NR 226 Exam 3

NR 226 Exam 3

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Chamberlain University

NR-226: Fundamentals – Patient Care

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Fundamentals of Nursing: Managing Patient Care

Nursing is a dynamic and essential field where effective management of patient care is crucial for ensuring positive patient outcomes. Prioritizing patient care is at the core of nursing responsibilities. By organizing care based on urgency, nurses can prevent serious complications and improve patient health. This article will delve into the fundamentals of nursing, focusing on the priorities in patient care, nursing models, communication techniques, surgical care, pain management, sleep interventions, and bowel elimination.

Prioritizing Patient Care in Nursing

Effective patient care management begins with setting clear priorities. Nurses must assess patients’ conditions to determine the urgency of care required.

1. High Priority: This includes emergencies that pose an immediate threat to survival, such as an obstructed airway or a severe anxiety attack. In these situations, immediate intervention is necessary.

2. Intermediate Priority: These are non-emergency situations but still significant to patient well-being. Examples include educating a patient about a new medication or managing postoperative pain.

3. Low Priority: These are non-urgent issues related to long-term care, such as pre-discharge education. These concerns are essential but do not require immediate attention.

Types of Nursing Care Models

Nursing models vary in their approach to patient care, each with distinct advantages and challenges.

• Primary Nursing: A single registered nurse (RN) is responsible for patient care, including assessment and care plan development. This model fosters communication between nurses but may not always be cost-effective.
• Total Patient Care: The RN assumes full responsibility for all aspects of patient care, often leading a team. While this ensures continuity, it may not be cost-effective due to the high number of RNs required.
• Functional Nursing: Care is divided into specific tasks assigned to different healthcare workers, promoting efficiency. However, it may hinder nurse-patient relationships.
• Case Management: This approach focuses on linking patients to healthcare services while controlling costs. The case manager monitors patient care quality and is responsible for cost management.
• Team Nursing: An RN leads a team of nurses and other healthcare professionals to deliver direct care. While this approach promotes collaboration, the RN may have limited time for patient interaction.

Communication in Nursing Practice

Effective communication is critical in nursing, especially when dealing with patients with special needs, such as cognitive impairments, hearing, or vision loss.

• Cognitive Impairment: Use simple language, ask one question at a time, and give the patient time to respond. It’s also important to include family members in the communication process.
• Hearing Impaired: Minimize background noise, speak clearly, and ensure the patient can see your face to read lips if necessary. Sign language interpreters may be used in some cases.
• Visually Impaired: Use clear verbal communication and avoid glare. When possible, provide large print materials for reading.

SBAR Communication

The SBAR (Situation, Background, Assessment, Recommendation) technique is an essential communication tool in healthcare settings. It standardizes the communication process, improving patient safety. In this method, healthcare providers share vital information about the patient’s condition, such as:

• Situation: The current problem.
• Background: The patient’s medical history.
• Assessment: Findings from the patient’s assessment.
• Recommendation: Proposed care plans.

Surgical Care in Nursing

Nurses play a pivotal role in both preoperative and postoperative care. They must prepare patients for surgery and ensure proper recovery afterward. This includes managing the patient’s nutritional needs, evaluating risks like age and obesity, and addressing potential complications such as anesthesia reactions or surgical site infections.

• Surgical Classifications: Surgeries are categorized based on urgency and severity, such as elective, emergency, and major surgeries.
• Anesthesia: Nurses must monitor patients under general, regional, or local anesthesia. Understanding the complications and nursing implications of each type is essential to ensure patient safety.
• Postoperative Care: After surgery, nurses monitor vital signs, respiratory status, pain levels, and surgical site conditions to ensure recovery progresses as expected.

Pain Management in Nursing

Managing pain effectively is crucial for patient comfort and recovery. Nurses employ various techniques to address both acute and chronic pain.

1. Non-Pharmacological Methods: These include methods like relaxation, guided imagery, and biofeedback. These techniques help in reducing pain perception and providing psychological comfort.
2. Pharmacological Methods: Medications like opioids are commonly used but come with risks such as addiction and tolerance. Nurses must monitor for side effects and adjust doses as needed.

Sleep Interventions in Nursing

Sleep is vital for recovery, and nurses must create an environment conducive to sleep. For patients experiencing sleep issues, such as insomnia or sleep apnea, strategies like establishing bedtime routines and controlling environmental factors can be beneficial.

• Stages of Sleep: Understanding the stages of sleep—NREM (Non-Rapid Eye Movement) and REM (Rapid Eye Movement)—helps nurses support patients’ rest and recovery.
• Sleep Disorders: Conditions like narcolepsy and sleep apnea require specific interventions, including the use of CPAP machines for sleep apnea and addressing the underlying causes of narcolepsy.

Bowel Elimination in Nursing

Bowel elimination is a critical aspect of nursing care, particularly for patients who undergo surgery or have digestive disorders.

• Bristol Stool Scale: This scale helps nurses assess the consistency of stool, which can indicate underlying health conditions.
• Enema Types: Enemas are used to promote bowel elimination, with different types, such as cleansing or oil retention, based on patient needs. Nurses must understand the risks and proper techniques for administering enemas to avoid complications.

Conclusion

Nursing encompasses a wide range of skills and knowledge, from managing patient priorities and effective communication to providing surgical and pain management care. By utilizing these foundational concepts, nurses can ensure the best outcomes for their patients, fostering a supportive and safe environment for healing. Nurses must continually update their knowledge to stay effective in these essential areas of patient care.

References

American Nurses Association. (2015). Nursing: Scope and standards of practice. American Nurses Association.

Miller, M. A., & Coats, T. (2020). Essentials of nursing practice. Elsevier.

NR 226 Exam 3

Smith, D. S., & Jackson, J. L. (2019). Pain management in nursing practice. Nursing Research Journal.