VATI RN COMPREHENSIVE PREDICTOR
Private rooms - ANSWER are required for clients who have an infectious disease
that requires airborne precautions, or clients who require a protective
environment._______ _____ are preferred for clients who are on droplet and contact
precautions. These clients can cohort if no _______ ______ are available and if all of
the following are true. ●The clients have the same active infection with the same
micro-organisms. ●The clients remain at least 3 feet away from each other. ●The
clients have no other existing infection. ______ _______ is also preferred for the
following clients. ●Client who are agitated ●Client who have dementia and a history
of wandering ●Clients who require a quiet environment (those at risk for increased
intracranial pressure [stroke, traumatic brain injury]) ●Clients who are at risk for
sensory overload (those who are having pain, are acutely ill, have invasive tubes
[nasogastric, IVs, endotracheal], or have reduced cognitive function [head injury])
●Clients who require privacy (those who are near death)
Prior to delegating client care, consider the following. - ANSWER Predictability of
outcome ●Will the completion of the task have a predictable outcome? ●Is it a
routine treatment? ●Is it a new treatment? Potential for harm ●Is there a chance that
something negative can happen to the client (risk for bleeding, risk for aspiration)?
●Is the client unstable? Complexity of care ●Are complex tasks required as a part of
the client's care? ●Is the delegatee legally able to perform the task and do they have
the skills necessary? Need for problem solving and innovation ●Is nursing judgment
required while performing the task? ●Does it require nursing assessment skills?
Level of interaction with the client ●Is there a need to provide psychosocial support
or education during the performance of the task?
Examples of tasks nurses can delegate to practical nurses and assistive personnel -
ANSWER TO PN Monitoring findings (as input to the RN's ongoing
assessment)Reinforcing client teaching from a standard care planPerforming
tracheostomy careSuctioningChecking NG tube patencyAdministering enteral
feedingsInserting a urinary catheterAdministering medication (excluding IV
medication in some states). TO AP Activities of daily living (ADLs) Bathing Grooming
Dressing Toileting Ambulating Feeding (without swallowing precautions). Positioning
Routine tasks. Bed making. Specimen collection Intake and output Vital signs (for
stable clients).
Right direction/communication (five rights of delegations) - ANSWER Data that
needs to be collected ●Method and timeline for reporting, including when to report
concerns/findings ●Specific task(s) to be performed; client-specific instructions
●Expected results, timelines, and expectations for follow-up communication
RIGHT DIRECTION AND COMMUNICATION: Delegate an AP to assist the client in
room 312 with a shower before 0900 and to notify the nurse when complete.
WRONG DIRECTION AND COMMUNICATION: Delegate an AP to assist the client
in room 312 with morning hygiene.
, Steps in providing educational programs - ANSWER 1. Identify and respond:
Determine the need for knowledge or skill proficiency 2. Analyze: Look for
deficiencies, and develop learning objectives to meet the need 3. Research:
Resources available to address learning objectives based on evidence-based
practice 4. Plan: Program to address objectives using available resources 5.
Implement: Program(s) at a time conducive to staff availability; consider online
learning modules 6. Evaluate: Use materials and observations to measure behavior
changes secondary to learning objectives
Tetralogy of Fallot. - ANSWER Four defects that result in mixed blood flow:
Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular
hypertrophy. Cyanosis at birth: progressive cyanosis over the first year of life.
Systolic murmur. Episodes of acute cyanosis and hypoxia (blue or "Tet" spells knee
chest position or squating). SURGICAL PROCEDURES Shunt placement until able
to undergo primary repair. Complete repair within the first year of life.
Defects that increase pulmonary blood flow - ANSWER Ventricular septal defect
(VSD) (20.1) Atrial septal defect (ASD), Patent ductus arteriosus (PDA),
Defects that increase pulmonary blood flow Ventricular septal defect (VSD) -
ANSWER _______ A hole in the septum between the right and left ventricle that
results in increased pulmonary blood flow (left-to-right shunt) ●Loud, harsh murmur
auscultated at the left sternal border ●Heart failure ●Many VSDs close
spontaneously early in life.
Defects that increase pulmonary blood flow Atrial septal defect (ASD) - ANSWER A
hole in the septum between the right and left atria that results in increased
pulmonary blood flow (left-to-right shunt) ●Loud, harsh murmur with a fixed split
second heart sound ●Heart failure ●Asymptomatic (possibly)
Defects that increase pulmonary blood flow Patent ductus arteriosus (PDA) -
ANSWER A condition in which the normal fetal circulation conduit between the
pulmonary artery and the aorta fails to close and results in increased pulmonary
blood flow (left-to-right shunt) ●Systolic murmur (machine hum) ●Wide pulse
pressure ●Bounding pulses ●Asymptomatic (possibly) ●Heart failure ●Rales
Obstructive defects - ANSWER include those where blood flow exiting the heart
meets an area of narrowing (stenosis), which causes obstruction of blood flow. ●The
pressure that occurs before the defect is increased (ventricle) and the pressure that
occurs after the defect is decreased. This results in a decrease in cardiac output.
