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28 Cards in this Set

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Developmental Considerations
Nurse and the patient or family should work together to eliminate or reduce accident risks in the home, community or healthcare setting.

Educate to promote awareness of dangerous situations must begin as early as possible & continue throughout the life span.
Factors Affecting Safety
Lifestyle
Ladders are major souce of injuries & death among construction workers, and that older workers are at particular risk for sustaining a fatal injury.

Reproductive hazards may exist for women with long-term exposure to certain anestetic agents.

Antiviral preparation used for respiratory infections in infants & children may be harmful to a developing fetus.
Factors Affecting Safety
Lifestyle
OSHA identifies risks and develops standards to prevent serious injuries and illnesses due to work-related musculoskeletal disorders resulting from repetitive motions.

Stress may precipitate an unhealthful lifestyle that involves drug or alcohol abuse.

Security measures such as locks, security systems and exterior lighting can promote safety.
Factors Affecting Safety
Mobility
Patient with an unsteady gait is more prone to falling.

Supportive devices, such as canes, walkerrs, and wheelchairs, may facilitate movement, but they require careful patient instruction and preparation for safe use.

Nurses must assess a pt's risk for injury w/ a view toward maintaing independence and fostering self-esteem while providing a safe and predictable environment.
Factors Affecting Safety
Sensory Preception
Visual changes may cause a erson to stumble, lose balance and fall.

Hearing defict may prevent hearing safery alarms, automobile horns, and sirens and may not hear healthcare instruction.

Smelling loss reduces abiility to detect leaking gas or smoke.

Taste loss may result in unsafe eating habits or may eat tainted food.
Factors Affecting Safety
Knowledge
Safety & security precautions is curcial for promoting and maintaining wellness.

Assessment: Id and recognize potentially threatening circumstances.
Factors Affecting Safety
Ability to Communicate
The nurse must assess any factor that influences the patient's ability to receive and send messages
Factors Affecting Safety
Physical Health State
Anything that affects the pt's health state potentially can affect the safety of the environment.

Focus of healthcare includes preventing accidents as well as promoting wellness and restoring the individual to a healthy state.
Factors Affecting Safety
Physical Health State
Pay particular attentoin to health teaching concerning the person's ability to maintain a sense of balance and carefully assists the pt with ambulation to prevent falls.

Many pt's who fall have a primary or secondary Dx of cardiovascular disease, such as stroke.

Maximize pt's potential by considering safety factors in all phases of the illness and recovery experience.
Factors Affecting Safety
Psychosocial Health State
Stressful situations tend to narrow a person's attention span & make them more prone to accidents.

Effects tend to be more devasting in the person's later years.

Depression may result in confusion & disorientation, accompanied by reduced awareness or concern about environmental hazard.
Factors Affecting Safety
Assessing the Individual
Consists of a Nursing History & Physical Exam
Assessment
Nursing History
Be alert to history of falls or accidents.

A person w/ a history is likely to fall again.

Note any assistive devices (cans or walkers)

Be alert to any history of drug or alcohol abuse.

Knowledge of family support systems and the home environment.
Assessment
Physical Examination
Assess the pt’s mobility status, ability to communicate, level of awareness or orientation and sensory perception in the physical examination.

Recognize any manifestations that suggest domestic violence or neglect.
Assessment
Assessing the Environment
Assessment of the environment requires the same attention to safety.

Risk in the home, community, and healthcare agency may cause injury.

Assessment includes identifying individuals at risk & recognizing unsafe situations.

Recognizing these factors helps the nurse develop an individual plan of care and nursing interventions for protecting the pt.

Focus assessment on the pt’s developmental level and health status.

