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Fundamentals of Nursing Crosswalk with NCLEX-PN 2011 Test Plan NCLEX-PN 2011 Test Plan All content categories and subcategories reflect client needs across the life span in a variety of settings. Related content includes, but is not limited the categories as listed. NOTE: The NCLEX-PN 2011 Test Plan contains very specific descriptions for each category below. The specific descriptions were compared to module objectives. Safe and Effective Care Environment The LPN/VN provides nursing care that contributes to the enhancement of the health care delivery setting and protects clients and health care personnel. Coordinated Care – The LPN/VN collaborates with health care team members to facilitate effective client care. Fundamentals of Nursing (160 hours) 1 – Skills for Wound Care; 2 – Respiratory Care Skills; 3 – Digestive Care Skills (Upper); 4 – Digestive Care Skills (Lower/Bowel Elimination); 5 – Basic Nutrition; 6 – Urinary Care Skills; 7 – Skills for Applying Heat and Cold; 8 – Mobility; 9 – Plan of Care; 10 – Skills for Admitting, Transferring and Discharging Patients; 11 – Documentation Skills; 12 – Assessment Skills; 13 – Therapeutic Procedures and Surgery; 14 – Skills for Care of the Dying Patient; 15 – Skills for Patients Experiencing Grief and Loss; 16 – Skills for Managing Pain; 17 – Skills for Geriatric Care; 18 – Phlebotomy Skills NOTE: This crosswalk will provide letter of first name of the course, module number and objective number from that module, ex: F1.3 would denote Fundamentals, Module 1, Objective 3 **Objectives F12.8; F5.1; F4.10 are included in this document, however these will be reworded when curriculum is updated Advance Directives Provide information about advance directives* Advance Directives Review client understanding of advance directives (e.g., living will, health care proxy, Durable Power of Attorney for Health Care [DPAHC]) F14.11 Discuss legal/ethic issues related to death, euthanasia, DNR orders, organ donation, dying person’s bill or rights, living will, and durable power of attorney. Verify the client advance directives status F14.2 Identify end-of-life needs. Advocacy Advocate for client rights or needs* F14.6 Assist in resolution of end-of-life issues. Advocacy F9.6 Include patient in decisions on priorities of care. Collaborate with patient regarding self-care needs. Discuss identified treatment options with client and respect the decisions made Promote client self-advocacy* F9.11 Use interpreters to assist in achieving client understanding F12.11.c. Identify individual consideration related to assessment of the following: Language barriers Client Care Assignment Assign client care and/or related tasks (e.g., assistive Client Care Assignment personnel or LPN/VN)* Compare needs of client to knowledge, skills and abilities of assistive personnel prior to making client care assignments Organize information for client assignments Provide information to supervisor when client care assignments need to be changed (e.g., change in client status) F9.13 F9.17 Discuss the implementation of the plan of care. Discuss the process of notification of staff regarding changes in patient condition. Client Rights Client Rights Inform client of individual rights (e.g., confidentiality, informed consent) F13.1 Explain routine preoperative preparation required by patients. F13.2 Assess patient’s preparation status for a diagnostic test, procedure or surgery. F13.19 Demonstrate the ability to prepare a patient for procedure or surgery. F13.20 Demonstrate the ability to complete a pre-operative checklist Involve client in care decision making* F9.1 F9.6 Intervene if client rights are violated Recognize client right to refuse treatment/procedure F9.15f List steps related to decision-making process. Include patient in decisions on priorities of care. Revise and contribute to a plan of care that includes: f. Refusal to follow plan of care Collaboration with Interdisciplinary Team Identify roles/responsibilities of health care team members Identify need for nursing or interdisciplinary client care conference Contribute to the development and/or update of the client plan of care* Contribute to planning interdisciplinary client care conferences Participate as a member of an interdisciplinary team* Collaboration with Interdisciplinary Team F9.16 Discus the role of the LPN/LVN at an interdisciplinary care conference. F9.9 F9.12 Distinguish between medical and nursing diagnoses. Identify resources to be utilized when contributing to an established nursing care plan. F9.15 a-g Revise and contribute to a plan of care that includes a. Religious and spiritual needs, b. Emotional needs, c. Physical needs, d. Cognitive needs, e. Barriers to plan of care, f. Refusal to follow plan of care, g. Promotion of safety and prevention of accident/error F9.19 Review established plans of care and recommend revisions as needed. F9.20 List the process of reviewing the effectiveness of care. F9.16 Discuss the role of the LPN/LVN at an interdisciplinary care conference. F9.20 List the process of reviewing the effectiveness of care. F10.3 Collect data for admission and health history. F10.4 Collect baseline data during admission physical condition. F10.5 Report abnormal data to appropriate health care provider and document findings according to agency or facility policies or procedures F9.16 Discuss the role of the LPN/LVN at an interdisciplinary care conference. F9.20 List the process of reviewing the effectiveness of care. Concepts of Management and Supervision Recognize and report staff conflict* Verify abilities of staff members to perform assigned tasks (e.g., job description, scope of practice, training, experience) Provide input for performance evaluation of other staff Participate in staff education* Use data from various sources in making clinical decisions* Serve as resource person to other staff Supervise/evaluate activities of assistive personnel* Concepts of Management and Supervision F9.12 Identify resources to be utilized when contributing to an established nursing care plan. Confidentiality/Information Security Confidentiality/Information Security Identify staff actions that impact client confidentiality and F9.18 List the steps of giving shift report on patient’s care. intervene as needed (e.g., access to medical records, discussions at nurses' station, change-of-shift reports) Recognize staff member and client understanding of confidentiality requirements Apply knowledge of facility regulations when accessing client records Maintain client confidentiality* Provide for privacy needs* Continuity of Care Follow-up with client after discharge* Participate in client discharge or transfer* Provide follow-up for unresolved client care issues Provide and receive report* Record client information (e.g., medical record, referral/transfer form) Use agency guidelines to guide client care (e.g., clinical pathways, care maps, care plans) Continuity of Care F10.6 F10.7 F10.8 F10.9 Discuss appropriate procedures for transferring a patient. Discuss appropriate procedures for discharging a patient. List methods of reinforcing a discharge plan. Perform teaching of a patient preparing for discharge. F10.11c List the steps of: c:Transferring a patient to a different nursing unit or facility F10.11b,c List the steps of: b: Identifying and managing patient’s valuables according to facility or agency policy c:Transferring a patient to a different nursing unit or facility F10.1 Identify common reaction of patients admitted to hospitals and other health care facilities. F10.2 F10.6 F10.7 F10.11d F9.2 F9.3 F9.4 Discuss common steps in the admission procedure. Discuss appropriate procedures for transferring a patient. Discuss appropriate procedures for discharging a patient. List the steps of: d: Discharging a patient to home. Explain the purpose and uses of nursing care plans. Identify the major components of the nursing care plan. Explain each step of the nursing process. Establishing Priorities Establishing Priorities F9.7 F9.8 Organize and prioritize care for assigned group of clients* F9.5 9.10 Participate in planning client care based upon client needs (e.g., diagnosis, abilities, prescribed treatment) Use effective time management skills Ethical Practice Identify ethical issues affecting staff or client Participate in the development of nursing diagnosis for patients. Ethical Practice Inform client of ethical issues affecting client care Intervene to promote ethical practice Review client and staff member knowledge of ethical issues affecting client care Informed Consent Identify appropriate person to provide informed