Ch.13 Provisions for a Safe Enviroment Flashcards
(168 cards)
1
Q
What are three key points of fire saftey?
A
- Keep open spaces free of clutter.
- Clearly mark fire exits.
- Know the locations of all firearms, exits, and extinguishers.
2
Q
What are the two priority nursing action in the event of a fire?
A
Pass & Race
3
Q
P.A.S.S
A
Get the firewstinguisher and :
Pull the pin
Aim at the base of the fire
Squeeze the estinguisher handle
Sweep at the base of the fire side to side. (not at the top of the flames)
4
Q
R.A.C.E
A
Rescue clients who are in immediate danger.
Activate the fire alarm
Confine the fire.
Estinguish the fire.
5
Q
Type A fire estinguishers are for?
A
Wood,cloth,paper, rubbish, plastic
6
Q
Type B fire estinguishers are for
A
Chemical fires from gases, oils, tar etc.
7
Q
Type C estinguishers are for?
A
Electrical equipment
8
Q
What do you need to know to report a fire?
A
Telephone number
9
Q
What should you know in the event of a fire for evacuation?
A
The facilities evacuation plan.
10
Q
What should be turned off in the vicinity of the fire?
A
Oxegen equipment.
11
Q
What should you never use in the event of a fire?
A
An elevator.
12
Q
How should you handle a client in life support in the event of a fire?
A
Maintain respiratory status with a Ambu bag(recitation bag) until they are removed away from the fire.
13
Q
How do you deal with amblitory client in the event of a fire?
A
Direct them in a safe direction, in some cases they can push others with them.
14
Q
How do you help bedridden client in the event of a fire?
A
Stretcher, bed, or wheelcahir.
15
Q
What if they need to be carried?
A
You need to use proper technique.
16
Q
How must electrical equipment be maintained?
A
Must be maintained in good working order and must be ground.
17
Q
What kind of electrical cords must be used?
A
Three pronged.
18
Q
How does a three pronged electrical cord work?
A
The Thor prong linger is the ground. Why the other two carry the electricity.
19
Q
What should be done with electrical cords?
A
Make sure they are not exposed, frayed, or damaged wires.
20
Q
How should electrical circuit be treated?
A
Never overloaded.
21
Q
How do you work with all electrical equipment?
A
Always read the directions; NEVER work with equipment you don’t know how to use.
22
Q
How should you handle extension cords?
A
Use only when nessary and tape them down to the floor with electrical tape.
23
Q
Where should you never place electrical wiring?
A
Covered up.
24
Q
How should you unplug a plug?
A
Never pull the cord only pull the plug itself.
25
Where should you never use electrical appliances?
Near sinks,bathtubs, or other water shources.
26
What do you did if the client takes an electrical shock?
Turn off the electricity before touching the client.
27
What must be done with any electrical equipment brought to the facility?
It must be inspected for safety before use.
28
How do you know how to deal with radiation?
Know the protocols and guidelines of the healthcare agency.
29
If it potentially radiation what should be done with it?
It should be labeled.
30
What are the top three ways to prevent radiation illness?
1. Limit time near the source.
2. Make your distance from the source as great as possible.
3. Use a shielding device such as a lead apron.
31
How can you monitor ration exposure?
Film badge. (Dosimeter).
32
Where should people that just had radiation be put?
In there own room.
33
What do you never do with dislodged radiation implants?
Never touch them.
34
What should not be removed from the room before the implants are removed?
Anything even linens.
35
How do you dispose of infectious wastes?
1. Handle all wastes as hazard.
2. Dispose of waste in designated areas.
3. Label it correctly.
4. dispose of all sharps immediately after used in a sharps container or a puncture proof container(like a milk jug.)
36
Sharps
Needles
37
What should never be done with needles?
Recapped, Brent, broken due to risk of a needle stick.
38
What are some physiological changes that put patients at risk for falls?
Miscoskeletal changes
Neurological changes
Sensory changes
Gerontological changes
39
How do muscoskeletal changes increases fall risk?
Strength/function of muscle decrease.
Bones brittle and joint function decrease.
