What are the Hospital National Patient Safety Goals
1. Identify pt's correctly 2. Improve staff communication 3. Use Meds safely 4. Use alarms safely 5.
... [Show More] Prevent Infection 6. ID pt safety risks 7. Prevent mistakes in Surgery
What are the Long Term Care National Patient Safety Goals
1. ID Residents correctly 2. Use meds safely 3. Prevent Infection 3. Prevent residents from falling 4. Prevent bed sores
Procedure for fecal Impaction Removal
1. Verify physician written order, Introduce self, hand hygiene, ID patient, explain procedure and provide privacy.
Fecal impaction cont'd...after explaining procedure, what's next?
Raise bed and lower side rail, position pt to Sim's position
Fecal impaction cont'd...after putting pt in Sim's, what do you do next?
Drape pt's trunk and lower extremities with bath blankets, put waterproof pad under buttocks/hips. Place bedpan next to pt.
Fecal Impaction cont'd...after placing bedpan next to pt, what is next?
Hand hygiene and don clean gloves, lubricate gloved index finger and middle finger of dominant hand and tell pt to take deep, slow breaths, in and out during procedure.
Fecal impaction cont'd... after instructing pt to breathe deeply, what is the next step?
Insert gloved index finger, gradually and gently, feel anus relax and insert middle finger. Move fingers gradually towards wall of rectum towards umbilicus and loosen mass by moving fingers in a scissor like motion. Work stool downward and remove small pieces of feces into bedpan.
Fecal impaction cont'd....what signs to observe during removal
Pt response, heart rate, dyspnea or heart palpitations
fecal impaction cont'd...after observing pt response, what do u do next?
Continue to clear feces and allow pt to rest at intervals. Perineal hygiene and Inspect feces color and consistency. Properly dispose of feces and gloves. Hand hygiene, position pt to comfortable position and call light within reach.
Sequence for med admin via NG tube...
1. Check proper placement
2. Check residual
3. Flush 30 mL
4. Give med
5. Flush 30 mL
Define SOAPIER with examples
Subjective-what pt says their pain is
Objective-facts u can measure like a temperature
Assessment-head to toe assessment
Plan-plan patient care
Intervention-implementation
Evaluation-reflecting on what was done
Revision-what would I have done differently
Define Professionalism
Behavior and attitude patterns exhibiting standards and character marked by pride in oneself and one's career, respect for the people served and commitment to the continued development of skills in the pursuit of excellence.
Define ethics
A principle of right or good behavior, a system of moral principles or values, a study of moral philosophy, or the rules and standards of conduct governing the members of a profession.
Subjective data
information perceived only by the affected person
objective data
information that is seen, heard, felt, or smelled by an observer; signs that can be measured
SBAR
S: Situation
B: Background
A: Assessment
R: Recommendation-effective communication between staff
Ohio Nurse Practice Act
Providing and practicing safe nursing care with satisfaction and established standards, we cannot teach the practice of nursing, supervise, evaluate nursing practice, cannot IV push (SCOPE OF PRACTICE)
What is the proper sequence to remove PPE? (DOFFING)
Gloves, goggles, gown, mask
What is the proper sequence to put on PPE? (DONNING)
Gown, mask, goggles, gloves
What can you do to prevent injuries from heat and cold packs?
Place a barrier
How do ineffective coping affects one health?
They might start drinking, doing drugs, or doing risky behaviors which effects the person in a negative way.
How do you properly apply wrist restrains?
Inspect skin, attach wrist restraint to a movable part of bed, attach other end to pt's wrist and be sure two fingers can fit between restraint and pt's skin.
Where is the preferred place to take pulse on an unresponsive patient?
Carotid
What is the z-track method?
This is used for IM injections. Use nondominant hand to pull skin laterally and hold it in position while giving injection. Release skin immediately after withdrawing needle to seal off the injection site. This prevents the medication from leaking through the more sensitive subcutaneous tissue from the muscle. Done at the ventrogluteal or dorsogluteal sites.
What is CAUTI and how can you minimize the patient's risk?
catheter-associated urinary tract infection: only if necessary, don't keep in place longer than necessary, hand hygiene and gloves, clean genital area every shift, chg drainage bag and keep below patient.
Define dysphagia
difficulty swallowing
Define dysphasia
Difficulty speaking
How do you draw regular (clear) and NPH (cloudy) insulin in syringe?
Air in cloudy, air in clear, draw up the clear, draw up the cloudy
What are the normal values for temperature
97.0-99.7
What is normal blood pressure?
BP: 90-140/50-90
What is normal pulse?
60-100
Normal respiration
12-20
Define HIPPA
Health insurance portable accountability act = takes care of the privacy of a patient.
What is the cognitive impairment and list some factors that put a patient at higher risk for it?
People that are at higher risk: elderly, trauma, very young, born that way, people with infections, and strokes.
Stage I pressure ulcer
Nonblanchable redness of a localized, area of intact skin
Stage II pressure ulcer
partial thickness skin loss
Stage III pressure ulcer
full thickness tissue loss with visible fat
Stage IV pressure ulcer
Full-thickness tissue loss with exposed bone, tendon, or muscle
How often should you turn/reposition a patient?
bed: 2 hours
wheelchair: 1 hour
Define HAI and give some examples including who is at higher risk?
Hospital Acquired Infection: the elders, the very young, people who live in group homes, the immunocomplex.
Define AMA. What actions are the responsibility of the nurse in this instance?
Against Medical Advice: if your patient tries to leave, educate them. If they are mentally ill or mentally unstable other precautions are taken.
How do you find the apical heart rate and for how long should you listen to the apex?
Midclavicular, 5th intercostal, listen for 60 seconds.
How would the nurse position the patient to administer rectal enema?
Sims
How would the nurse position the patient to administer a feed via NG tube?
Fowlers or semi fowlers
How would the nurse position a patient to administer vaginal foam?
Dorsal recombinant (10 mins)
What are some of the benefits and disadvantages of electronic health records?
+ (easily accessible for all team members, easier than hand writing, cuts down on errors, used for research and studies, efficient and legible)
- (system goes down and then unable to access info, possibility of unauthorized access, system crash)
What angle do you hold the needle when administering an IM injection?
90 degrees (for vaccines, antibiotics, steroids, deltoid)
What angel do you hold the needle when administering an sub-q injection?
45 degrees (insulin, allergy shots, MMR, Varicella, abdomen)
What angel do you hold the needle when administering an ID injection?
15 degrees (TB skin test)
Which injection do you have to aspirate, or "pull back" before injecting the medication?
IM
Define "Patient centered care"
Providing care that is respectful of and responsible individual patient preference, needs and values, and insuring that patients values guide all clinical decisions.
How does the nurse properly administer nitroglycerin ointment?
Wear gloves, remove previous dose, wipe, date time and initial new paper, apply amount of inches per physicians order, apply different location then last time (not on hair or scars) then secure with tape.
What are the two basic categories of functional ability?
ADL's-grooming bathing and dressing and IADL's-managing finances and shopping
How do you administer a MDI (metered dose inhaler)?
Shake inhaler and spray during inhalation, wait 20-30 seconds (same medication) and wait 2-5mins (different medication)-rinse with water when finished to avoid yeast in mouth
Define clostridium difficile. How can you prevent it?
CDIFF: a bacterial infection of spores found in feces. Symptoms include: diarrhea, rapid heart failure, dehydration, nausea, blood in stool (CONTACT ISLOLATION PREVENTS THE SPREAD OF CDIFF) [Show Less]