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Questions and Answers
What is the medical term for an overgrowth or thickening of the nail which can become discolored turning white, yellow, red, or black?
What is the medical term for an overgrowth or thickening of the nail which can become discolored turning white, yellow, red, or black?
Onychauxis
What causes clubbing nails, most likely due to Cardiopulmonary Disease?
What causes clubbing nails, most likely due to Cardiopulmonary Disease?
Urinary retention is the accumulation of urine in the bladder, and it is the inability to empty urine in the bladder.
Urinary retention is the accumulation of urine in the bladder, and it is the inability to empty urine in the bladder.
True
____ is the loss of voluntary control to void, and possible causes include infection, nerve damage to the brain or bladder, spinal cord damage, or the aging process.
____ is the loss of voluntary control to void, and possible causes include infection, nerve damage to the brain or bladder, spinal cord damage, or the aging process.
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According to the Health and Safety at Work Act of 2015, what are employers and employees required to do?
According to the Health and Safety at Work Act of 2015, what are employers and employees required to do?
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Hand hygiene is the most important element of standard precautions.
Hand hygiene is the most important element of standard precautions.
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According to the acronym RACE, what does 'R' stand for?
According to the acronym RACE, what does 'R' stand for?
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What is the purpose of using gowns in healthcare?
What is the purpose of using gowns in healthcare?
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Match the components of the Chain of Infection with their respective descriptions:
Match the components of the Chain of Infection with their respective descriptions:
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What is the main cause of perineal dermatitis?
What is the main cause of perineal dermatitis?
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Which of the following are risk factors for impaired skin integrity in older adults? (Select all that apply)
Which of the following are risk factors for impaired skin integrity in older adults? (Select all that apply)
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What is malabsorption?
What is malabsorption?
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Aphagia refers to the complete inability to swallow.
Aphagia refers to the complete inability to swallow.
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______ pneumonia is a condition caused by the inhalation of foreign material into the lungs.
______ pneumonia is a condition caused by the inhalation of foreign material into the lungs.
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Study Notes
Legislation and Health and Safety
- The Health and Safety at Work Act of 2015 requires employers and employees to identify and assess hazards, control hazards, and notify accidents.
- Employers' responsibilities include: • Providing a safe place of work • Providing instructions and training • Regularly assessing risks • Providing safe equipment • Providing safe systems of work • Providing safe access and egress to emergency drills, evacuation, and sign alarms • Providing personal protective equipment (PPE)
- Employees' responsibilities include: • Familiarizing themselves with policies and procedures • Familiarizing themselves with emergency and evacuation procedures • Using PPE correctly • Reporting defects in fixtures, fittings, and equipment • Caring for their own and others' safety and health
General Hazards in Healthcare Settings
- Physical hazards
- Chemical hazards
- Clinical hazards
- Biological hazards
- Infection control hazards
- Security hazards
- Data protection hazards
Healthcare Waste
- Sharps safety: place sharps in yellow plastic sharps containers
- Linen: use color-coded systems
- Infectious wastes: use yellow biohazard bags and personal protective equipment (PPE); use safe handling techniques; and be aware of spills
Emergency Procedures
- RACE (Remove, Announce, Contain, Extinguish, and Evacuate) for fire safety
- Be aware of local emergency procedures (e.g. fire safety, civil defense emergencies, intruders, gas, and local flooding)
- Identify emergency exits and equipment
- Participate in emergency drills
- Observe "NO SMOKING" requirements
- Evacuation principles: • Remove from immediate danger • Remove to a safe place beyond doors and fire doors • Evacuate the building
- Order of evacuation: • Ambulant (1) - patients/residents who can walk • Semi-ambulant (2) - patients/residents who need assistance with wheelchairs and walkers • Non-ambulant (3) - patients/residents who are unable to walk
Hazard Management
- Local systems for identifying and managing risks include: • Hazard registers • Identifying actual and potential hazards • Reporting hazards, incidents, and adverse events
- Hazard management strategies: • Eliminate • Isolate • Minimise
- Reporting hazards and incidents is important to: • Generate a database • Identify hazards and adverse events • Evaluate response to adverse events • Continuously improve safety and welfare of the environment • Improve procedures for reducing, controlling, and managing adverse events
Hand Hygiene
- Hand hygiene is the most important element of standard precautions
- Removes microorganisms such as bugs and germs from hands
- Reduces the risk of person-to-person transmission of harmful organisms
- 5 Moments of Hand Hygiene: • Before touching a patient • Before a procedure • After a procedure or body fluid exposure risk • After touching a patient • After touching a patient's surroundings
Personal Protective Equipment (PPE)
- The purpose of using gloves: • Unsterile gloves for contact with body fluids • Sterile gloves for sterile procedures
- The purpose of using gowns: • To prevent contamination of clothing and act as a barrier isolation
- Face protection: • Goggles: must fit snug over and around eyes • Face shields/visor masks: must cover forehead, extend below chin, and wrap around the side of the face • Masks: must cover nose and mouth and prevent fluid penetration • N95 masks: disposable, high-filtration face masks or particulate respirators
Infection Control
- Chain of infection: • Infectious agent • Source • Portal of exit • Means/modes of transmission • Portal of entry • Susceptible host
- Standard precautions: • Effective hand hygiene • Personal hygiene • Personal protective equipment (PPE) • Aseptic technique • Sharps safety
