PSW: Final Exam study set
5 RIGHTS OF DELEGATION - ANS-right task
right circumstance
right person
right direction/communication
right supervision/evaluation
A nurse who delegates a task is required to: - ANS-• Have the knowledge, skill, and
judgement to perform the task competently.
• Have the additional knowledge, skill and judgement to teach the task to others. The
delegating nurse is responsible for providing all necessary teaching, but not everyone is able
to teach others how to perform something. Good communication skills and patience
required.
• Accept responsibility for teaching the task to the support worker. The nurse must first
determine the risks and benefits of teaching the task and be able to confidently predict its
outcome.
• Assess your performance. The nurse must determine if you're able to perform the task
correctly.
• Determine if the task that is taught can be performed for more than one client. Each client
is unique.
• Monitor you over time to ensure you remain able to perform the task correctly and safely.
In the community the nurse may provide you with written instructions, predicted outcome
and what to record.
Abduction - ANS-Movement away from the midline of the body
abuse - ANS-physical or mental harm caused by someone in a position of trust.
Active Listening - ANS-Paying close attention to a client's verbal and nonverbal
communication - listening o the content, the intent and feelings behind the words. The
following are guidelines for active listening:
• Stand in front of the customer because the customer frequently needs to see your facial
expressions and body language to know that you are listening. • make eye contact: however,
consider cultural preferences in regards to eye contact.
• lean toward the client: Do not sit back with your arms crossed as this can be interpreted as
an indication that you are not open and receptive to what the client is telling you.
• respond to your client: note however that sometimes your client may just need to vent
• avoid communication barriers (interrupting, answering your own questions, giving advice,
minimizing problems, using patronizing language, failing to listen)
Adduction - ANS-Movement toward the midline of the body
Aging and growing older is - ANS-normal process during which the body experiences
changes in body structure and function, increasing the risk for illness, injury, persistent
illness and disability. These changes are usually gradual. Emotional and social changes
also occur.
ALL RULES REGARDING DELEGATION - ANS-Only regulated health care providers like
nurses have the authority (legal right) to perform certain tasks because they have the
knowledge, skill and training to perform them. They are called controlled acts and are
,considered harmful if they are performed by unqualified people. In some circumstances
some acts will be delegated to you. In order to do this, specific conditions called
"exceptions" must be met for delegation to be permitted. The nurse must feel confident the
support worker understands what the responsibilities are when performing the task, knowns
when and who to ask for assistance, and knowns when, how and whom to report the
outcome of the task.
Tasks that may be delegated to support workers must be routine ones with predictable
outcomes that require little supervision and can only be delegated for stable clients.
Delegation tasks may include: suctioning a permanent tracheotomy in and out catherization;
administering glucometers, dressings, tube feedings and medication.
Only some nursing tasks can be delegated. Your employer's policies and guidelines, your
job description and provincial or territorial legislation determine what tasks can be delegated
to you.
Sometimes these rules vary between community and LTC.
In Ontario an RN, RPN and LPN can delegate.
A delegated task is not transferrable to another client. Just because you did it for one
person, does not mean you are able to perform the SAME task on another client without
training.
Anaphylactic shock can occur within seconds. Signs and symptoms include the following: -
ANS-• severe restlessness
• increased anxiety
• possible combativeness (from struggling to breathe)
• sweating
• shortness of breath
• low blood pressure
• irregular pulse
• respiration congestion
• swelling of the larynx
• hoarseness
• dyspnea
anaphylaxis - ANS-is a severe sensitivity to an antigen (allergic reaction) that occurs rapidly
and causes a life-threatening response involving the whole body. The reaction can lead to
difficulty breathing and shock and can ultimately lead to death.
ANGINA PECTORIS: - ANS-chest (pectoris) pain (angina) caused by ischemia, a lack of
blood supply to the heart muscle, which is usually caused by an obstruction or spasm of the
coronary arteries because of coronary artery disease.
Asking Closed Questions - ANS-Focuses on specific information, so you use them when
you need to learn something precise. Some closed responses require a yes or no answer,
others require a brief response.
