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What is one of the main goals of maintaining a safe environment in nursing care?
What is one of the main goals of maintaining a safe environment in nursing care?
Emergency alarms should be removed from doorways to ensure a clear exit path.
Emergency alarms should be removed from doorways to ensure a clear exit path.
False
What should a nurse do if a patient spills a drink?
What should a nurse do if a patient spills a drink?
Pick it up to prevent a safety hazard.
The nurse should ensure that the ______ is within reach of the patient.
The nurse should ensure that the ______ is within reach of the patient.
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Match the emergency alerts to their categories:
Match the emergency alerts to their categories:
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Which of the following factors can affect a person's ability to protect themselves?
Which of the following factors can affect a person's ability to protect themselves?
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Infection control guidelines are not necessary for promoting patient safety.
Infection control guidelines are not necessary for promoting patient safety.
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What should nurses memorize for safety and security emergencies?
What should nurses memorize for safety and security emergencies?
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What is the primary purpose of the document related to patient status post-accident?
What is the primary purpose of the document related to patient status post-accident?
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Smoke inhalation is a common cause of death in fires.
Smoke inhalation is a common cause of death in fires.
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What does the 'R' in the RACE acronym stand for?
What does the 'R' in the RACE acronym stand for?
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To properly use a fire extinguisher, you should remember the acronym PASS which stands for Pull, Aim, Squeeze, and _____.
To properly use a fire extinguisher, you should remember the acronym PASS which stands for Pull, Aim, Squeeze, and _____.
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Match the developmental stages with their common safety concerns:
Match the developmental stages with their common safety concerns:
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Which of the following is NOT a common cause of fires in hospitals?
Which of the following is NOT a common cause of fires in hospitals?
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Physical restraints can be used for positioning supports necessary for treatment.
Physical restraints can be used for positioning supports necessary for treatment.
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What should be contained during a fire according to the RACE protocol?
What should be contained during a fire according to the RACE protocol?
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Which of the following is NOT an intervention for sensory-perception alterations?
Which of the following is NOT an intervention for sensory-perception alterations?
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Dementia and Alzheimer's can affect judgment and the ability to recognize threats.
Dementia and Alzheimer's can affect judgment and the ability to recognize threats.
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What is one intervention for fall risk prevention?
What is one intervention for fall risk prevention?
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Proper handwashing is a key component of _____ Asepsis.
Proper handwashing is a key component of _____ Asepsis.
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Match the described issues with their respective interventions:
Match the described issues with their respective interventions:
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What is a potential con of using side rails?
What is a potential con of using side rails?
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Education on creating a safe home environment is considered an environmental factor intervention.
Education on creating a safe home environment is considered an environmental factor intervention.
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List one characteristic of a fall risk patient.
List one characteristic of a fall risk patient.
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The nurse is responsible for assessing, treating, and _____ in the event of patient injury.
The nurse is responsible for assessing, treating, and _____ in the event of patient injury.
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Which of the following is a role of the nurse for preventing hospital injuries?
Which of the following is a role of the nurse for preventing hospital injuries?
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What is a potential risk of improperly applying a belt restraint?
What is a potential risk of improperly applying a belt restraint?
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Restraints should be applied without notifying a physician if the situation is critical.
Restraints should be applied without notifying a physician if the situation is critical.
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What is the maximum duration for applying heat therapy?
What is the maximum duration for applying heat therapy?
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Cold therapy works primarily as a __________ agent, producing numbness and slowing blood flow.
Cold therapy works primarily as a __________ agent, producing numbness and slowing blood flow.
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Match the type of restraint with its description:
Match the type of restraint with its description:
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Which of the following is NOT a contraindication for heat therapy?
Which of the following is NOT a contraindication for heat therapy?
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Reassessing a patient under restraint is required every 24 hours.
Reassessing a patient under restraint is required every 24 hours.
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What physiological effect does heat therapy have on blood vessels?
What physiological effect does heat therapy have on blood vessels?
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Cold therapy should be limited to __________ minutes to avoid tissue damage.
Cold therapy should be limited to __________ minutes to avoid tissue damage.
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Match the type of thermal therapy to its description:
Match the type of thermal therapy to its description:
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What is a potential outcome of rebound phenomena from cold therapy?
What is a potential outcome of rebound phenomena from cold therapy?
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It is safe to apply heat therapy to a pregnant woman's abdomen.
It is safe to apply heat therapy to a pregnant woman's abdomen.
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What is the purpose of using a gait belt?
What is the purpose of using a gait belt?
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Restraints should be documented every __________ hours.
Restraints should be documented every __________ hours.
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Study Notes
Patient Safety
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Significance:
- Assessing and maintaining a safe environment is crucial for patient outcomes.
- Knowing the location of emergency equipment is essential.
