pharm grades for exam #4 are posted on turnitin.com!

GRMs for week #13 are available with answers on Mr. Scott's docushare!

a ridiculous amount of pharm questions for exam #4...kind of

*Can sustained release capsules be crushed for administration?

*A patient is concerned about damage to her liver because of the 81 mg dose of aspirin she is getting. What can you tell this patient about the mechanism of action and why it is safe for her to get this daily dose?

*What is a safety issue for a Parkinson’s Disease patient?

*What are typical treatments for EPSs?

*Describe oxyhemoglobin-dissociation and factors affecting it.

*A patient on a statin is complaining of muscle pain and hemutria. What is the nurse’s concern?

*What tames heparin?

*Is it safe for a patient to be on coumadin and heparin IV?

*What is the treatment for status asthmaticus?

*How does Lopid lower LDLs?

*What else is Serevent useful in treating

*In what way is heparin and insulin similar, regarding medication administration?

*What is the normal range for PaO2 and PaCO2?

*What are the benefits of Clariton?

*What is the correct procedure for using Advair?

*What are the five things that can be done for a hypoxemic patient?

*What labs should be monitored for patients on lithium? Why?

*What is the relation between Sinemet and B6?

*A patient is receiving Plavix and is scheduled for surgery in a week and the nurse calls the
physician to discontinue the medication. What does the physician tell the nurse?

*Is it okay for a patient to be receiving 18-21% FIO2?

*What is warfarin’s mechanism of action?

*What is the nursing care of a patient on Plavix after coming back from surgery?

*How does adrenergics work as a decongestant?

*How can you test if a rescue inhaler is empty?

*Why should a patient on Albuterol or Serevent avoid caffeine?

*What labs should be checked for a patient on Lipitor or Zocor?

*What can result in pleural effusion and can it be solved?

*What is ordered for a person undergoing a percutaneous coronary intervention and what is the route of administration?

*What should a nurse always watch for when a patient is taking Tegretol and Depakote?

*What are the signs of a hypoxemic patient?

*How are mucolytics useful?

*What is another anti-hyperlipidemic drug that is best combined with Lipitor or Zocor?

*What are the two types of lung disorders and how do they differ?

*Why is warfarin’s therapeutic range for a prosthetic valve patient different from a patient
without a prosthetic valve?

*In general, how does an anti-hyperlipidemic work?

*What does a PaO2 less than 80 mm Hg indicate and what can it lead to?

*What labs should a nurse know about a patient before administering heparin?

*A patient is about to receive a tissue plasminogen activator to prevent clots. Is this correct?

*What type of lung disorder is pulmonary tuberculosis? Why?

*What are the routes of administration of heparin?

*What is the significance of high CYP3A4 enzyme levels of a patient on Lipitor or Zocor?

*What is the significance of monitoring the baseline platelet count?

*What is the right procedure for using a rescue inhaler? A MDI?

*What is the therapeutic range for theophylline?

*What are 4 types of respiratory units?

*What is the most common treatment of Parkinson’s Disease?

*Describe safety precautions for a patient prone to hypoxia of the brain.

*Compare and contrast Intal and Singulair.

*How should Dilantin be administered orally? IV?

*How are opiods and Robitussin DM similar?

*What can consolidation be a result of?

*What is the difference between a lipoprotein high in lipids and a lipoprotein low in lipids?

*What labs should be taken for a person on Rifampin?

*What is the mechanism of action of Atrovert?

*What is the patient suffering from acidemia prone to? Why?

*What is Zetia’s mechanism of action?

*A newly admitted patient has a platelet count of 650,000. What is this referred to as and
should the nurse be concerned about the count?

*What is the significance of PaCO2 that is out of normal range?

*What fluids can Dilantin IV be mixed with?

*How is tuberculosis spread?

*For every liter of O2, ___ increases by __%.

*What is the significance of administering heparin SubQ and administering heparin IV?

*What actions should be taken for a patient experiencing status epilepticus?

*Why is Benadryl discouraged in the elderly?

*What specific questions should a nurse ask a patient on Isoniazid?

*What is normal range for a platelet count?

*What are the three routes of administration of corticosteriods and an example of each?

*Why do anemic patients have a decreased circulation of gas?

*What should a patient know before beginning to take MAOIs?

*What are the adverse effects of lipoprotein removal drugs?

*What is the biochemical reason for mental illnesses?

*What is safe administration for a dose of heparin to prevent a clot?