Assess your own environmental safety when visiting unfamiliar areas.
Assessment
Falls: High Risk Factors
1) Age of 65 or older
2) History of falls
3) Impaired vision or sense of balance
4) Altered gait or posture
5) Meds regimen that include diuretics, tranquilizers, sedatives, hypnotics or analgesics
6) Postural Hypotension
7) Slow reaction time
8) Confusion or disorientation
Assessment
Fires: Risk Factors
1) Smoking in bed or falling asleep while smoking on a sofa or chair
2) Kitchen Stoves
3) Candles
4) Electric Heaters
5) Faulty Wiring
6) Unsafe electrical equipment
Assessment
Poisoning: Risk Factors & Facts
1) Childhood poisoning has been reduced drastically in the past 10yrs
2) Young children: Ingestion of household chemicals
3) Older children: Swallowing meds in a suicide attempt
4) Preschoolers: Ingestion of lead-containing substances in home
5) Adolescents & Young Adults: Experimenting with drugs may suffer accidental poisoning and death
6) Inhalants on store shelves & in homes may provide the opportunity for kids to “sniff’ or “huff’ these dangerous substances.
7) Older person may inadvertently take an overdose of a medication
Assessment
Suffocation and Choking: Risk Factors
1)Drowning
2)Choking on a foreign substance inhaled into the trachea
3)Gas or smoke poisoning
4)Infant may suffocate when a pillow or a piece of plastic inadvertently covers the nose or mouth
Assessment
Firearm Injuries
Young children are curious and like to explore their surroundings and when they encounter a loaded gun the outcome is often tragic
Assessment
Neonate and Infant Safety
Smoking lowers birthweight.

Alcohol & drugs may cause adverse effects that are apparent at birth.

Never leave infants unattended. Use crib rails & monitor the setting for objefcts that can be swallowed.

Rear facing carseat if under 1yr & less than 20lbs.

Air bags in cars can casue injury to kids in front seat.

Most parents don't facing carseats or harness straps tight enough.
Addressing Developmental Consideration
Toddler & Preschooler Safety
Childproof the home environment.

Ingestion of poisons or meds is major threat.

Protecting kids are also includes being alert to manifestations that indicate child abuse.

Abuse can be physical, sexual or emotional and may also be a result of neglect.
Addressing Developmental Consideration
School Aged Child Safety
Accidents are leading cause of death.

Are becoming increasingly independent.

Counsel parents about inverventions for safety @ home, school and in the neighborhood.

Protective measures include bike helmets.
Addressing Developmental Consideration
Adolescent Safety
At risk for MVA

Important to wear seat belt & discuss drugs & alcohol.

Education regarding smoking can prevent them from starting.

Body piercing popular sites: ears, nose, eyebrows, lips, tongue, nipples, navel & genitals.

Risk for infection is real.

Gun is most common form of suicide.

Encouragement & education about ways to solve arguments w/o guns & violence.

Guidance & direction for developing a healthful lifestyle while coping w/ the stresses of daily living.
Addressing Developmental Consideration
Adults Safety
Stress has an effect on their lifestyles & health.

Stress & succeeding @ career may lead to unsafe health habits & a reliance on drugs or alcohol.

Deomestic violence is high, 1:4 women is a victim at some point.

Childhood abuse has been linked to adult onset GI symptoms, eating disorders & substance abuse.
Addressing Developmental Consideration
Older Adult Safety
Most accidents are preventable.

Vision changes, slowed reaction & impaired thinking due to mental illness are concerns.

Keep auto's in optimal driving condition to prevent accidents.

Regular eye exams, wear corrective lenses if needed

Keep noise (radio & others equip) to a minimum.

Accidental overdosing on meds, related to poor eyesight & confusion.

Med trays can be pre-filled to lower Over dosing.
Addressing Developmental Consideration
Orienting the Person to Surroundings
Being familiar with surroundings is less likely to suffer an accidental injury.

Orient the pt to the safety features & equip room.

Explain and demonstrate the adjustable bed & side rails, call sys, telephone, TV and bathroom.

Stress to family the importance of orienting older people with new surroundings.
Using Restraints
Restraints are physical devices that limit pt's movement.

Use of restraints for purposes of protecting pt from harm in know seen as questionable.

Hazards of restraints:
1) Danger of Suffocation from entrapment in side rails or improperly applied vest.
2) Impaired Circulation
3) Altered skin intergrity
4) Pressure ulcer & contractures
5) Diminished muscle & bone mass
6) Fractures
7) Altered nutrition & hydration
8) Aspiration & breathing difficulties
9) Incontinence
10) Changes in mental status
Side Rail as Restraints
Side rail is not considered a restraint if pt asked for it to be raised.

Pt must be able to raise & lower it themselves.

If family memeber asks for side rails to be used for a pt, the nurse must review benefits & risks assoc w/ thier use and periodically evaluate the reason for their use.