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Unit 4
Unit4
| Question | Answer |
|---|---|
| environment | where the nurse "...promotes achievement of client outcomes by providing and directing nursing care that enhances the care delivery setting in order to protect clients, family/significant others and other health care personnel" |
| Factors affecting safety | Developmental Considerations, Lifestyle, occupation, social behavior, environment # Mobility # Sensory Perception # Knowledge Ability to Communicate Physical Health State Psychosocial Health State |
| Aspects of Safety | risks or hazards in the environment, developmental considerations, infection control, sensory function, adequate rest and sleep, pain, |
| Physical Health State | Anything that affects the patient's health state potentially can affect the safety of the environment. |
| Psychosocial Health State | Stressful situations tend to narrow a person's attention span and make him or her more prone to accidents.(Stress,Depression,Social isolation) |
| Environmental safety hazards | result in falls, fires, poisoning, suffocation, and accidents involving motor vehicles, equipment, and procedures. |
| Falls | older than 65 (fall-related injuries), they are the leading cause of injury fatality. Falls occur in community settings, as well as in acute and long-term care facilities. |
| childhood poisoning | children are more apt to ingest household chemicals, whereas older children may swallow medicines in a suicide attempt. sniff or “huff” |
| Preschoolers poisoning. | ingestion of lead-containing substances in the home and sniff or “huff” |
| Adolescents and young adults poisoning. | experiment with drugs may experience accidental poisoning and death. and sniff or “huff” |
| Suffocation (asphyxiation)and Choking | may occur at any age, but the incidence is greater in children. drowning, choking on a foreign substance inhaled into the trachea, and gas or smoke poisoning. |
| Infant Suffocation | a pillow or a piece of plastic inadvertently covers the nose and mouth. |
| young child Suffocation | strangled accidentally by the shoulder harness of a seat belt or become trapped while playing in a discarded refrigerator and suffocate. |
| Drowning children | Nearly half of all drowning victims are children younger than 5 years of age. Most drowning deaths in young children occur because of inadequate supervision of a child in or near a bathtub or pool, even a small wading pool. |
| Firearm Injuries | Unintentional gunshot wounds are a leading cause of mortality and morbidity in children. In 1999, nearly 25% of all Americans who died of firearm injuries were between 15 and 24 years of age. |
| Nursing diagnoses/ Risk for Injury related to lack of awareness of environmental hazards: | visual or auditory sensory deficits; history of falling; unsteady gait; substance abuse; refusal to use seat belt or child safety seat; effects of medication; age greater than 65 years; generalized weakness; biological, chemical, or nuclear exposure |
| Nursing diagnoses /Risk for Poisoning related to impaired vision; | medications stored in unlocked medicine cabinet that is accessible to a child; presence of poisonous plants; excess alcohol intake; use of illicit drugs; knowledge deficit; chemical contamination of food and water |
| Nursing diagnoses /Risk for Suffocation related to a plastic bag that is accessible to a young child; | child left unattended in bathtub; smoking in bed; placing an infant prone in a water bed; lack of safety precautions (door left on discarded refrigerator); unfamiliarity with fire prevention guidelines; household gas leaks |
| Nursing diagnoses /Risk for Trauma related to history of previous falls; | unsteady gait; presence of unsecured scatter rugs; smoking in bed; inoperable smoke detector; history of substance abuse; lack of experience operating an automobile; presence of unsecured loaded gun in the home; high-crime neighborhood |
| Nursing diagnoses /Impaired Home Maintenance related to insufficient finances; | substance abuse; physical disability; inadequate support systems; lack of knowledge |
| Nursing diagnoses /Risk for Disuse Syndrome related to use of physical restraints | Risk for Disuse Syndrome related to use of physical restraints |
| Planning for NDx | The patient will: Identify unsafe situations in his or her environment,Identify potential hazards in his or her environment,Demonstrate safety measures to prevent falls and other accidents, |
| Continue Planning for NDx | Establish safety priorities with family members or significant others,Demonstrate familiarity with his or her environment,Identify resources for safety information,Remain free of injury during hospitalization. |
| Implementation | Acquiring first aid knowledge Preventing injury Teaching to promote safety # Orientation to the surroundings Preventing falls Preventing fires and maintaining fire safety |
| Continue/ Implementation | Preventing poisoning Preventing suffocation Preventing injury from firearms # Preventing procedure related accidents # Maintaining emergency preparedness # Awareness of use of restraints as "last resort" |
| Safety Considerations for Neonate/Infant | Avoid behaviors that might harm the fetus Wash hands frequently Never leave the infant unattended • Use crib rails Childproof the environment Use car seats properly |
