Podcast
Questions and Answers
A patient over 65 with a permanent disability would most likely be covered by:
A patient over 65 with a permanent disability would most likely be covered by:
- Medicaid
- Worker's compensation
- Private insurance
- Medicare (correct)
Which of the following is an example of secondary health care?
Which of the following is an example of secondary health care?
- Immunizations at a community health center
- Routine physical examination
- Treatment in an emergency department (correct)
- Health promotion activities
A client requiring specialized care in an oncology center is receiving which level of health care?
A client requiring specialized care in an oncology center is receiving which level of health care?
- Tertiary care (correct)
- Long-term care
- Secondary care
- Primary care
Which healthcare personnel is primarily responsible for assisting clients with activities of daily living such as eating and dressing?
Which healthcare personnel is primarily responsible for assisting clients with activities of daily living such as eating and dressing?
A nurse is asked to witness a client's signature on an informed consent form. What does the nurse's signature primarily verify?
A nurse is asked to witness a client's signature on an informed consent form. What does the nurse's signature primarily verify?
Which of the following ethical principles refers to fair delivery and use of resources?
Which of the following ethical principles refers to fair delivery and use of resources?
A nurse administers the wrong medication to a patient, but no harm results. This is an example of:
A nurse administers the wrong medication to a patient, but no harm results. This is an example of:
A nurse threatens a patient with a medication if they do not comply with treatment. Which tort could the nurse be charged with?
A nurse threatens a patient with a medication if they do not comply with treatment. Which tort could the nurse be charged with?
Which element is most important when communicating with a provider via telephone regarding a prescription?
Which element is most important when communicating with a provider via telephone regarding a prescription?
A nurse is writing an incident report after a patient fall. Which guideline should the nurse follow?
A nurse is writing an incident report after a patient fall. Which guideline should the nurse follow?
Which of the following tasks cannot be delegated to an LPN or UAP?
Which of the following tasks cannot be delegated to an LPN or UAP?
According to the five rights of delegation, which component involves making sure the staff member is competent to perform the delegated task?
According to the five rights of delegation, which component involves making sure the staff member is competent to perform the delegated task?
What should be a nurse's primary action when a client reports feeling pain?
What should be a nurse's primary action when a client reports feeling pain?
A nurse is collecting data during an initial client assessment. Which finding is considered objective data?
A nurse is collecting data during an initial client assessment. Which finding is considered objective data?
Which intervention represents an example of an independent nursing intervention?
Which intervention represents an example of an independent nursing intervention?
According to Maslow's hierarchy of needs, which client need should the nurse address first?
According to Maslow's hierarchy of needs, which client need should the nurse address first?
Which action demonstrates the correct technique for performing hand hygiene?
Which action demonstrates the correct technique for performing hand hygiene?
When setting up a sterile field, which action compromises the sterility of the field?
When setting up a sterile field, which action compromises the sterility of the field?
A nurse is caring for a client in the incubation stage of an infection. What is the primary characteristic of this stage?
A nurse is caring for a client in the incubation stage of an infection. What is the primary characteristic of this stage?
Which patient is at the highest risk of infection?
Which patient is at the highest risk of infection?
Serous drainage from a wound is best described as:
Serous drainage from a wound is best described as:
What is the appropriate hand hygiene practice for a nurse who has visibly soiled their hands after assisting a patient?
What is the appropriate hand hygiene practice for a nurse who has visibly soiled their hands after assisting a patient?
A patient is diagnosed with measles. Which type of precautions should the nurse implement?
A patient is diagnosed with measles. Which type of precautions should the nurse implement?
What is the priority nursing action when assisting a patient who is experiencing a seizure?
What is the priority nursing action when assisting a patient who is experiencing a seizure?
A nurse is caring for a patient who has restraints. Which action is essential while the patient is restrained?
A nurse is caring for a patient who has restraints. Which action is essential while the patient is restrained?
Following the RACE acronym for fire safety, what is the first action a nurse should take?
Following the RACE acronym for fire safety, what is the first action a nurse should take?
Which intervention is most important for preventing falls in a healthcare setting?
Which intervention is most important for preventing falls in a healthcare setting?
A nurse is caring for an infant. Which of the following foods/fluids should the nurse educate the parents to avoid giving the infant?
A nurse is caring for an infant. Which of the following foods/fluids should the nurse educate the parents to avoid giving the infant?
At what age should children be switched from a rear-facing car seat to a forward-facing car seat?
