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47 Cards in this Set

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Pivot
Definition
Prevention
Def: Turn or change the direction with your feet while remaining in a fixed place

Prevent twisting of the body & possible injury to the nurse
What is the 1st Rule about moving a heavy person when you can’t handle it?
Get help
When it comes to (mobility) transferring a pt, you want to keep in mind
Correct Alignment
How would you determine who has correct alignment & what kind of disease process will give you an incorrect alignment
eg. Stroke, scoliosis
When someone develops a pressure ulcer, what do we do
Keep them off of it
Know the difference position in bed: def of ea
Sims (variation of lateral)
Lateral, side-lying (on side)
Prone (lying face down)
Semi Fowler’S(30-60)
Fowler’s (60-90)
Low Fowler’s (15-30)
Dorsal Recumbent (supine, knees flexed, feet flat on bed)
Dorsal Lithotomy (supine, knees up, feet in stirrups)
Knee Chest (chest on bed, knees on bed, lower legs on bed)
Supine (lying on back)
Know the uses:

SIMS
LATERAL,SIDE LYING
PRONE
*FOWLER’S, SEMI FOWLER’S , LOW FOWLER’S
DORSAL RECUMBENT
DORSAL LITHOTOMY
KNEE CHEST
SUPINE (lying on back)
-rectal exams, enemas, suppositories, unconscious pt
-Lay on side
-prolonged bed rest, immobilized, spinal cord injuries
-Improve cardiac output & resp. promote urinary & bowel elimination, NOT abdominal surgery unless ordered
-variety of procedures & examinations
-pelvic exams eg giving birth
-Rectal examination & a method for to restore Uterus to a normal position NOTE: not for joint abn or arthritis
-after spinal surgery, & after spinal anesthesia
What keeps feet dorsiflexed?
High Tops Snickers
Bed Boards
What is called when a pt sits on the side of the bed with feet hanging down
dangling
What are you monitoring ( signs) as they sit on side of bed
HTN
Nausea
Dizziness
When is logrolling used?
For spinal surgery pt.
Roll them as a single unit or as a whole
What can you use to prevent hand contractures?
Handrolls & splints Use a hand towel
you are using a gait belt to ambulate a pt. The pt says "I am getting dizzy" or " I am going to pass out" p 269
slide pt to the floor using your legs
increase exercise
When pt is weak from inactivity: what kind of exercise does a nurse offer & how often is it done
Active ROM
book says several times but @ least twice a day
If pt is immobile how much do they drink? What do you make sure they get
3000 ml
fiber
adequate diet (eat)
If a pt is comatose what nsg intervention do you do?
Talk to pt
Hearing is the last thing to go
Know what the purpose of "Buck Traction" is
AKA "skin traction"
Reduce Spasm that accommpanies fractures

Noninvasive
If you put a pt in skeletal traction what kind of drainage should you expect in 48 hrs
clear drainage
How long does it take for a synthetic fiber glass cast to dry
30 mins
Know what part of hand to use on a cast
-Palms
-flat part of fingers
NO FINGER TIPS
What does skin look like when you take cast off?
Dry
which type of pt would you omit form an air fluid bed
Not for spinal surgery
CPM machine bed: What kind of lining is used?
sheep skin
When performing head to toe assessment of the immobilized patient, be alert to indicator of circulatory impairment
-redness
-pale
-blue color
-coldness
-diminished or absent pulse
Triangle bandage sling ???
Read 802 read about applying it
is used when no commercial sling is at hand
end around neck, under the injured arm then over, tie both ends at neck
Note: triangle toward elbow
-hand 4" above elbow
Walkers
know the correct height
Pt's elbow is bent @ a 15 to 30 deg while standing upright & grasping the handgrips
Most common type of occupational injury for nurses
lower back injury
Nsg Diagnosis: pt @risk for injury r/t rt side weakness as evidence of unsteady gait. What is my expected outcome or goal?
Free of injury while ambulating or transferring

Remember Safety 1st
Gait Belt/ transferring belt

read entire paragraph p268
-hand is inserted @bottom/ under belt
-belt tightened just enough to allow for your hand to grasp it from the rear
Know what part of hand to use on a cast
-Palms
-flat part of fingers
NO FINGER TIPS
What does skin look like when you take cast off?
Dry
which type of pt would you omit fro an air fluid bed
Not for spinal surger
CPM machine bed: What kind of lining is used?
sheep skin
When performing head to toe assessment of the immobilized patient, What alert are there to indicate circulatory impairment
-reddness
-pale
-blue color
-coldness
-diminished or absent pulse
Triangle Sling

Read 802 about applying it
-is used when no commerical sling is at hand
-behind neck, under arm (triangle is formed at elbow)& behind arm then tied at neck
hand is 4" above elbow
Walkers
Know correct height it needs to be
pt's elbow is bent @15 to 30 deg while standing upright & grasping the handgrip
Most common type of occupational injury for nurses
Lower back injury or strain
Nsg Diagnosis: pt @ risk for injury related to rt side weakness as evidence of unsteady gait: What's my expected outcome or goal?
Free of injury while ambulating or transferring a pt
NOTE: Safety 1st
Gait belt/ transferring belt

Read 268 entire paragraph
Belt is tighten just enough to allow hand placement @ rear and bottom/under belt
Passive ROM Exercise: Knee & hip
Where is the placement of hand
placement hand is under knee and heel of foot for support
Elastic Bandage: SPIRAL REVERSE TURN what is the important part?
p 800 or 798
Overlap turns of bandage equal 2/3 of the width

Remember Distal to proximal

Assess skin, distal circulation & sensation
Mechanical lift

NOTE: Look @ #7 closely
P 803
Eg; Hoyer Lift
takes two people to use it safely
NOTE never leave a pt in lift or in whirlpool tub unattended
Crutches
Order of which goes first upstairs & downstairs
-Upstairs Good leg, then injured leg & crutch next

-Downstairs crutch & injured leg then good leg next
Skeletal traction: What do you make sure about wt?
P 798
That the wt is free hanging
CNS check: during blanching the capillary refill should be what
3mins
5 mins for elderly (65)

NOTE for a 64 y/o male whose capillary refill is 5 mins is called delayed capillary refill
Pt w/ leg cast: How do you alleviate or reduce edema other than bivalve (cut in half lengthwise) P 788
elevate cast using 1 or 2 pillows
What are complications of immobility
clots
hypostatic pneumonia
contractures

- contractures
-muscles cramps
-respiratory problems