consent Prioritize care according to patient’s condition. Prioritize patient problems according to Maslow’s Hierarchy of Needs. Discuss components of each level of Maslow’s’ Hierarchy of Needs for client (e.g., client, parent, legal guardian) Participate in client consent process* Describe informed consent requirements (e.g., purpose for procedure, risks of procedure) Recognize that informed consent was obtained (e.g., completed consent form, client understanding of procedure) Informed Consent F13.1 Explain routine preoperative preparation required by patients. Information Technology Information Technology Use information technology in client care* F11.8 Discuss guidelines related to computer based charting. F10.10 Discuss the importance of documentation as it relates to admission, transfer and discharge of patients. F11.1 Discuss the importance of documentation. F11.2 Discuss various formats used for charting. Access data for client or staff through online databases and journals Enter computer documentation accurately, completely and in a timely manner F11.7 F11.8 Correctly document information in a patient’s chart. Discuss guidelines related to computer based charting. Legal Responsibilities Identify legal issues affecting staff and client (e.g., Legal Responsibilities refusing treatment) Receive and process health care provider orders* Recognize task/assignment you are not prepared to perform and seek assistance* Respond to the unsafe practice of a health care provider (e.g., intervene or report)* Follow regulation/policy for reporting specific issues (e.g., abuse, neglect, gunshot wound, or communicable disease)* Document client care F10.10 Discuss the importance of documentation as it relates to admission, transfer and discharge of patients. F11.1 Discuss the importance of documentation. F11.2 Discuss various formats used for charting. F11.3 Identify rules utilized when documenting information. F11.4 Identify types of information that should be documented. F11.5 Translate patient data and activities into charting phraseology. F11.6 Identify common forms found in a patient’s chart. Performance Improvement (QI) Identify impact of performance improvement/quality Performance Improvement (QI) improvement activities on client care outcomes Participate in quality improvement (QI) activity (e.g., collecting data or serving on QI committee)* Document performance improvement/quality improvement activities Report identified performance improvement/quality improvement concerns to appropriate personnel (e.g., nurse manager, risk manager) Apply evidence-based practice when providing care* Referral Process Identify community resources for client (e.g., respite care, social services, shelters) Recognize need for client referral for actual or potential problem (e.g., physical therapy, speech therapy) Use appropriate documents to contribute information needed for client referral (medical record, referral form) Participate in client data collection and referral* Referral Process F10.6 Discuss appropriate procedures for transferring a patient. Resource Management Resource Management F1.6 F2.10 Recognize client need for materials and equipment (e.g., oxygen, suction machine, wound care supplies) F2.11 F2.12 F2.13 F2.14 F2.15 F2.16 F2.17 F2.18 F4.9 F4.10 F18.4 F18.5 F4.14 F4.15 F4.16 F4.17 Review effective use of client care materials by assistive personnel (e.g., supplies) Participate in providing cost effective care* Describe various types of wound care equipment. Demonstrate the ability to perform oronasophayngeal suctioning. Demonstrate the ability to instruct a patient to utilize incentive spirometry. Demonstrate the ability to initiate oxygen therapy via piped-in wall unit. Demonstrate the ability to initiate oxygen therapy via cylinder. Demonstrate the ability to use an oxygen concentrator. Demonstrate the ability to initiate oxygen therapy via oxygen delivery systems: Nasal cannula and mask; Flowby; Tracheostomy collars; Face shields and oxygen hoods; Face tent Demonstrate the ability to perform endotracheal suctioning. Demonstrate the ability to perform tracheostomy care. Demonstrate the ability to provide care for a patient with a chest tube. Differentiate between types and uses of enemas. Identify type of ostomy Identify common equipment used when collecting blood. Match types of collection tubes to their use/purposes in specimen collection. Demonstrate the ability to administer a cleansing enema Demonstrate the ability to administer a retention enema. Demonstrate the ability to administer a colonic irrigation Demonstrate the ability to perform ostomy irrigation. Safety and Infection Control – The LPN/VN Safety and Infection Control – The LPN/VN contributes to the protection of clients and health care personnel from health and environmental hazards. contributes to the protection of clients and health care personnel from health and environmental hazards. Accident/Error/Injury Prevention Identify client allergies and intervene as appropriate* Accident/Error/Injury Prevention Identify and facilitate correct use of infant and child car seats by client Identify client factors that influence accident/error/injury prevention (e.g., age, developmental stage, lifestyle) Recognize what factors related to mental status may contribute to the client potential for accident or injury (e.g., confusion, altered thought processes, diagnosis) Determine client/staff member knowledge of safety procedures Verify the identity of client* Utilize facility client identification procedures (e.g., client name band, allergy bands) Monitor client care environment for safety hazard and report problems to appropriate personnel Assist in or reinforce education to client about safety precautions* Remove fire hazards from client care areas Protect client from accident/error/injury (e.g., protect from another individual, falls, environmental hazards, burns) F17.3 Explain safety concerns related to the care of geriatric patients. F1.7 Implement safety standards related to wound care. F2.2 Implement safety standards related to respiratory care skills. F3.11 Implement safety standards related to digestive care skills (Upper) F4.5 Implement safety standards related to digestive care skills (lower). F6.5 Integrate safety standards related to urinary care skills. F7.3 Identify safety factors for consideration when utilizing heat therapy. F7.7 Identify safety factors that should be considered when utilizing cold therapy. F12.2 Implement safety standards related to assessment. F17. 3. Explain safety concerns related to the care of geriatric patients. F18.7 Identify safety precautions to take when performing phlebotomy procedures. Provide client with appropriate method to signal staff members Evaluate the appropriateness of health care provider order for client* F10.11a List the steps of: a. Orientating a patient to a nursing unit. Emergency Response Plan Identify nursing and assistive personnel roles during internal and external disasters Participate in preparation for internal and external disasters (e.g. fire or natural disaster)* Contribute to selection of client to recommend for discharge in disaster situation Ergonomic Principles Use safe client handling (e.g. body mechanics)* F8.3 Use immobilizing equipment. Handling Hazardous and Infectious Materials infectious agents (e.g., cleaning with appropriate solutions) Identify and address hazardous conditions in health care F1.7 environment (e.g., chemical, smoking or biohazard)* Demonstrate knowledge of facility protocols for handling F1.7 hazardous and infectious materials Home Safety Identify fire/environmental hazards (e.g., frayed Ergonomic Principles Provide instruction and information to client about body positions that prevent stress injuries Handling Hazardous and Infectious Materials Identify and employ methods to control the spread of Emergency Response Plan electrical cords, small area rugs, inadequate footwear) Determine client understanding of home safety needs Provide client with information on home safety Reinforce client education on home safety precautions (e.g., home disposal of syringes, lighting, handrails, kitchen safety) Implement safety standards related to wound care. Implement safety standards related to wound care. Home Safety Reporting of Incident/Event/Irregular Occurrence/ Variance Identify situations requiring completion of incident/event/irregular occurrence/variance report (e.g., medication administration error, client fall) Acknowledge and document practice error (e.g., incident report)* Monitor client response to error/event/occurrence Restraints and Safety Devices Demonstrate knowledge of appropriate application of Reporting