Postural changes and limited range of motion.
40
Nervous system ch ages that increase fall risk?
Voluntary and autonomic reflexes become slower.
Decreased ability to respond to multiple stimuli occurs.
Decreased sensitivity to touch occurs.
41
Sensory changes that increase fall risk?
Decreased vision and lens accommodation and cataracts develop.
Delayed transmission of hot and cold impulses occurs.
Impaired hearing develops, with high-frequency tones less perceptible.
42
Genitourinary Changes increase fall risk?
Genitourinary Changes
Increased nocturia and occurrences of incontinence may occur.
43
Nocturna
Peeing during the night.
44
F. Risk for falls assessment 🔺(6 items)
1. Should be client-centered and include the use of a fall risk scale per agency procedures
2. Include the client's own perceptions of their risk factors for falls and their method to adapt to these factors. Areas of concern may include gait stability, muscle strength and coordination, balance, and vision.
3. Assess for any previous accidents.
4. Assess with the client any concerns about their immediate environment, including stairs, use of throw rugs, grab bars, a raised toilet seat, or environmental lighting.
5. Review/analyze the medications, both prescription and nonprescription, that the client is taking that could have side/adverse effects that could place the client at risk for a fall.
6. Determine any scheduled procedures that pose risks to the client.
45
What are some measurements to be taken to prevent falls?
Assess the client's risk for falling; use agency fall risk assessment scale.
▪Assign the client at risk for falling to a room near the nurses' station.
▪Alert all personnel to the client's risk for falling; use agency fall risk alert procedures and methods as necessary.
▪Assess the client frequently.
▪Orient the client to physical surroundings.
▪Instruct the client to seek assistance when getting up.
▪Explain the use of the nurse call system.
▪Use safety devices such as floor pads, and bed or chair alarms that alert health care personnel of the person getting out of bed or a chair.
▪Keep the bed in the low position with side rails adjusted to a safe position (follow agency policy).
▪Lock all beds, wheelchairs, and stretchers.
▪Keep clients' personal items within their reach.
▪Eliminate clutter and obstacles in the client's room.
▪Provide adequate lighting.
▪Reduce bathroom hazards.
▪Maintain the client's toileting schedule throughout the day.
46
Measures to promote safety in ambulation for the client? What is mainly used? Steps of use?
1. Gait belt may be used to keep the center of gravity midline.
a. Place the belt on the client prior to ambulation.
b. Encircle the client's waist with the belt.
c. Hold on to the side or back of the belt so that the client does not lean to one side.
d. Return the client to bed or a nearby chair if the client develops dizziness or becomes unsteady.
e. When finished safely ambulating the client, remove belt and replace it in its appropriate storage area.
47
What are The Joint Commission: National Patient Safety Goals 2018?
▪Improve the accuracy of client identification.
▪Improve the effectiveness of communication among caregivers
▪Improve the safety of using medications
▪Focus on the risk points related to medication reconciliation
▪Reduce the harm associated with clinical alarm systems
▪Reduce the risk of health care–associated infections
▪Identify client safety risks
▪Prevent mistakes in surgery
48
🔺 Steps to prevent injury to the health care worker? (4)
▪Use available safety equipment.
▪Keep the weight to be lifted as close to the body as possible.
▪Bend at the knees.
▪Tighten abdominal muscles and tuck the pelvis.
▪Maintain the trunk erect and knees bent so that multiple muscle groups work together in a coordinated manner.
49
🔺 restraints are?
Restraints (safety devices) are protective devices used to limit the physical activity of a client or to immobilize a client or an extremity.
50
🔺what four things need to be done with restraints?
a. The agency policy should be checked and followed when using side rails.
b. The use of side rails is not considered a restraint when they are used to prevent a sedated client from falling out of bed.
c. The client must be able to exit the bed easily in case of an emergency when using side rails. Only the top two side rails should be used.
d. The bed must be kept in the lowest position.
51
Physical restraints?
Restrict client movement through the application of a device.
52
Chemical restraints are?
Chemical restraints are medications given to inhibit a specific behavior or movement.
53
Before you use restraints what should be done?