Asking Open-Ended Questions - ANS-These types of questions invite a person to share
thoughts, feelings, or idea. Answers must be more than a yes or a no. The person being
questioned chooses and controls what is talked about and the information given. It shows
that you are interested in hearing about their life.
Use both open and closed ended questions help find out about a client's needs and
preferences and to find out if a client is satisfied with your care.
Assault - ANS-identified in identified in Canada's Criminal Code and can be defined as
intentionally attempting or threatening to touch a client's body without the client's consent,
causing the client to fear bodily harm.Canada's Criminal Code and can be defined as
,intentionally attempting or threatening to touch a client's body without the client's consent,
causing the client to fear bodily harm.
Assessment in community setting - ANS-Usually a meeting in the client's home takes place
with the client, family and the case manager. This meeting identifies the client's issues and
needs. If coming from a hospital, information from the hospital is used. The family is very
important as we know illness affects everyone in the house. Together with the client and
their family, a decision is made as to the care and services needed. The case manager also
evaluates if the house is a safe environment. It needs to be reasonably clean, free of
infestations, and have handwashing facilities and adequate heating and cooling systems.
The case manager will also determine if there are any modifications (like grab bars) that are
needed in the home. Sometimes other specialists are needed like an occupational therapist
to evaluate the homes wheelchair accessibility.
Assessment: - ANS-An evaluation occurs through information collected about the client
through observation, reflection and communication. In some facilities a team leader
evaluates the emotional, spiritual, social and intellectual health of a client. A client's physical
assessment can only be done by a nurse or a doctor. The team leader (nurse, social worker,
or caseworker) gathers as much information as possible. Once the assessment has been
completed, the team members, including the client and the client's family gather to set goals
and to meet the needs of the client.
autonomy: ANS have the freedom and choice to make life-altering choices. Also known as
self-determination.
Baby boomers (people born during post WWII) from, 1946 - the mid 1960's age, Canada is
increasing it's efforts to better understand the implications of the aging population - ANS-on
health and long-term care needs and costs. "Active Aging" is becoming the norm, meaning
that older adults are increasingly contributing to society through pain and unpaid activities.
Bacteria that grows in the oral cavity - ANS-can be aspirated into the lungs and cause
diseases such as pneumonia. Clients with oral disease are at risk for thickening of the
carotid arteries, which leads to heart disease.
Oral care is given to the client on awakening, after each meal, and at bedtime. Oral care is
given at least every 2 hours.
Always wear gloves during oral care. Gather up the needed supplies first.
Bag Baths - ANS-a prepackaged bath containing moist washcloths that are heated in the
microwave. No towel is needed as the skin is air dried.
BASIC NUTRITION: - ANS-Nutrition refers to the processes involved with ingestion,
digestion, absorption, and use of foods and fluids by the body.
Ingestion is the process of taking food and fluids into the body. Digestion is the process of
physically and chemically breakdown nutrients so that they can be absorbed for the use by
the cells.
Absorption is the process by which substances pass through the intestinal wall into the
blood.
Good nutrition is needed for growth, healing and maintenance of body functions.
Those who follow the recommendations in the Canadian Food Guide will obtain all the
nutrients they need for a balanced diet.
BATHING AND ORAL CARE - NURSING CONSIDERATION: - ANS-Bathing helps keep the
skin as well as the genital and anal areas clean by removing microbes, dead skin,
perspiration and excess oils.
A bath is relaxing, stimulates circulation, and exercises body parts. During baths you're
able to make important observations about clients, and you have time to get to know them.
, The client may require a complete bath or a partial bed bath, a tub bath or a shower
depending on the client's condition, self care ability and personal choice.
In facilities bathing usually happens after breakfast or the evening meal. The client's bath
time is respected whenever possible.
Bath water that is too hot can scald a frail, thin person.
Many agencies require 2 people to check the water temperature and record it in the client's
chart.
Aging and soap can cause dry skin, which is easily damaged. When using soap, ensure
you're rinsing thoroughly. Bath oils should never be added to tubs baths, as they can
increase the risk of the client slipping and falling.