*What drug class is aminophylline?

*What is the relation between carbon monoxide poisoning and oxygen affinity?

*What are the adverse effects of beta-2 agonists?

*What is offered to treat neurological symptoms of a patient on Isoniazid?

*What are examples of SSRIs and what do they improve?

*Describe three problems associated with corticosteroids.

*What are the side effects of niacin?

*What are specific signs and symptoms of bleeding?

*How does Sinemet work?

*A patient on warfarin is exhibiting unexplained swelling, chest pain, and weak pulses. What is
the nurse’s interpretation of these symptoms and what can be done?

*What is the duration of drug therapy for the schizophrenic patient?

*What is a side effect of Atrovert?

*What is patient education needed for a patient on drugs altering the clotting mechanism?

*What are the adverse effects of TCAs and MAOIs?

*What should a nurse expect to see after administering a methylxanthine and what might be a
side effect?

*What should a patient on TB treatment avoid?

*What is Robitussin useful for?

*What is the mechanism of action of unfractionated heparin?

*Can heparin be used on an emergency patient experiencing a stroke?

Nursing 2 Exam #2 scores posted on Docushare

study guide #2 (brief)

1. Discuss the legal implications of death and dying. (End-of-Life Lecture)
-Dying Person’s Bill of Rights
-Advanced Directives
-DNR Status
-Durable Power of Attorney/Living Will

2. Discuss therapeutic communication when caring for the dying patient. (End-of-Life Lecture)
-be direct and avoid false reassurances
-Hospice says, “Do you know you are dying?”

3. Discuss the types of grief and grief responses. (P/P: Ch. 30, pp. 463, 465-467)
-normal grief
-complicated grief: prolonged and difficult time moving forward
-anticipatory grief: “letting go” before death even occurs
-disenfranchised grief: unsupported grief which is not openly acknowledged
*grief responses vary depending on:
-developmental stage
-personal relationship
-nature of loss
-coping strategies
-socioeconomic status
-culture/ethnicity
-spiritual/religious beliefs
-hope

4. Discuss the concerns of the dying patient. (End-of-Life Lecture)
-arrange a variety of affairs
-cope with loss of loved ones and own death
-future medical needs
-plan for future

5. Discuss the interventions needed to assist the patients to die with dignity. (P/P, Ch. 30, pg. 475)
-treat patient as a whole being rather than a patient will an illness
-encourage conversation about patient’s life experience
-maintain personal hygiene and appearance
-be respectful: address by title

6. Explain the purpose of Hospice care. (P/P: Ch. 30, pp. 478-479)
-provides end-of-life support for patient and familiy
-priority to managing pain and symptoms, comfort, quality of life, and other needs for the patient with less than 6 months to live

7. Discuss the concepts of pain and pain management. (Pain Lecture)
-follow assessment principles
-patient centered
-drug and non-drug therapies
-collaborative care

8. Discuss ethical considerations for the terminal patient. (End-of-Life Lecture)
-Euthanasia/Assissted Suicide
-Organ Donations

9. Discuss the nursing interventions for the patient receiving chemotherapy or radiation treatment. (Cancer Lecture)
-adequate moisturizing
-ambulate/turn
-cough/deep breathe or incentive spirometer
-alternate resting and active periods
-make sure antiemetics are ordered
-therapeutic communication
-protective isolation: avoid crowds
-be aware of food preferences

10. Discuss the relevant assessment data needed for the terminal patient on pain medication. (P/P: Ch. 30, pp. 1078, 1080)
-monitor breakthrough pain

11. Differentiate between the assessment needed for the patient in acute and chronic pain. (Pain Management Lecture)
-based on cause, course, manifestation, and treatment

12. Describe the different types of pain. (P/P: Ch. 43, pp. 1055-1056)
-acute/transient pain: can identify cause, short term, limited tissue damage and emotional response
-chronic/persistent pain: lasts longer than anticipated, not always an identifiable cause, great personal suffering
-chronic episodic pain: sporadic pain over an extended period of time
-cancer pain: usually related to tumor progression or treatment of cancer
-pain by inferred pathological process: musculoskeletal, internal organ, or neuropathic pain
-idiopathic pain: no identifiable physical or psychological cause for chronic pain

13. Discuss the education needed for the patient on opioid medication. (Pain Management Lecture)
-low risk of addiction when treating pain

14. Discuss the nursing diagnoses relevant to grief. (P/P, Ch. 30, pg. 470)
-death anxiety
-compromised family coping
-ineffective denial
-complicated grieving
-hopelessness
-spiritual distress

