Full Client Needs coverage
Choose your pressure point 01 Management of Care Delegation • Prioritizing client assignments • Informed consent • RN and LPN scope-of-practice conflict • Making unit-wide staffing assignments • SBAR change-of-shift handoff • Documentation and reporting after a client fall • Advance directive conflicting with family wishes • DNR order conflict with family • Responding to a HIPAA/confidentiality breach • Restraint order renewal timing • Informed consent for a minor • Chain of command for reporting an unsafe order • Delegating to a float-pool nurse unfamiliar with the unit • Prioritizing among multiple new admissions • Telephone/verbal order read-back rule • Sentinel-event root-cause response • Ethics committee referral for a treatment dispute • Client leaving against medical advice • Timing of the organ-donation conversation • Disaster triage using the START method • Referral for continuity of care • Supervising a nursing student • Floating and unsafe assignments • Suspected impaired colleague • Living will versus healthcare POA conflict • Elements of nursing malpractice • Good Samaritan law scope • Mandatory reporting of suspected abuse • Just culture after a medication error • PDSA quality improvement cycle • Implementing evidence-based practice change • Reallocating staff during a code • Workplace violence de-escalation • Patient privacy and social media • Surrogate decision-making conflict • Interfacility transfer safety • Collective bargaining and staffing grievance
Challenge me → 02 Safety & Infection Control C. difficile • Transfusion reaction • Restraint alternatives • Hand hygiene moments • PPE doffing sequence • Airborne precautions • Droplet precautions • MRSA contact precautions • Needle-stick exposure protocol • Fall risk assessment • Fire response (RACE) • Fire extinguisher use (PASS) • Electrical equipment safety • Seizure precautions • Medication error reporting • Universal Protocol time-out • Safe patient handling • Sharps disposal • Latex allergy precautions • Bioterrorism exposure (anthrax) • Home safety assessment • Toddler poisoning ingestion • Lead poisoning exposure • Carbon monoxide exposure • Restraint monitoring • Elopement risk (dementia) • CLABSI prevention • CAUTI prevention • Surgical site infection prevention • Early sepsis screening • Hand-off communication • Look-alike/sound-alike medications • Radiation safety • Viral hemorrhagic fever PPE • Norovirus outbreak control • Influenza droplet precautions • Pediculosis management • Scabies management
Challenge me → 03 Health Promotion Newborn hypoglycemia • Live vaccine contraindication • Preeclampsia warning signs • Prenatal folic acid supplementation • Gestational diabetes screening timing • Fetal heart rate category interpretation • Postpartum hemorrhage risk factors • Breastfeeding latch correction • Preterm infant car seat safety • Developmental milestones at 2 months • Developmental red flags at 6 months • 12-month developmental milestones • Lead screening timing • Failure to thrive recognition • Adolescent scoliosis screening • Concussion return-to-play teaching • STI prevention counseling for adolescents • Contraception counseling with migraine history • Nonhormonal menopause symptom management • Osteoporosis screening guidelines • Colorectal cancer screening guidelines • Breast cancer screening teaching • Testicular self-exam teaching • Prostate cancer screening shared decision-making • Smoking cessation counseling strategies • Adult immunization recommendations • Pre-travel vaccination counseling • Child safety seat transitions • Poison prevention teaching for toddlers • Skin cancer prevention teaching • Fall prevention for older adults • Elder abuse screening • Advance care planning teaching • Sleep hygiene teaching • Childhood obesity counseling • Vaccine-hesitant parent communication • Postpartum depression screening • Umbilical cord care teaching
Challenge me → 04 Psychosocial Integrity Command hallucinations • Therapeutic communication with a dying client • Alcohol withdrawal • Therapeutic communication techniques • Active listening • Generalized anxiety disorder coping • Panic attack intervention • PTSD trauma-informed care • Suicide risk assessment • Suicide safety planning and means restriction • Borderline personality disorder splitting • Anorexia nervosa refeeding syndrome • Bulimia nervosa electrolyte consequences • Bipolar mania de-escalation • Schizophrenia negative symptoms • Therapeutic response to delusions • Prolonged grief disorder • Intimate partner violence screening • Child abuse disclosure • Elder abuse and neglect • Culturally competent care • Spiritual distress • Body image after mastectomy • Psychosocial adjustment to a new ostomy • Coping with a new chronic illness diagnosis • Caregiver burden and burnout • Stages of change in substance use disorder • Opioid use disorder harm reduction • Cocaine intoxication • Benzodiazepine withdrawal risk • Co-occurring dual-diagnosis disorders • Therapeutic milieu principles • Group therapy dynamics • Identifying defense mechanisms • ADHD behavior management teaching • Autism spectrum communication strategies • Dementia sundowning management • Delirium versus dementia