Battery - ANS-(part of tort law) is the actual intentional touching of a client's body without the
client's consent.
Before delegating tasks, the nurse must know the following: - ANS-• What tasks your
province or territory allows support workers to perform.
• The tasks included in your job description.
• What you were taught in your training program.
• What skills you have learned and how they were evaluated.
• Your work experiences.
Benign - ANS-noncancerous
Body alignment - ANS-the way in which body parts (head, trunk, arms and legs) are
positioned in relation to one another, whether lying, sitting, or standing. Also known as
posture.
Bones that weight bear are called - ANS-long bones
BRUSHING TEETH: - ANS-Most clients can perform oral hygiene themselves but in LTC
the majority cannot perform them adequately. However, everyone agrees that you should
begin brushing at the gum line and hold at a 45-degree angle. Brush with short strokes.
Brush back and forth on the biting surfaces of the teeth.
Cancer - ANS-a group of diseases characterized by the out of control cell division and
growth, which can occur in many body systems. This cell division leads to the development
of a lump or mass of cells. This new growth of abnormal cells is called a tumour.
capsule - ANS-small gelatin containers that hold medications
CARBOHYDRATES: - ANS-Provide energy for the body and fibre for bowel elimination.
Most carbohydrates come from plants. There are 3 kinds of carbohydrates.
Simple sugars: found in table sugar, fruits, and fruit juices
Starches: found in bread, pasta, rice and potatoes
Fibre: found in bran, nuts, seeds, and raw fruits with skin. Fibre cannot be digested and is
passed through the intestines undigested.
During digestion, most carbohydrates (except fibre) are broken down into sugars, which are
then absorbed into the bloodstream.
CARE OF BABY/NEWBORN - ANS-Infants are helpless and cannot protect themselves.
They depend on others for their basic needs. It is important to practice hand hygiene as an
infant's immune system is delicate.
Care of Equipment - ANS-• Handle equipment carefully. Do not let it touch your skin,
mucous membranes or clothing
• Do not use reusable items for another client. The item MUST be disinfected or sterilized
first
• Discard disposable (single use) items properly
5 RIGHTS OF DELEGATION - ANS-right task
right circumstance
right person
right direction/communication
right supervision/evaluation
A nurse who delegates a task is required to: - ANS-• Have the knowledge, skill, and
judgement to perform the task competently.
• Have the additional knowledge, skill and judgement to teach the task to others. The
delegating nurse is responsible for providing all necessary teaching, but not everyone is able
to teach others how to perform something. Good communication skills and patience
required.
• Accept responsibility for teaching the task to the support worker. The nurse must first
determine the risks and benefits of teaching the task and be able to confidently predict its
outcome.
• Assess your performance. The nurse must determine if you're able to perform the task
correctly.
• Determine if the task that is taught can be performed for more than one client. Each client
is unique.
• Monitor you over time to ensure you remain able to perform the task correctly and safely.
In the community the nurse may provide you with written instructions, predicted outcome
and what to record.
Abduction - ANS-Movement away from the midline of the body
abuse - ANS-physical or mental harm caused by someone in a position of trust.
Active Listening - ANS-Paying close attention to a client's verbal and nonverbal
communication - listening o the content, the intent and feelings behind the words. The
following are guidelines for active listening:
• Stand in front of the customer because the customer frequently needs to see your facial
expressions and body language to know that you are listening. • make eye contact: however,
consider cultural preferences in regards to eye contact.
• lean toward the client: Do not sit back with your arms crossed as this can be interpreted as
an indication that you are not open and receptive to what the client is telling you.
• respond to your client: note however that sometimes your client may just need to vent
• avoid communication barriers (interrupting, answering your own questions, giving advice,
minimizing problems, using patronizing language, failing to listen)
Adduction - ANS-Movement toward the midline of the body
Aging and growing older is - ANS-normal process during which the body experiences
changes in body structure and function, increasing the risk for illness, injury, persistent
illness and disability. These changes are usually gradual. Emotional and social changes
also occur.