Use alternative devices, such as pressure-sensitive beds or chair pads with alarms or other types of bed or chair alarms, whenever possible.
54
If restraints are necessary, the primary health care provider's (PHCP's) prescriptions should state?
The type of restraint, identify specific client behaviors for which restraints are to be used, and identify a limited time frame for use.
55
The PHCP's prescriptions for restraints should be renewed within?
A specific time frame according to agency policy.
56
Restraints are not to be prescribed as?
Restraints are not to be prescribed PRN (as needed).
57
What should be documented Edith rest aunts and who should be told?
The reason for the safety device should be given to the client and the family, and their permission should be sought and documented.
58
Restraints should not interfere with?
Any treatments or affect the client's health problem.
59
What should be used when securing a saftey device?
Use a half-bow, a safety knot (quick release tie), or a restraint with a quick release buckle to secure the device to the bed frame or chair.
60
Where can you not tie restraints?
not to a movable part of bed (including the side rails).
61
How much slack should be in the straps?
Enough to move the body part.
62
What should you asses for when they are in restraints? How often?
Assess skin integrity and neurovascular and circulatory status every 30 minutes.
63
How often should you remove restraints?
remove the safety device at least every 2 hours to permit muscle exercise and to promote circulation (follow agency policies).
64
What should be documented when using a saftey device? (7)
▪Reason for safety device
▪Method of use for safety device
▪Date and time of application of safety device
▪Duration of use of safety device and client's response
▪Release from safety device with periodic exercise and circulatory, neurovascular, and skin assessment
▪Assessment of continued need for safety device
▪Evaluation of client's response
65
How often should you offer fluids for restraints?
2 hours
66
How often should you offer toileting?
Every two hours.
67
🔺What is always needed when using a restraint?
Doctors order.
68
🔺What should you do before looking to use restsraints?
Exhauste every other option.
69
Alternatives to safety devices for a client with confusion?
a. Orient the client and family to the surroundings with every interaction and identify the client by their name.
b. Explain all procedures and treatments to the client and family.
c. Encourage family and friends to stay with the client, and use sitters for clients who need supervision.
d. Assign confused and disoriented clients to rooms near the nurses' station.
e. Provide appropriate visual and auditory stimuli, such as a night light, clocks, calendars, television, and a radio, to the client; leave the client's room door open.
f. Place familiar items, such as family pictures, near the client's bedside.
g. Maintain toileting routines.
h. Eliminate bothersome treatments, such as nasogastric tube feedings, as soon as possible.
i. Evaluate all medications that the client is receiving.
j. Use relaxation techniques with the client.
k. Institute exercise and ambulation schedules as the client's condition allows.
l. Collaborate with the PHCP to evaluate oxygenation status, vital signs, electrolyte/laboratory values, and other pertinent assessment findings that may provide information about the cause of the client's confusion.
70
Where should you assign confused residents?
In a room closest to the nurses station.
71
Posion
A poison is any substance that impairs health or destroys life when ingested, inhaled, or otherwise absorbed by the body.
72
Are all poisons curable?
Specific antidotes or treatments are available only for some types of poisons.
73
The capacity of body tissue to recover from a poison determines the?
Reversibility of the effect.
74
Poison can impair what body organ systems?
The respiratory, circulatory, central nervous, hepatic, gastrointestinal, and renal systems of the body.
75
🔺What age groups need to be protected from accidnetal positioning?
The infant, toddler, the preschooler, and the young school-age child, and elderly.
76
🔺Why do the elderly need to be protected from accidnetal positioning?
In older adults, diminished eyesight and impaired memory may result in accidental ingestion of poisonous substances or an overdose of prescribed medications.
77
🔺What should always be handy just incase of poisoning?
A Poison Control Center phone number should be visible on the telephone in homes with small children; in all cases of suspected poisoning, the number should be called immediately.
78
🔺What should you do before any interventions with poisoning?
Call Poison control
79
HAI
Healthcare acquired infections
80
What are healthcare acquired infections also known as?
nosocomial infections and are also referred to as hospital-acquired infections.
81
Where do you get HAI?
