What does “RACE” stand for in regard to fire safety?
- Rescue the clients
- Activate the alarm
- Contain the fire
- Extinguish the fire
What does “PASS” stand for in regard to fire safety?
How to use a fire extinguisher:
- Pull the pin
- Aim the extinguisher
- Squeeze the handle
- Sweep from side to side
What should be turned OFF in a fire?
oxygen
Since oxygen can feed a fire.
If a client needs to be taken off the ventilator in an emergency, what should be used in place of a ventilator?
Ambu bag
Use this to manually ventilate the client.
In what order should clients be evacuated during a fire?
(Immediate Complication)
- Clients who can walk first
- Clients in wheelchairs next
- Bedridden clients last
Why are damaged electrical cords dangerous?
Because they can start a fire.
Report them immediately.
If extension cords have to be used where clients walk, what is the best way to place them?
Tape extension cords to the floor.
Don’t put cords under rugs due to risk of fire.
If a client experiences a shock from faulty electrical equipment, what should be done first before touching the client?
Turn off the electricity.
What are 3 sources of radiation in the clinical setting?
- x-rays
- radiation implants
- radioactive iodine
What should the nurse wear when close to a client who is radioactive?
lead apron
This blocks radiation.
What is a dosimeter badge?
Is worn on the shirt or wrist that monitors how much radiation the nurse has been exposed to.
What type of room should a client get that has a radiation implant?
Private room to protect others from receiving radiation.
When should the bed linens be removed when caring for a client with a radiation implant?
Keep the bed linens in the room until the client is discharged. Then remove them all at once.
Why are older clients at risk for falling?
They typically have decreased strength, balance, and vision putting them at risk for falls.
How do urinary problems with older clients put them at risk for falling?
They may have:
- nocturia (urinating at night), causing them to bump or trip over things in the dark
- incontinence: this causes them to rush to the bathroom, putting them at risk of falling
What can be implemented to prevent falls due to having to urinate or being incontinent?
A toileting schedule where the client is prompted to use the restroom every 2-3 hours.
How do medications cause risk of falling in older adults?
These medications can have side effects of:
- orthostatic hypotension: can cause dizziness
- sedation: can cause imbalance
Where should a client’s room be located when they are a high risk for falls?
Near the nurse’s station.
Where should the call light be placed when the client is at risk for falls?
In the client’s lap.
Instruct the client to use the call light to contact a nurse or UAP before getting up.
What are bed and chair alarms?
A pad is placed under the client that alerts the nurse when the client is getting up.
It is used for clients that are at risk of falling.
Which position should the bed be in when leaving the room in order to prevent falls?
In the lowest position with 3 of the side rails up.
Where should the client’s personal items be placed to prevent reaching too far or getting up and falling?
Near the client on the bedside table or in the client’s lap.
What should be cleaned up and removed from a client’s room to prevent falls?
Clean up clutter and remove throw rugs.
Both increase the risk of tripping and falling.
What can be turned on at night to prevent falls?
Adequate lighting is important such as a night light or bathroom light.
What does home safety include?
- preventing falls
- preventing break-ins
- working appliances and utilities
- fire/smoke/carbon monoxide alarms
- no gas cars running in a garage
How are falls prevented at home?
- using adequate lighting
- using handrails in bathroom
- removing clutter and throw rugs
What is a gait belt?
Used around a client’s waist to assist in getting the client up or down and to prevent injuries in the caretaker.
When lifting objects, where should the nurse keep the weight in order to prevent injuries?
Keep the weight close to the body to prevent strain and injuries.
How should the nurse bend when picking something up?
Bend at the knees to prevent back injuries.
What is the difference between a physical restraint and a chemical restraint?
- Physical restraint uses a device to restrain the client or putting a client in seclusion.
- Chemical restraint uses medication to restrain the client.
When should restraints be used?
When the client’s safety is at risk and all other measures to prevent the client from harm have been used.
How often are restraint orders renewed by the HCP?
Every 24 hours.
How often are restraint orders renewed if the client is violent or a child?
Every 1 hour.
If all side rails are up, is that considered a physical restraint?
Yes.
(In an alert client)
It’s not considered a restraint if it is to prevent a sedated client from getting out of bed.
What type of restraint it this?
Vest restraint.
What type of restraint is this?
Mitt restraint.
What type of restraint is this?
Elbow restraint.
What type of restraint is this?
Ankle or leg restraint.
What type of restraint is this?
Wrist or arm restraint.
What type of restraint is this?
Leather restraints.
What type of bow is used for soft restraints?
Bow knot or safety knot.
This is a quick-release knot.
Do not tie knots to the side rails.
