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303 Cards in this Set
- Front
- Back
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Four outcomes of safety in healthcare settings. |
1. Reduces illnesses and injury. 2. Prevents extended length of treatment/stay. 3. Improves/maintains functional status. 4. Increases patients’ sense of well being. |
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Five personal & environmental factors that impair ability to prevent injury |
Work hazards Environmental hazards Physical Factors Psychosocial Factors Communication Barriers |
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Five types of WORK HAZARDS that impair the ability to prevent injury. |
1. Noise 2. Pollution 3. Toxic Chemicals 4. Infectious Agents 5. Chemical Vapors |
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Exposure to these four potentially unhealthy substances is a factor that impairs the ability to prevent injury. |
1. Carbon monoxide 2. Cigarette smoke 3. Factory pollutants 4. Car exhausts |
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Explain a physical factor that could impair the ability to prevent injury. |
Someone who had a stroke may not be able to ambulate as well and is now considered to be a fall risk when trying to do so. |
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Three examples of psychosocial illnesses that impair the ability to prevent injury. |
1. Stress 2. Depression 3. Social Isolation |
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Five examples of communication factors that impair the ability to prevent injury. |
1. Fatigue 2. Aphasia 3. Stress 4. Medication 5. Language Barriers |
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A type of aphasia that affects the Wernicke’s area of the brain that involves the comprehension of the written and spoken word. |
Receptive Aphasia |
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Loss of ability to understand or express speech, caused by brain damage. |
Aphasia |
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A type of aphasia that affects the Broca’s area of the brain, preventing someone to fluently speak although they understand the spoken or written words. |
Expressive Aphasia |
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Determining these types of risk factors that is normally associated with a patient who has a hindered ability to ambulate, reduces the risk of injury. |
fall risk factors |
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Eleven things to look for when completing a home safety check. |
1. Emergency contacts 2. Stop-Drop-Roll for Fires 3. Sunscreen use 4. Frayed or damaged electrical cords 5. Screens & gates around pools 6. Water heating setting at or below 120°F 7. Poison Control number 8. Clear and clutter-free stairs and hallways 9. Trip/fall hazards 10. Guns locked away 11. Plastic bags and choking hazards out of reach of children. |
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Ten ways to reduce injury in older patients. |
1. Remove damaged or improper fitted rugs in the home. 2. Modify the home environment as necessary: ex. wheelchair ramps, safe walk-in showers/tubs. 3. Encourage hearing and vision screenings 4. Encourage use of proper footwear. 5. Regular fire alarm checks. 6. Regular use of seat belts. 7. Safe driving. 8. Properly identify patient and always use 6 rights of mediation administration. 9. Be sure patient knows and understands their medication administration for themselves. 10. Report suspicious abuse. |
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The six rights of medication administration. |
1. Right patient 2. Right medication 3. Right dose 4. Right time 5. Right route 6. Right documentation |
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What age is considered a vulnerable population? |
65 or older |
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Inside of a hospital, falls are whose responsibility? |
The primary nurse. |
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Twelve nursing interventions to prevent falls. |
1. Complete risk assessment - use facility approved door/wall signs to indicate fall risk 2. Keep the bed in the lowest position. 3. Keep wheelchairs and beds locked. 4. Keep call bell in reach and instruct on its use 5. Answer call bell IMMEDIATELY. 6. Eliminate all physical hazards. 7. Use non-skid socks or footwear. 8. Leave patient’s personal items within reach. 9. Keep bedside commode out of reach to discourage patient from using without assistance. 10. Report immediate changes in patient’s mental/physical condition. 11. Use least restrictive methods of restraint. 12. Use restraints per hospital protocol. |
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When a patient falls, which is a priority: documenting the fall or assessing the patient to make sure they are not injured? |
Assessing the patient to make sure they are not injured. |
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Four safety precautions to prevent injury during a seizure. |
1. Place a small pillow under the head. 2. Loosen restrictive clothing. 3. Roll person on side to prevent aspiration. 4. Ease from a standing or sitting position to the floor. |
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During a seizure, if a person is unconscious, we must make sure this is not obstructed with any object. |
Nose and mouth |
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Is it necessary to place a finger or object in someone’s mouth when they are having a seizure? Explain your answer. |
No, because it is dangerous. You can be bitten or the object could be swallowed. |
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Why should you not perform artificial respirations on someone when they are having a seizure, even if they are turning blue? |
Most seizures are long over before brain damage begins. |
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Should you try to restrict a person when they are having a seizure? Explain your answer. |
No, because you can either injure them or yourself. You should just make sure the environment around them is safe. |
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When should someone have something to eat or drink after having a seizure? |
Only after they have fully recovered. |
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When should someone who has had a seizure be given medications? |
Only after the seizure is over and they are completely awake. |
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While trying to maintain a patient’s airway, what five things should we try to note when someone is having a seizure? |
1. Frequency 2. Type 3. Time 4. Body parts involved 5. Length of seizure |
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Seven ways to prevent medication errors. |