●These children can present with manifestations of heart failure. Pulmonary stenosis
(20.2), Aortic stenosis, Coarctation of the aorta (20.3)
Pulmonary stenosis (20.2) - ANSWER A narrowing of the pulmonary valve or
pulmonary artery that results in obstruction of blood flow from the ventricles ●Systolic
ejection murmur ●Asymptomatic (possibly) ●Cyanosis varies with defect, worse with
severe narrowing ●Cardiomegaly ●Heart failure
Private rooms - ANSWER are required for clients who have an infectious disease
that requires airborne precautions, or clients who require a protective
environment._______ _____ are preferred for clients who are on droplet and contact
precautions. These clients can cohort if no _______ ______ are available and if all of
the following are true. ●The clients have the same active infection with the same
micro-organisms. ●The clients remain at least 3 feet away from each other. ●The
clients have no other existing infection. ______ _______ is also preferred for the
following clients. ●Client who are agitated ●Client who have dementia and a history
of wandering ●Clients who require a quiet environment (those at risk for increased
intracranial pressure [stroke, traumatic brain injury]) ●Clients who are at risk for
sensory overload (those who are having pain, are acutely ill, have invasive tubes
[nasogastric, IVs, endotracheal], or have reduced cognitive function [head injury])
●Clients who require privacy (those who are near death)
Prior to delegating client care, consider the following. - ANSWER Predictability of
outcome ●Will the completion of the task have a predictable outcome? ●Is it a
routine treatment? ●Is it a new treatment? Potential for harm ●Is there a chance that
something negative can happen to the client (risk for bleeding, risk for aspiration)?
●Is the client unstable? Complexity of care ●Are complex tasks required as a part of
the client's care? ●Is the delegatee legally able to perform the task and do they have
the skills necessary? Need for problem solving and innovation ●Is nursing judgment
required while performing the task? ●Does it require nursing assessment skills?
Level of interaction with the client ●Is there a need to provide psychosocial support
or education during the performance of the task?
Examples of tasks nurses can delegate to practical nurses and assistive personnel -
ANSWER TO PN Monitoring findings (as input to the RN's ongoing
assessment)Reinforcing client teaching from a standard care planPerforming
tracheostomy careSuctioningChecking NG tube patencyAdministering enteral
feedingsInserting a urinary catheterAdministering medication (excluding IV
medication in some states). TO AP Activities of daily living (ADLs) Bathing Grooming
Dressing Toileting Ambulating Feeding (without swallowing precautions). Positioning
Routine tasks. Bed making. Specimen collection Intake and output Vital signs (for
stable clients).
Right direction/communication (five rights of delegations) - ANSWER Data that
needs to be collected ●Method and timeline for reporting, including when to report
concerns/findings ●Specific task(s) to be performed; client-specific instructions
●Expected results, timelines, and expectations for follow-up communication
RIGHT DIRECTION AND COMMUNICATION: Delegate an AP to assist the client in
room 312 with a shower before 0900 and to notify the nurse when complete.
WRONG DIRECTION AND COMMUNICATION: Delegate an AP to assist the client
in room 312 with morning hygiene.
, Steps in providing educational programs - ANSWER 1. Identify and respond:
Determine the need for knowledge or skill proficiency 2. Analyze: Look for
deficiencies, and develop learning objectives to meet the need 3. Research:
Resources available to address learning objectives based on evidence-based
practice 4. Plan: Program to address objectives using available resources 5.
Implement: Program(s) at a time conducive to staff availability; consider online
learning modules 6. Evaluate: Use materials and observations to measure behavior
changes secondary to learning objectives
Tetralogy of Fallot. - ANSWER Four defects that result in mixed blood flow:
Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular
hypertrophy. Cyanosis at birth: progressive cyanosis over the first year of life.
Systolic murmur. Episodes of acute cyanosis and hypoxia (blue or "Tet" spells knee
chest position or squating). SURGICAL PROCEDURES Shunt placement until able
to undergo primary repair. Complete repair within the first year of life.
Defects that increase pulmonary blood flow - ANSWER Ventricular septal defect
(VSD) (20.1) Atrial septal defect (ASD), Patent ductus arteriosus (PDA),
Defects that increase pulmonary blood flow Ventricular septal defect (VSD) -
ANSWER _______ A hole in the septum between the right and left ventricle that
results in increased pulmonary blood flow (left-to-right shunt) ●Loud, harsh murmur
auscultated at the left sternal border ●Heart failure ●Many VSDs close
spontaneously early in life.
Defects that increase pulmonary blood flow Atrial septal defect (ASD) - ANSWER A
hole in the septum between the right and left atria that results in increased
pulmonary blood flow (left-to-right shunt) ●Loud, harsh murmur with a fixed split
second heart sound ●Heart failure ●Asymptomatic (possibly)
Defects that increase pulmonary blood flow Patent ductus arteriosus (PDA) -
ANSWER A condition in which the normal fetal circulation conduit between the
pulmonary artery and the aorta fails to close and results in increased pulmonary
blood flow (left-to-right shunt) ●Systolic murmur (machine hum) ●Wide pulse
pressure ●Bounding pulses ●Asymptomatic (possibly) ●Heart failure ●Rales
Obstructive defects - ANSWER include those where blood flow exiting the heart
meets an area of narrowing (stenosis), which causes obstruction of blood flow. ●The
pressure that occurs before the defect is increased (ventricle) and the pressure that
occurs after the defect is decreased. This results in a decrease in cardiac output.
●These children can present with manifestations of heart failure. Pulmonary stenosis
(20.2), Aortic stenosis, Coarctation of the aorta (20.3)
Pulmonary stenosis (20.2) - ANSWER A narrowing of the pulmonary valve or
pulmonary artery that results in obstruction of blood flow from the ventricles ●Systolic
ejection murmur ●Asymptomatic (possibly) ●Cyanosis varies with defect, worse with
severe narrowing ●Cardiomegaly ●Heart failure
