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E Handouts 1A 2023 Prioritizing and Delegation
E Handouts 1A 2023 Prioritizing and Delegation
OUR RULE #2
NO. 1
CONCEPTS
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Example: ➢ The nurse is reviewing a 68 year-old
Bowtie Item client’s assessment data to prepare the
client’s plan of care.
The following were noted:
Action to take Parameter to Monitor
Frequent orthostatic hypotension
Pounding heart beat
Diagnosis
Chest pain
Shortness of breath
Fatigue
Weakness
Action to take Parameter to Monitor
ECG tracing reveals
Example:
Bowtie Item STRATEGY
Identify the main topic: ECG pattern that leads to stroke
Action to take Parameter to Monitor
Atrial Fibrillation
Diagnosis
failure Digoxin
Metoprolol
Propranolol
Warfarin
Dabigatran
Quinidine
Flecainide
Propafenone
IV IV Amiodarone
Procainamide Heparin Disopyramide
Amiodarone Sotalol
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
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Functional Concept ® NCLEX QUICK FIX TIP
Drugs that may cause atrial
fibrillation includes:
ECG TRACING
M ilrinone
A tropine
denosine
D obutamine
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The Ray A. Gapuz Test Prep System For The NCLEX RN
O ndansetron
I nherited traits
NO known cause (idiopathic)
T reatment with lithium and antiarrythmics
E lectrolyte imbalance: hypomagnesemia, hypokalemia, hypocalcemia
S ubstances from foods like grapefruit
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The Ray A. Gapuz Test Prep System For The NCLEX
16 of RN
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5:59
The Ray A. Gapuz Test Prep System For The NCLEX RN The Ray A. Gapuz Test Prep System For The NCLEX
16 of RN
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✓Rhythm – Regular
✓Rate - Normal or Slow
✓P wave - Ratio 2:1, 3:1
✓P wave rate - Normal but faster than QRS rate
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The Ray A. Gapuz Test Prep System For The NCLEX RN The Ray A. Gapuz Test Prep System For The NCLEX RN
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
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Functional Concept ® NCLEX QUICK FIX
PRIORITIZING
Atropine sulfate is given in
complete heart block to increase PREGNANT CLIENTS
the heart rate.
Functional Concept ®
Priorities for MCN cases include:
C ardiac compromise A bnormal V/S
A cute mental status change
S evere respiratory distress P rolapsed cord
eizures
igns of abruptio placenta I mminent birth
igns of uterine rupture
H emorrhage Image from: "32 Weeks (8 Months Pregnant!)" by Pretty Poo Eater is licensed
under CC BY-SA 2.0”
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Functional Concept ®
Guidelines from the Neonatal
Resuscitation Program (NRP)
recommends against
oronasopharyngeal suctioning with a
bulb syringe after birth.
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
PEDIATRIC CLIENTS
deficiency anemia (IDA) must be
assessed for their diet !
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NCLEX QUICK FIX Functional Concept ®
Risk factors to lung cancer include the following:
PRIORITIZING CLIENTS MODIFIABLE
(You can change)
NON- MODIFIABLE
(You can not change)
UNCERTAIN
(Needs validation)
CANCER
a, vinyl chloride, nickel
compounds,chromium
compounds, coal products,
mustard gas,chloromethyl
ethers,diesel exhaust
Betacarotene supplements
Arsenic in drinking water
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
CLIENTS
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
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PRIORITIZING STRATEGY 1 Rationale
REMEMBER
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PRIORITIZING STRATEGY 4 Rationale
•Jaundice that occurs in a client taking
antipsychotics indicates hepatotoxicity.
Any adverse effect of a drug
•It is expected that valium causes
related to the kidneys and liver drowsiness. The normal serum level of
is a nursing priority ! digoxin is 0.5 to 2.5, so a level of 1.9 is
normal. Methergine causes elevation of
BP, so a BP of 130/90 is expected
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PRIORITIZING STRATEGY 7 Rationale
A client with multiple sclerosis with
A client with ongoing ongoing IV treatment is a priority for
treatment is a nursing priority the nurse to visit.
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PRIORITIZING STRATEGY 10 Rationale
REMEMBER
A client with a surgical incision near
the diaphragm is a nursing priority The surgical incision of a post-
cholecystectomy client is nearest the
diaphragm. This may lead to altered
breathing patterns.
Think ABC !
Remember
NO. 2
Think MACS
1. Maslow says physiologic needs
first
2. ABC
3. Complications- Acute first
4. Signs indicative of worsening
STRATEGY
➢For each task, click to specify whether it is
Question and Answer agreement: Note the phrase “post-partum unit”
appropriate for the RN,LPN and UAP:
Task RN LPN UAP
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NCLEX QUICK FIX Functional Concept ®
Five interventions implemented to prevent falls
(physicians, PT, RN, food service staff, housekeepers
FUNCTIONS of the and family members):
1. Put bed in low position
UNLICENSED ASSISTIVE 2. Keep room free of clutter
3. Have personal items and call light within reach
PERSONNEL 4. Maintain adequate lighting
5. Call for help if assistance is needed
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
&
technical task of medication
administration to the UAP
DELEGATION
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
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Functional Concept ® Functional Concept ®
Delegation of medication administration to
All on-going assessments, appropriately educated and competent UAP
includes the following routes:
interpretations, judgments and P Pills (oral), powder and paste
decision-making required relative to O Oral, opthalmic, otic
I Inhalant
clients receiving medications must be N Nasal drops and sprays
carried out by the RN. T Topical, transdermal
S Sublingual, buccal, suppositories (vaginal)
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
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Functional Concept ® Functional Concept ®
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
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Functional Concept ® Functional Concept ®
In the care of the client with hearing
impairment, the UAP should:
The UAP may feed the dependent 1. Gain the client’s attention and inform the client of your presence
2. Face the person
client ! 3. Ensure sufficient light
4. Speak in a normal tone of voice
5. Avoid over enunciating words
6. Use short sentences and simple words
7. Minimize background noise
8. Speak to the better ear
9. Use communication board or hand gesture or sign language
10. Repeat or rephrase statements as needed using different words to
vary pitch
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
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Functional Concept ® Functional Concept ®
LPNs can: LPNs can:
Assist the RN Administer oral medications
Assist in collecting data and monitoring client Administer enteral feedings
findings Give NG tube feedings and check NGT patency
Reinforce client teaching Change wound dressings
Delegate to UAPs May monitor blood products BUT NOT initiate it
Perform tracheostomy care and suctioning
Insert urinary catheter
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM FUNCTIONAL CONCEPT ® IS A REGISTERED TRADEMARK OF RAY A. GAPUZ TEST PREP SYSTEM
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Remember
Remember these:
1. A,T,E for the RN
2. ADL for the UAP
3. CST- chronic, stable , in traction
can be delegated
4. Routine, Unchanging, Standard
procedures can be delegated
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