15. Discuss goals/outcomes for patients in chronic pain. (Pain Management Lecture)
-sometimes the best thing is to decrease pain level
-describe experience in order to treat
-identify goal for therapy and resources for self-management
-prevent pain whenever possible
-will require only oral analgesics for pain
-reports pain of <3 on a scale of 1-10 after PCA use

16. Discuss the safety precaution education needed for patients receiving chemotherapy. (Cancer Lecture)
-radiation source being used
-method of administration
-start of treatment
-length of treatment
-prescribed nursing precautions: protective gear and isolation
-avoid crowds
-do not allow small children to sit on lap
-cough and deep breathe
-moisturize
-ambulate/turn
-alternate resting and active periods

17. Discuss the use of the pain diary in pain management. (Pain Management Lecture)
-helps both nurse and patient identify pain patterns and causative factors

18. Discuss titration in pain management. (Pain Management Lecture)
*adjusting dose or using the smallest dose possible:
-based on assessment of analgesic effect
-to provide effective pain control
-working with patient to decide the optimal analgesic dosage required
**to minimize side effects

19. Discuss the nursing care for the patient using PCA or continuous opioid analgesia. (P/P: Ch. 30, pg. 1076)
-monitor dosing and dosage rate
-teach patient how to use PCA and instruct visitors not to tamper with it
-monitor vital signs

20. Discuss nursing diagnoses relevant for patients with terminal disease. (P/P: Ch. 30, pg. 470)
-death anxiety
-caregiver role strain
-compromised family coping
-readiness for enhanced comfort
-disturbed personal identity
-ineffective denial
-fear
-hopelessness
-spiritual distress
-readiness for enhanced spiritual well-being

21. Discuss risk factors for cancer and the education needed. (Cancer Lecture)
-diet, health history
-ethnicity
-lifestyle
-genetics
-environment
*encourage diet high in fiber, low in fat
*note and report (as they may be early signs of cancer):
C-changes in bowels or bladder
A-a lesion that does not heal
U-unusual bleeding or discharge
I-indigestion or difficulty swallowing
O-obvious changes in wart of mole
N-nagging cough or persistant hoarseness

22. Dosage and Calculations:
-microdrops: 60 gtt/ml
-macrodrops: 10, 15, or 20 gtt/ml

noo2 exam #1 grades are posted on docushare!

Hey everyone. Mr. Meza had given this documentation paper to his clinical group. He thought it would be helpful for Semillo's group, but I think it might be useful to everyone. It's kinda lengthy, but very informative. Hope it helps.

Keys To Documentation
Course # 111
2 contact hours
Written By: Monica Oram, RN, BSN

Upon completion of this course the reader will be able to achieve the following objectives:
1. Define documentation and identify its importance
2. Describe four forms commonly used in documentation
3. Describe legal aspects of documentation
4. List five reasons for careful documentation
5. List ten guidelines for documentation

What Is Documentation?

Documentation means “to give written information that is proof or support of something that has been done or observed.” Documentation is the written account of observations, the information the client, resident or family relates or states, the data you collect during care, and the care that you provide.

A medical record is a collection of information about the person you are caring for. It is a legal and confidential record with pertinent information related to the care provided.

We have heard it said over and over again, “ If you did not document it, it was not done”. We have heard this a thousand times. Lets look at what all this means………….

Simply put, a medical record is the record of all care that is provided. If it is not recorded, it did not happen. If it is recorded incorrectly, it happened incorrectly. This is why it is so important to be accurate when documenting.

Four most commonly used forms with particular importance are:
1. Nurse’s progress notes
2. Graphic sheet for vital signs
3. Care plans
4. Activities of daily living sheets by CNA’s


These are the forms where the most pertinent data is collected. There is little room for error on these documents. This is not to say that the rest of the chart is not equally as important, as the whole record is essential. These forms are particularly important because the content they contain sum up what was done ( or not done ) for the patient.

Legal Implications

Documentation provides crucial legal protection. Admissible in court, the patient’s medical record must be documented in an accurate, complete, systematic, logical, concise, and timely manner. Courts will view the documentation in the medical record as proof and verification to patient care. By showing that the individual under your care received quality, adequate care, a well documented record can, and will most likely protect you legally.