ALL RULES REGARDING DELEGATION - ANS-Only regulated health care providers like
nurses have the authority (legal right) to perform certain tasks because they have the
knowledge, skill and training to perform them. They are called controlled acts and are
,considered harmful if they are performed by unqualified people. In some circumstances
some acts will be delegated to you. In order to do this, specific conditions called
"exceptions" must be met for delegation to be permitted. The nurse must feel confident the
support worker understands what the responsibilities are when performing the task, knowns
when and who to ask for assistance, and knowns when, how and whom to report the
outcome of the task.
Tasks that may be delegated to support workers must be routine ones with predictable
outcomes that require little supervision and can only be delegated for stable clients.
Delegation tasks may include: suctioning a permanent tracheotomy in and out catherization;
administering glucometers, dressings, tube feedings and medication.
Only some nursing tasks can be delegated. Your employer's policies and guidelines, your
job description and provincial or territorial legislation determine what tasks can be delegated
to you.
Sometimes these rules vary between community and LTC.
In Ontario an RN, RPN and LPN can delegate.
A delegated task is not transferrable to another client. Just because you did it for one
person, does not mean you are able to perform the SAME task on another client without
training.
Anaphylactic shock can occur within seconds. Signs and symptoms include the following: -
ANS-• severe restlessness
• increased anxiety
• possible combativeness (from struggling to breathe)
• sweating
• shortness of breath
• low blood pressure
• irregular pulse
• respiration congestion
• swelling of the larynx
• hoarseness
• dyspnea
anaphylaxis - ANS-is a severe sensitivity to an antigen (allergic reaction) that occurs rapidly
and causes a life-threatening response involving the whole body. The reaction can lead to
difficulty breathing and shock and can ultimately lead to death.
ANGINA PECTORIS: - ANS-chest (pectoris) pain (angina) caused by ischemia, a lack of
blood supply to the heart muscle, which is usually caused by an obstruction or spasm of the
coronary arteries because of coronary artery disease.
Asking Closed Questions - ANS-Focuses on specific information, so you use them when
you need to learn something precise. Some closed responses require a yes or no answer,
others require a brief response.
Asking Open-Ended Questions - ANS-These types of questions invite a person to share
thoughts, feelings, or idea. Answers must be more than a yes or a no. The person being
questioned chooses and controls what is talked about and the information given. It shows
that you are interested in hearing about their life.
Use both open and closed ended questions help find out about a client's needs and
preferences and to find out if a client is satisfied with your care.
Assault - ANS-identified in identified in Canada's Criminal Code and can be defined as
intentionally attempting or threatening to touch a client's body without the client's consent,
causing the client to fear bodily harm.Canada's Criminal Code and can be defined as
,intentionally attempting or threatening to touch a client's body without the client's consent,
causing the client to fear bodily harm.
Assessment in community setting - ANS-Usually a meeting in the client's home takes place
with the client, family and the case manager. This meeting identifies the client's issues and
needs. If coming from a hospital, information from the hospital is used. The family is very
important as we know illness affects everyone in the house. Together with the client and
their family, a decision is made as to the care and services needed. The case manager also
evaluates if the house is a safe environment. It needs to be reasonably clean, free of
infestations, and have handwashing facilities and adequate heating and cooling systems.
The case manager will also determine if there are any modifications (like grab bars) that are
needed in the home. Sometimes other specialists are needed like an occupational therapist
to evaluate the homes wheelchair accessibility.
Assessment: - ANS-An evaluation occurs through information collected about the client
through observation, reflection and communication. In some facilities a team leader
evaluates the emotional, spiritual, social and intellectual health of a client. A client's physical
assessment can only be done by a nurse or a doctor. The team leader (nurse, social worker,
or caseworker) gathers as much information as possible. Once the assessment has been
completed, the team members, including the client and the client's family gather to set goals
and to meet the needs of the client.
autonomy: ANS have the freedom and choice to make life-altering choices. Also known as
self-determination.
Baby boomers (people born during post WWII) from, 1946 - the mid 1960's age, Canada is
increasing it's efforts to better understand the implications of the aging population - ANS-on
health and long-term care needs and costs. "Active Aging" is becoming the norm, meaning
that older adults are increasingly contributing to society through pain and unpaid activities.