1. Follow the six rights of medication administration 2. Use the correct procedures for telephone/verbal orders 3. Question/clarify any orders that you do not understand. 4. Follow all patient identification procedures 5. Use correct protocols when using all medication machines and dispensing systems 6. Ensure all equipment is functioning properly. 7. If an error occurs, take responsibility or accountability immediately, and follow all facility protocols when reporting the error. |
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What are the correct procedures when taking a telephone or verbal order? |
Repeat the order to confirm it. document it by: recording the manner in which the order was taken date and time of order who gave the order and their credentials your name and credentials and that it was repeated and verified. |
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What does each letter in the acronym RACE stand for? |
Rescue: Remove persons who are in immediate danger. Alarm: Alert others and emergency services. Contain: contain fire and smoke (close doors) Extinguish: extinguish and evacuate |
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To use a fire extinguisher, remember the acronym PASS. What does each letter stand for? |
P: pull the pin A: aim the nozzle S: squeeze the handle S: sweep side to side at the base of the fire. |
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Restraints should only be used after these types of methods have been exhausted. |
Least restrictive methods |
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When can an RN initiate a restraint? |
In an emergency situation |
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What must be done within minutes of an RN initiating the use of restraints in an emergency situation? |
The RN must notify the provider for an order. |
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T/F - Restraints can be used PRN. |
False, restraints can never be used or ordered PRN. |
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How many finger-breadths should you be able to place when restraints are being used and why. |
Two, for circulation purposes and to prevent skin issues. |
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What type of knot should be used with restraints. |
Slip knots |
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What part of the bed should restraints be placed to? |
An immovable part. |
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How often should restraints be checked. |
Every hour |
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How often do you need a new order for restraints? |
Every 24 hours |
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What should be documented when using restraints? |
1. Least restrictive method used prior to full restraints. 2. Date and time of restraint use. 3. Type and location of restraint used. |
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These sores occur by pressure being applied to the skin, causing decreased circulation to the area, causing the skin to breakdown. |
Pressure Ulcer |
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Pressure sore, decubitus ulcer, skin breakdown, or bed sores are also known as what? |
Pressure ulcers |
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Five pathogenesis of pressure ulcers. |
1. Pressure Intensity 2. Tissue ischemia 3. Blanching 4. Pressure Duration 5. Tissue Tolerance |
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The injury of a cell arising from reduced blood flow. |
Tissue ischemia |
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Obstruction of blood flow to an area. |
Blanching |
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How many grade classifications are there of pressure ulcers? |
4 |
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Superficial reddening of the skin, usually in patches, as a result of injury or irritation causing dilatation of the blood capillaries. |
Erythema |
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What grade classification of a pressure ulcer is: Non-blanchable erythema (redness) of intact skin with discoloration, warmth, & edema. Hardness may be used as indicator, especially with darker skin? |
Grade 1 |
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What grade classification is an ulcer with: Partial thickness, skin loss involving epidermis, dermis, or both. The ulcer is superficial and presents clinically as an abrasion or blister. |
Grade 2 |
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What grade classification of a pressure ulcer is where hardness may be used as an indicator, especially with darker skin? |
Grade 1 |
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What grade classification is an ulcer that is superficial and presents clinically as an abrasion or blister. |
Grade 2 |
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What grade classification is a pressure ulcer where there is full thickness skin loss involving damage to or necrosis of subcutaneous tissue that may extend down to, but not through underlying fascia? |
Grade 3 |
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What grade classification is a pressure ulcer with extensive destruction, tissue necrosis or damage to muscle, bone, or supporting structures with or without full thickness skin loss. |
Grade 4 |
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Six risk factors for pressure ulcers |
1. Impaired Sensory Perception, such as neuropathy 2. Shear 3. Alterations in level of consciousness, such as that in dementia patients 4. Friction 5. Impaired mobility 6. Moisture |
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Six pressure points in patients. |
1. Head 2. Shoulder 3. Elbow 4. Buttock 5. Heel 6. Toes |
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How often should a patient be turned? |
Every two hours |
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Three techniques of wound treatment. |
1. Primary Intention 2. Secondary Intention 3. Tertiary Intention |
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A technique in wound treatment where all tissue including skin are closed with suture material. |
Primary Intention |
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A technique of wound treatment in which the wound is left open and closes naturally. |
Secondary Intention |
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A technique in wound treatment in which the wound is left open for a number of days and then closed if it’s found to be clean. |
Tertiary Intention |
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Five complications of wound healing. |
Hemorrhage Hematoma Infection Dehiscence Evisceration |
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an escape of blood from a ruptured blood vessel, especially when profuse. |
Hemorrhage |
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An escape of blood from a ruptured blood vessel, especially when profuse. |
Hemorrhage |
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A pool of mostly clotted blood that forms in an organ, tissue, or body space. |