When a restraint is applied, how many fingers should be able to fit underneath?
2 fingers
How often are restraints removed?
Every 2 hours.
And document if the client still needs the restraint.
How often is a skin and circulation assessment done when a client is in restraints?
At least every 30 minutes.
How often are restraints removed, and fluids and bathroom offered?
Every 2 hours.
Can restraints be applied in an emergency without an order from the HCP?
Yes.
The HCP will need to write the order within 1 hour of restraints being applied.
How often is a client checked if they are in seclusion and have restraints applied?
Constantly.
Who is asked to stay with the client for safety reasons as an alternative to restraints?
Family or friends.
What is a “sitter”?
A person that sits with a confused or suicidal client for safety reasons.
In order to prevent a confused client from pulling out a tube, when should tubes or other treatments be discontinued?
As soon as possible.
What type of relaxation techniques can be used to prevent a confused client from getting out of bed or pulling at tubes?
- guided imagery
- music
- therapeutic communication
What age of clients is more at risk for poisoning?
The young and the old.
They are at risk of poisoning due to cognitive function and decreased functioning of kidneys and the liver.
Who can the nurse or parent call if a client has potentially ingested a poison?
Poison Control Center
Why should a parent be advised to NOT induce vomiting in a child that has ingested a poison?
Because the poison can damage the esophagus.
What are 3 common allergies that are assessed for?
- medications
- foods
- latex
What is an anaphylactic reaction?
(Immediate Complication)
An overactive response of the immune system to substances that can cause a rash or severe difficulty with breathing.
What are the steps if a client has an anaphylactic reaction?
- assess respiration status and maintain a patent airway
- call HCP and rapid response team
- give oxygen
- start an IV and give normal saline
- prepare to give diphenhydramine and epinephrine
- possible intubation and ventilator
- document the event
Which common equipment will need to be latex-free if a client has a latex allergy?
- blood pressure cuff
- gloves
- stethoscope
- syringes
- IV tubing
- other tubes
What are some client identifiers for medications and treatments?
- client name
- birthday
- medical record number
- phone number
- social security number
- address
- photo
How many client identifiers are required before giving medication or a treatment?
Two
- client name and
- 1 more identifier such as:
- birthday
- medical record number
- phone number
- social security number
Where is a car seat placed for an infant?
In the back seat facing the rear of the vehicle.
Up to what age does a child have to face the rear of a vehicle while in a car seat?
2 years old
At what age can a child face the front of the car and use a booster seat?
At age 2 - 3 years old.
Up to what age is it recommended that a child stay in the back seat?
Until 13 years old.
What is a controlled substance?
An illegal drug or legal medication that is highly addictive and closely monitored for abuse.
What is a schedule 1 controlled substance?
Illegal drugs in most states:
- marijuana
- heroin
- LSD
- ecstasy
What is a schedule 2 controlled substance?
- cocaine
- opioids/narcotics
- methylamphetamine
What are schedule 3 controlled substances?
- acetaminophen with codeine
- buprenorphine
- testosterone
How should controlled substances be secured?
Must be kept locked up.
How is a controlled substance medication disposed of if the client did not use it?
Two nurses need to witness the wasted medication and then it’s placed in a pharmaceutical waste container.
Medications are not placed in a biohazard container.
What is a “med count”?
A count of all the controlled substances done at the end of the shift.
This is to make sure all the controlled medications are accounted for.
If there is suspected drug abuse by a coworker or a med count is incorrect, who should be notified?
Notify the nurse supervisor immediately.
What are seizure precautions?
Prevent injury when a client has a seizure:
- pad the side rails or put mattresses on the floor
- raise side rails when the client is sleeping
- keep suction at the bedside
- clear furniture and remove hard objects
- wrist band for fall precautions
What are 2 seizure precautions for children?
- always swim with a buddy
- wear pads and helmets when bike riding
What are the guidelines for rooming two confused clients together?
- don’t put a mildly confused client with a severely confused client together
- don’t put a talkative client with a non-verbal client
Why are ID bracelets applied to both the mom and baby on a maternity unit?
To prevent infant abduction.
What are the safety measures for a newborn in a hospital to prevent infant abduction?
- ID bracelet is applied to both mom and baby
- every person caring for baby must have ID on
- baby is wheeled in a bassinet when leaving the room, never carried by staff
What are signs of violence or potential violence?
- physical harm
- loud yelling
- threats
Who is called if a client or visitor is showing signs of violence?
Security
What is a medic alert bracelet?
What the client wears on their wrist to inform others of a serious medical condition.
Used for chronic conditions such as allergies, heart, endocrine, and respiratory conditions.