Bacteria that grows in the oral cavity - ANS-can be aspirated into the lungs and cause
diseases such as pneumonia. Clients with oral disease are at risk for thickening of the
carotid arteries, which leads to heart disease.
Oral care is given to the client on awakening, after each meal, and at bedtime. Oral care is
given at least every 2 hours.
Always wear gloves during oral care. Gather up the needed supplies first.
Bag Baths - ANS-a prepackaged bath containing moist washcloths that are heated in the
microwave. No towel is needed as the skin is air dried.
BASIC NUTRITION: - ANS-Nutrition refers to the processes involved with ingestion,
digestion, absorption, and use of foods and fluids by the body.
Ingestion is the process of taking food and fluids into the body. Digestion is the process of
physically and chemically breakdown nutrients so that they can be absorbed for the use by
the cells.
Absorption is the process by which substances pass through the intestinal wall into the
blood.
Good nutrition is needed for growth, healing and maintenance of body functions.
Those who follow the recommendations in the Canadian Food Guide will obtain all the
nutrients they need for a balanced diet.
BATHING AND ORAL CARE - NURSING CONSIDERATION: - ANS-Bathing helps keep the
skin as well as the genital and anal areas clean by removing microbes, dead skin,
perspiration and excess oils.
A bath is relaxing, stimulates circulation, and exercises body parts. During baths you're
able to make important observations about clients, and you have time to get to know them.
, The client may require a complete bath or a partial bed bath, a tub bath or a shower
depending on the client's condition, self care ability and personal choice.
In facilities bathing usually happens after breakfast or the evening meal. The client's bath
time is respected whenever possible.
Bath water that is too hot can scald a frail, thin person.
Many agencies require 2 people to check the water temperature and record it in the client's
chart.
Aging and soap can cause dry skin, which is easily damaged. When using soap, ensure
you're rinsing thoroughly. Bath oils should never be added to tubs baths, as they can
increase the risk of the client slipping and falling.
Battery - ANS-(part of tort law) is the actual intentional touching of a client's body without the
client's consent.
Before delegating tasks, the nurse must know the following: - ANS-• What tasks your
province or territory allows support workers to perform.
• The tasks included in your job description.
• What you were taught in your training program.
• What skills you have learned and how they were evaluated.
• Your work experiences.
Benign - ANS-noncancerous
Body alignment - ANS-the way in which body parts (head, trunk, arms and legs) are
positioned in relation to one another, whether lying, sitting, or standing. Also known as
posture.
Bones that weight bear are called - ANS-long bones
BRUSHING TEETH: - ANS-Most clients can perform oral hygiene themselves but in LTC
the majority cannot perform them adequately. However, everyone agrees that you should
begin brushing at the gum line and hold at a 45-degree angle. Brush with short strokes.
Brush back and forth on the biting surfaces of the teeth.
Cancer - ANS-a group of diseases characterized by the out of control cell division and
growth, which can occur in many body systems. This cell division leads to the development
of a lump or mass of cells. This new growth of abnormal cells is called a tumour.
capsule - ANS-small gelatin containers that hold medications
CARBOHYDRATES: - ANS-Provide energy for the body and fibre for bowel elimination.
Most carbohydrates come from plants. There are 3 kinds of carbohydrates.
Simple sugars: found in table sugar, fruits, and fruit juices
Starches: found in bread, pasta, rice and potatoes
Fibre: found in bran, nuts, seeds, and raw fruits with skin. Fibre cannot be digested and is
passed through the intestines undigested.
During digestion, most carbohydrates (except fibre) are broken down into sugars, which are
then absorbed into the bloodstream.
CARE OF BABY/NEWBORN - ANS-Infants are helpless and cannot protect themselves.
They depend on others for their basic needs. It is important to practice hand hygiene as an
infant's immune system is delicate.
Care of Equipment - ANS-• Handle equipment carefully. Do not let it touch your skin,
mucous membranes or clothing
• Do not use reusable items for another client. The item MUST be disinfected or sterilized
first
• Discard disposable (single use) items properly