Hematoma |
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The invasion and growth of germs in the body. |
Infection |
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Partial or total separation of previously approximated wound edges, due to a failure of proper wound healing. |
Dehiscence |
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The uncontrolled exteriorization of intraabdominal contents through the dehisced surgical wound outside of the abdominal cavity. |
Evisceration |
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What is the chain of infection? |
1. Organism - the disease 2. Reservoir - the carrier 3. Portal of Exit: anyway it is getting out (breathing out) 4. Transmission: how it is transmitted (ex. through the air, direct contact) 5. Portal of Entry: How the infection enters the body (ex. ears, eyes, nose, mouth) 6. Vulnerable Hosts: who/what is vulnerable to reception of infection |
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Having an impaired immune system. |
Immunocompromised |
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The ability to produce disease. |
Virulence |
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A bacteria that requires oxygen for survival and for multiplication sufficient to cause disease. |
Aerobic bacteria |
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A bacteria that thrives where there is little or no free oxygen available. |
Anaerobic bacteria |
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The prevention of growth and reproduction of bacteria. |
Bacteriostasis |
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Destructive to bacteria. |
Bactericidal |
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Biggest population of immunocompromised people. |
HIV/AIDS |
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A disease in which the body's immune system attacks healthy cells. |
Autoimmune Disease |
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The five stages of infectious disease. |
1. Incubation Period 2. Prodromal Period 3. Illness 4. Decline 5. Convalescence |
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In this stage of infectious disease there are no signs or symptoms of the disease. |
Incubation period |
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In this stage of infectious disease, there are vague, general symptoms. |
Prodromal period |
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In this stage of infectious disease the signs and symptoms are most severe. |
Illness |
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In this stage of disease, signs and symptoms are declining. |
Decline |
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In this stage of infectious disease, there are no signs or symptoms. |
Convalescence |
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In what stage is a disease most infectious? |
Prodromal |
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Helps resist infection by releasing antibacterial substances and inhibiting multiplication of pathogenic microorganisms. |
Normal flora |
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Give an example of a body system defenses against infection |
Organs such as skin, which is our first layer of defense to keep infections from entering the body. You should wash hands often. |
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Vascular and cellular response as a defense against infection. |
Inflammation |
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Drainage that is clear. |
Serous |
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Drainage that is bloody. |
Sanguineous |
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Drainage that is puss(ie) and discolored. |
Purulent |
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Serous, sanguineous, or purulent drainage. |
Exudates |
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When our body is performing tissue repair, this is the type of tissue seen. |
Granulation tissue |
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Five signs of local inflammation |
1. Redness 2. Swelling 3. Heat 4. Pain or Tenderness 5. Loss of function at affected body part. |
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Four types of patients who are at a greater risk for health-care associated infections. |
1. Multiple illnesses 2. Older adults 3. Poorly nourished 4. Lowered resistance to infection (immunocompromised) |
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Three types of Health Care Associated Infections |
Iatrogenic Exogenous Endogenous |
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A type of HAI that occurs from a procedure. |
Iatrogenic |
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A type of HAI that occurs from microorganisms outside of the individual. |
Exogenous |
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A type of HAI that occurs when the patient’s flora becomes altered and an overgrowth results. |
Endogenous |
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Four risk factors for health care associated infections. |
1. Number of health care employees with direct contact with the patient. 2. Types and numbers of invasive procedures 3. Therapy received 4. Length of hospitalization |
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Three major sites for health care associated infections. |
1. Surgical or traumatic wounds 2. Urinary & respiratory tracts 3. Bloodstream |
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Using these type of precautions prevent and control infection and its spread. It applies to contact with blood, body fluid, non-intact skin, and mucous membranes. |
Standard precautions |
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A standard precaution that includes using an instant alcohol hand antiseptic before and after providing patient care, washing hands with soap and water when they are visibly soiled, and performing a surgical scrub. |
Hand hygiene |
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The act of washing hands with soap and water, followed by rinsing under a stream of water for 15 seconds. |
Hand washing |
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Absence of pathogenic (disease producing) microorganisms. |
Asepsis |
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Practices/procedures that assist in reducing the risk for infection. |
Aseptic technique |
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Includes procedures for reducing the number of organisms present and preventing the transfer of organisms. |
Medical asepsis or clean technique |
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Prevents contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery. |
Surgical asepsis or sterile technique |
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Do you turn your back on a sterile field. |
NO |
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At what level should a table be when creating a sterile field. |