The medical record is a legal document. It is also regarded as highly confidential, especially in light of the new HIPAA regulations. In the event of a medical malpractice case, the medical record may be used to provide the court with evidence about a person’s condition and treatments. In a malpractice case, the jurors usually view the medical record as the best evidence of what really happened. For this reason, all documentation should be neatly written and legible. Illegible handwriting is handwriting that cannot be read or understood by others. This would account for sloppy writing, and often misspelled words and poor grammar. Illegible or poorly written documentation makes you look careless and distracted. Take the time to write neatly and clearly. Avoid words that are unnecessary or very long. When you abbreviate, make sure it is a standard abbreviation with no possibility of having more than one meaning.

DO NOT cover up anything in a chart with white out. Draw one line through it and indicate “error”, and be certain you initial it.

NOTE: if you didn’t chart it, you didn’t do it… has another meaning, if you did not do it, don’t have someone else chart you did what you did not. Also, do not document care provided by someone else. If there is a problem, you will be held liable.


Do’s to good charting

1. Check to be sure you have the correct chart before you begin writing
2. Make sure your documentation reflects the nursing process and your professional capabilities.
3. Write LEGIBLY
4. Use a permanent black ink pen ( other colors do not Xerox well)
5. Chart completely
6. Be concise and accurate
7. Chart time for each entry
8. Document PRN medications and exceptional things in the record.
9. Chart precautions or preventative measures, ( Such as use of side rails)
10. Include the following for procedures: what was done, when it was done, who did it, how it was done, how the client tolerated it, adverse reactions, if any. Paint a clear picture of what happens.
11. Record each phone call to or from a physician, including exact time, message, and response.
12. Chart when a doctor makes a visit, and if there are any new orders.
13. Chart as soon as possible after providing care.
14. Chart a client’s refusal of treatment or medications.
15. Chart client’s subjective data.. ( what he says and how he says it) use quotations if necessary.
16. If you remember something important after you have completed your documentation, write “ late entry” and make the note.
17. If information on a flow sheet does not pertain to your patient, write N/A for not applicable, leaving it blank appears that it was not addressed or an oversight.
18. Make sure that each page has the patients name on it. Just last name is not acceptable, as it could become misplaced, and posted on the wrong chart of someone else with the same last name.

These good rules of charting is a good start to successful documentation.

The do not’s of charting are very important also:

1. Don’t chart a symptom such as “c/o Pain” without also writing what you did about it.
2. Don’t alter a chart….this is a criminal offense.
3. Don’t add information at a later date without indicating that you did so.
4. Don’t date the entry so that it appears to have been written at an earlier time.
5. Don’t use shorthand or abbreviations that are not standard.
6. Don’t write vague descriptions such as “ large amount of drainage”
7. Don’t make excuses, such as “meds not given because not available.”
8. Don’t chart what someone else says unless you use quotations and state who said it.
9. Don’t chart an opinion.
10. Don’t use words that suggest a negative attitude, such as “weird” or “nasty”
11. Don’t chart ahead of time. If something happens it will look bad to go back and make that correction.
12. Misspelled words and bad grammar are as bad as illegible handwriting.
13. Don’t record staffing problems.
14. Don’t document that an incident report was completed.
15. Don’t record staff conflicts.


Charting care that was not given is fraud. It is punishable by the Board Of Nursing and can land you in court, or put your license in jeopardy.

Also… if you make a mistake, draw a line through the error, and indicate it as an error, and then initial it. Do not write “oops” or “sorry” or draw a happy or sad face in the margin, or any where on the document. This is unprofessional and inappropriate. Don’t leave any blank spaces. Never save a space for a colleague who forgot to chart.

To avoid litigation, healthcare professionals must document according to State and Federal Legislation. Remember it is the law.

Nurses are also mandated by their state’s nurse practice act to document appropriately.

Avoid block charting, such as 0700-1500, this makes it very difficult to pin point a time that anything was done on the shift.




Types of charting

Regardless of the system of charting you use, it must include the nursing process as a guideline.
1. Assessment
2. Planning
3. Implementation
4. Evaluation


Assessment includes observing the patient for signs and symptoms that may indicate actual or potential problems.

Planning includes developing a plan of care directed at preventing, or resolving identified client problems or issues.

Implementation (or intervention) of the plan that has been developed includes the specific action that the nurse needs to take to accomplish the plan.

Evaluation determines whether or not the goal was met in identifying if the plan of care was effective in preventing, or resolving the problem.

Narrative charting

The nurse documents in chronological order the events that took place throughout the shift. Narrative charting is time consuming, so make certain your notes are legible and clear to understand by all who reads them.
A note should be made at least every two hours.