Challenge me → 05 Basic Care & Comfort Heart failure trends • Opioid oversedation • Enteral feeding aspiration precautions • Pressure injury staging • Repositioning and pressure injury prevention • Wound dressing selection • Bladder scanning and urinary retention • Fecal impaction management • Bowel training after spinal cord injury • Sleep hygiene for a hospitalized client • Hypothermia and rewarming • Oral care for an unconscious client • Hygiene care for a fully dependent client • Positioning for respiratory comfort • Positioning for enema administration • Passive range-of-motion exercises • Cane gait training • Walker safety • Crutch gait training • Safe transfer technique with a gait belt • Renal diet teaching • Cardiac diet sodium restriction • Dysphagia diet texture modification • Total parenteral nutrition precautions • Comparing NG tube and PEG tube care • Indwelling urinary catheter care • Bladder retraining after stroke • End-of-life comfort measures • Nonpharmacologic pain management • Heat and cold therapy application • Contracture prevention positioning • Neurovascular checks with splinting • Skin integrity in a bariatric client • Incontinence-associated dermatitis prevention • Oxygen delivery device selection for comfort • Environmental modification for low vision • CPAP adherence support • Elastic compression stocking application
Challenge me → 06 Pharmacological Therapies Magnesium toxicity • Lithium toxicity • Supratherapeutic INR • Digoxin toxicity • Heparin overdose and protamine reversal • Insulin peak-time hypoglycemia • Beta-blocker hold parameters • ACE inhibitor angioedema • Potassium-sparing diuretic hyperkalemia • Loop diuretic hypokalemia • Corticosteroid taper and adrenal crisis • Phenytoin toxicity • Antipsychotic-induced neuroleptic malignant syndrome • Extrapyramidal symptoms from antipsychotics • SSRI-induced serotonin syndrome • MAOI tyramine dietary interaction • Tricyclic antidepressant overdose cardiotoxicity • Vancomycin infusion reaction • Aminoglycoside oto/nephrotoxicity monitoring • Chemotherapy neutropenic precautions • Post-transplant immunosuppressant teaching • Beta-agonist inhaler tachycardia • Theophylline toxicity • Long-term proton pump inhibitor risks • NSAID GI bleeding risk • DOAC vs warfarin teaching • Aspirin toxicity and Reye syndrome risk • Statin-associated rhabdomyolysis • Levothyroxine administration timing • Methimazole agranulocytosis monitoring • Calcium channel blocker overdose • Nitroglycerin administration and tolerance • Antiemetic QT prolongation risk • PCA pump safety • Epidural analgesia monitoring • Iron supplement teaching • Oral contraceptive missed-dose teaching • Antitubercular medication adherence and hepatotoxicity
Challenge me → 07 Risk Reduction Acute ischemic stroke • Postoperative hemorrhage • Chest tube nursing care • Multifactorial fall-risk assessment • VTE/DVT prophylaxis • Braden Scale pressure-injury risk • Aspiration-risk screening before oral intake • Verifying informed consent • Contrast media risk reduction • Radiation exposure minimization • Genetic-risk counseling referral • Polypharmacy medication review • Suicide-risk environmental reduction • Neutropenic precautions • Postoperative atelectasis prevention • Pressure-injury prevention with repositioning • Early ambulation for DVT prevention • Compartment syndrome recognition • Latex-allergy risk reduction • Correct patient identification • Medication reconciliation at transitions of care • Discharge-readiness risk assessment • Home-hazard fall-risk assessment • Choking-hazard prevention in toddlers • Drowning-prevention teaching • Burn-prevention home safety teaching • Firearm-safety counseling • Sports pre-participation injury-risk screening • Needlestick exposure risk reduction • Pregnancy medication risk counseling • Skin integrity risk in bariatric clients • Postpartum hemorrhage risk identification • Aspiration risk during tube feeding • Seizure-precaution room setup • Bleeding risk on anticoagulant therapy • Risk reduction before lumbar puncture • Hospital-acquired pressure injury in ventilated clients • Air embolism risk reduction with central lines
Challenge me → 08 Physiological Adaptation Septic shock • DKA • Epiglottitis • Acute MI (right ventricular infarction) • Cardiogenic shock • Pulmonary embolism • Acute respiratory distress syndrome • Status asthmaticus • COPD exacerbation with CO2 narcosis • Acute kidney injury (oliguric phase) • Hyperkalemia in CKD • Tumor lysis syndrome • Disseminated intravascular coagulation • Acute pancreatitis • Esophageal variceal hemorrhage • Hepatic encephalopathy • Increased intracranial pressure • Status epilepticus • Autonomic dysreflexia • Guillain-Barré syndrome • Myasthenic crisis • Thyroid storm • Addisonian (adrenal) crisis • SIADH • Diabetes insipidus • Hyperosmolar hyperglycemic state • Acute compartment syndrome • Burn injury fluid resuscitation • Anaphylaxis • Sickle cell vaso-occlusive crisis • Hemophilia A bleeding episode (hemarthrosis) • Neutropenic fever • Superior vena cava syndrome • Spinal shock • Cardiac tamponade • Hypovolemic shock (hemorrhagic) • Acute mitral regurgitation (papillary muscle rupture) • Amniotic fluid embolism
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