At least waist high. |
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A process that eliminates many or all microorganisms, with the exception of bacterial spores, from inanimate objects. |
Disinfection |
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The complete elimination or destruction of all microorganisms, including spores. |
Sterilization |
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Medical equipment used to sterilize equipment. |
Autoclave |
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This explains how a pathogen is transmitted from a reservoir by an area (like the hands), to later infect a vulnerable host. |
Chain of infection and transmission of infection |
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Other names for a N95 mask |
HEPA Respirator TB Mask |
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A room where air is only filtered from within it, cycled more than two hundred times a day, and goes through a HEPA filtration system. |
Negative air pressure room |
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This type of isolation precaution calls for the following patient placement: in a private room, cohorting acceptable with infection control consult. |
All levels |
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This type of isolation measurement calls for the following patient transport procedures: Transport for essential purposes only to minimize risk of disease transmission. |
Contact precautions |
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This type of isolation measure calls for the following gloves and hand washing procedures: Wear clean gloves upon entreating room. Change gloves after contact with infectious material. Remove gloves before leaving patient’s environment and wash hands immediately with anti microbial agent or waterless antiseptic. Do not touch any potentially contaminated surface or item. |
All levels: contact, droplet, airborne |
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This type of isolation measure calls for the following gloves and hand washing procedures: Wear clean gloves upon entreating room. Change gloves after contact with infectious material. Remove gloves before leaving patient’s environment and wash hands immediately with anti microbial agent or waterless antiseptic. Do not touch any potentially contaminated surface or item. |
All levels: contact, droplet, airborne |
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This type of isolation measure calls for the following gown procedures: Wear clean gown upon entering room if anticipating contact with patient, surface, or item. Remove gown before leaving room and avoid contact with contaminated items. |
All levels of precautions: contact, droplet, precautions. |
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What type of precaution is a patient placed on who has C Diff, MRSA, or VRE. |
Contact Precautions |
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This type of isolation measure calls for all non critical patient care equipment to be dedicated to single patient use. |
All levels: contact, droplet, airborne |
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This isolation measure calls for a private room, or cohorting acceptable with patient placed more than 3 feet away. Visitors must stay more than 3 feet away as well. |
Droplet precautions |
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This type of isolation calls for the patient to be transported for essential purposes only and they must wear a surgical mask. |
Droplet and airborne precautions |
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When a patient is placed on this precaution, one must wear a surgical mask when entering the room. |
Droplet precautions |
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Flu, pneumonia, and the common cold are all infections that require you to wear a surgical/droplet mask when entering the room and providing care to a patient that is placed on what precaution level? |
Droplet precautions |
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A patient placed on this level of precaution is placed in a private negative pressure room with six to twelve air changes an hour, plus external air discharge or HEPA filtration. Cohorting is acceptable or consult with infection control. Room door must be kept closed and patient must stay in room. |
Airborne precaution |
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Patients who have TB, measles, varicella, or Covid are placed on what type of precaution? |
Airborne precaution |
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What type of mask is required to enter a patient’s room who is placed on airborne precautions? |
N95, respirator |
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What should you do prior to donning a gown, mask or respirator N95, goggle or face shield, or gloves? |
Wash hands |
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In what order should you don PPE? |
1. Gown 2. Mask 3. Goggles/Face Shield 4. Gloves |
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In what order should you doff ppe? |
1. Gloves 2. Goggles or face shield 3. Gown 4. Mask |
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Redness, swelling, pain/tenderness, pus or purulent are all signs of what? |
Infection |
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A white blood cell count higher than 10,000mm3 is a sign of white? |
Infection |
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What is a normal white blood cell count. |
5,000 - 10,000 |
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Foul or offensive odors to a skin area or site is a sign of what? |
Infection |
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An elevated temperature higher than 101°F is a sign of what? |
Infection |
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ESR (Erythrocyte sedimentation rate) or Sed Rate (having a condition that causes inflammation like Lupus or Rheumatoid Arthritis) higher than 22 in men and higher than 29 in women is a sign of what? |
Infection |
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Presence of pathogens in the blood, urine, sputum, or a wound is a sign of what? |
Infection |
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A wbc greater than what is a sign of infection? |
10,000mm3 |
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A temp elevated higher than what is a sign of infection? |
101°F |
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An ESR or Sed rate higher than what in men and higher than what in women is a sign of infection. |
Men - 22 Women - 29 |
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Five things that should be done during a dressing change. |
1. Asses the skin beneath the tape. 2. Recognize normal signs of healing. 3. Wear sterile gloves before directly touching an open or fresh wound. 4. Remove or change dressings over closed wounds when they become wet or if the patient has signs or symptoms of infection, and as ordered. 5. Perform thorough hand hygiene before and after wound care. |