of Incident/Event/Irregular Occurrence/ Variance restraints/safety devices Follow protocol for timed client monitoring (e.g., restraint, safety checks)* Implement least restrictive restraints or seclusion* Document use of restraints/safety devices and client response Check for proper functioning of restraints/safety devices Restraints and Safety Devices Safe Use of Equipment Assure availability and safe functioning of client care equipment* Safe Use of Equipment F1.6 Describe various types of wound care equipment. F2.4 Discuss basic techniques of chest tube management. Follow facility protocols/procedures for safe use of equipment F1.7 Implement safety standards related to wound care. F2.2 Implement safety standards related to respiratory care skills. F3.11 Implement safety standards related to digestive care skills (Upper) F4.5 Implement safety standards related to digestive care skills (lower). F6.5 Integrate safety standards related to urinary care skills. F7.3 Identify safety factors for consideration when utilizing heat therapy. F7.7 Identify safety factors that should be considered when utilizing cold therapy F2.2 Implement safety standards related to respiratory care skills. Provide safe equipment use for client care (e.g., continuous passive motion [CPM] device, oxygen, mobility aids) F2.4 F2.5 F3.10 F8.3 Security Plan Initiate and participate in security alert (e.g., infant abduction or flight risk)* Use principles of triage and evacuation protocols/procedures Monitor effectiveness of security plan Discuss basic techniques of chest tube management. Demonstrate the ability to utilize a pulse oximeter. Demonstrate knowledge related to tube feedings and formulas. Use immobilizing equipment. Security Plan Standard Precautions/Transmission-Based Precautions/Surgical Asepsis Identify communicable diseases and modes of Standard Precautions/Transmission-Based Precautions/Surgical Asepsis F1.7 Implement safety standards related to wound care. transmission (e.g., airborne, droplet, contact) Identify client knowledge of infection control procedures Identify the need for and implement appropriate isolation techniques* Use standard/universal precautions* F1.12 Demonstrate the ability to apply a clean dressing. Use aseptic and sterile techniques* Use appropriate supplies to maintain asepsis (e.g., gloves, mask, sterile supplies) Use correct techniques to apply and remove gloves, mask, gown and protective eye wear Use correct hand hygiene techniques F1.10 Demonstrate the ability to set up a sterile field F1.11 Demonstrate the ability to perform a sterile dressing change. F6.15 Demonstrate the ability to set up a sterile field. F1.10 Demonstrate the ability to set up a sterile field F1.11 Demonstrate the ability to perform a sterile dressing change. F13.18 Demonstrate the ability to use correct techniques to apply and remove mask, gown, gloves and protective eyewear. F1.6 Describe various types of wound care equipment. Prevent environmental spread of infectious disease through correct use of equipment Protect immunocompromised client from exposure to infectious diseases/organisms Monitor client care area for sources of infection Set up a sterile field F1.10 Demonstrate the ability to set up a sterile field F6.15 Demonstrate the ability to set up a sterile field Reinforce appropriate infection control procedures with client and staff members F1.7 Implement safety standards related to wound care. Health Promotion and Maintenance Health Promotion and Maintenance The LPN/VN provides nursing care for client that incorporate knowledge of expected stages of growth and development and prevention and/or early detection of health problems. Aging Process Identify client knowledge on aging process and assist in Aging Process reinforcing teaching on expected changes related to aging Provide care that meets the special needs of the newborn – less than 1 month old* Provide care that meets the special needs of infants or children aged 1 month to 12 years* Provide care that meets the special needs of adolescents aged 13 to 18 years* Provide care that meets the special needs of young adults aged 19 to 30 years* Provide care that meets the special needs of adults aged 31 to 64 years* Provide care that meets the special needs of clients aged 65 to 85 years of age* Provide care that meets the special needs of clients aged greater than 85 years of age* F17.7 Provide care to meet age-related needs to the aging adult. F17.7 Provide care to meet age-related needs to the aging adult. Ante/Intra/Postpartum and Newborn Care Identify client emotional preparedness for pregnancy (e.g., support systems, perception of pregnancy) Assist in performing client non-stress test Assist with fetal heart monitoring for the antepartum client* Assist with monitoring a client in labor* Perform care of postpartum client (e.g., perineal care, assistance with infant feeding) Contribute to newborn plan of care Reinforce client teaching on infant care skills (e.g., feeding, bathing, positioning) Monitor recovery of stable postpartum client* Monitor client ability to care for infant Ante/Intra/Postpartum and Newborn Care Data Collection Techniques Data Collection Techniques Collect data for health history* Collect baseline physical data (e.g., skin integrity, or height and weight)* Prepare client for physical examination (e.g., reinforce explanation of procedure, provide privacy and comfort) Document findings according to agency/facility policies/procedures F12.11 Identify individual consideration related to assessment of the following: a. Psychosocial status; b. Spiritual and religious beliefs; c. Language barriers; d. Coping status; e. Cultural beliefs; f. Physical status; g. Mobility status **F12.8 Explain aspects of patient’s data collections during the physical examination. F12.9 Discuss the methods of physical assessment. F12.10 Identify basic components included in the assessment of each body system. F12.12 Demonstrate the ability to perform a focused head to toe assessment. F17.1 Identify age related changes that occur in body systems. F12.1 Discuss the role of the practical nurse when assisting with a physical assessment. F12.6 Describe common equipment used during physical assessment. F12.7 Explain the process of the physical examination to the patient. F12.18 Demonstrate the ability to evaluate vision using a Snellen chart. F12.19 Demonstrate the ability to administer a hearing test. F12.20 Demonstrate the ability to prepare an otoscope for an exam by a primary health provider. F12.21 Demonstrate the ability to prepare an ophthalmoscope for an exam by a primary health provider. F12.23 Relate physical examination results to health care provider and document findings according to agency or facility policies or procedures Report client physical examination results to health care provider F12.23 Relate physical examination results to health care provider and document findings according to agency or facility policies or procedures Developmental Stages and Transitions Identify and report client deviations from expected Developmental Stages and Transitions F14.1 Discuss the meaning of death for different developmental age groups. growth and development Identify occurrence of expected body image changes Recognize barriers to communication or learning* Compare client development to norms* Assist client with expected life transition (e.g., attachment to newborn, parenting or retirement)* Assist client to select age-appropriate activities Modify approaches to care in accordance with client development stage F17.5 Identify actions to promote health and wellness in aging adults Provide care and resources for beginning of life and/or end of life issues and choices* F17.7 Provide care to meet age-related needs to the aging adult. Determine client acceptance of expected body image change (e.g., aging, pregnancy, menopause) Determine impact of expected body image changes on client (e.g., temperament) F12.11 Identify individual consideration related to assessment of the following: a. Psychosocial status; c. Language barriers F17.2 Discuss cognitive changes that occur due to aging. F17.3 Discuss psychosocial issues related to the aging adult. Health Promotion/Disease Prevention Health Promotion/Disease Prevention Identify risk factors for disease/illness (e.g., age, gender, ethnicity, lifestyle) Identify and educate clients in need of immunizations (required and voluntary)* Identify precautions and contraindications to immunizations Identify client health seeking behaviors (e.g., breast and testicular self-examinations) Gather data on client health history and risk for disease (e.g., lifestyle, family and genetic