- Understanding the reason for medication administration is fundamental.
- Assessing patients before medication administration is paramount.
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Environmental Safety:
- Maintain clutter-free rooms, hallways, and walkways.
- Ensure emergency alarms are accessible on doorways.
- Eliminate debris.
- Maintain cleanliness and a debris-free environment.
- Keep IV poles away from movement and unplugged when not in use.
- Ensure safe use of sockets and plugs, free of clutter.
- Identify fire alarms and extinguishers within the immediate area.
- Ensure call bells are within reach.
Nurse Promotion of Patient Safety
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Be the eyes and ears:
- Do not ignore patient needs, such as spilled drinks.
- Adhere to infection control guidelines, including PPE and handwashing.
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Safety and Security:
- Memorize the security emergency hotline.
- Understand facility alert systems for fire, evacuations, missing persons, active shooters, mass casualties, and medical emergencies.
Factors Affecting Patient Safety
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Lifestyle:
- Factors like diet, exercise, substance abuse, and sleep patterns significantly impact safety.
- Nurse interventions focus on education, promoting physical activity, rehabilitation, support groups, and health screenings to address lifestyle concerns impacting safety.
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Mobility:
- Fall risk, skin breakdowns, and fractures are concerns.
- Interventions include assistive devices, fall prevention strategies, safe environments, and exercises to improve mobility and reduce risks.
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Sensory Perception Alterations:
- Impaired senses, particularly vision, hearing, touch, and taste, increase the risk of safety hazards.
- Interventions emphasize assessments, adaptations, adequate lighting, assistive devices, and clear, simple communication to assist those with sensory alterations.
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Cognitive Awareness:
- Conditions like dementia, Alzheimer's disease, and confusion negatively impact judgment and ability to recognize threats, leading to unsafe behaviors.
- Interventions include structured environments, consistent instructions, memory aids, and regular assessments to support patients with cognitive challenges.
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Communication:
- Language barriers or impairments hinder communication and create safety risks.
- Interventions focus on assessing communication abilities, employing adaptation methods, and ensuring patient understanding.
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Environmental Factors:
- Environmental hazards, such as poor lighting, pollution, clutter, and unsafe equipment, can threaten safety.
- Interventions involve educating patients about creating a safe home environment, conducting environmental assessments, and recommending modifications for hazardous areas.
Asepsis
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Medical Asepsis (Clean Technique):
- Follows standard precautions and handwashing protocols, as well as transmission-based precautions.
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Surgical Asepsis (Sterile Technique):
- Requires that only sterile objects touch other sterile objects.
Side Rails
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Pros:
- Aid in patient turning and repositioning.
- Provide support for getting in and out of bed.
- Promote feelings of comfort and security.
- Reduce the risk of falls.
- Allow easy access to the bed.
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Cons:
- Risks include suffocation, strangulation, injury, and death.
- May contribute to falls.
Fall Risk
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Preventing Hospital Injuries:
- Nurses play a critical role in comprehensive assessments upon admission and ongoing risk assessments.
- Previous safety concerns, including prior injuries, falls, and home hazards, are essential to consider.
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Common Characteristics of Fall Risk Patients:
- History of falls.
- Gait disturbance or balance issues.
- Dizziness.
- Visual impairment.
- Medications that increase fall risk.
- Incontinence.
- Frequent need to use the restroom.
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Nurse Interventions:
- Utilize side rails as a safety measure.
- Educate patients, families, and other healthcare professionals about safety measures.
- Consider restraints when necessary.
- Implement fall alerts.
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Patient Injury:
- Nurses are accountable for assessing, treating, and stabilizing patients.
- Involving physicians and families is essential.
- Injury reports documenting the incident, vital signs, treatment provided, and the patient's status are crucial.
- The purpose of the incident report is to investigate the incident and identify potential changes to prevent similar occurrences. Additionally, incident reports may be used in legal cases.
Fire Safety
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Common Causes of Hospital Fires:
- Malfunctioning electrical equipment.
- Damaged wires.
- Patient or employee smoking.
- Unsafe disposal of cigarettes.
- Inadvertent combustion of anesthetic gases.
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Common Cause of Death in Fires:
- Smoke inhalation.
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RACE Protocol:
- Rescue: Evacuate those in immediate danger.
- Alarm: Pull the alarm (call operator, dial 911, activate fire alarms).
- Contain: Confine the fire/smoke (close doors).
- Extinguish: Extinguish or stop the fire.
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PASS Protocol:
- Pull: pull the pin on the fire extinguisher.
- Aim: Point the nozzle at the base of the fire.
- Squeeze: Squeeze the handle to release the extinguishing agent.
- Sweep: Sweep the nozzle from side to side to cover the fire.
Developmental Considerations
- Fetus: Risk of abnormal growth and development.