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What should you know going into a dressing change? |
1. Type of dressing 2. Placement of drains 3. Equipment needed |
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In preparing a patient for a dressing change, what three things should you do? |
1. Evaluate for pain, medicate if necessary before changing. 2. Describe procedure steps. 3. Answer questions about the procedure or wound. 4. Gather supplies. |
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When packing a wound, you should assess for these three things. |
Size, depth, shape |
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Three things used to secure a wound dressing. |
Tape, toes, binders |
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Comfort measures that can be taken when changing a dressing. |
Carefully remove tape. Gently clean the wound. Administer analgesics before dressing change if needed. |
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These are placed when the provider intends to have wound edges that are approximated (primary intention healing). |
Stitches and sutures |
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When are sutures and staples removed? |
When the wound has developed enough strength to hold the edges together during the remainder of healing. |
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Accelerates the inflammatory process to promote healing of a wound. |
Heat |
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Constricts peripheral blood vessels, reduces muscle spasms, and promotes comfort. |
Cold |
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What type of order is given for medication to be administered until the dosage is changed or another medication is prescribed. |
Standing or routine |
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A type of order where medication is given when the patient requires it at the as needed times and intervals as needed. |
prn/As Needed |
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An order for medication that is given one time for a specified reason. |
Single (one-time) |
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An order where medication is given immediately in an emergency situation such as an ACLS medication |
STAT |
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An order where medication is needed right away, but isn’t STAT (usually within 30 minutes) |
Now: (ASAP) |
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Medications that are ordered/prescribed to be taken outside of the medical facility. |
Prescription |
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Seven recommendations to reduce medication errors. |
1. Avoid distractions and follow same routine. 2. Administer only medications you prepared. 3. Never leave medications unattended. 4. Document immediately after medication are administered. 5. Use clinical judgement in determining the best time to administer PRN medications. 6. When preparing medications, check the medication container label against the medication administration record three times. 7. Encourage providers to write out medication orders and not give verbal and telephone orders. |
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What is MAR? |
Medication Administration Record |
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How many times should you check the medication label against the MAR before administering the medication. |
At least three times. |
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5 error prone abbreviations |
1. U for units - confused with O,o, or the number 4 - write it out 2. IU for international units - confused with IV - write it out 3. QD or QOD for daily and every other day - write it out 4. Trailing 0s, such as 5.0 - decimal point can be missed 5. MS or MSO4 or MgSO4 - morphine sulfate can be confused with magnesium sulfate - write it out. |
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Time until effect: intravenous administered medication |
Immediately |
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Time until effect: intraosseous administered medication |
30-60 seconds |
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Time until effect: endotracheal administered medication |
2-3 minutes |
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Time until effect: inhalation administered medication |
2-3 minutes |
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Time until effect: sublingual administered medication |
3-5 minutes |
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Intramuscularly administered medication time until effect. |
10-20 minutes |
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Subcutaneously administered medication time until effect. |
15-30 minutes |
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Rectal administered medication time until effect. |
5-30 minutes |
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Ingestion administered medication time until effect. |
30-90 minutes |
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Transdermal (topical) administered medication time until effect. |
Variable (minutes to hours) |
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12 Types of Drug Preparations |
1. Caplet 2. Capsule 3. Elixir/Syrup 4. Gel/Jelly 5. Liniment 6. Lotion 7. Lozenges 8. Ointment 9. Pill 10. Suppository 11. Tablet 12. Transdermal Patch |
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A type of drug coating that is used to prevent stomach irritation. It cannot be crushed up. |
Enteric coated drug |
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Deepest area used for an adult injection |
Ventrogluteal area |
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The eight steps when using a metered dose inhaler. |
1. Shake the inhaler and remove protective cap. 2. Hold the inhaler upright. 3. Exhale to residual volume. 4. Place mouthpiece between lips and teeth. 5. Inhale slowly and simultaneously activate the canister. 6. Continue slow and sept inhalation. 7. Hold breath 5-10 seconds. 8. Take inhaler out of mouth and hold breath 5-10 seconds. |
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The seven steps when using a dry powder inhaler. |
1. Prepare the inhaler before usage. 2. Keep inhaler horizontal. 3. Exhale to residual volume. 4. Place mouthpiece between lips and teeth. 5. Inhale forcefully and deeply. 6. Take the inhaler out of the mouth. 7. Hold breath for 5 seconds. |
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The easiest and most desirable route to give medication. |
Oral Route |
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Other than directly in the mouth, how can an oral medication be given and how should it be prepared? |
Through a G or NG tube and crushed. |
