N12 Week 2

Front 1

Many factors that affect client's ability to protect himself

Back 1

Age (young & old); Mobility cognitive; Sensory awareness; Emotional state; Lifestyle; Safety awareness

Front 2

All HCW's must be aware of:

Back 2

How to assess for & recog. c's at risk for safety issues; Procedural safety guidelines; Protocols for responding to dangerous situations; Security plans; ID/doc of incidents & responses per HC agency policy.

Front 3

Why older c's may be at an increased risk for falls

Back 3

decreased strength, impaired mobility and balance, and endurance limitations combined with decreased sensory perception.

Front 4

Other Clients at increased risk for falls

Back 4

decreased visual acuity, generalized weakness, urinary frequency, gait & balance problems (cerebral palsy, inj, MS) & cognitive dysfunction. Side effects of meeds (hypotension/drowsiness). *Greater risk when more than 1 risk factor present.

Front 5

To prevent falls, (a major nursing priority), what should be done

Back 5

All clients admitted to HCI's s/b assessed for risk factors related to falls, and, based on the assessment, preventative measures s/b implemented

Front 6

Fall prevention for C w/orthostatic hypotension

Back 6

Instruct C to avoid getting up too quickly, to sit on the side of the bed for a few seconds prior to standing and to stand at the side of the bed for a few secs prior to walking.

Front 7

General measures for preventing falls
(1-5)

Back 7

Be sure C know how/where call light is; Respond to calls timely; Orient C to all assistive devices, e.g. grab bars; At risk C's s/b near nursing station; Put tables & freq. used items w/in reach (water, tissue, phone, etc.)

Front 8

General measures for preventing falls 6-10

Back 8

Bed in low position; Bed rails up for sedated/unconscious or other compromised pt's; Avoid full bed rails for C's who get out of bed w/out assist.; nonskid footwear; clutter free floor w/clear path to bath;

Front 9

General measures for preventing falls 11-14

Back 9

keep assistive devices near after validation of safe use by C/fam. (glasses, walkers, transfer devices);Educate pt/fam on id's risks & plan of care; lock wheels on bed/wheelchairs/carts to prevent rolling during transfers or stops; Use chair/bed sensors to alert staff to independent ambulation.

Front 10

Seizure precautions

Back 10

Rescue equip @ bedside; Inspect for items near that may cause injury & are not necessary for immed. care.; Other basic items p. 104; Stay w/C in the event of seizure, admin med as ordered; note duration, sequence, type of movement. Quiet for C/explain/ comfort - document

Front 11

General procedures for Seclusion and Restraints

Back 11

N must follow fed/state/facility policies that govern use of restraints.
Seclusion/restraints s/b ordered for shortest duration possible only if less restrictive measures are not sufficient. For protection of C/staff. Restraints can be physical/chemical (neuroleptic calming meds)

Front 12

Seclusion and/or restraint must NEVER be used for:

Back 12

Convenience for staff
Punishment for the C
C's who are extremely physically or mentally unstable.
C's who can't tolerate the decreased stim of a seclusion rm

Front 13

Restraints should:

Back 13

Never interfere w/treatment.
Restrict movement as little as necessary to ensure safety.
Fit properly
Be easily changed to decrease chance of inj. & provide greatest level of dignity.

Front 14

What must occur for seclusion or restraints to be used?

Back 14

Must be prescribed by provider in writing, based on face-face assessment.
In emergency situation w/immediate risk to C or others, Nurse may put on restraint, but get order from Dr. w/in 1 hr. or HCI policy

Front 15

A prescription for a restraint must include:

Back 15

Reason, type, location, how long restraint may be used and the type of behaviors demonstrated by C that warrant use of restraint.

Front 16

How long is an order for a restraint effective?

Back 16

Provider must rewrite every 24 hr or HCI policy. PRN prescript. are not allowed.

Front 17

What must an order prescribing restraints contain?

Back 17

Nursing responsibilities must be id's in the protocol, including how often C s/b: Assessed; Offered food and fluid; Provided w/means for hygiene & elimination; monitored for VS, offered ROM of extremities.

Front 18

How often is a restrained C to be assessed?

Back 18

at least every 2 hr., including neurosensory checks of affected extremities (circulation, sensation, mobility).