history) Check results of client health screening tests (e.g., Papanicolaou [Pap] test or smear, stool occult blood test) Provide assistance for screening examinations (e.g., scoliosis, breast and testicular self-examinations, blood pressure check) Participate in a health screening or health promotion programs* Assist client in disease prevention activities Monitor client actions to maintain health and prevent disease (e.g., smoking cessation, exercise, diet, stress management) Monitor incorporation of healthy behaviors into lifestyle by client (e.g., screening examinations, immunizations, limiting risk taking behaviors) Reinforce teaching with client about health risks and health promotion Recognize client unexpected response to immunizations F9.24 Contribute to selecting teaching strategy to use in reviewing health promotion teaching High Risk Behaviors Assist client to identify high risk behaviors Provide information for prevention of high risk behaviors* Monitor client lifestyle practice risks that may impact health (e.g., excessive sun exposure, lack of regular exercise) Reinforce client teaching related to client high risk behavior (e.g., unprotected sexual relations, needle sharing) High Risk Behaviors F9.24 Contribute to selecting teaching strategy to use in reviewing health promotion teaching Lifestyle Choices Lifestyle Choices Identify client lifestyle practices that may have an impact on health Identify contraindications to chosen contraceptive method (e.g., smoking, compliance, medical conditions) Identify client attitudes/perceptions on sexuality Recognize client need/desire for contraception Recognize expected outcomes for client family planning methods Recognize client need to discuss sensitive issues related to sexuality Support client in family planning Respect client sexual identity and personal choices (e.g., sexual orientation) Respect client lifestyle choices (e.g., child-free, home schooling, rural or urban living) Reinforce teaching with client on healthy lifestyle choices (e.g., exercise regimen, smoking cessation) F9.24 Contribute to selecting teaching strategy to use in reviewing health promotion teaching Self-care Determine client ability and support for performing self care (e.g., feeding, dressing, hygiene) Consider client self care needs before contributing to changes in plan of care Monitor client ability to perform instrumental activities of daily living (e.g., using telephone, shopping, preparing meals) Psychosocial Integrity Self-care F12.11.c. Identify individual consideration related to assessment of the following: Language barriers Psychosocial Integrity The LPN/VN provides care that assists with promotion and support of the emotional, mental and social well-being of clients. The LPN/VN provides care that assists with promotion and support of the emotional, mental and social well-being of clients. Abuse/Neglect Identify client risk factors for abusing or neglecting Abuse/Neglect others Identify signs and symptoms of physical, psychological or financial abuse in client (e.g., family involvement, inadequate weight gain, poor hygiene) Recognize risk factors for domestic, child and/or elder abuse/neglect and sexual abuse Provide safe environment for abused/neglected client Provide emotional support to client who experienced abuse or neglect Reinforce client teaching on coping strategies to prevent abuse or neglect Evaluate client response to interventions Behavioral Management Monitor client appearance, mood and psychomotor behavior and observe for changes Explore cause of client behavior Assist client with achieving self-control of behavior (e.g., contract, behavior modification) Assist client in using behavioral strategies to decrease anxiety Assist in or reinforce education of caregivers/family on ways to manage client with behavioral disorders* Participate in behavior management program by recognizing environmental stressors and/or providing therapeutic environment* Participate in reminiscence therapy, validation therapy or reality orientation* Participate in client group session* Reinforce client participation in therapy Use behavioral management techniques when caring for a client (e.g., positive reinforcement, setting limits) Evaluate client response to behavioral management interventions Behavioral Management F15.3 Encourage the patient to reminisce. Chemical and Other Dependencies Identify signs and symptoms of substance abuse/chemical dependency, withdrawal or toxicity* Plan and provide care to client experiencing substancerelated withdrawal or toxicity (e.g., nicotine, opioid, sedative) Provide care and support for client with impulse-control disorders (e.g., gambling, sexual addiction, pornography) Reinforce provided information on substance abuse diagnosis and treatment plan to client Encourage client participation in support groups (e.g., Alcoholics Anonymous, Narcotics Anonymous) Monitor client response to treatment plan and contribute to revision of plan as needed Chemical and Other Dependencies Coping Mechanisms Collect data regarding client psychosocial functioning* Identify client support systems and available resources Identify client use of effective and ineffective coping mechanisms* Identify significant body or lifestyle changes and other stressors that may affect recovery/health maintenance* Recognize abilities of client to adapt to temporary/permanent role changes Recognize client response to illness (e.g., rationalization, hopelessness, anger) Provide support to the client with unexpected altered body image (e.g., alopecia) Use therapeutic techniques to assist client with coping ability Assist client to cope/adapt to stressful events and changes in health status (e.g., end of life, grief and loss, life changes or physical changes)* Assist client in maintaining level of independence after unexpected body image changes (e.g., amputation, paralysis) Monitor client progress toward achieving improved body image (e.g., mastectomy, colostomy) Coping Mechanisms F15.2 Collect data on patient’s reaction to loss. F10.1 Identify common reaction of patients admitted to hospitals and other health care facilities. F15.1 Provide patient with resources to help adjust to grief or loss. F15.3 Encourage the patient to reminisce. F15.4 Reinforce teaching on common reactions to grief and loss. Crisis Intervention Identify client in crisis Identify client risk for self injury and/or violence (e.g., suicide or violence precaution) Collect data on client potential for violence* Assist in managing the care of angry/agitated client* Use crisis intervention techniques to assist client in coping Provide opportunities for client to understand why the crisis occurred Guide client to resources for recovery from crisis (e.g., social supports) Reinforce client teaching on suicide/violence prevention Report changes in client behavior (indicating a developing crisis) to supervisor Cultural Awareness Identify importance of client culture/ethnicity when F15.1 Provide patient with resources to help adjust to grief or loss. Cultural Awareness planning/providing/monitoring care Recognize client cultural practices that may affect interventions for procedures/surgery (e.g., direct eye contact) Recognize cultural issues that may impact client understanding/acceptance of psychiatric diagnosis Make adjustment to care with consideration of client spiritual or cultural beliefs* Respect cultural background/practices of client (does not include dietary preferences) Document how client language needs are met Crisis Intervention F14.3 Compare different cultural responses to death. End of Life Concepts End of Life Concepts Identify client end of life needs (e.g., financial concerns, fear, loss of control, role changes) F14.2 Identify end-of-life needs. F14.9 Explain the physical and psychological needs of the dying patient. Identify client ability to cope with end of life interventions Provide care or support for client/family at end of life F14.4 Collect data on patient’s reaction to loss of a child. F14.5 List nursing interventions to assist patients as they process through the grieving process. F14.9 Explain the physical and psychological needs of the dying patient. F14.10 Implement nursing interventions for dying patients and their families. Assist client in resolution of end of life issues F14.6 Assist in resolution of end-of-life issues. Grief and Loss Grief and Loss F14.1 Identify client reaction to loss (e.g., denial, fear) F15.2 Support the client in anticipatory grieving Reinforce client teaching on expected client reactions to grief and loss (e.g., denial, fear) F15.4 F14.1 F14.7 Provide client with resources to adjust to loss/bereavement (e.g., individual counseling, support groups) F15.1 Discuss the meaning of death for different developmental age groups. Collect data on patient’s reaction to loss. Reinforce teaching on common reactions to grief and loss. Discuss the meaning of death for different developmental age groups. Match steps of the grieving process to their appropriate characteristics. Provide patient with resources to help adjust to grief or loss. Mental Health Concepts Mental Health Concepts Identify expected behaviors of client with independent or dependent personality Identify client symptoms of acute or chronic mental illness (e.g., schizophrenia, depression, bipolar disorder) Recognize client use of defense mechanisms Recognize change in client mental status Recognize client symptoms of relapse Explore why client is refusing or not following treatment plan* Assist in the care of the cognitively impaired client* Assist in promoting client independence Establish trusting nurse-client relationship Promote positive self-esteem of client* Religious and Spiritual Influences on Health Identify client emotional problems related to religious/spiritual beliefs (e.g., spiritual distress, conflict between recommended treatment and beliefs) Recognize effect of client religious/spiritual beliefs on plan of care Assist client to meet religious/spiritual needs (e.g., referral to pastoral care) Assist in evaluation of client religious/spiritual needs related to necessary nursing interventions Respect client religious/spiritual beliefs Religious and Spiritual Influences on Health F12.11b Identify individual consideration related to assessment of the following: b. Spiritual and religious beliefs Sensory/Perceptual Alterations Identify needs of client with altered sensory perception Sensory/Perceptual Alterations (e.g., hallucinations, delirium) Verify client ability to effectively communicate needs F12.11c Identify individual consideration related to assessment of the following: c. Language barriers Stress Management Stress Management F10.1 Identify actual/potential stressors for client (e.g., fear, lack of information) F13.11 Implement measures to reduce environmental stressors (e.g., noise, temperature, pollution) Monitor client effective use of stress management techniques Support Systems Determine client abilities to provide client support Identify client support systems/resources Identify family response to client illness (e.g., acute episodes, chronic disorder, terminal illness) Identify common reaction of patients admitted to hospitals and other health care facilities. Identify common concerns of patients undergoing surgical procedures. Support Systems Therapeutic Communication Provide emotional support to client and family* Assist client in communicating needs to health care staff Develop and maintain therapeutic relationships with client Respect client personal values and beliefs Establish a trusting nurse-client relationship Use therapeutic communication techniques with client* Encourage client appropriate use of verbal and nonverbal communication Monitor effectiveness of communications with client Therapeutic Environment Identify external factors that may interfere with client recovery (e.g., stressors, noise) Participate in community meetings Contribute to maintaining a safe and supportive environment for client Monitor client response to environmental factors Therapeutic Communication Therapeutic Environment Physiological Integrity Physiological Integrity The LPN/VN assists in the promotion of physical health and well-being by providing care and comfort, reducing risk potential for clients and assisting them with the management of health alterations. Basic Care and Comfort – The LPN/VN provides comfort to clients and assistance in the performance of their activities of daily living. The LPN/VN assists in the promotion of physical health and well-being by providing care and comfort, reducing risk potential for clients and assisting them with the management of health alterations. Basic Care and Comfort – The LPN/VN provides comfort to clients and assistance in the performance of their activities of daily living. Assistive Devices Identify appropriate use of assistive devices (e.g., cane, Assistive Devices walker, crutches) Use transfer assistance device (e.g., t-belt, slide board, or mechanical lift)* Contribute to care of client using assistive device (e.g., feeding devices, telecommunication devices, touch pad, communication board) Reinforce teaching for client using assistive device Review correct use of assistive devices of client and staff members F8.3 Use immobilizing equipment. F3.3 Demonstrate knowledge related to tube feedings and formulas Elimination Elimination Identify client at risk for impaired elimination (e.g., medication, hydration status) F4.1 F4.2 F4.3 Institute bowel or bladder management* F4.7 F4.8 F6.8 F6.9 Monitor client bowel sounds F4.2 Identify normal bowel elimination patterns. Discontinue or remove peripheral intravenous (IV) line, nasogastric (NG) tube or urinary catheter* F3.5 Demonstrate the ability to remove a nasogastric tube. F6.19 Demonstrate the ability to discontinue a urinary catheter. Perform an irrigation of urinary catheter, bladder, wound, ear, nose or eye* Provide skin care to client who is incontinent (e.g., wash frequently, barrier creams/ointments) F1.15 Demonstrate the ability to irrigate a wound. F3.4 Demonstrate the ability to irrigate a nasogastric tube. F3.8 Demonstrate the ability to perform a gastric lavage.??? F3.9 Demonstrate the ability to irrigate a gastric tube. F4.16 Demonstrate the ability to administer a colonic irrigation. F4.17 Demonstrate the ability to perform ostomy irrigation. F6.22 Demonstrate the ability to perform closed intermittent bladder irrigation. F6.23 Demonstrate the ability to manage a continuous bladder irrigation. F6.27 Identify types and purposes of bladder irrigation. F4.3 Explain the causes of and nursing interventions for altered elimination patterns: c. Bowel incontinence. Identify normal and abnormal characteristics of feces. Identify normal bowel elimination patterns. Explain the causes of and nursing interventions for altered elimination patterns: a. Constipation; b. Diarrhea; c. Bowel incontinence; d. Fecal impaction; e. Flatulence F4.4 Identify signs and symptoms of fecal impaction. F4.6 Discuss factors that affect bowel elimination. F4.13 Demonstrate the ability to remove fecal impaction. F6.3 Perform focused assessment on fluid/volume status. F6.4 Distinguish between normal and abnormal voiding patterns. Discuss steps of a bowel retraining program. Reinforce methods of preventing constipation and incontinence. Reinforce teaching regarding maintenance of urinary function. Discuss steps of a bladder re-training program. Mobility/Immobility Mobility/Immobility Identify signs and symptoms of venous insufficiency and F8.1 Observe patient for complications of immobility. intervene to promote venous return (e.g., elastic stockings, sequential compression device) Check client for mobility, gait, strength, motor skills Provide for mobility needs (e.g., ambulation, range of motion, transfer to chair, repositioning, or the use of adaptive equipment)* Reinforce client teaching on methods to maintain mobility (e.g., active/passive range of motion [ROM], strengthening, isometric exercises) Use measures to maintain or improve client skin integrity* Maintain client correct body alignment Provide care to client in traction* Apply or remove immobilizing equipment (e.g., splint or brace)* F8.6 Implement nursing actions to prevent complications of immobility. F8.6 Implement nursing actions to prevent complications of immobility. F8.5 Determine patient understanding of techniques to prevent the effects of immobility F8.4 Teach the importance of changing position. F8.2 Position patient in correct body alignment. F8.6 Implement nursing actions to prevent complications of immobility. F8.2 Position patient in correct body alignment. F8.3 Use immobilizing equipment F8.3 Use immobilizing equipment. Non-Pharmacological Comfort Interventions Identify client need for palliative/comfort care Assist in the care and comfort for a client with a visual and/or hearing impairment* Assist in planning comfort interventions for client with impaired comfort Apply therapies for comfort and treatment of inflammation/swelling (e.g., apply heat and cold treatments, elevate limb) Use an alternative/complementary therapy (e.g., acupressure, music therapy or herbal therapy) in providing client care* Provide non-pharmacological measures for pain relief (e.g., imagery, massage or repositioning)* Provide palliative/comfort care