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When oral medication is given, what may decrease therapeutic effect? |
Good |
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When oral medication is given, be sure the patient has swallowed the medication to avoid what? |
Aspiration |
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When applying topical medications: 1. Use _____ and possibly an _____. 2. Use _____ technique if the patient has an open wound. 3. Clean skin with _____ and _____ first. 4. Follow _____ for each type of medication. |
1. Gloves/applicator 2. Sterile 3. Soap & water 4. Directions |
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Steps in using transdermal patches: 1. Remove ____ patch before applying ____ patch. 2. Document the _____of the new patch. 3. Ask about patches during the _____ history. 4. Apply a label to the patch with _____, _____, and _____ it. 5. Document _____ of the old patch as well. |
1. Old, new 2. Location 3. Medication 4. Date, time, initial 5. Removal |
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What is the recommended number of days to use nasal spray and why? |
Three days because it can have a rebound effect. |
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What is the recommended number of days to use nasal spray and why? |
Three days because it can have a rebound effect. |
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What is a rebound effect caused by nasal spray? |
It is where the opposite happens from using nasal spray too long, causing the nostrils to restrict or even waste away the nasal septum. |
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Because the eyes are sterile, when administering ophthalmic medications, be sure to do these two things. |
Wash hands and wear gloves |
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Four preventive measures to take when administering ophthalmic medications. |
1. Avoid the cornea 2. Avoid the eyelids with droppers or tubes to decrease the risk of infection. 3. Use only on the affected eye. 4. Never allow a patient to use another patient’s eye medication. |
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Where should ophthalmic medication be administered? |
Only in the lower pink area of the eye, somewhere between the inner and outer campus in the conjunctival site. |
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Position of ear when administering ear medication: 1. Adult 2. School aged child 3. Infant - Child under 3 |
1. Pull ear up and back 2. Pull ear straight back 3. Pull ear down and back |
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Five steps in administering ear medications. |
1. Position patient with head tilted or lying on unaffected side. 2. Clean external ear canal if necessary. 3. Position ear according to age. 4. Instill drops. 5. Have patient maintain position 3-5 minutes. |
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How long should you wait until patient moves head after instilling ear medication? |
2-3 minutes |
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How long should you wait until patient moves head after instilling ear medication? |
2-3 minutes |
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Before applying a second medication to the eye, you should wait how long before doing so? |
Five minutes |
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Which hand to use to hold the buttocks open when administering rectal medication? |
Non dominant hand |
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What position should a patient be turned in when administering rectal medication? |
Left, lateral, SIMS |
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How long should a patient hold the left lateral position after rectal medication is administered? |
Five minutes at least |
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How far should rectal medication be inserted? |
One to one and a half inch. Should pass the internal sphincter. |
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The smaller the number of a needle, the _____ the gauge. |
bigger |
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Intradermal injections are given at what four sites and at what angle? |
in the dermis, just below the epidermis inner surface of the forearm, upper chest, upper back, and under the scapula at a 5-15 degree angle. |
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Subcutaneous injections are given in what tissue, at what six sites, and at what angle? |
given in the adipose tissue layer, just below the epidermis and dermis outer aspect of the upper arm, abdomen, anterior aspects of the thigh, upper back, upper Ventrogluteal dorsogluteal at a 45-90 degree angle |
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Where and at what angle should intramuscular injections take place? |
ventrogluteal, vastus lateralis, and the deltoid sites 90 degree |
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When blood bags are being checked at the bedside, how many licensed personnels must be present. |
Two |
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Before giving blood to a patient, you must do what first. |
Take vital signs. |
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An herbal remedy and prescription medication that cannot be taking together because it could result in bleeding to death. |
Ginkgo Biloba and Coumadin (anticoagulant) |
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Seven factors influencing medication routes |
1. Physical and chemical properties of the drug 2. Site of desired 3. Rate and extent of absorption from different routes 4. Effect of digestive juices and first pass metabolism on the drug. 5. Rapidity with which the response is desired 6. Accuracy of dosage desired 7. Condition of patient |
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Five causes that increases a patient’s fall risk? |
1. Patient 65 or older 2. History of falls 3. Any treatment of leg 4. Narcotics taken 5. Vital signs must be specific and drastic to be considered fall risk. |
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What do patients use as a stress reliever? |
1. Listening to music 2. Guided imagery 3. Use 5 senses to make things pleasant for you |
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The largest organ in our body. |
The skin |
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What are the layers of the skin? |
Epidermis Dermis Subcutaneous tissue/fatty connective tissue |
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Any break in the skin is considered a _____. |
Wound |
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The process of the healing of wounds. |
Primary Intention Secondary Intention Tertiary Intention |
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The process of the healing of wounds. |
Primary Intention Secondary Intention Tertiary Intention |
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The healing process of a wound where the edges are approximated and are healing well. |