These infections are acquired in a hospital or other health care facility and were not present or incubating at the time of a client's admission.
82
🔺 Clostridium difficile is spread mainly by?
Hand-to-hand contact in a health care setting. Clients taking multiple antibiotics for a prolonged period are most at risk.
83
What are some common drug resistant infections?
Vancomycin-resistant enterococci VRE
methicillin-resistant Staphylococcus aureus (MRSA),
multidrug-resistant tuberculosis,
carbapenem-resistant Enterobacteriaceae (CRE)
84
Why is it a thing that happens often HAI
Illness and some medications such as immunosuppressants impair the normal defense mechanisms.
85
The hospital environment provides exposure to a variety of?
Virulent organisms that the client has not been exposed to in the past; therefore, the client has not developed resistance to these organisms.
86
What is the most common way to spread stuff in the healthcare setting?
Infections can be transmitted by health care personnel who fail to practice proper standard precautions (i.e., hand-washing procedures or failing to change gloves between client contacts).
87
Is Hand sanitizer the best way to disinfect your hands? Why?
No hand washing is
it is important to note that alcohol-based sanitizers are not effective against some infectious agents such as Clostridium difficile spores; therefore, handwashing is necessary.
88
What do you need to wash your hands in with c.diff?
Antimicrobial soap. To kill the spores
89
What are standard precautions?
Gloves
Washing hands
Washing hands before and after patient care.
90
Who does the nurse use standard precaustions with?
Nurses must practice standard precautions with all clients in any setting, regardless of the diagnosis or presumed infectiveness.
91
What else is considered standard precaustions?
Additionally, standard precautions include the use of masks, eye protection, and gowns, when appropriate, for client contact.
92
What bodily fluid do standard precautions apply to?
All
93
🔺when should you wash your hands?
Wash hands between client contacts; after contact with blood, body fluids, secretions or excretions, nonintact skin, or mucous membranes; after contact with equipment or contaminated articles; and immediately after removing gloves.
94
🔺When should you wear gloves?
Wear gloves when touching blood, body fluids, secretions, excretions, nonintact skin, mucous membranes, or contaminated items; remove gloves and wash hands between client care contacts.
95
🔺When is it okay to just use hand sanitizer?
When your hands are not visibly soiled.
96
🔺when do you wear masks and eye protection?
Wear masks and eye protection, or face shields, if client care activities may generate splashes or sprays of blood or body fluid.
97
🔺When do you wear a gown?
Wear gowns if soiling of clothing is likely from blood or body fluid; wash hands after removing a gown.
98
🔺Order for donning PPE?
Gown
Mask
Goggles
Gloves
99
🔺Order for doffing PPE?
Gloves
Goggles
Gown
Mask
100
How should you handle contaminated linens?
Place contaminated linens in leak-proof bags and limit handling to prevent skin and mucous membrane exposure. Dispose according to agency policy.
101
🔺What should be done whenever possible when feeling with needles?
Use the safety feature! Or go needles when you can.
102
Discard all sharp instruments and needles how?
Discard in a puncture-resistant container.
103
Dispose of needles how?
Uncapped or engage the safety mechanism on the needle if available. In a sharps container.
104
🔺What can you use to clean spills of blood and other things?
Clean spills of blood or body fluids with a solution of bleach and water (diluted 1:10) or agency-approved disinfectant.
105
How should you handle all blood and bodily fluid?
Handle all blood and body fluids from all clients as if they were contaminated.
106
Transmission-Based Precautions
Transmission-based precautions include airborne, droplet, and contact precautions.
107
Airborne precautions need for?
1. Diseases
a. Measles
b. Chickenpox (varicella)
c. Disseminated varicella zoster
d. Pulmonary or laryngeal tuberculosis
108
🔺What are the methods of airborn precaustions?
You need barriers.
109
🔺What are the airborn precautions?
Single room is maintained under negative pressure; door remains closed except upon entering and exiting.
c. Negative airflow pressure is used in the room, with a minimum of 6 to 12 air exchanges per hour via high-efficiency particulate air (HEPA) filtration mask or according to agency protocol.
d. Ultraviolet germicide irradiation or HEPA filter is used in the room.
e. Health care workers wear a respiratory mask (N95 or higher level). A surgical mask is placed on the client when the client needs to leave the room; the client leaves the room only if necessary.
