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nurs 130 class 7
HCC 2008 Activity and Safety
| Question | Answer |
|---|---|
| Safety | the freedom from harm, danger or risk |
| Where does safety fall on Maslow's Hierarchy of needs? | second, after physiological needs |
| What is the nurse's role in safety? | prevention of accidents, health promotion, implementation of safety measures |
| JCAHO (Joint Commission on Accreditation of Healthcare Organizations) | set national patient safety goals |
| Name two fire hazards in a HCF | 1. oxygen 2. anesthetic gases |
| R.A.C.E. | rescue, alarm, control, extinguish rescue, activate, confine, evacuate |
| Who is at the greatest risk for falls? | adults over 65 |
| what are the two most serious injuries from falls? | 1. hip fractures 2. head injuries |
| Name some risks for falls | age, history of falls, impaired mobility, communication skill, cognitive skills, meds, impaired vision, new environment |
| What will decrease falls at home? | decreased clutter, clean spills, no throw rugs, handrails in the hallways, stairs and bath |
| What can decrease falls at a HCF? | identify the clients at risk, observe their orientation to their surroundings and call bell, make sure call bell and other personal belongings are within reach, keep the bed low with the wheels locked |
| What are the 3 steps you do if a patient falls? | 1. Assessment (injured area, VS, neurological, pain) 2. Notify MD 3. Incident report |
| What are safety measures for an infant? | childproof home and supervision, bathtub/drowning, fire retardant clothes, assess water temps, toy safety |
| What are safety measures for a toddler? | avoid poisons, choking hazards, burns and fire hazards, car seats, toy and water safety, guns, strangers |
| What are safety measures for a child? | bike and traffic safety, sports and safety equip, home alone instructions, facts on sex, drugs and firearms |
| What are safety measures for adolescents? | car accidents, DUI, smoking and substance abuse, gun safety, peer pressure, suicide, STDs |
| What is the problem with restraints? | they do not prevent injuries, and may actually cause injuries |
| What are some problems associated with restraints? | skin sores, fractures, strangulation, impaired circulation, emotional distress |
| What are the regulations with restraints? | alternative measures must be tried first and documented, requires a physicians order every 24hrs, use least restrictive device, patient assessment and documentation, family must be consulted |
| What are alternative measures to restraints? | toileting schedules, monitoring devices, modify the environment, involve the family in care, keep tubes out of sight |
| What are the types of restraints? | wrist and leg, vest, side rails |
| What are the guidelines for restraints? | fasten to bed frame, use easy to release knot, should not be applied to tight |
| What are the Activities of Daily Living? (ADLs) | BATTED! bathing, ambulation, toileting, transfers,eating, dressing |
| What are some safety guidelines for Moving and Transferring? | PREPARATION: Explain procedure, patient in non skid shoes, Medicate if their in pain, EQUIPMENT: inspect & Lock, Check IV tubing, Oxygen, ENVIRONMENT: Remove Obstacles NURSE: Determine amount of assistance needed prior to transfer, use of mechanical lifts |
| COAL | Cane, Opposite, Affected, Leg |
| What might you use to help a patient move up in bed? why? | a drawsheet, to help move the patients weight adequately, the patient can still help you though |
| what is the purpose of dangling? | orthostatic hyper tension- inability of the body to equalize the BP that fast going from lying to sitting or sitting to standing |
| what is logrolling? | The body is kept in straight alignment when turning, they must roll as one. |
| when would you use logrolling? | used when a patient has a spinal injury or is recovering from neck, back, or spinal surgery. |
| what is a quadriceps exercise? | isometric exercise, contract or tightening muscles on front of thighs for count of 4 and then relax, perform 2-3x/day, 4-6x/day |
| what are gluteal setting drills? | tightening and relaxing buttocks |
| what are some Patient Instruction when Ambulating? | dangling, distance-telling them how far they are going, tell them to tell you if they feel dizzy or weak, encouragement; benefits of ambulation ex. promotes circulation, give skin a chance to breath, you will feel better |
| when ambulating where should you stand? | on the affected side with arms around waist |
| How do you protect a patient who is falling? | control their body as the descend to the floor by widening your base, slide patient down your leg, protect the head |
| What are some benefits to proper positioning? | provides comfort, prevents complications r/t bed rest, change position every 2 hrs (asses skin every time you roll), promotes circulation and respiration |