Primary intention |
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The process of a wound healing from the inside out that involves extensive tissue loss because of a burn, a pressure ulcer, decubitus ulcer |
Secondary Intention |
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The process in wound healing where a wound is left open to heal because of infection, swelling, or exudate. |
Tertiary Intention |
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Factors that affect wound healing |
1. Diet - needs protein, zinc, vitamins 2. Age 3. Lack of oxygen 4. Chronic diseases such as diabetes, COPD 5. Medications such as steroids 6. Infections within the wound 7. Weakened immune system 8. Smoking because of carbon monoxide |
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Factors that affect wound healing |
1. Diet - needs protein, zinc, vitamins 2. Age 3. Lack of oxygen 4. Chronic diseases such as diabetes, COPD 5. Medications such as steroids 6. Infections within the wound 7. Weakened immune system 8. Smoking because of carbon monoxide |
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Complications of wound healing |
1. Hemorrhaging 2. Infection 3. Edema |
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Factors that affect wound healing |
1. Diet - needs protein, zinc, vitamins 2. Age 3. Lack of oxygen 4. Chronic diseases such as diabetes, COPD 5. Medications such as steroids 6. Infections within the wound 7. Weakened immune system 8. Smoking because of carbon monoxide |
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Complications of wound healing |
1. Hemorrhaging 2. Infection 3. Edema |
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What color should a wound be? |
A nice pink color |
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When classifying wounds we need to know these five things? |
1. It’s age 2. Is it acute 3. Is it chronic 4. The depth 5. The color |
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White or yellow tissue growing in a wound. |
Slough in a wound |
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What must be done when there is white or yellow tissue growing in a wound? |
It must be debrided. |
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Black on a wound. |
Necrosis |
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A black covering over the entire wound. |
Eschar |
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A wound that is eschar is what? |
Unstagable |
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Five components of assessing a wound we need to know. |
Location of wound Size of wound The characteristics of the wound: the wound bed, the edges of the wound The skin around the wound Exudate (drainage): amount, color, and odor |
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Clear, watery drainage |
Sereous |
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Five components of assessing a wound we need to know. |
Location of wound Size of wound The characteristics of the wound: the wound bed, the edges of the wound The skin around the wound Exudate (drainage): amount, color, and odor |
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Clear, watery drainage |
Serous |
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Drainage that has thin, red blood in it. |
Sangeuinous |
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Pink, light red, thin drainage |
Sero Sangeuinous |
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Discolored, thick drainage that is a sign of infection |
Purulent |
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When swabbing a wound to be tested, where do you swab? |
In the deepest part of the wound. |
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What must be done prior to swabbing a wound to be tested? |
The dressing must be removed and the wound must be cleaned. |
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When redressing a wound, you must wear _____ gloves and use ____ technique. |
Sterile and sterile |
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Where the wound opened up |
Dihiscence |
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a wound where organs begin to protrude out. |
Evisceration |
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Sores that occur from pressure being applied to a specific area for too long. |
Pressure ulcers |
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Shearing wound |
A wound created from the skin sticking to something while the body is being moved. |
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A wound that is created from your skin sliding across something. |
Friction wound |
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A tool that is used to predict pressure sore risk |
The Braden scale |
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A score of or less than what on the Braden Scale places a patient at risk for pressure soars. |
18 or less |
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Preventing pressure ulcers |
1. Reposition patient every two hours. 2. Increase activity 3. Air mattresses 4. Look at bottom of heels, asses skin |
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Preventing pressure ulcers |
1. Reposition patient every two hours. 2. Increase activity 3. Air mattresses 4. Look at bottom of heels, asses skin |
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What stage is a pressure ulcer that is a redden area |
Stage 1 |
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What stage is a pressure ulcer where the skin has come off |
Stage 2 |
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What stage is a pressure ulcer that is down into the subcutaneous tissue |
Stage 3 |
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The stage of a pressure ulcer that is down to the bone or muscle. |
Stage 4 |
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Does the stage of an ulcer change? How would it be documented? |
No. It is always what it is determined. When it is healing you document the original determination, followed by “healing.” |
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Explain why eschar is an un-stagable ulcer. |
Because you are unable to see what is under it. |
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Explain what gloves and when used in wound cleaning. |
Clean gloves to remove dressing and clean Sterile gloves to pack and redress wound |
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Dressing used to maintain moisture |
A gauze dressing Hydrocolloid dressing Transparent dressing |
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A dressing to absorb moisture because of too much exudate |
Alginate dressing |
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To provide comfort during a dressing change, what can you do? |
Give pain meds 30 minutes prior to change. |
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When changing a dressing, you said ask a patient about their _____. |