110
🔺Airborn precautions what kind of room are pateo wyd put in?
Single room under negative airflow.
| Door stays closed except when exiting or entering.
111
🔺What is the airflow of a airborn precaution room?
Negative airflow pressure is used in the room, with a minimum of 6 to 12 air exchanges per hour via high-efficiency particulate air (HEPA) filtration mask or according to agency protocol.
112
🔺What kind of air filter is used is used in an airborn precaution room?
Ultraviolet germicide irradiation or HEPA filter is used in the room.
113
🔺What kind of mask is worn with airborne precautions?
N95 Respirator or higher level.
114
🔺When can an airborn precautions patient leave a room?
Only when nessary.
115
🔺When a airborn precaution client leaves a room what needs to be done?
A surgical mask is placed on the client.
116
What diseases is droplet precautions used for?
Adenovirus
b. Diphtheria (pharyngeal)
c. Epiglottitis
d. Influenza (flu)
e. Meningitis
f. Mumps
g. Mycoplasmal pneumonia or meningococcal pneumonia
h. Parvovirus B19
i. Pertussis
j. Pneumonia
k. Rubella
l. Scarlet fever
m. Sepsis
n. Streptococcal pharyngitis
117
🔺What kind of patients do you use droplet precautions with?
Used for clients with known or suspected infection with pathogens transmitted by respiratory droplets, generated when coughing, sneezing, or talking.
118
What kind of rooms are patients with droplet precaustions put in?
Private room or cohort client (a client whose body cultures contain the same organism)
119
🔺What should you wear when around someone with droplet precautions?
Wear a surgical mask when within 3 feet of a client.
120
🔺How far do you stay away from droplet precautions?
3 feet.
121
🔺If a droplet precautions patient has to leave a room what need to be done?
Place a regular mask on them.
122
What kind of disease do you need contact precautions with?
a. Colonization or infection with a multidrug-resistant organism
b. Enteric infections, such as Clostridium difficile
c. Respiratory infections, such as respiratory syncytial virus
d. Influenza: Infection can occur by touching something with flu viruses on it and then touching the mouth or nose.
e. Wound infections
f. Skin infections, such as cutaneous diphtheria, herpes simplex, impetigo, pediculosis, scabies, staphylococci, and varicella zoster
g. Eye infections, such as conjunctivitis
h. Indirect contact transmission may occur when contaminated object or instrument, or hands, are encountered.
123
🔺 What kind of room do you put contact clients in?
Private room or cohort client
124
🔺What should be worn with contact clients?
.Use gloves and a gown whenever entering the client's room.
125
In the vent of a disaster what should you know?
Know the emergency response plan of the agency.
126
Internal disasters
Those that occur within the health care facility.
127
External disasters occur where?
Occur External disasters occur in the community, and victims are brought to the health care facility for care.
128
🔺When the health care facility is notified of a disaster, the nurse should ?
Follow the guidelines specified in the emergency response plan of the facility.
129
🔺 In the event of a disaster, the what is activated?
emergency response plan is activated immediately.
130
Biological Warfare Agents
A warfare agent is a biological or chemical substance that can cause mass destruction or fatality.
131
What is anthrax?
The disease is caused by Bacillus anthracis
132
How is anthrax contracted?
Can be contracted through the digestive system, abrasions in the skin, or inhalation through the lungs.
133
How can anthrax be spread?
Anthrax is transmitted by direct contact with bacteria and spores.
134
Spores
spores are dormant encapsulated bacteria that become active when they enter a living host (no person-to-person spread) (Box 13-6).
135
After contracted can anthrax be spread?
No person to person.
136
Three ways you can get anthrax?
Spores on skin.
Eating it
Inhalation
137
How does anthrax make its way through the body?
The infection is carried to the lymph nodes and then spreads to the rest of the body by way of the blood and lymph systems; high levels of toxins lead to shock and death.
