mechanisms - publically federally funded progams
-Medicare
-Medicaid
-Private pay
Levels of Healthcare - Preventive Health-immunization, stress management
Primary-nutrition counseling
Secondary-emergency
Tertiary-techincal care, cancer centers
Restorative-home health, rehab
Continuing-long-term, chronic
Interdisplinary Personnel-Non-Nursing - Clergy-spiritual
Registered Dietitian-educate on nutrition
Lab Tech-obtain specimens
Occupational Therapist-regain ADLs
Pharmacist-provide/monitor medications
,Physical Therapist-increase musculoskeletal function
Provider-assess, diagnose, treat client
Radiologic Techs-perform xrays
Respiratory Therapist-evaluate respiratory status
Social Worker-equip client/family with community resources
Speech Therapist-assist with regaining speech
Autonomy (Ethical Responsibilities) - ability of the client to make personal diecisins, even when those
decissions may not be in the clients best interest
Beneficence (Ethical Responsibilities) - agreement that the care given is in the best interest o the client;
taking positive actions to help others
Fidelity (Ethical Responsibilities) - agreement to keep one's promise to the client about care that was
offered
Justice (Ethical Responsibilities) - fair treatment in matters related to physical an psychosocial care and
use of resources
Nonmaleficnce (Ethical Responsibilities) - avoidance of harm of pain as much as possible when giving
treatments
Ethical dilemna (Ethical Responsibilities) - it cannot be solved solely by a review of scientiic data; it
involves a conflict between two moral imperatives; the answer will have a profound effect on the
situation/client
Nurses basic code of ethics (Ethical Responsibilities) - advocacy, responsibility, accountability and
confidentiality
nurses role in ethical decision making (Ethical Responsbilities) - 1. an agent fo the client facing and
ethical decision-helping decision of abortion for adolscent; discussing blood transfusion w/JW;
2. the decison maker in regard to nursing practice-witnessing surgeon provide options but not dangers
,Sources of Law (legal responsibilities) - Health Insurance Portablity and Accountability Act-HIPAA;
The Americans with Disabilities Act-ADA;
The Mental Health Parity Act-MHPA;
The Patient Self-Determination Act-PSDA
Criminal law - subsection of public law and relates to the relationship of an individual with the
govenment-nurse who falsifies medical record
Civil law - protects the individual rights of people-provision of nursing care is tort law
Negligence - Unintentional Torts - nurse fails to implement safety measures for a client who has been
identified as at risk for falls
Malpractice - Unintentional Torts - nurse administers a large dose of medication due to a calculation
error. Client has a cardiac arrest and dies
Breach of Confidentiality - Quasi-Intentional Tort - a nurse release the medical diagnosis of a client to a
member of the press
Defamation of Character - Quasi-Intentional Tort - a nurse tells a coworker that she believes the
clienthas been unfaithful to her spouse
Assault - Intentional Torts - the conduct of one person makes another person fearful-threatening
Battery - Intentional Tort - intentional and wrong physical contact that involves injury or offensive
contact-restraining of a client
False Imprisionment - Intentional Tort - a person is confined/restrained against their will-competent
client put in restraints to prevent leaving facility
, Professional Negligence - failure of a person with professional training to act in a reasonable and
prudent manner
Responsiblities for informed consent - Provider-obtain consent;
Client-give consent;
Nurse-witnesses consent
Types of Advance Directives - Living Will-expressin clients wishes regarding medical treatment;
Durable Power of Attorney for Healthcare-designates a healthcare proxy;
Providers Order-DNR-do not resuscitate; AND-allow natural death; CPR-cardiopulmonary resuscitation
Chart Information - assessments; medication administration; treatments geven and the clients
responses; client education
Chart documentation - subjective data-what the client says in quotation marks;
objective data-what you see;
accurate/concise-info documented must be precise;
complete/current-info is comprehensive and timely;
organized-communicate in logical order
Delegation and Supervision - RNs to RNs, LPNs and Nursing assistants
Delegation Factors - Predictability of outcome; Potential for harm; Complexity of care; need for problem
solving and innovation; level of interaction with the client
Five Rights of Delegation - Right Task-identify task;
Right Circumstance-access health status/complexity of care;
Right person-verify compentencey of delegatee;
Right direction/communication-data to collect;
Right supervision/evaluation-provide direct/indirect supervision