- Examples of patients at risk: • Dyspnoeic clients • Patients who are febrile and dehydrated • Patients who are taking medications • Patients who are unable to care for themselves • Patients with impaired movement • Patients with feeding tubes or catheters • Patients with dentures or partial plates
Hygiene Care
- Factors affecting hygiene care (SLAPEECKE): • Stage of development • Level of independence • Availability of facilities • Physical and cognitive ability • Environment • Economic status • Choice • Knowledge • Emotional
- Patients/clients at risk: • Dyspnoeic clients • Patients who are febrile and dehydrated • Patients who are taking medications • Patients who are unable to care for themselves • Patients with impaired movement • Patients with feeding tubes or catheters • Patients with dentures or partial plates
- Hygiene cares: • Bathing and hygiene • Oral care • Toileting • Dressing • Grooming
- Nursing observations and assessments to look out for when bathing older adults: • Observation • Mobility • Sensation • Mood • Skin condition • Change in ability
Elimination: Urinary and Urinalysis
- Urinary retention: • Accumulation of urine in the bladder • Inability to empty urine in the bladder
- Residual urine: • Urine retained in the bladder after voiding
- Incontinence: • Loss of voluntary control to void • Possible causes: infection, nerve damage, spinal cord damage, or the aging process
- Urinary terminologies: • Frequency: abnormal frequent urination • Urgency: abrupt, strong need to urinate • Nocturia: frequent urination at night • Oliguria: low passing urine, less than 500 mls/24hr • Enuresis: involuntary discharge of urine • Renal anuria: cessation of urine production, less than 100 mls/24hr
Urinalysis
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Reagent strips: used to screen urine samples • Leukocytes and nitrates: sign of possible UTI • Protein: sign of kidney damage • Ketones or glucose: sign of kidney damage • Blood: sign of kidney disease • Bilirubin: sign of liver damage • pH levels: measures acidity or alkalinity/acid-base balance of the body • Specific gravity: gives measure of concentration of components of urine sample
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Abnormal results: • pH levels: acidosis or alkalosis • Protein: proteinuria • Glucose and ketones: ketoacidosis • Blood: haematuria • Bilirubin and urobilinogen: liver or gallbladder disease### Urinary Elimination
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Incontinence is the loss of bladder control.
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Urinary retention is the inability to empty the bladder completely.
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Residual urine is the urine retained in the bladder after voiding.
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Enuresis is bed-wetting or nighttime loss of bladder control.
Bowel Elimination
- The function of bowel elimination is to excrete and eliminate waste products of digestion.
- Determinants that affect elimination include dietary patterns and fluid intake.
- A daily fluid intake of 6-8 glasses of water (1400-2000ml) helps to liquify stool and stimulate peristalsis.
Factors Affecting Elimination
Fibre
- Fibre is an undigestible residue that provides bulk to stool, absorbs fluids, and increases stool mass, triggering peristalsis.
Personal Habits
- Postponing bowel movements can lead to constipation.
Activity and Exercise
- Immobile activity can lead to constipation.
Medications
- Laxatives stimulate evacuation of bowels.
- Morphine and narcotics with codeine can harden stool, cause constipation, and slow down peristalsis.
Emotions
- Anxiety can increase peristalsis and cause diarrhea.
- Depression can lead to low peristalsis.
Pain
Surgery
- Anaesthetics can cause temporary cessation of peristalsis.
- Direct manipulation of the bowel during abdominal surgery can stop peristalsis.
- Paralytic ileus is a temporary paralysis of intestinal muscles.
Common Problems of Elimination
- Constipation is the difficult passage of dry stool.
- Faecal impaction is a large, hard mass of stool stuck in the rectum.
- Diarrhea is a liquid stool.
- Flatulence is the accumulation and expulsion of gas from the digestive system.
- Incontinence is the inability to control passage of stool.
- Haemorrhoids are swollen, inflamed veins in the rectum or anus.
Promoting Healthy Bowel Elimination
- Privacy and comfort can aid bowel elimination.
- Squatting position and bedpan position can aid bowel evacuation.
- Cathartics, laxatives, and enemas can help induce bowel movements.
- Stool softeners and anti-diarrheal agents can aid bowel elimination.
Assisting with Elimination
- Residents often have the urge to defecate after one hour of a meal.
- Bedpans, urinals, and commodes can aid bowel elimination.
Causes of Constipation in the Elderly
- Reduced activity, fibre intake, and fluid intake contribute to constipation.
- Side effects of medications and co-existing medical conditions can also contribute to constipation.
Secondary Causes of Constipation in the Elderly
- Depression, dementia, diabetes, hypercalcaemia, hypothyroidism, stroke, and Parkinson's disease can contribute to constipation.
Skin Care
- Urinary and faecal incontinence can cause skin damage and irritation.
- Skin dampness is the main cause of perineal dermatitis.
- Incontinence dermatitis is skin irritation and inflammation caused by prolonged contact with urine or faeces.
Risk Factors for Impaired Skin Integrity
- Reduced mobility, immunodeficiency, nutritional deficiencies, pressure, altered circulation, psychosocial disorders, and increased excretions contribute to impaired skin integrity.
Nutrition and Fluid Balance: Older Adults
- Nutrition is the process that involves taking in nutrients for proper body functioning and maintenance of health.
Factors Affecting Nutrition in Older Persons
- Reduced saliva and dry mouth, reduced sensory ability, reduced strength, and malabsorption affect nutrition in older persons.
- Arthritis, eyesight changes, taste and smell changes, swallowing and chewing problems, and oral problems also affect nutrition.
- Income, health, and medications can also affect nutrition in older persons.
Terminologies
- Aphagia is the complete inability to swallow.
- Dysphagia is the difficulty or discomfort in swallowing.
- Aspiration pneumonia is the inflammatory condition of lungs and bronchi due to inhalation of foreign material like food and vomit.
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Description
This quiz assesses your understanding of the Health and Safety at Work Act of 2015, including the responsibilities of employers and employees. It covers risk assessment, hazard management, and safe work practices.