- a.Medications: Drug name, dosage, purpose, effect,
and times taken, stated verbally and in writing
b.Procedures and treatments: Demonstrate all
steps, practice, and put in writing. Caregivers
should demonstrate procedures.
c. Diet: Explain diet and purpose; give examples of
meals and provide written plans.
d.Referrals: Instruct patient and family how to
make follow-up visits and whom to call with
problems.
e.Health promotion: All aspects of the illness or
effects of treatment should be described verbally,
and written materials should be supplied. - a.Discharge planning: Exchanges information
among the patient, caregivers, and those respon-
sible for home care while the patient is in the
institution and after the patient returns home.
b.Collaboration with other members of the health-
care team: Meets the patient’s and family’s physi-
cal, psychological, sociocultural, and spiritual
needs in all settings and at all levels of health.
c. Involving patient and family in planning:
Ensures that patient and family needs are consis-
tently met as the patient moves from one level
of care to another. - a.Assess the patient’s need for nursing care related
to admission.
b.Include consideration of biophysical, psychoso-
cial, environmental, self-care, educational, and
discharge planning factors in each patient’s
assessment.
c. Involve the patient and family in care as appro-
priate.
d.Nursing staff members should collaborate, as
appropriate, with physicians and members of
other clinical disciplines to make decisions
regarding the patient’s need for nursing care.
e.Assess need for continuing care in preparation
for discharge, and document referrals for such
care in the patient’s medical record. - a.Establish the health database: age; sex; height;
weight; medical history, including any prior mis-
carriages; and current medical treatment, follow-
up treatment
b.Assess for personal data: Personal feelings about
her miscarriage, effectiveness of personal coping
methods
c. Explore husband’s relationship with patient and
ability to provide emotional support.
d.Check if there are any support services (e.g., sup-
port groups, fertility clinics) that would be avail-
able to this couple. - a.Transfer within the hospital setting: Patient’s
belongings and/or furniture are moved; patient’s
chart, Kardex, care plan, and medications must
be correctly labeled for the new room; and other
departments must be notified as appropriate. If
transfer is to a new floor, the nurse at the
original area gives a verbal report about the
patient to the nurse at the new area.
b.Transfer to a long-term facility: All the patient’s
belongings are carefully packed and sent to the
facility; prescriptions and appointment cards for
return visits to the physician’s office may be sent;
patient is discharged from hospital setting, but a
copy of the chart may be sent to long-term facility
along with a detailed assessment and care plan.
c. Discharge from a healthcare setting: Check
patient discharge order, instructions, equipment
and supplies, and financial arrangements. Assist
patient to dress and pack belongings; check for
written order for future services; transport
patient to car and assist as necessary; make nec-
essary recordings on records and complete
discharge summary.
7.A form must be signed that releases the physician
and healthcare institution from any legal responsi-
bility for the patient’s health status; the patient is
informed of any possible risk before signing the
form; the signature of the patient must be
witnessed; and the form becomes part of the
patient’s record.
8.Position the bed in its highest position; arrange the
furniture in the room to allow easy access to the
bed. Open the bed by folding back the top bed
linens. Assemble necessary equipment and supplies.
Assemble special equipment and supplies (e.g., oxy-
gen therapy equipment) and make sure it is
working properly. Adjust the physical environment
of the room.
REFLECTIVE PRACTICE USING CRITICAL
THINKING SKILLS
Sample Answers
1.How might the admitting nurse respond to the
grandmother’s refusal to sign consent forms?
The nurse should speak to the grandmother and ask
her if there is another contact for Jeff, such as a par-
ent. The nurse could also check if there is a durable
power of attorney on file for Jeff, and if not, a legal
consult may be in order.
2.What would be a successful outcome for this
patient?
Jeff’s grandmother states the importance of getting
medical attention for her grandson and cooperates
with the staff to authorize the necessary care or
assign this responsibility to another caretaker.
3.What intellectual, technical, interpersonal, and/or
ethical/legal competencies are most likely to bring
about the desired outcome?
Intellectual: knowledge of mental retardation and
the settings available to meet the needs of a patient
with profound mental retardation
Interpersonal: ability to establish trusting
professional relationships with patients, family
caregivers, and healthcare professionals in different
practice settings to ensure continuity of care
Ethical/Legal: knowledge of the nurse’s legal and
ethical obligations as patients are transferred
between home and different practice settingsCopyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing:ANSWER KEY 337
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