- Neonate: Risk of infection, falls, and suffocation.
- Infant: Risk of car seat safety, drowning, crib safety, SIDS, burns, injuries from toys, and inhaling foreign objects.
- Toddler: Risk of cuts, burns, drowning, suffocation, inhaling foreign objects, and window safety.
- School Age/Adolescence: Risk of chemical safety, sharp objects, drowning, substance use, bullying, and sports injuries.
- Young Adult: Risk of motor vehicle accidents, drug/alcohol use, drowning, workplace injuries, domestic violence, and stress.
- Elderly: Risk of home hazards, vision and hearing loss, reduced reflexes, falls, abuse, and motor vehicle accidents.
Restraints
- Physical Restraints: Devices that restrict free movement of a body part.
- Alternative Restraints: Staff and environmental involvement, behavior management, and structured activities.
- Contradictions of Restraints: Restraints should not be used for convenience of staff or as punishment.
- Before Applying Restraints: Consult with a physician and document the use of alternative restraints.
- Emergency Protocol for Restraints: Use restraints when a patient poses a threat to themselves or others, interferes with treatment, or causes physical damage. Always notify the physician immediately.
- Reassessment and Reordering: Restraints require reassessment every 24 hours by a physician, documentation every 2 hours, and skin integrity checks.
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Types of Restraints:
- Belt Restraints: Used for sitting patients, preventing rising while allowing for extremity and upper body mobility.
- Jacket/Vest: Used for bed or chair, restricting rising while allowing extremity movement.
- Mitt: Prevents grasping but allows upper extremity movement.
- Wrist/Ankle Restraints: Prevents upper/lower extremity movement, used for safety of patients who hit, kick, or try to get out of bed.
- Gait Belt: A safety device used to assist with ambulation and prevent falls.
Hot & Cold Therapies
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Physiologic Effects:
- Heat (Vasodilation): Dilates blood vessels, increases blood flow, reduces blood viscosity, increases inflammation, promotes healing, has a sedative and muscle relaxation effect, and increases tissue metabolism. Limit heat therapy to 20-30 minutes.
- Cold (Vasoconstriction): Constricts blood vessels, reduces blood flow, decreases histamine release, reduces edema and inflammation, alters tissue sensitivity, and decreases oxygen supply. Limit cold therapy to 15-20 minutes.
- Rebound Phenomena: After treatment, the opposite effect may occur. For example, after heat therapy, blood pressure may decrease and pulse rate may increase.
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Contradictions:
- Heat: Open wounds, hemorrhage, edema, inflamed areas, localized malignant tumors, testes, pregnant abdomen, areas over metallic implants.
- Cold: Open wounds, impaired peripheral circulation, hypersensitivity to cold.
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Guidelines for Thermal Therapies:
- Tolerance: Assess patient tolerance to heat and cold.
- Contradictions: Ensure there are no contraindications to therapy.
- Explanation: Explain the therapy to the patient.
- Assessment: Continuously monitor the patient during therapy.
- Discomfort: Stop therapy if the patient expresses discomfort.
- Revisit: Revisit the therapy and assess the patient according to a schedule.
- Remove: Safely remove the therapy device.
- Examine: Examine the treatment area for any adverse effects.
Different Types of Thermal Therapies
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Heat:
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Dry:
- Hot Water Bags: Fill 1/2 to 2/3 full with water at 105-109°F, expel air, plug, cover with a towel.
- Electric Heating Pads: Warm up before placement, use a power switch that can't be turned up too high, cover with a towel, place anterior or lateral to the affected area, avoid moisture.
- Aquathermia Pads: Fill with distilled water, set to 105°F, warm pad before use, secure with gauze or tape.
- Hot Packs: Cover with a washcloth, check for leaks.
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Moist:
- Warm Moist Compress: Soak a cloth in warm water, cover with an impervious wrap.
- Sitz Bath: Warm soak of the perineum/rectal area, water temperature 93-99°F.
- Warm Soaks: Immersion in warm water, water temperature 105-109°F for 15-20 minutes.
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Cold:
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Dry:
- Ice Bags: Fill 2/3 full with crushed ice, expel air, close cap, cover with a towel.
- Cold Packs: Follow instructions, check for leaks.
- Hypothermia Blanket: Used for body temperature regulation.
- Glove Ice Pack: Used for postpartum patients.
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Dry:
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Elderly Patient Considerations for Thermal Therapies:
- Older adults have different needs when it comes to thermal therapies.
- They may have reduced kidney function, sensory losses, decreased reflexes, and a longer lifespan.
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Description
This quiz focuses on the critical aspects of patient safety in nursing. It covers the importance of maintaining a safe environment, proper medication administration, and the nurse's role in promoting patient safety. Test your knowledge on best practices and emergency protocols essential for optimal patient care.