SOAP Notes

This method is preferred by many nurses. It stands for Subjective data, Objective data, Assessment, and Plan. Sometimes it can be referred to as SOAPIE or SOAPIER, in which the “I” indicates implementation and “E” indicated Evaluation. When an “R” is included, this indicates Revision.



APIE

More commonly known as “Pie Charting”
Assessment, Plan, Intervention (or implementation), and Evaluation. It is more concise in the aspect that the nurse will indicate subjective and objective data in the assessment section, what will be done in the plan, the intervention and the outcome. As it follows through in A, P, I, E format.

Flow Sheets

Also known as graphic sheets, or graphic records. These are a quick way to document. They need to be used CAREFULLY, as some areas do not apply to all patients. Avoid leaving any boxes unmarked, and individualize it to meet your patients needs.
Focus Charting

The term focus was developed to encourage the nurse to view the client’s status from a positive perspective rather than a negative perspective. The system uses three columns to indicate date/time, focus, and progress note.
The progress note portion includes DAR( date, time, response)

Date/time focus progress note

Date:
Action:
Response:


Charting by exception

Also known as CBE. A system of charting in which only significant information, findings, or exceptions are documented.

No matter which method you prefer, or your facility uses, make sure that the content is addressing the proper do’s and don’ts for charting.




Care Plans

Most care plan formats have three columns. One for the nursing diagnosis, one for the interventions, and one for the expected outcome. The nurse must develop a care plan for each client usually within a specified period of time after the client arrives to the facility. They are generally initiated upon admission.

Standardized care plans are preprinted care plans to help save time for the nurse. They must be individualized to fit the needs of each patients separately and individually.

Critical pathways or health care maps are usually preprinted care plans. They include nursing actions for a client with a specific medical diagnosis. The specify care that should be given on a daily basis including, but not limited to diet, medications, activity, treatments, ect. Pathways are popular with managed care becoming about more and more.

Kardexes

Kardexes are useful, but need to be maintained and up to date to be of any value. The card system is readily available to all staff who need information at a glance to what is pertinent with the patient. The cards are written in pencil so they can be updated appropriately and easily.

Things To Remember

We have learned a lot about proper documentation. Here are a few other things to consider:

The following mistakes can cause legal problems:

Ÿ Documentation not accurate
Ÿ Documentation not complete
Ÿ Failure to record prevention efforts
Ÿ Particularly falls, side rails, call bells in reach, restraints( if used), smoking and any other potential for injury
Ÿ Failure to record treatments and care
Ÿ Failure to record refusal of care
Ÿ Failure to record families refusal to accept care provided to patient
Ÿ Incomplete incident reports (do not note incident reports in a chart)
Ÿ Tampering with a medical record
Ÿ Failure to record client’s failure to follow orders, noncompliance


Reimbursement

Another very important aspect of charting is related to reimbursement. In health care, sometimes private insurance and Medicare will deny payment if documentation is not satisfactory or is not done at all. This means that Insurance Companies, Medicare, and Medicaid pay the facility in reimbursement for care provided, which in turn pays salaries and supply costs. Payment can be denied if documentation is missing or incomplete from the chart. The importance of good documentation, charting vital information, and patient status is essential for reimbursement in many cases.

Reasons For Careful Documentation

1. Documentation gives written evidence of care given, the patient’s response, and the effect of the care.
2. Documentation plans for the future care and changes in plan of care so all members can be kept current.
3. Documentation serves as a communication tool. When you document, remember that you alone are responsible for noting what was done, and observed.
4. Documentation is legal, and reimbursement is often dependant on the notes that are written.
5. Documentation allows for continuity of care and focuses on clients needs and goals from all those involved in their care.
6. If the chart goes to court, you will most likely go to court too.

Summary

In closing, it is important to remember the basics for good documentation to protect yourself legally and to be able to provide good care to your patients. Cover all your bases, and think about legal aspects everyday as you go about your daily routines. Remember that what you write today, can save you and your license in the future, should the record end up in a court room.
Keep in mind, whether your facility uses narrative charting or the more modern documentation systems on a computer, you need to document your actions expertly. By following these tips and guidelines, you will be well on your way to protecting yourself legally and provide the best possible care to your patients.

And we will say it one more time…… “ If you didn’t chart it, it wasn’t done.”


References:

Clinical Nursing, Mosby
5th Edition Philadelphia, Pa.