At what age should children be switched from a rear-facing car seat to a forward-facing car seat?
For a client experiencing a heat stroke, what is the primary goal of the treatment?
For a client experiencing a heat stroke, what is the primary goal of the treatment?
What is the recommended water temperature setting to prevent burns for school-age children?
What is the recommended water temperature setting to prevent burns for school-age children?
What is the correct method for warming a client's tissue that has been exposed to frostbite?
What is the correct method for warming a client's tissue that has been exposed to frostbite?
Which patient position is most appropriate for promoting lung expansion in a client with dyspnea?
Which patient position is most appropriate for promoting lung expansion in a client with dyspnea?
A client is lying on their left side with their right knee and hip bent. Which position is this client in?
A client is lying on their left side with their right knee and hip bent. Which position is this client in?
A client needs to have postural drainage and venous return. Which position should the nurse place the client?
A client needs to have postural drainage and venous return. Which position should the nurse place the client?
During a disaster drill, a patient is identified as Class III. What does this triage category indicate?
During a disaster drill, a patient is identified as Class III. What does this triage category indicate?
Which of the following is a non-modifiable risk factor for disease?
Which of the following is a non-modifiable risk factor for disease?
When should visual acuity screenings begin occurring every 3-5 years?
When should visual acuity screenings begin occurring every 3-5 years?
A nurse is preparing to educate a client about a new medicationWhat action should the nurse perform first?
A nurse is preparing to educate a client about a new medicationWhat action should the nurse perform first?
By the end of the first year, an infant's weight should:
By the end of the first year, an infant's weight should:
According to Erikson's stages of psychosocial development, a toddler who is 1-3 years old is mastering which stage??
According to Erikson's stages of psychosocial development, a toddler who is 1-3 years old is mastering which stage??
Which of the following communication techniques promotes patient sharing?
Which of the following communication techniques promotes patient sharing?
During a physical examination, what part of the hand is best to for assessing temperature?
During a physical examination, what part of the hand is best to for assessing temperature?
In what order should the nurse perform an abdominal assessment?
In what order should the nurse perform an abdominal assessment?
Which description aligns with the Justice principle of ethics?
Which description aligns with the Justice principle of ethics?
A nurse is caring for a client refusing a medication. Which ethical principle should the nurse apply?
A nurse is caring for a client refusing a medication. Which ethical principle should the nurse apply?
Which action by a nurse constitutes battery?
Which action by a nurse constitutes battery?
A nurse is delegating tasks to assistive personnel. Which 'Right of Delegation' ensures the staff member's competence?
A nurse is delegating tasks to assistive personnel. Which 'Right of Delegation' ensures the staff member's competence?
Which action violates client confidentiality?
Which action violates client confidentiality?
Which of the scenarios describes tertiary healthcare?
Which of the scenarios describes tertiary healthcare?
A client is being discharged home with a new medication. What action will help evaluate client understanding?
A client is being discharged home with a new medication. What action will help evaluate client understanding?
Which of the following falls outside the scope of practice that can be delegated to a UAP?
Which of the following falls outside the scope of practice that can be delegated to a UAP?
A nurse is preparing an incident report after a medication error. What information is most appropriate to include?
A nurse is preparing an incident report after a medication error. What information is most appropriate to include?
During which stage of infection would a patient have nonspecific symptoms like fatigue and malaise?
During which stage of infection would a patient have nonspecific symptoms like fatigue and malaise?
When opening a sterile package, which action ensures sterile technique?
When opening a sterile package, which action ensures sterile technique?
What is the priority nursing intervention for a client experiencing a seizure?
What is the priority nursing intervention for a client experiencing a seizure?
According to the RACE acronym, what is the priority nursing action when a fire is discovered?
According to the RACE acronym, what is the priority nursing action when a fire is discovered?
Which finding on the skin would the nurse classify as Erythema?
Which finding on the skin would the nurse classify as Erythema?
A client has a prescription for a medication to be administered via the intramuscular route. Which action should the nurse implement?
A client has a prescription for a medication to be administered via the intramuscular route. Which action should the nurse implement?
The nurse is caring for a post-operative patient who reports incisional pain. Which intervention should the nurse implement first?
The nurse is caring for a post-operative patient who reports incisional pain. Which intervention should the nurse implement first?
The nurse is caring for a client with a new diagnosis of glaucoma. What information is important to include in patient teaching about vision loss?