interventions to client Respect client palliative care choices Reinforce client teaching on stress management techniques (e.g., relaxation exercises, exercise, meditation) Reinforce client teaching on palliative/comfort care Monitor client non-verbal signs of pain/discomfort (e.g., grimacing, restlessness) Monitor client response to non-pharmacological interventions Monitor outcome of palliative care interventions Evaluate pain using rating scale* Non-Pharmacological Comfort Interventions F7.10 Discuss signs of the effectiveness of heat and cold therapies. F7.15 Demonstrate the ability to apply a warm compress (dry and moist) F7.16 Demonstrate the ability to apply a cold compress (dry and moist) F7.11 Incorporate aspects of complementary and alternative medicine into patient's care according to practice setting guidelines. F17.7 Describe non-pharmacological pain management techniques. F17.10 Select appropriate nursing measures when caring for a patient in pain. F17.3 List factors that can influence pain response. F16.6 Discuss “pain scales” utilized in pain assessment. Nutrition and Oral Hydration Identify client potential for aspiration (e.g., feeding tube, sedation, swallowing difficulties) Check client feeding tube placement and patency. Nutrition and Oral Hydration F3.10 Demonstrate knowledge related to tube feedings and formulas F3.13 Explain guidelines for caring for a patient with a nasogastric/gastric tube. Provide feeding and/or care for client with enteral tubes* F3.3 Demonstrate the ability to insert a nasogastric tube. F3.4 Demonstrate the ability to irrigate a nasogastric tube. F3.5 Demonstrate the ability to remove a nasogastric tube. F3.6 Demonstrate the ability to feed patient via feeding tube. F3.7 Demonstrate the ability to feed patient via gastrostomy tube F3.12 Discuss types of nasogastric/gastric tubes and their purposes. F3.13 Explain guidelines for caring for a patient with a nasogastric/gastric tube. F3.1 Discuss principles of maintaining nutritional status Monitor and provide for nutritional needs of client (e.g., F5.1 ** Utilize terms associated with nutrition. labs, calorie counts/percentages or daily weight)* F5.9 Discuss changes in nutrient needs throughout the life cycle. F5.11 Identify interventions to maximize nutrition in the clinical setting. F5.4 List the functions and food sources of carbohydrates, protein and fats. F5.5 Identify correct percentages of fats, carbohydrates and proteins that are recommended for the daily diet. F5.6 Discuss key vitamins and minerals, including food sources and health benefits. F5.7 Describe the health benefits of fiber and water in the diet. F5.8 Calculate calories in servings of foods given the carbohydrate, protein and fat content. F5.14 Discuss the characteristics of vomitus. Monitor client ability to eat (e.g., chew, swallow) F5.15 Identify nursing actions to relieve nausea and vomiting. F3.16 Demonstrate ability to perform a focused nutritional assessment. F3.1 Discuss principles of maintaining nutritional status Monitor impact of disease/illness on client nutritional status F3.2 F5.2 Monitor client intake/output* F6.12 Demonstrate the ability to calculate intake and output. Reinforce client teaching on special diets based on client diagnosis/nutritional needs and cultural considerations (e.g., high protein, kosher diet, calorie restriction) F5.3 Identify factors that affect food habits, including culture. Promote client independence in eating F5.10 Identify ways for the nurse to promote a patient’s independence while assisting with intake. Personal Hygiene Determine client usual personal hygiene habits/routine Personal Hygiene Assist with activities of daily living* Assist in providing postmortem care* Reinforce teaching to client on required adaptations for performing activities of daily living (e.g., shower chair, hand rails) Rest and Sleep Identify client usual rest and sleep patterns (e.g., Describe types of therapeutic diets. Describe the role of the practical nurse in promotion of good nutrition. bedtime, sleep rituals) Provide measures to promote sleep/rest* Schedule client care activities to promote adequate rest and sleep Rest and Sleep Pharmacological Therapies – The LPN/VN Pharmacological Therapies – The LPN/VN provides care related to the administration of medications provides care related to the administration of medications and monitors clients who are receiving parenteral therapies. and monitors clients who are receiving parenteral therapies Adverse Effects/Contraindications/Side Effects/Interactions Identify potential and actual incompatibilities of client medications Identify a contraindication to the administration of a prescribed or over-the-counter medication to the client Identify symptoms of an allergic reaction (e.g., to medication) Implement procedures to counteract adverse effects of medications Withhold medication dose if client experiences adverse effect to medication Monitor and document client response to actions taken to counteract adverse effects of medications Monitor client for actual and potential adverse effects of medications (e.g., prescribed, over-the-counter and/or herbal supplements) Monitor anticipated interactions among client prescribed medications and fluids (e.g., oral, IV, subcutaneous, IM, topical) Monitor and document client side effects to medications Monitor and document client response to management of medication side effects including prescribed, over-thecounter and herbal supplements Reinforce client teaching on possible effects of medications (common side effects or adverse effects, when to notify primary health care provider) Notify primary health care provider of actual/potential adverse effects of client medications Adverse Effects/Contraindications/Side Effects/Interactions Dosage Calculations Perform calculations needed for medication administration* Use clinical decision making when calculating doses Expected Actions/Outcomes Identify client expected response to medication Use resources to check on purposes and actions of Dosage Calculations pharmacological agents Apply knowledge of pathophysiology when addressing client pharmacological agents Monitor client use of medications over time (e.g., prescription, over-the-counter, home remedies) Reinforce education to client regarding medications* Reinforce client teaching on actions and therapeutic effects of medications and pharmacological interactions Evaluate client response to medication* Expected Actions/Outcomes Medication Administration Identify client need for PRN medications Medication Administration Mix client medication from two vials as necessary (e.g., insulin) Follow the rights of medication administration* Maintain medication safety practices (e.g., storage, checking for expiration dates or compatibility)* Reconcile and maintain medication list or medication administration record* Review pertinent data prior to medication administration (e.g., vital signs, lab results, allergies) Assist in preparing client for insertion of central line Administer medication by oral route* Administer intravenous piggyback (secondary) medications* Administer medication by gastrointestinal tube (e.g., gtube, nasogastric [NG] tube, g-button or j-tube)* Administer a subcutaneous (SQ), intradermal, or intramuscular (IM) medication* Administer a medication by ear, eye, nose, rectum, vagina or skin route* Dispose of client unused medications according to facility/agency policy Count narcotics/controlled substances* Regulate client intravenous (IV) rate* Monitor transfusion of blood product* Monitor client intravenous (IV) site and flow rate* Reinforce client teaching on client self administration of medications (e.g., insulin, subcutaneous insulin pump) F1.5 Identify treatments for wounds and ulcers. Pharmacological Pain Management Pharmacological Pain Management F16.1 F16.2 F16.3 F16.4 F16.5 Identify client need for pain medication F16.7 F16.8 F16.9 F16.10 F16.11 Monitor client non-verbal signs of pain/discomfort (e.g., Differentiate between chronic and acute pain. Discuss physiological and neurological mechanisms of pain. List factors that can influence pain response. Discuss the effects of pain. Identify subjective and objective data considered in pain assessment. Identify types of pain medications, their effects and side effects. Identify types of pain medications, their effects and side effects. Assess a patient who is in pain. Select appropriate nursing measures when caring for a patient in pain. Incorporate aspects of complementary and alternative medicine into patient's care according to practice setting guidelines. grimacing, restlessness) F16.5 Identify subjective and objective data