ATI Quiz 2 Flashcards
use of precise practices to REDUCE the number, growth, and spread of micro-organisms (clean technique)
medical asepsis
the absence of illness- producing micro-organisms
asepsis
use of precise practices to ELIMINATE all micro-organisms from and abject or area and prevent contamination (sterile technique)
surgical asepsis
what kind of allergy must be check for before beginning a procedure that requires aseptic technique
latex
3 essential components of handwashing
soap
running water
friction
when should hand hygiene be performed
- before and after client contact
- before and after gloves
- before and after eating
- between certain tasks on the same patient to prevent cross-contamination of different body sites
- after using the restroom
- if hands are visibly soiled
how long should you wash your hands for? (normal & visibly soiled)
15 seconds
up to 2 minutes if visibly soiled
what are some examples of PPE
masks
gloves
gowns
protective eyewear
factors affecting clients’ ability to protect themselves
age mobility cognitive and sensory awareness emotional state ability to communicate lifestyle and safety awareness
people who are at increased risk for falls
older adults decreased vision general weakness urinary frequency balance problems cognitive dysfunction
some examples of measure to prevent falls
call light wristbands regular toileting orienting frequently used items within reach for the patient bed in low position bed rails up (half) use sensors educate patient and family
sudden urge of electrical activity in the brain due to epilepsy, fever, or a variety of medical conditions
seizure
seizure precautions:
rescue equipment at bedside (oxygen, oral airway, suction, padding)
remove unnecessary items from room
assist with ambulation and transferring
what to do during seizure
stay with patient call for help check clock and keep time do not restrain lower bed protect head remove nearby furniture put patient on side with head flexed forward if possible loosen clothing note duration and type of movement
nursing responsibilities with a patients in restraints
assess skin every 2 hours offer food and fluid provide means for hygiene and elimination monitor vitals offer range of motion for extremities explain need to patient and family
when can a nurse apply restraints without a presciption?
in an emergency, and the prescription and provider assessment must occur within the hour
what does the fire safety acronym RACE stand for?
rescue (those in close proximity)
alarm
contain (close doors and windows around fire)
extinguish (if possible)
three classes (ABC) of fire extinguishers
A- for paper, wood, upholstery, rags, other trash fires
B- for flammable liquids and gas fires
C- for electrical fires
what does the acronym PASS stand for when using a fire extinguisher?
P-pull pin
A- aim at base of fire
S- squeeze lever
S- sweep extinguisher from side to side
what are some in home risks for infants and toddlers
aspiration suffocation drowning poisoning falls motor vehicle injury burns
what are some home risks of pre-schoolers and school-aged children?
drowning (teach to swim) motor vehicle injury (sitting in back seat) firearms (keep unloaded and locked up) play injury burns (kitchen...) poison (drugs, alcohol)
what are some home risks for adolescents
motor vehicle injury (seat belts, driving)
burns (sunbathing)
general accidental injuries
self harm
home modifications to reduce fall risks and increase home safety
removing items that would cause tripping providing balance aids maintain steps and sidewalks grab bars near toilet and tub non-slip mat in tub shower chair and bedside commode if needed adequate lighting
unintentional inhalation of tobacco smoke
passive smoking (second-hand smoke)
gas that binds with hemoglobin and reduces oxygen supply to the body
carbon monoxide
rapid assessment of life threatening conditions (no longer then 60 secs) that is completed systematically using standard precautions
(ABCDE)
Airway/ Cervical Spine Breathing Circualtion Disability Exposure
combination of basic interventions deigned to sustain oxygen and circulation to vital organs until more advanced interventions can be initiated.
made up of chest compressions and ventilations
CPR
the CABs of CPR
Chest Compressions
Airway
Breathing
factors or qualities in an objects design that contribute to comfort, safety, effciency, and ease of use
ergonomics
proper use of muscles to maintain balance, posture, and body alignment when performing a physical task
body mechanics
quantity of matter acted on by the force of gravity
weight
the center of a mass
center of gravity
patient lies supine with bed at 30 degrees with knees bent at about 15 degrees
semi- fowlers
patient lies supine with bed at 45 degrees and knees bent at about 15 degrees
Fowler’s position
patients lies supine with bed at 90 degrees
High-Fowler’s position
patients lies on back with head and shoulders elevated on pillow, arms at side and foot support to maintain proper alignment
supine
patient lies flat on abdomen with head to one side
prone
patient lies on side with most of weight on hip and shoulder, with arms flexed to front and pillows supporting head, neck, upper arm, leg and thigh
Lateral (side-lying)
patient lies on side halfway between prone and lateral positions with lower arm behind them and upper arm in front.