The nurse is caring for a client with a new diagnosis of glaucoma. What information is important to include in patient teaching about vision loss?
A nurse caring for a client who is Jewish. Which interventions will the nurse implement when delivering meals?
A nurse caring for a client who is Jewish. Which interventions will the nurse implement when delivering meals?
The nurse is caring for a client with a wound. Which type of drainage would the nurse chart as containing blood and serum?
The nurse is caring for a client with a wound. Which type of drainage would the nurse chart as containing blood and serum?
The nurse is taking a blood pressure. What is the relationship of Cardiac output, Systemic vascular resistance and Blood pressure?
The nurse is taking a blood pressure. What is the relationship of Cardiac output, Systemic vascular resistance and Blood pressure?
The nurse obtains a pulse deficit when assessing the client. Which action should the nurse implement?
The nurse obtains a pulse deficit when assessing the client. Which action should the nurse implement?
A client is requesting assistance to ambulate. Which action by the nurse is most important?
A client is requesting assistance to ambulate. Which action by the nurse is most important?
The nurse is caring for a client with herpes zoster. What precautions should the nurse initiate?
The nurse is caring for a client with herpes zoster. What precautions should the nurse initiate?
Which of the following foods should the nurse remove from the dietary tray of a client who practices Mormonism?
Which of the following foods should the nurse remove from the dietary tray of a client who practices Mormonism?
A nurse is preparing to administer continuous feeding via NG tube. What actions should nurse take?
A nurse is preparing to administer continuous feeding via NG tube. What actions should nurse take?
Flashcards
Medicare
Medicare
Patients age 65+ or those with permanent disabilities
Medicaid
Medicaid
Low income patients
Primary Level of Health Care
Primary Level of Health Care
Health promotion, family planning, nutrition counseling, disease control
Secondary Level of Health Care
Secondary Level of Health Care
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Tertiary Level of Health Care
Tertiary Level of Health Care
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Advocacy
Advocacy
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Responsibility
Responsibility
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Accountability
Accountability
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Confidentiality
Confidentiality
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Autonomy
Autonomy
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Beneficence
Beneficence
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Fidelity
Fidelity
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Justice
Justice
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Nonmaleficence
Nonmaleficence
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Veracity
Veracity
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Negligence
Negligence
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Malpractice (Professional Negligence)
Malpractice (Professional Negligence)
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Informed Consent
Informed Consent
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Living will
Living will
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Durable Power of Attorney
Durable Power of Attorney
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DNR
DNR
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AND
AND
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ISBAR
ISBAR
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Incident Reports
Incident Reports
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Five Rights of Delegation
Five Rights of Delegation
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Assessment/Data Collection
Assessment/Data Collection
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Objective Data
Objective Data
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Subjective Data
Subjective Data
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Independent Interventions
Independent Interventions
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Dependent Interventions
Dependent Interventions
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Medical Asepsis
Medical Asepsis
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Surgical Asepsis
Surgical Asepsis
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Incubation Stage
Incubation Stage
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Prodromal Stage
Prodromal Stage
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Inflammation
Inflammation
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First Stage of Inflammation
First Stage of Inflammation
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Second Stage of Inflammation
Second Stage of Inflammation
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Third Stage of Inflammation
Third Stage of Inflammation
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Droplet Precautions
Droplet Precautions
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Patients at risk for Falls
Patients at risk for Falls
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RACE (fire response)
RACE (fire response)
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PASS (fire extinguisher)
PASS (fire extinguisher)
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Fire Classes
Fire Classes
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NURSING PROCESS
NURSING PROCESS
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Assessment/Data Collection
Assessment/Data Collection
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Assessment/Data Collection Types
Assessment/Data Collection Types
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Assessment/Data Collection
Assessment/Data Collection
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Study Notes
Healthcare Financing
- Medicare serves patients who are 65+ years or those with permanent disabilities.
- Medicaid serves low-income patients.
Levels of Healthcare
- Primary Prevention: Includes health promotion, family planning, nutrition counseling, and disease control.
- Examples of primary level of care: community health centers, screenings, and immunizations.
- Secondary Prevention: Involves diagnosis and treatment of acute illness/injury.
- Examples of secondary level of care: inpatient and emergency departments, and diagnostic centers.
- Tertiary Prevention: Consists of specialized and highly-technical care.
- Examples of tertiary level of care: intensive care, oncology center, burn center, rehabilitation, and support groups.
Personnel
- Healthcare teams include various professionals.