| Safety Considerations for Toddler/Preschooler | Childproof home environment Prevent poisoning Be alert to manifestations of child abuse • Use c Never leave unattended Utilize safety equipment as necessary appropriate for activity |
| Safety Considerations for School‐Age Child | Help to avoid activities that are potentially dangerous Provide interventions for safety at home, school, and neighborhood • Teach bicycle safety • Teach about child abduction • Wear seat belts |
| Safety Considerations for Adolescents | Teach safe driving skills, Teach avoidance of tobacco and alcohol, Teach risk of infection with body piercing, Teach about guns and violence, Teach about sexuality, STD’s. |
| Safety Consideration for Adults | Remind them of effects of stress on lifestyle and health Counsel about unsafe health habits (reliance on drugs and alcohol) • Counsel about domestic violence • Evaluate workplace safety |
| Safety Considerations for Older Adults | Prevent accidents Orient person to surroundings (avoid falls) • Maintain vehicle in working order, schedule eye exams, and keep noise at a minimum • Promote safe environment at home (avoid fires) Be aware of signs of neglect and abuse |
| A major concern for health practitioners | the danger of spreading microorganisms from person to person and from place to place. |
| control of infections | mass immunization programs, laws concerning safe sewage disposal, regulations for the control of communicable diseases, and hospital infection-surveillance programs. |
| Prevention of infection is a major focus for nurses | As primary caregivers, nurses are involved in identifying, preventing, controlling, and teaching the patient about infection Use of the nursing process can prove critical in breaking the cycle of infection. |
| Infection Cycle | Infectious agent Reservoir Portal of exit * Means of transmission Portal of entry Susceptible host |
| Infectious Agents | Bacteria—most significant and most prevalent in hospital settings Virus—smallest of all microorganisms • Fungi—plant like organisms present in air, soil, and water |
| Factors Affecting an Organism’s Potential to Produce Disease | Number of organisms Virulence Competence of person’s immune system Length and intimacy of contact between person and microorganism |
| Possible Reservoirs for Microorganisms | Other humans Animals Soil Food, water, milk Inanimate objects |
| Common Portals of Exit | Respiratory Gastrointestinal Genitourinary tracts Breaks in skin Blood and tissue |
| Means of Transmission | Direct or indirect contact Vectors Airborne Droplet |
| Portal of Entry | Urinary Gastrointestinal Respiratory Skin |
| Susceptible Host | Intact skin and mucous membranes Normal pH levels – Body’s white blood cells Age, sex, race, hereditary factors Immunization, natural or acquired Fatigue, climate, nutritional and general health status Stress Use of invasive or indwelling medical |
| Stages of Infection | Incubationperiod/organisms growing and multiplying Prodromalstage/person is most infectious, vague and nonspecific signs of disease • Full stage of illness/presence of specific signs and symptoms of disease Convalescent period/recovery |
| Body’s Defense Against Infection | Body’s normal flora Inflammatory response Immune response |
| Aseptic Technique | Includes all activities to prevent or break the chain of infection Two categories Medial asepsis—clean technique Surgical asepsis—sterile technique |
| Factors Determining Use of Sterilization and Disinfection | Nature of organisms present Number of organisms present Type of equipment –Intended use of equipment Available means for sterilization and disinfection Time |
| Factors Predisposing Patients to Nosocomial Infections | Use of invasive medical devices Antibiotic‐ resistant organisms developed in hospitals |
| Standard precautions | used in care of all hospitalized patients Apply to blood, body fluids, secretions, excretions, non‐intact skin, mucous membranes |
| Transmission‐based precautions | used in addition to standard precautions for patients with suspected infection Include airborne, droplet, or contact precautions |
| Personal Protective Equipment and Supplies | Gloves Gowns Masks Protective eye gear |
| NDx Risk for Infection related to presence of chronic disease: | altered immune response; effects of medication; altered skin integrity; malnutrition; presence of invasive or indwelling medical device; lack of proper immunization |
| NDx Social Isolation related to | presence of communicable disease (AIDS) |
| NDx Impaired Oral Mucous Membrane related to | ineffective dental hygiene; trauma; side effect of medication; presence of invasive medical device |
| NDx Deficient Diversional Activity related to | lack of visitors; restrictions imposed by airborne isolation precautions |
| NDx Risk for Imbalanced Body Temperature related to | infectious process, dehydration |
| Anxiety related to | high risk for infection; social isolation |
| asepsis | The nurse uses aseptic techniques to halt the spread of microorganisms and minimize the threat of infection. |
| Medical asepsis | or clean technique, involves procedures and practices that reduce the number and transfer of pathogens. (hand hygiene and wearing gloves) |
| Surgical asepsis | or sterile technique, includes practices used to render and keep objects and areas free from microorganisms.(inserting an indwelling urinary catheter or inserting an IV catheter.) |
Created by:
russianalaskan
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