NCLEX Notes

Notes I got from allnurses.com, thank you very for sharing this and so I will share to others, too. 




RN 
- Invasive procedure = I AM RN EDUCATED
- Initial/Comprehensive/Baseline (assessments)

- Assess (FREQUENT/ONGOING =UNSTABLE Patients)
- MANAGING and LEADING client care environment
Ex. Clients who are in severe and Refusing Meds (needs more assessment)

- Review
- NSG Process/ NSG Judgement Use (APIE= Assessment,Planning, Implementation,Evaluation)

- Encourage
- Develop
- Use Of IV meds (ex. plasma, blood products-- these and IV are done by RN only)
- Consult/Counsel/Suggest & Update
- ADMISSION .. NEW & POST OP
- Teach 
- Educate 
- DISCHARGE & ADMISSION Preparation

LPN/LVN- 
-Certain Invasive Task =I-SOUND STAR CROSS ++
- IM adm

- SQ adm.
- ORAL meds adm 
- URINARY CATHETERIZATION
- Nitroglycerin
- DREASSING of WOUND (CHANGING & IRRIGATING) very commonly seen Q.
- SUCTIONING
- TUBE FEEDING
- Auscultate/Listen
- Routine/Standard

- Check(s) 
- Reinforce/remind
- Observe 
- Set up (basic equipment)
- Specimen Collection & Data Colletion 
+
-Blood glucose readings
-Monitor
-Review/Teach-- Usually standard practices (hand washing/hygiene) or med administration (ie. eye drops) -- RN mostly teaches/educated and LPNs Reinforce
+
CAST & TOE Amputation are stable clients and need on going assessment and pain mgt./La Charity Book(Don’t know too..just dont deprive with it.. just follow the book
Data Collection such as LISTENING to LUNG SOUNDS & CHECKING for PERIPHERAL EDEMA_Part of LPN scope of practice: /LaCharity Book
** Don't assign LVN/LPN to do a task an nurse assistant can complete**

NURSING ASSISTANT/UAP- Unlicense assistive personnel
- Non Invasive procedure/Basic Care =SPARRTACUS GROAM +++
-SKIN CARE (ex. bed rest with a skin tear and hematoma from a fall 2 days ago, Apply and care for a client’s rectal pouch )
-POSITIONING-- Special positioning-- requires initial education by RN -- assistant will assist not teach
-AMBULATION/ Assisting with ADL (AMBULATION of FRACTURED HIP only RN& PT) ( Patienst with CHESTUBE ambulating the hall-LPN/LVN)
-RECORDING & MONITORING of V/S (BP,Pulse, Oxygen sat,)
-RANGE OF MOTION &EXERCISE
-TRANSPORT OF CLIENT
-ASSIST (Assisting for Prep for SITZ Bath)
-COLLECTION OF 
-URINE &
-STOOL
-GROAM (Groaming & Hygiene Measure, Bathing & checking water temp)
+
WEIGHTING
INTAKE & OUTPUT
FEEDING 
+ 
- Remind/Reinforce: usually reminds pt. TO do something rather than HOW to do it (skills previously taught by other health care professional or precaution measures)***
- They can detach suction and remove a foley but not connect or insert
- Gather (equipment)
+
- Measurement of ankle and bracial blood pressure for ankle brachial index calculation.(Calculated already)
( Calculation on the ankle-brachian index is responsibility of RN)
-Experienced Nsg Assistant should have been taught how to..
Monitor Apical Pulse, However, the RN should observe to be sure that s/he mastered this skills.
---La Charity Book---

NEW RN
-Education and hospital orientation includes.. SAFE administration of IV meds.
-STABLE PATIENTS

SOME KEY POINTS:
Patients that require teaching about drugs or need procedures done are NOT RN priority. 

PHYSICIAN
-Informed Consent
-Medical diagnosis
-Prescriptions
-Order procedures

Avoid These Assignments for New/Float/LVN/LPN/Traveling
-New onset/sudden/acute
-New admission
-Transfer
-Newly diagnosed
-Discharge
-Require education/teaching (beyond basic skills -- tend to be complex and specific to patients on that particular unit)
- Unstable (ie. High risk of sudden respiratory failure, or requires frequent assessments and changes in therapy(like electrolyte imbalances)
Give:
- Chronic
- Routine meds/procedures
- Stable