- Spiritual support staff provide emotional and spiritual care to patients and families.
- Registered dietitians manage nutritional needs.
- Laboratory technicians perform diagnostic tests.
- Occupational therapists assist with ADLs.
- Pharmacists are experts in medication management.
- Physical therapists aid in improving musculoskeletal function.
- Providers (MD, DO, APN, PA) assess, diagnose, and treat diseases.
- Radiologic technicians perform imaging procedures.
- Respiratory therapists manage respiratory care.
- Social workers provide psychosocial support and coordinate resources.
Principles of Ethics
- Advocacy involves supporting the client's wishes.
- Responsibility means committing to obligations.
- Accountability entails answering for one's actions.
- Confidentiality involves protecting patient privacy.
- Autonomy respects the patient's right to make decisions.
- Beneficence promotes doing good.
- Fidelity involves keeping one's promises.
- Justice ensures fair delivery and use of resources.
- Nonmaleficence means doing no harm.
- Veracity entails truthfulness.
Legal Responsibilities
- Unintentional torts refer to harm caused without malicious intent.
- Negligence is the failure to follow safety measures, showing carelessness.
- Malpractice is improper, illegal, or incompetent professional conduct, leading to harm or death.
- Quasi-intentional torts: such as breaches of confidentiality or defamation.
- Intentional torts:
- Assault is verbal or physical threat.
- Battery Involves physical harm.
- False imprisonment involves unlawful restraint.
- Informed consent: a provider explains procedure risks and benefits. An RN witnesses the client's signature and competence.
- Advanced directives express a the client's end-of-life care wishes.
- A Durable Power of Attorney designates a proxy healthcare decision maker.
- DNR (Do Not Resuscitate) orders prevent resuscitation.
- AND (Allow Natural Death) orders allow natural death.
Information Technology
- ISBAR (Introduction, Situation, Background, Assessment, Recommendation) promotes horizontal communication.
- For telephone prescriptions, repeat them back and obtain the provider's prescription within 24 hours.
- Incident reports document medication errors, needlestick injuries, and falls.
- Avoid opinions and do not include on client's medical record.
Delegation and Supervision
- Delegation must follow the Five Rights: right task, right circumstance, right person, right direction/communication, and right supervision/evaluation.
- LPN's are able to complete AUP, while AUP's are not able to complete certain procedures
- RNs cannot delegate aspects of the nursing process like assessment, diagnosis, planning, implementation, and evaluation.
Nursing Process - Assessment/Data Collection
- Collecting information about the client's health includes initial, focused, and ongoing assessments.
- Subjective Data includes the clients perceptions and feelings.
- Objective Data is is objective data.
- Planning includes admission, ongoing, and discharge planning. Priority is determined by Maslow's hierarchy of needs.
- There are three types of interventions, which include: Independent, Dependent and Collaborative Interventions
- Initiate Independent Interventions
- Dependent Interventions: Cannot be done without physician's order
Maslow's Hierarchy of Needs
- Self-actualization: achieving one's full potential.
- Esteem: respect, status, accomplishment, recognition.
- Love and Belonging: intimacy, friendships, family, social life, inclusion.
- Safety: resources, employment, personal security, health.
- Physiological: breathing, water, food, sleep, sex, shelter, reproduction, homeostasis, excretion.
Medical and Surgical Asepsis
- Medical asepsis is clean, and surgical asepsis is sterile.
- Hand hygiene should be completed with an alcohol-based product or soap before/after every client contact, and before/after donning/doffing gloves.
- Washing hands should use soap when visibly soiled, before eating, and after the restroom.
- Hands should be washed for at least 15 seconds
- Should use 3-5ml of a product
Physical Environment
- Use plastic bags for soiled materials & do not shake linen.
Sterile Field
- The outer wrapping and 1 inch border of the field are not sterile.
- Do not hold materials below the waist or above chest.
- Open packages flap away from you, side flaps, flap towards you.
- Hold bottles so label is under your palm and place bottle caps on non sterile field.
- Pour 2mL of sterile solution away and sterile solutions expire 24h after opening.
- Discard sterile packages which are wet or torn. Do not reach across or turn your back. Regarding donning gloves, pick up your dominant hand. The dominant hand gloved, pick up the non-dominant hand's glove from the inside cuff.
Infection Control - Stages of Infection
- Incubation is the time between pathogen entry and manifestation appearance.
- Prodromal Stage presents with nonspecific symptoms.