considered in pain assessment. Monitor and document client response to pharmacological interventions (e.g., pain rating scale, verbal reports) F16.6 Discuss “pain scales” utilized in pain assessment. F16.7 Identify types of pain medications, their effects and side effects. Reduction of Risk Potential – The LPN/VN Reduction of Risk Potential – The LPN/VN reduces the potential for clients to develop complications or health problems related to treatment, procedures or existing conditions. reduces the potential for clients to develop complications or health problems related to treatment, procedures or existing conditions. Changes/Abnormalities in Vital Signs Changes/Abnormalities in Vital Signs Check and monitor client vital signs* F12.13 Demonstrate the ability to identify normal heart tones. F12.14 Demonstrate the ability to identify normal breath sounds. F12.15 Demonstrate the ability to identify normal bowel sounds Compare vital signs to client baseline vital signs Reinforce client teaching about normal and abnormal vital signs (e.g., hypertension, tachypnea, bradycardia, fever) Diagnostic Tests Perform an electrocardiogram (EKG/ECG)* Diagnostic Tests Perform diagnostic testing (e.g., blood glucose, oxygen saturation, testing for occult blood) F2.5 F4.11 F4.12 F12.22 Reinforce client teaching about diagnostic test F13.27 Demonstrate the ability to perform EKG Demonstrate the ability to utilize a pulse oximeter. Demonstrate the ability to collect a stool specimen. Demonstrate the ability to check stool for occult blood. Demonstrate the ability to perform a capillary blood glucose check. Laboratory Values Identify laboratory values for ABGs (pH, PO2, PCO2, Laboratory Values SaO2, HCO3), BUN, cholesterol (total), glucose, hematocrit, hemoglobin, glycosylated hemoglobin (HgbA1C), platelets, potassium, sodium, WBC, creatinine, PT, PTT & APTT, Compare client laboratory values to normal laboratory values Perform venipuncture for blood draws* F18.1 F18.2 F18.3 F18.4 F18.5 F18.6 F18.7 F18.9 F18.10 F18.11 F18.12 F18.13 F18.14 F18.15 State the general purposes for phlebotomy. Differentiate between arteries, veins and capillaries. Identify commonly used sites/veins for venipuncture. Identify common equipment used when collecting blood. Match types of collection tubes to their use/purposes in specimen collection. Identify steps necessary to prevent hemolysis of blood specimens during venipuncture. Identify safety precautions to take when performing phlebotomy procedures Identify possible complications of phlebotomy procedures and appropriate nursing actions if they occur. Identify other methods to obtain blood specimens. Demonstrate ability to obtain a venous blood specimen via Vacutainer. Demonstrate ability to obtain a venous blood specimen via needle/syringe. Demonstrate ability to obtain a blood culture. Demonstrate ability to use finger stick method to obtain blood specimen in a microtainer. Demonstrate ability to use a capillary tube to obtain a hematocrit specimen. Collect specimen (e.g., urine, stool, gastric contents or sputum for diagnostic testing)* F2.6 F2.7 F4.11 F4.12 F6.11 F6.14 F6.16 F6.21 F6.24 F6.29 Reinforce client teaching on purposes of laboratory tests Monitor diagnostic or laboratory test results* Notify primary health care provider about client laboratory test results Demonstrate the ability to collect a throat culture. Demonstrate the ability to collect a sputum specimen. Demonstrate the ability to collect a stool specimen. Demonstrate the ability to check stool for occult blood. Differentiate between the types of urine specimens. Demonstrate the ability to obtain clean catch/midstream urine specimen. Demonstrate the ability to obtain a sterile urine specimen from Foley catheter. Demonstrate the ability to collect a 24-hour urine specimen. Demonstrate the ability to strain urine for stones. Identify ways to adapt the collection of urine specimens to meet the needs of various age groups F13.7 Review the patient’s diagnostic test results. Potential for alterations in Body Systems Identify signs or symptoms of potential prenatal Potential for alterations in Body Systems complication* Identify client with increased risk for insufficient blood circulation (e.g., immobilized limb, diabetes) F12.16 Demonstrate the ability to perform a focused neurovascular check. Recognize change in client neurological status (level of consciousness, orientation, muscle strength) F12.17 Demonstrate the ability to perform a focused neurological check. Compare current client clinical data to baseline information Perform neurological checks* F12.1 Discuss the role of the practical nurse when assisting with a physical assessment. F12.3 Identify responsibilities of the practical nurse when performing a physical assessment. F12.4 Illustrate the difference between objective and subjective data. F12.5 Explain patient positions used for various types of assessments. F13.4 Determine patient’s response to a procedure or surgery. F13.5 Observe patient before, during and after a diagnostic test, procedure and surgery and document accordingly. F13.8 Gather data on nutritional status of postoperative patients. F13.11 Identify common concerns of patients undergoing surgical procedures. F13.12 Discuss nursing responsibilities during the intraoperative period. F13.13 Perform focused assessment on patient during diagnostic test, procedure or surgery. F13.15 Discuss components of a focused postoperative assessment. F13.16 Identify postoperative complications. F13.21 Demonstrate the ability to perform a focused post-operative assessment. F14.17 Support patients who experience postoperative complications. F12.17 Demonstrate the ability to perform a focused neurological check. Perform circulatory checks* Check for urinary retention (e.g., bladder scan, palpation)* Administer and check proper use of compression stockings/sequential compression devices (SCD) F6.26 Demonstrate the ability to perform a bladder scan Monitor client output for changes from baseline (e.g., nasogastric emesis, stool, urine) F6.1 F6.2 F12.16 Demonstrate the ability to perform a focused neurovascular check. Discuss the relationship of urination and fluid volume Differentiate between normal and abnormal characteristics of urine. F6.3 Perform focused assessment on fluid/volume status. F6.4 Distinguish between normal and abnormal voiding patterns. F6.7 Identify nursing interventions for patients who are experiencing urinary incontinence. F6.13 Demonstrate the ability to assist with urinary elimination utilizing a bedpan or fracture pan, bedside commode, and urinal. F1.9 Identify types of wound drainage F13.22 Demonstrate the ability to clean and care for a surgical drain. F13.25 Demonstrate the ability to care for a biliary drainage tube. F13.26 Demonstrate the ability to care for a closed wound drainage Reinforce client teaching on methods to prevent complications associated with activity level/diagnosed illness/disease (e.g., foot care for client with diabetes mellitus) F6.8 Reinforce teaching regarding maintenance of urinary system function. F13.6 Explain how the patient’s developmental status must be considered when discussing procedures or surgery with patient. F13.9 Teach postoperative breathing techniques and controlled cough. F13.10 Contribute to a preoperative teaching plan for a patient. F13.11 Identify common concerns of patients undergoing surgical procedures. F13.14 Reinforce patient teaching to reduce post procedure or surgery risks. Potential for Complications from Surgical Procedures and Health Alterations Potential for Complications from Surgical Procedures and Health Alterations Identify client response to surgery or health alterations F13.5 Observe patient before, during and after a diagnostic test, procedure and surgery and document accordingly. F13.11 Identify common concerns of patients undergoing surgical procedures. Provide care for client before surgical procedure including teaching* F13.1 Explain routine preoperative preparation required by patients. F13.2 Assess patient’s preparation status for a diagnostic test, procedure or surgery. F13.6 Explain how the patient’s developmental status must be considered when discussing procedures or surgery with patient. F13.7 Review the patient’s diagnostic test results. F13.10 Contribute to a preoperative teaching plan for a patient. F13.19 Demonstrate the ability to prepare a patient for procedure or surgery. F13.20 Demonstrate the ability to complete a pre-operative checklist Provide intra-operative care (e.g., positioning client for surgery, maintaining sterile field, or providing operative observation) Reinforce teaching to prevent complications due