Surefire Documentation
Mosby Publisher’s, 1999St. Louis , Missouri

study guide exam #1 (brief)

1. Explain the components of a teaching plan: Cognitive domain, Psychomotor domain, and Affective domain. Include in your explanation how the presenter would evaluate each. (P/P: Ch. 25, pp. 365-366 and Lecture: Introduction to Patient Education 10/23)
--cognitive (understanding):
-knowledge-recalling new facts or information
-comprehension-understand meaning of new facts
-application-applying new ideas in a given situation
-analysis-break down facts in an organized manner
-synthesis-apply new ideas and create a whole new one
-evaluation-be critical about new information for a specific purpose
*patient states name and purpose of medication

--psychomotor (motor skills):
-perception: awareness of objects
-set: mental, physical, or emotional readiness to take action
-guided response: imitation of an act under guidance
-mechanism: higher level of guided response with gained confidence
-complex overt response: smooth and accurate performance of a skill
-adaptation: ability to change skill when unexpected problems arise
-origination: use existing skills to create new movement patterns
*patient gives self-injection

--affective (attitudes):
-receiving: willing to attend to another’s word
-responding: active participation by listening and reacting
-valuing: attaching worth to object or behavior
-organizing: utilizing personal value system to resolve conflicts
-characterizing: acting with a consistent value system
*patient accepts he/she has chronic illness

2. Describe the elements of a community assessment. (P/P: Ch. 3, pg. 41)
-structure: observe layout, location of services, and common meeting places
-population: demographics according to statistics
-social system: learn about social services such as school and health care

3. Discuss the factors to consider when providing health education. (P/P: Ch. 25, pp. 366-369 and Lecture: Introduction to Patient Education 10/23)
-motivation to learn: physiological and psychological factors
-ability to learn: sociocultural and capability factors
-learning environment: is it ideal?

4. Describe the physiological, cognitive and psychosocial changes of the aged. Include pharmacological aspects and multiple health problems. (Geriatric Concept Map, 10/30)
-physiological: decreased muscle mass, increased joint stiffness and bone loss, and overall decreased function
-cognitive: impaired memory and sensation
-psychosocial: decreased support and socialization, increased isolation and loss of identity and self-worth
-decreased liver function: decreased drug metabolism
-decreased kidney function: increased drug retention
-decreased GI function: decreased drug absorption
-polypharmacy: multiple medications can cause cascade effects to other problems

5. Discuss the assessment needed for the elderly patient. (Geriatric Concept Map, 10/30)
-standardized assessement tool to determine how limitations impair or affect ADLs

6. Discuss the nursing diagnoses appropriate for the elderly patient. (Geriatric Concept Map, 10/30)
-impaired gas exchange and ineffective tissue perfusion related to decreased cardiac ouput aeb activity intolerance
-risk for injury related to altered sensory perception, decreased muscle mass, or multiple medications

7. Discuss the roles of the community health nurse. (P/P: Ch. 3, pp. 38-41)
-caregiver: primary role; build safe community to achieve higher quality of life and function using nursing process
-case manager: establish plan of care for community using available resources and breakthrough obstacles
-collaborator: work with all persons involved with health care of a patient to develop and achieve goals
-educator: teach community skills and knowledge needed to care for themselves
-counselor: identify and clarify problems and guide through courses of action to solve problem
-client advocate: provide community with information to make informed decisions regarding healthcare services
-change agent: identify and implement more effective solutions to problems
-epidemiologist: protect community level health by surveying community risk factors for illnesses


8. Discuss the principles of appropriate delegation. (P/P: Ch. 21, Box 21-6)
-right task
-right circumstance
-right person
-right direction/communication
-right supervision

9. Discuss the attributes of a nurse manager. (Lecture: Leadership, Management, Delegation 10/23)
-effective communicator
-assertive
-accurate
-honest

10. Discuss the interventions for the elderly patient with visual impairment; hearing impairment. (Geriatric Concept Map, 10/30)
-visual: large print, bright colors, glasses, lit hallways
-hearing: low tones, speaking slowly, face patient, eliminate distractions

11. Discuss the home safety strategies for the aged. (Geriatric Concept Map, 10/30)
-assistive devices: adequate lighting, canes, and safety bars
-clearing pathways

12. Discuss the strategies to enhance and maintain long term memory. (Geriatric Concept Map, 10/30)
-stimulate thinking process: crosswords, crafts, engaging in conversations