| In what position is the patient if they are face down on their stomach? | Prone |
| what is a pro and con to prone? | pro- prevents hip and knee contractors, cons-can cause foot drop, impaired respirations |
| What is the supine position? | face up on back... pillow under head unless after spinal surgery, patients with respiratory and cardiac problems may not tolerate supine |
| Lie on either side with top leg flexed and brought forward describes what position? | Side-lying, pillows to support back upper arm and leg. relieves pressure on sacrum and heels |
| What is the Sims position? | lower arm behind and upper arm is flexed at shoulder and elbow with upper leg more acutely flexed... both shoulders should be alines with hips |
| What is Fowlers position? | HOB elevated above 45-60 degrees, promotes resp. and cardiac function. Problem-pressure on the sacrum and heals |
| Patient is in an incline position with the head below the heart, legs and feet describes... | Trendelenberg Position. may be used for chest percussion and drainage, may impair respirations, lead to aspirations |
| What is the purpose of a footboard/foot boot? | to prevent foot-drop and keep the feet dorsiflexed |
| what id the best thing to prevent foot-drop? | high-top canvas sneakers |
| what is foot-drop a sign of? | neurological damage |
| what is the purpose of a trochanter roll? | prevents external rotation of the hips |
| what is a trapeze bar used for? | helps to raise trunk off the bed, strengthens the biceps, allows the patient to help themselves |
| what is a wedge? | prevents adduction of leg during a position change, strapped btw legs to keep them fixed; usually after hip surgery |
| What is an Occupational Therapist (OT)? | a person who assists clients to adapt to physical limitations |
| what are some OT devices | foot utensils with special grips, plate guards/bumpers, dressing sticks, universal ADL cuff |
| What is a Physical Therapist (PT)? | a person who helps restore function or prevent further decline in clients mobility |
| What are some safety considerations for a person using a walker? | nonskid shoes, inspect rubber tips, individually fitted, do not use to pull up in standing position, clear path, instruct on use |
| what is the nurses role when is comes to exercise? | ask yourself/look at: what has been allowed/perscribed by the physician, what is realistic, how can you support them, teach them the benefits and risks and explore strategies |
| ***What are the types of exercise? | Isotonic, Isometric, Isokinetic |
| What is isotonic exercise? | muscle shortening and active movement. ex. active ROM, swimming, walking, bicycling, ADLs |
| What is ISOMETRIC exercise? | muscle contraction without shortening, increases muscle mass, tone and strength. Ex. quadriceps drills, pushing palms against chair or wall |
| What is Isokinetic exercise? | muscle contraction with resistance, leg lifts with weights, rehab exercised for knee and elbow injuries |
| ROM | Range Of Motion |
| what is active range of motion? | they can do it independently |
| what is passive range of motion? | the nurse can do it but stops when there is pain or resistance |
| What is the roll of passive and active range of motion? | improves joint motility and increases circulation |
| What are some basic guidelines for ROM? | move joint until there is resistance but NO pain, support proximal and distal joints, cupping, avoid neck hypertension and overexertion, independent nursing action, exercise each joint 2-3 times bid |
| What are some cardiovascular hazards of Immobility? | Increase cardiac workload, venous stasis and thrombi formation, orthostatic hypotension |
| What are some Respiratory hazards of immobility? | Decreased depth and rate of respirations, increase pooling of secretion, pneumonia |
| What are some Musculoskeletal hazards of immobility? | Muscle atrophy, contractures, decreases joint mobility |
| What are some Metabolic/GI hazards of immobility? | Increased risk of electrolyte imbalance and negative nitrogen balance, changes in appetite and digestion, constipation |
| What are some Urinary hazards of immobility? | UTI, renal calculi, incontinence |
| What are some Integument hazards of immobility? | Skin breakdown, decubiti |
| What are some Psycho-social hazards of immobility? | Decreased self-esteem, decreased sensory stimulation, ineffective coping |
| What do you look for during a physical assessment? | ease of movement, gait and posture, spine alignment, joint and muscle function |
| Paresis | impaired muscle strength or weakness |
| paralysis | complete muscle loss |
| What are good body mechanics for nurses at work? | spread feet, flex hips and knees, use major muscle groups, work close to your body at a comfortable height |
Created by:
afisher6009
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