Legal Scope (class 11)

Question 1

LPN scope

Answer 1

limited assessment privileges.
limited in interpretation of clinical data.
typically do not have authority to alter nursing care plans.

Question 2

LPN role responsibilities

Answer 2

be licensed.
be supervised by RN, Physician, or dentist.
Be trained to perform the nursing tasks he/she does.
Not delegate LPN tasks or functions to UAP.

Question 3

duties of LPN

Answer 3

assist with ADLs.
assist in development & modification of patient care plans.
observe patients, chart, and report problems to RN or DR in charge.
Taking vital signs, administering meds.
Implementing plan of care.
evaluating whether identifited expected outcomes are met.
documentation and reporting patient condition/problem.
following approved institutional procedures.
catheters, dressings, trach care & suctioning, tube feeding, irrigating wounds.
assist in teaching of patient & family.
emotional support.
perform simple diagnostic tests.
postmortem care.
observe patient monitoring equipment.

Question 4

Delegation

Answer 4

only delegate tasks down the chain of command. cant delegate nursing interventions RT: critical thinking, professional judgement.
Assistive personel fucntion under RN.

Question 5

5 rights of delegation

Answer 5

• right task- can i delegate it?
• right circumstances- should i delegate it?
• right person-who is best prepared to do it.
• right direction/communication- what does the NAP need to know?
• right supervision- how will i follow up?

Question 6

PRIORITIES

Answer 6

1. life threatening-STAT action.
2. High risk to patient if no action.
3. lower risk, but could cause paitent harm if no action.
4. health maintenance: exercise, diet.
5. self-actualization.

Question 7

Abuse

Answer 7

elder mistreatment. signs often missed by people r/t lack of training. only 1 in 14 cases ever come to attention of authorities. females more likely to be abused. abuse risk rise as persons age increases. majority of abusers are family members.

Question 8

physical abuse

Answer 8

use of force to threaten or injure, force feeding.

Question 9

emotional abuse

Answer 9

verbal attacks, threats, isolation, silent treatment, treat like child

Question 10

sexual abuse

Answer 10

contact without consent

Question 11

exploitation

Answer 11

theft, fraud, misuse, undue influence over money or property

Question 12

neglect

Answer 12

caregiver refusal to meet needs

Question 13

abandonment

Answer 13

desertion of vulnerable person by anyone with duty of care

Question 14

self-neglect

Answer 14

mentally competent elder willingly engages in acts that threaten their safety- personal choice.

Question 15

risk factors of elder abuse

Answer 15

advanced age.
physical, functional, or cognitive impairment. 
mental illness.
subastance abuse
social isolation or poor social netowrk.
dependence on others.
past history of abusive relationships.
low income.
depression/low self-esteem.
financial or unsafe housing. 
poor health.
caregiver stress/frustration.

Question 16

perpetrator characteristics

Answer 16

family members who:

abuse drugs or ETOH, have mental/emotional illness, feel burdened,.

Question 17

assessment findings of physical abuse

Answer 17

bruises, fractures, sprains, dislocations. broken eyeglasses, signs of restraints, med overdose or underuse.

Question 18

assessment findings of sexual abuse

Answer 18

torn stained or blood underclothes. unexplained vaginal dischaged, anal bleeding, infections.

Question 19

assessment findings of neglect

Answer 19

dehydration, malnourished, poor hygiene, bed sores, unsafe/unclean living environment.

Question 20

assessment findings of abandonment

Answer 20

desertion at facility, shopping center, hospital.

Question 21

assessment findings of exploition

Answer 21

abrupt will changes, large amount of $ withdrawn, forged elder signatures, sudden appearance of family not usually involved claiming rights to assets.

Question 22

assessment findings of emotional abuse

Answer 22

extremely withdrawn/non communicative. unusual behavior (rocking, sucking, biting), emotionall upset or agitated.

Question 23

advanced directives

Answer 23

legal document that allow an individual to plan their healthcare. they include: living wills, durable power of atorney, healthcare surrogate, physician orders for life-sustaining treatment.

Question 24

living will

Answer 24

• legal document that expresses pt wishes regarding life-sustaining tx in terminal illness or permanent unconsciousness.
• does not delegate a substitute decsion maker.
• responsibility of the nurse to advocate Y record plan of care

Question 25

DPOA

Answer 25

document that delegates authority to make health, financial, and legal decisions.
-must be in writing and state that the person is authorized to make healthcare decisions.

Question 26

full code

Answer 26

presumed status unless documentation/orders to limit interventions

Question 27

DNR

Answer 27

order written by Dr based on patient/family wishes. No CPR performed for respiratory or cardiac arrest. DNAR means same thing

Question 28

comfort measures

Answer 28

a Dr order that means no further life-sustaining interventions are necessary. goal of care is comfortable, dignified death.

Question 29

euthanasia

Answer 29

a deliberate ending of a life of someone suffering from terminal illness.
slow codes- considered malpractice

Question 30

voluntary euthanasia

Answer 30

competent adult patient makes decisions to terminate life.

Question 31

involuntary euthanasia

Answer 31

mercy killing performed without the patients consent.

Question 32

NI for comfort care

Answer 32

clean skin &  linens.
comfort positioning.
foley or bed pads for incontinence.
gentle massage to improve circulation & shift edema.
small frequent sips of fluids.
oral care.
clear secretions from eyes & nose.
administer ordered pain meds prn.
oxygen as rx'd to relieve dyspnea.