138
What can anthrax do to the lungs?
In the lungs, anthrax can cause buildup of fluid, tissue decay, and death (fatal if untreated).
139
How do you test for anthrax?
A blood test is available to detect anthrax (detects and amplifies Bacillus anthracis DNA if present in the blood sample).
140
How is anthrax treated?
Anthrax is usually treated with antibiotics such as ciprofloxacin, doxycycline, or penicillin.
141
Is there a vaccine for anthrax?
The vaccine for anthrax has limited availability.
142
🔺how is anthrax spread?
Anthrax is transmitted by direct contact with bacteria and spores and can be contracted through the digestive system, abrasions in the skin, or inhalation through the lungs.
143
🔺 How is smallpox spread?
Smallpox is transmitted in air droplets and by handling contaminated materials and is highly contagious.
144
When do symptoms of smallpox occur? What are they?
Symptoms begin 7 to 17 days after exposure and include fever, back pain, vomiting, malaise, and headache.
145
When do smallpox papules show up?
Papules develop 2 days after symptoms develop and progress to pustular vesicles that are abundant on the face and extremities initially.
146
Is there a vaccine for smallpox?
Yes for those at risk.
147
Botulism?
Botulism is a serious paralytic illness.
148
What is botulism caused by?
Caused by a nerve toxin produced by the bacterium Clostridium botulinum (death can occur within 24 hours).
149
🔺How is botulism spread?
Its spores are found in the soil and can spread through the air or food (improperly canned food) or via a contaminated wound.
150
🔺Can botulism be spread from person to person?
Nope
151
Symptoms of botulism?
Symptoms include abdominal cramps, diarrhea, nausea and vomiting, double vision, blurred vision, drooping eyelids, difficulty swallowing or speaking, dry mouth, and muscle weakness.
152
How long after botulism contact will you get it?
Neurological symptoms begin 12 to 36 hours after ingestion of food-borne botulism and 24 to 72 hours after inhalation and can progress to paralysis of the arms, legs, trunk, or respiratory muscles (mechanical ventilation is necessary).
153
What kind of botulism can be cured if caught early on?
If diagnosed early, food-borne and wound botulism can be treated with an antitoxin that blocks the action of toxin circulating in the blood.
154
What can be done for wound botulism?
For wound botulism, surgical removal of the source of the toxin-producing bacteria may be done; antibiotics may be prescribed.
155
Is there a vaccine for botulism?
No.
156
What causes the plague?
Plague is caused by Yersinia pestis, a bacteria found in rodents and fleas.
157
🔺What are the main ways to contract the plague?
Plague is contracted by being bitten by a rodent or flea that is carrying the plague bacterium, by the ingestion of contaminated meat, or by handling an animal infected with the bacteria.
158
🔺Can the plague be spread person to person?
Yes
159
What are the three types of plague?
Forms include bubonic (most common), pneumonic, and septicemic (most deadly).
160
What are the main symptoms of the plague?
Symptoms usually begin within 1 to 3 days and include fever, chest pain, lymph node swelling, and a productive cough (hemoptysis).
161
How does the plague kill you?
The disease rapidly progresses to dyspnea, stridor, and cyanosis; death occurs from respiratory failure, shock, and bleeding.
162
How can you treat the plague?
Antibiotics are effective only if administered immediately; the usual medications of choice include streptomycin or gentamicin.
163
Is there a vaccine for the plague?
Yes.
164
Tularemia
Tularemia (also called deer fly fever or rabbit fever) is an infectious disease of animals caused by the bacillus Francisella tularensis.
165
🔺How is tularmia spread?
The disease is transmitted by ticks, deer flies, or contact with an infected animal.
166
Symptoms of tulermia?
Symptoms include fever, headache, and an ulcerated skin lesion with localized lymph node enlargement, eye infections, gastrointestinal ulcerations, or pneumonia.
167
How is tulermia treated?
Treatment is with antibiotics such as streptomycin, gentamicin, doxycycline, and ciprofloxacin.
168
Is there a vaccine for tularmia?
Recovery produces lifelong immunity (a vaccine is available).