to surgery or health alterations (e.g., cough and deep breathing, elastic stockings) F13.4 Determine patient’s response to a procedure or surgery. F13.12 Discuss nursing responsibilities during the intraoperative period. F13.13 Perform focused assessment on patient during diagnostic test, procedure or surgery. F13.8 Gather data on nutritional status of postoperative patients. F13.9 Teach postoperative breathing techniques and controlled cough. F13.14 Reinforce patient teaching to reduce post procedure or surgery risks. Suggest change in interventions based on client response to surgery or health alterations F13.15 Discuss components of a focused postoperative assessment. F13.16 Identify postoperative complications. F13.17 Support patients who experience postoperative complications. F13.21 Demonstrate the ability to perform a focused post-operative assessment. F13.22 Demonstrate the ability to clean and care for a surgical drain. F13.23 Demonstrate the ability to remove sutures or staples from a surgical wound. F13.24 Demonstrate the ability to apply a stump bandage. F13.25 Demonstrate the ability to care for a biliary drainage tube. F13.26 Demonstrate the ability to care for a closed wound drainage system. Therapeutic Procedures Therapeutic Procedures Insert urinary catheter* F6.17 Demonstrate the ability to perform a straight catheterization. Male Female F6.18 Demonstrate the ability to insert a Foley catheter Male and Female F6.10 Describe the types and care of urinary catheters. F6.19 Demonstrate the ability to discontinue a urinary catheter. F6.20 Demonstrate the ability to change a supra-pubic catheter. Insert nasogastric (NG) tube* F3.3 Assist with the performance of a diagnostic or invasive procedure * Reinforce client teaching on treatments and procedures Demonstrate the ability to insert a nasogastric tube. Physiological Adaptation – The LPN/VN Physiological Adaptation – The LPN/VN participates in providing care for clients with acute, chronic or life-threatening physical health conditions. participates in providing care for clients with acute, chronic or life-threatening physical health conditions. Alterations in Body Systems Alterations in Body Systems Identify signs and symptoms of an infection (e.g., temperature changes, swelling, redness, mental confusion or foul smelling urine) F1.1 F1.2 F1.3 F1.4 F1.8 Identify/intervene to control signs of hypoglycemia or hyperglycemia* Recognize and report basic abnormalities on a client cardiac monitor strip* Provide care for client drainage device (e.g., wound drain or chest tube)* Provide cooling/warming measures to restore normal temperature* Differentiate between wound classifications. Discuss the process of wound healing. Identify factors that affect wound healing. Discuss complications related to wound healing. Identify factors that may interfere with wound healing. F1.19 Demonstrate the ability to remove a wound drain F2.4 Discuss basic techniques of chest tube management. F2.18 Demonstrate the ability to provide care for a patient with a chest tube. F7. 1 Identify indications for heat therapy. F7.2 Discuss the effects of heat therapy on body tissues. F7.9 Identify appropriate temperature ranges for various types of heat and cold therapies. F7.12 Demonstrate the ability to utilize a temperature control blanket F7.14 Demonstrate the ability to assist with a warm soak F7.15 Demonstrate the ability to apply a warm compress (dry and moist) F7.16 Demonstrate the ability to apply a cold compress (dry and F7.17 F7.18 F7.11 F7.12 F7.13 F7.4 F7.5 F7.6 F7.8 moist) Demonstrate the ability to apply a chemical warm/cold pack Demonstrate the ability to give a tepid sponge bath Identify therapeutic implications related to use of temperature control blankets. Demonstrate the ability to utilize a temperature control blanket Demonstrate the ability to use an aquathermia pad Identify sources/equipment used to deliver heat therapy. Identify indications for cold therapy Discuss the effects of cold therapy on body tissues. Identify sources/equipment used to delivery cold therapy. Provide care for a client with a tracheostomy* F2.17 Demonstrate the ability to perform tracheostomy care. Provide care to a client with an ostomy (e.g., colostomy, ileostomy or urostomy)* **F4.10 Identify type of ostomy. F6.28 Discuss the purposes and care of urostomies Provide care to client on ventilator* Provide care to correct client alteration in body system Provide care to client undergoing peritoneal dialysis Provide care for client experiencing increased intracranial pressure Provide care to client who has experienced a seizure Provide care for client experiencing complications of pregnancy/labor and/or delivery (e.g., eclampsia, precipitous labor, hemorrhage) F17.1 Identify age related changes that occur in body systems. Perform wound care and/or dressing change* F1.10 F1.11 F1.12 F1.13 F1.14 F1.17 F1.18 Perform check of client pacemaker* F17.1 Identify age related changes that occur in body systems. Perform care for client after surgical procedure* Remove wound sutures or staples* F14.17 Support patients who experience postoperative complications. F1.16 Demonstrate the ability to remove sutures and staples Remove client wound drainage device* F1.19 Demonstrate the ability to remove a wound drain Intervene to improve client respiratory status (e.g., breathing treatment, suctioning or repositioning)* F2.1 F2.3 F2.8 F2.9 Reinforce client teaching on ostomy care Reinforce education to client regarding care and condition* Notify primary health care provider of a change in client status Document client response to interventions for alteration in body systems (e.g., pacemaker, chest tube) Demonstrate the ability to set up a sterile field Demonstrate the ability to perform a sterile dressing change. Demonstrate the ability to apply a clean dressing. Demonstrate the ability to apply a wet-to-dry dressing Demonstrate the ability to pack a wound. Demonstrate the ability to apply an eye dressing. Demonstrate the ability to apply a transparent dressing. Describe nursing interventions that promote lung expansion and respiratory efficiency. Identify indications for performing postural drainage percussion or vibration therapy. Demonstrate the ability to assist a patient with deep breathing/coughing exercises. Demonstrate the ability to perform postural drainage, percussion, and vibration. F6.28 Discuss the purposes and care of urostomies Basic Pathophysiology Identify signs and symptoms related to an acute or chronic illness* Consider general principles of client disease process when providing care (e.g., injury and repair, immunity, cellular structure) Apply knowledge of pathophysiology to monitoring client for alterations in body systems Fluid and Electrolyte Imbalances Identify signs and symptoms of client fluid and/or F17.1 Identify age related changes that occur in body systems. F14.12 Provide postmortem care F6.6 F14.8 Discuss causes of urinary incontinence. List signs and symptoms of impending death. Fluid and Electrolyte Imbalances electrolyte imbalances Provide interventions to restore client fluid and/or electrolyte balance Monitor client response to interventions to correct fluid and/or electrolyte imbalance Medical Emergencies Respond to a client life-threatening situation (e.g., Basic Pathophysiology cardiopulmonary resuscitation)* Provide emergency care for wound disruption (e.g., evisceration, dehiscence) Notify primary health care provider about client unexpected response/emergency situation Recommend change in emergency treatment based upon client response to interventions Reinforce teaching of emergency intervention explanations to client Review and document client response to emergency interventions (e.g., restoration of breathing, pulse) Medical Emergencies Radiation Therapy Radiation Therapy Provide interventions for client side effects to radiation therapy Monitor client for signs and symptoms of adverse effects of radiation therapy Reinforce client teaching for management of side/adverse effects of radiation therapy Document client response to radiation therapy (e.g., skin condition) Unexpected Response to Therapy Identify and treat a client intravenous (IV) line infiltration Unexpected Response to Therapy Recognize complications of acute or chronic illness and intervene* Intervene in response to client unexpected negative response to therapy (e.g., unexpected bleeding) F13.16 Identify postoperative complications. Document client unexpected response to therapy F13.17 Support patients who experience postoperative complications. Promote recovery from client unexpected negative response to therapy (e.g., urinary tract infection)