- Illness involves specific symptoms.
- Convalescence: This is the resolution phase.
Infection - Patients at Risk and Expected Findings
- Immunocompromised and post-surgery patients are at risk.
- Those who have indwelling devices, poor oxygenation, and skin breakdown are at risk.
- Those with chronic/acute diseases and poor hygiene are at risk.
- Also at risk are individuals experiencing stress or excessive alcohol intake.
- Those with poor nutrition, sharing needles for IV drugs or having unprotected sex are predisposed to infection as well.
- Expected findings include fever, chills, high RR and HR, malaise, fatigue, and enlarged lymph nodes.
- Older adults might only show agitation, confusion, or incontinence because of a reduced immune response.
Inflammation
- This is the body's natural response to an infection.
- First stage presents with redness, warmth, pain, or tenderness.
- Second stage presents with exudate, which includes: Serous (clear), Sanguineous (bloody), and Purulent (PUS - contains bacteria).
- Third stage represents scar tissue formation.
Hand Hygiene
- Regarding spore contamination water and soap should be used
Airborne Precautions
- Droplets are smaller than 5 mcg when in the air.
- Common diseases such as chickenpox, measles, herpes zoster, and TB.
- Always place clients in a private room.
- Patient must wear mask outside of their room and N95 or HEPA mask should be used if the patient has TB.
Droplet Precautions
- Droplets are large than 5 mcg and travel 3-6 ft when emitted through droplets.
- Common diseases include (SPIDERMAN):
- Sepsis
- Scarlet fever
- Strep, Pertussis (whooping cough)
- Pneumonia
- Parvovirus
- Influenza
- Diphtheria, Epiglottitis
- Rubella (german measles), Mumps (parotitis), Adenovirus
Contact Precautions
- These are implemented pathogens which can be spread through direct or indirect contact.
- They include diseases: MRSA, Wound infections, Eye infections, Enteric infections (C. Diff), Shigella, Herpes Simplex Impetigo, Scabies
- Patients are placed in a private room or with a patient with the same disease. Always wear gloves and a gown.
Protective Environment
- For the immunocompromised patient there should be a private room with a positive airflow of 12/hr.
- Always use a HEPA filtration system and ensure the patient wears a mask outside the room.
Client Safety - Falls & Seizures
- Patients at risk for falls include: those with impaired mobility/balance or visual problems.
- Those with cognitive dysfunction or those taking medications that cause orthostatic hypotension or drowsiness are at increased risk.
- Complete a fall-risk assessment and demonstrate call light use to prevent falls.
- Fall-risk alerts and wristbands also prevent falls.
- Prevent falls by avoding side rails (if possible) and also provide a non-skid mat.
- Keep the environment clutter-free, lock bed's wheels, and provide adequate lighting to prevent the risk of falls.
- Bed should be in a low position and provide regular elimination.
- Focal/Partial Seizure: Only on one side of the Brain
- Generalized Seizure: Both Hemispheres
- Status Epilepticus: This is a medical emergency.
- Seizure Precautions: This includes pad side rails.
- Also keep suction equipment and oxygen nearby.
- During Seizure: never put anything in the patient's mouth or restrain the patient.
- Instead, lower the patient to the floor and on their side.
- Do not leave the patient and suction PRN & administer meds. After a seizure, orient the patient, access their mental status, document, and provide a therapeutic environment.
Seclusion/Restraint
- Patients can request seclusion but restraints can be physical or chemical.
- Never use restraint as punishment or convenience.
- Must be absolute LAST resort
- Must a order from physician. Always follow the 4hr, 2hr, and 1hr duration rules.
- Can be renewed no more than 24hrs
- Quick Assess Skin: Q2hrs Patient and Guardian: must sign • Ensure bony • Finger room: 2 Remove Q2hrs
Pad to moveable part bed.
Fire Safety
- RACE (Rescue, Alarm, Contain Confine, extinguish)
- PASS (Pull, Aim, Squeeze, Sweep)
- For classes
- Class A: Combustible
- Class B: Flammable
- Class C: Electrical
Home Safety - Safety Prevention
- Always have safety devices for all populations
Vitals
- Take vitals with appropriate devices and never take the temperature on infants
Eye
- Eye tests: Check eye charts
Heart/Lung
- Heart location where
Skin
- Follow ABCDE guidelines
Pulses
- Check and document pulses
Alignment
- Check normal position for patients who are post. Op
Disasters
- Who is the hospital priority patient
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