A nurse in an emergency department is preparing change-of-shift report for an adult client who is transferring to a medical-surgical unit using the SBAR communication tool. Which of the following information should the nurse include in the report? (Select all that apply.)
The client has a do-not-resuscitate (DNR) prescription.
The client has a continuous IV of lactated Ringer's.
The client was straight catheterized for 350 mL 2 hr ago.
The client has Medicare insurance.
The client lives in a one-story home.
Correct Answer : A,B,C
A. The client has a do-not-resuscitate (DNR) prescription: Including the client’s code status is essential for ensuring that the receiving medical-surgical team follows the appropriate resuscitation plan. This information directly impacts emergency decision-making and aligns with the client's wishes.
B. The client has a continuous IV of lactated Ringer’s: Reporting active IV fluids is necessary for continuity of care, as it affects fluid balance, medication administration, and overall treatment planning. The receiving nurse must be aware of the infusion to monitor for effectiveness and complications.
C. The client was straight catheterized for 350 mL 2 hr ago: Details about recent procedures, such as urinary catheterization, are relevant to ongoing assessment and care. Monitoring urinary output helps evaluate kidney function and fluid status, making it crucial information for the next shift.
D. The client has Medicare insurance: Insurance details are important for administrative and billing purposes but do not directly impact immediate patient care. This information is typically managed by case management or the hospital’s financial services.
E. The client lives in a one-story home: While discharge planning may involve assessing home arrangements, this detail is not immediately necessary for a shift report. Relevant home considerations should be discussed later when planning for discharge and follow-up care.
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Related Questions
Correct Answer is A
Explanation
A. "We should start tracking how soon clients are discharged after laparoscopic versus open surgery.": This statement reflects the QSEN concept of quality improvement by focusing on collecting and analyzing data related to patient discharge times. By tracking this information, the team can identify trends, evaluate the effectiveness of care, and implement changes to improve patient outcomes and streamline the discharge process.
B. "We should be sure to log out of the computers immediately following documentation.": While this statement emphasizes an important aspect of safety and confidentiality in documentation, it does not directly address quality improvement initiatives. It focuses more on operational procedures rather than evaluating and enhancing the quality of patient care.
C. "We should involve our clients' partners in care planning as much as possible.": Involving clients' partners in care planning aligns with the QSEN concept of patient-centered care. While this approach is essential for improving patient satisfaction and outcomes, it is not specifically a quality improvement initiative.
D. "We should provide change-of-shift report as a team, including the assistive personnel who assisted with care.": This statement reflects teamwork and communication strategies, which are important for effective patient care. However, it does not directly focus on quality improvement initiatives aimed at evaluating and enhancing the overall quality of care provided to clients.
Correct Answer is ["A","B","E"]
Explanation
A. Anesthesiologists: Anesthesiologists have full prescriptive authority as licensed physicians, allowing them to provide telephone medication orders. Their prescribing rights apply in various healthcare settings, following institutional policies and legal guidelines.
B. Physician assistants: Physician assistants have prescriptive authority under physician supervision and can give telephone medication orders where permitted. Their prescribing ability depends on state regulations and facility policies but generally includes routine and emergency prescriptions.
C. Facility pharmacists: Facility pharmacists dispense medications and provide guidance on drug therapy but do not have the legal authority to prescribe. While they collaborate with providers, they cannot issue telephone medication prescriptions.
D. Mental health technicians: Mental health technicians assist with patient care in psychiatric settings but lack the training and licensure required to prescribe medications. Their responsibilities focus on supportive tasks, and they cannot give telephone medication prescriptions.
E. Nurse practitioners: Nurse practitioners have independent or collaborative prescriptive authority depending on state regulations. They can provide telephone medication orders within their scope of practice, ensuring timely medication management for patients.
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