LVN Fundamental Review

Pioneer Nursing Leaders

  • Nursing Leader: Dorothea Dix

    A key figure in advocating for better care standards for mentally ill patients. Superintendent of Female Nurses of the Union Army:

    Recognized for significant contributions during the Civil War.

  • Civil War Contributions: Mary Ann Ball
      - Organized diet kitchens and laundries.
      - Managed ambulance services and supervised nursing staff.

  • Pioneer in Nurse-Midwifery: Mary Breckenridge
      - Established the Frontier Nursing Service to provide obstetric care to mothers in Kentucky hills.
      - Nurses traveled on horseback to deliver care.

  • First African American Professional Nurse: Mary Eliza Mahoney
      - Graduated from the New England Hospital for Women and Children in 1879.
      - Advocated for the inclusion of African Americans in nursing.

  • Leader in Nursing Education: Mary Adelaine Nutting
      - Developed curriculum concepts and guidelines for nursing students.
      - Contributed to the creation of the International Council of Nurses.

  • First Trained Nurse in America: Linda Richards
      - Contributed significantly to the establishment of nursing and hospital records.
      - Credited with developing modern documentation systems.

  • Founding of Henry Street Settlement: Lillian D. Wald
      - Crucial in developing public health nursing in the U.S.

  • American Society of Superintendents of Training Schools: Lavina Dock
      - Collaborated with Robb to form what became the National League for Nursing Education.
      - Created the first graded system of nursing theory and practice in schools.

  • American Journal of Nursing: Isabel Hampton Rob
      - Co-founded this publication to support nursing knowledge dissemination.

Understanding the Duties of the Licensed Vocational Nurse (LVN)

  • In 1944, there was a commission that studied practical and vocational nursing tasks, leading to a clearer distinction between the roles of LPN/LVN and RN.

  • Following the study, state boards of nursing began specifying duties and responsibilities of each nursing group.

Maslow’s Hierarchy

  • Arrange based on needs:
      a) Affection, acceptance of peers
      b) Full use of individual talents
      c) Stability, protection, security, freedom from fear and anxiety
      d) Self-respect, self-confidence, feelings of self-worth
      e) Nutrition, elimination, oxygenation, sexuality

Nursing Theories

  • Match nursing theorists to their concepts:
      - Leininger (1978): To facilitate “the body’s reparative processes” by arranging the patient’s environment.
      - Orem (1971): To care for and help the patient attain total self-care.
      - Benner and Wrubel (1989): To focus on the patient’s needs for caring as a means of coping with illness stressors.
      - Nightingale (1860): To provide care consistent with nursing’s emerging science and knowledge, with caring as the central focus.

True or False Statements

  • LPN/LVNs are required to understand the state nurse practice act.

  • LPN/LVN does not function independently.

  • LPN/LVNs provide care under the supervision of an RN or physician and are accountable for their actions.

Legal and Ethical Responsibilities

  • The concept of professional negligence involves actions taken or omitted that harm another person.
      - Four key elements required to establish liability:
        1. Duty
        2. Breach
        3. Causation
        4. Damages

  • Malpractice: Doing an act or failing to act as a reasonably prudent person would in similar circumstances.

  • Defamation: A malicious or untrue written statement about another party brought to others' attention.

  • Tort: Injury to a person or property that leads to legal action against the responsible person.

Understanding Informed Consent

  • Informed consent is the process of obtaining permission from the patient after informing them about the procedure, its risks, benefits, and alternatives.

HIPAA

  • HIPAA stands for Health Insurance Portability and Accountability Act.

Reporting Abuse

  • The LVN must report any suspected abuse or neglect of patients and is legally obligated to do so.

Advanced Directive

  • An advanced directive is a legal document that outlines a patient’s wishes regarding medical treatment in situations where they are unable to communicate their preferences.

Code of Ethics

  • The Code of Ethics in nursing consists of guidelines that govern the ethical conduct of nurses, ensuring care is provided with dignity, respect, and integrity.

Documentation Importance

  • ISBARR: A communication framework in nursing.
      - I: Introduction
      - S: Situation
      - B: Background
      - A: Assessment
      - R: Recommendation
      - R: Read back (repeat the information for confirmation)

Patient Safety and Records

  • Purpose of Patient Records:
      1. To facilitate communication
      2. To provide information for research
      3. To serve as a legal document
      4. To aid in monitoring quality care
      5. To support reimbursement processes

Nursing Diagnoses

  • An nursing diagnosis identifies health-related problems that occur during nursing assessments, differing from medical diagnoses, which identify specific diseases or conditions through various evaluations.

Patient Outcomes and Public Health Disparities

  • Preventable negative health outcomes that largely affect disadvantaged populations due to socio-economic factors.

Cultural Competence

  • Culture: A set of shared values, beliefs, customs, and practices within a group.

  • Cultural Stereotypes: Preconceived notions about individuals based on their cultural backgrounds that may not change easily.

  • Cultural Awareness: Understanding one's cultural beliefs and their relationship to those of others.

Infection Control

  • Major hospital-acquired infections include CLABSIs, CAUTIs, SSIs, and VAP. The best prevention is stringent hand hygiene.

Guidelines for Medication Safety

  • Maximum dosage of acetaminophen: Ensure patients do not exceed recommended amounts, monitoring liver function.

  • Antidote for Acetaminophen toxicity: N-Acetylcysteine.

Understanding Healing Processes

  • Healing by secondary intention refers to the process where a wound must granulate during healing due to the skin edges not being closely approximated or because of pus formation.

Ageism

  • Ageism describes prejudice against older adults, impacting the quality of care they receive in healthcare settings.

Assessment of Vital Signs

  • Normal heart rate range: 60-100 beats per minute

  • Normal respiration rate range: 12-20 breaths per minute

  • Listening to an apical pulse should be for 1 full minute.

  • Tube feedings: Start slowly to prevent complications such as aspiration or gastrointestinal distress.