Allergies |
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Bacteria that require oxygen to live and grow. |
Aerobic |
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Spreading of microorganisms that are less than 5 mcm when an infected host coughs, sneezes, or talks, or when the organism becomes attached to dust particles. |
airborne transmission |
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Bacteria that can live without oxygen |
Anaerobic |
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Immunoglobulin produced by the body in response to a specific antigen |
Antibody |
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Foreign material capable of inducing a specific immune response |
Antigen |
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Antibacterial agent that kills bacteria or suppresses their growth |
Antimicrobials |
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Absence of disease-producing microorganisms |
Asepsis |
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Using methods to prevent infection |
Asepsis |
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The most significant and most commonly observed infection-causing agents |
Bacteria |
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Evidence-based best practices that have proven positive outcomes when implemented together to prevent infection. |
Bundles |
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Way for organisms to enter the body that involves proximity between the susceptible host and an infected person or a carrier, such as through touching, kissing, or sexual contact |
Direct contact |
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Process used to destroy microorganisms; destroys all pathogenic organisms except spores |
Disinfection |
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Transmission of particles great than 5 mcm |
Droplet transmission |
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Something that occurs with predictability in one specific region or population and can appear in a different geographical location. |
Endemic |
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Infection in which the causative organism comes from microbial life harbored within the person |
Endogenous |
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Infection in which the causative organism is acquired from outside the host. |
Exogenous |
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Plant-like organisms (molds and yeasts) that can cause infection |
Fungi |
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An infection that was not present on admission to a health care institution and develops during the course of treatment for other conditions (nonsocomical) |
Health care-associated infections (HAIs) |
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Animal or person on or within which microorganisms live |
Host |
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Infection that occurs as a result of a treatment or diagnostic procedure |
iatrogenic |
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Personal contact with either a vector, a living creature that transmits an infectious agent to a human, usually as an insect; or an inanimate object, called a fomite, such as equipment or countertops |
Indirect contact |
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Disease state resulting from pathogens in or on the body. |
Infection |
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Protective procedure designed to prevent the transmission of specific microorganisms; also called protective aseptic techniques and barrier techniques. |
Isolation |
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Practices designed to reduce the number and transfer of pathogens; synonym for clean technique |
Medical asepsis |
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Organism that lives on or in a host and relies on it for nourishment |
Parasites |
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Disease producing microorganism |
Pathogens |
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Gloves, gowns, masks, and protective eye gear designed to minimize or prevent the healthcare workers exposure to infectious material. |
Personal Protective Equipment (PPE) |
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Natural habitat for the growth and multiplication of microorganisms |
Reservoir |
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The process by which all microorganisms, including spores, are destroyed. |
Sterilization |
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Surgical procedure performed to render a person infertile |
Sterilization |
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Practices that render and keep objects and areas free from microorganisms; synonym for sterile technique |
Surgical asepsis |
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Non-human carriers - suave as mosquitos, ticks, and lice - that transmit organisms from one host to another. |
Vector |
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Ability to produce disease |
Virulence |
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Smallest of all microorganisms; can be seen only by using an electron microscope |
Virus |
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Living being where an infectious, parasitic,or pathogenic agent resides and receives sustenance. |
Host |
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Drugs that treat infections by killing or slowing the growth of microbes causing infection |
Antimicrobials |
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What are bacterial infections treated with? |
Antibiotics |
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The U.S. government facility responsible for investigating, preventing, and controlling disease. |
The CDC |
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A disease state that results from the presence of pathogens. |
Infection |
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Disease-producing microorganisms |
Pathogens |
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Infection Cycle |
- Infection Agent - Reservoir - portal of exit - means of transmission - portals of entry - Susceptible host |
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The most significant and most commonly observed infection-causing agents in health care institutions. |
Bacteria |
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Three shapes bacteria can be organized by. |
Spherical (cocci) Rod (bacilli) Corkscrew (spirochetes) |
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This type of medicine has no effect on viruses. |
Antibiotics |
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Gram-positive bacteria have a _____ cell wall that _____ decolorization and are stained _____. |
thick resists violet |
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Gram negative bacteria can be decolonized by ______. |
Alcohol |