Front 19

How often should C assessments re: food, fluids, comfort, and safety be performed and documented?

Back 19

every 15-30 min.

Front 20

What should complete documentation for restraint include?

Back 20

Precipitating events and behavior of C prior to; Alternative actions taken to avoid; Time restraints were applied and removed (if discont.); Type and location used; C's behavior while restrained.; Type & freq of care; C's response when removed; Med admin.

Front 21

What causes most fires in HCF's

Back 21

Problems related to electrical or anesthetic equipment. Unauthorized smoking

Front 22

What is the fire response in the health care setting?

Back 22

RACE: Rescue-protect/veal. C's in close proximity to fire; Alarm; Contain-by closing doors & windows/turn off O2, ventilate life support C's w/bag-valve mask. Extinguish-using approp fire extinguisher if possible.

Front 23

How many classes of Fire Extinguisher are there?

Back 23

Class A is for paper, wood, upholstery, rags, or other types of trash fires.
Class B - flammable liquids/gas fires.
Class C-electrical firest

Front 24

Infant/Toddler Risks - Aspiration

Back 24

*Keep small obj out of reach * Ck toys for loose parts* Don't feed infant hard candy, peanuts, popcorn, hotdog slices* No supine feeding or bottle propping;*Pacifiers made of 1 pc.;* Lead poison prevention info to parents

Front 25

Infant/Toddler Risks - Suffocation

Back 25

Plastic bags out of reach* Snug fitting crib mattress (2 3/8" from slats)* Supervise Baths* Remove mobiles, etc. when baby can push up* No latex balloons* Fence, lock gate swim pools* Early swim lessons* Keep toilet lids down & bath doors closed.

Front 26

Infant/Toddler Risks - Poisoning

Back 26

Keep houseplants & cleaning agents out of reach* Put poisons, paint, gas in locked cabinet* Meds in child-proof contains & locked up* Dispose of meeds which are out of date or no longer used

Front 27

Infant/Toddler Risks - Falls

Back 27

Crib & playpen rails up* Don't leave unattended on changing table or other high surface* Restrain when in high chair, swing, stroller, etc.* Put toddler in low bed when climbing starts

Front 28

Infant/Toddler Risks- Motor Vehicle Injury

Back 28

Use backward facing car seat until 1 yr/20 lb.* Federally approved car seats in back of car.

Front 29

Infant/Toddler Risks- Burns

Back 29

Test temp of formula/bath water* Pots on back burner & turn handle away from front of stove* Supervise use of faucets

Front 30

Preschoolers/School Age Children- Drowning

Back 30

Verify child swims/knows rules of water safety* Locked fences around pools

Front 31

Preschoolers/School Age Children - Motor Vehicle/Injury

Back 31

Booster seats < 4'9"; 40lbs. (4-8 yrs) Kid sits w/back against car seat & legs dangle over.* Properly use seat belts* Protective gear on bikes, sports* Play in safe areas* Supervise/teach safe use of equip.* Road safety rules* Stranger danger* Sex Ed for school-age

Front 32

Preschoolers/School Age Children - Burns

Back 32

Reduce setting on water heater to <120 F.* Dangers of playing w/matches, fireworks, firearms.* Teach school-age how to use microwave/cooking instruments properly

Front 33

Preschoolers/School Age Children - Poison

Back 33

Teach hazards of alcohol, prescription, non-prescription & illegal drugs* keep potentially dangerous substances out of reach.

Front 34

Safety Risks & Prevention - Young adults

Back 34

Auto crashes = most common cause of death and injury to adult. Occupational injuries and high consumption of alcohol and suicide are also major concerns for adults.

Front 35

Passive Smoking

Back 35

The unintentional inhalation of tobacco smoke.

Front 36

What causes most food poisoning

Back 36

bacteria, such as E. coli; Listeria monocytogenes, and Salmonella
Most food poisoning occurs because of unsanitary food practices.

Front 37

Bioterrorism

Back 37

the dissemination of harmful toxins, bacteria, viruses, and pathogens for the purpose of causing illness or death. Ex: Anthrax, variola, C. botulism, Yersinia pests.
Health Pro's must be proficient in early detection, recognizing causative agent, id'ing affected community, providing early trtmnt.