Sim’s position
patient lies on bed leaning forward laying head and resting arms on pillow on the bedside table
orthopneic position
entire bed tilted with head of bed lower than foot
trendelenburg position
entire bed tilted with head of bed higher than foot
reverse trendelenburg
patients remains flat with legs elevated above heart level
modified trendelenburg
personal hygiene for most patients includes:
bathing oral care nail and foot care perineal care hair care shaving
freedom and independence in purposeful movement
mobility
inability to move freely and independently at will
immobility
4 types of immobility
temporary (post-op)
permanent (parapalegia)
sudden onset (broken limb in an accident)
slow onset (MS)
mobility/immobility assessment focuses on:
mobility range of motion (ROM) gait exercise status activity tolerance body alignment while standing, sitting and lying
what things would you look for when assessing skin after heat or cold application?
redness pain or burning numbness shivering blisters decreased sensation cyanosis
hose that help maintain external pressure on muscles to promote blood return and decrease risk of blood clots
elastic stockings or thromboembolic device (TED)
sleeves that go hook around legs and inflate and deflate to promote venous return and decrease risk for blood clots
sequential compression device or intermittent pneumatic compression
inflammation of a vein that results in a clot formation
thrombophlebitis
potentially life threatening occlusion of blood flow to one or more of the pulmonary arteries by a clot, which often originates in the lower extremities.
pulmonary embolism
a legal record of care
chart / medical record
fully compliant documentation in includes information that is? (4 points)
- factual
- accurate and concise
- complete and current
- organized
start EVERY entry with the ___ & ___
date & time
what occurs when the presence of a pathogen leads to a chain of events?
infection
micro-organisms or microbes that cause infection
pathogens
5 examples of a pathogen
bacteria viruses fungi prions parasites
ability of a pathogen to invade and injure a host
virulence
native immunity that restricts entry or immediately responds to a foreign organism through the activation of phagocytic cells, complement, and inflammation
nonspecific innate
body’s first line of defense
intact skin
immunity that allows the body to make antibodies in response to a foreign organism
specific adaptive immunity
4 modes of infection transportation
contact
droplet
airborne
vector
4 stages of an infection
incubation
prodromal
illness
convalescence
interval of infection where symptoms specific to the infection occur
illness stage
interval between the pathogen entering the body and the presentation of the first symptom
incubation
interval from onset of general symptoms to more distinct symptoms, when the pathogen is multiplying
prodromal stage
interval when acute symptoms disappear
convalescense
infections that a client acquires while receiving care in a health care setting
Health-Care Associated Infections (HAIs)
most common site of HAIs
urinary tract
written summary of impressions of overall health
general survey
measurements of the body’s most basic functions
vitals signs
what do vital signs include
blood pressure pulse temperature respirations (sometimes pain and oxygen saturation)
reflects the balance between the heat that the body produces and loses
temperature
measurement of the heart rate and rhythm
pulse
body’s mechanism for exchanging oxygen and carbon dioxide, recorded as breaths per minute
reespiration
reflects the force that the blood exerts against the walls of the arteries during contraction (systole) and relaxation (diastole)
blood pressure
represents maximum amount of pressure exerted on the arteries
systolic pressure
represents the minimum amount of pressure exerted on the arteries
diastolic pressure
average body temperature
98.6
acceptable temperature range
96.8 to 100.4 (36 to 38 C)
body’s temperature response to infectious and inflammatory processes
fever
techniques for taking temperature
oral rectal axillary tympanic temporal
abnormally elevated body temperature
hyperthermia
abnormally low temperature
hypothermia
number of times in a minute that you hear or feel the pulse
pulse rate
regularity of impulses
rhythm
reflects the volume of blood that is ejected against the arterial wall with each heart contraction
pulse strength
pulse rate that is faster than normals
tachycardia
pulse rate that is slower than normal
bradycardia
exchange of oxygen and carbon dioxide in the lungs
ventilation
expected range of respirations for adults
12 to 20
regular breathing rhythm is called
eupnea
noninvasive indirect measurement of the oxygen saturation of the blood
pulse oximetry
normal blood pressure
<80
abnormally high blood pressure
hypertension
abnormally low blood pressure
hypotension
pattern of sleeping and awakening
Circadian rhythm
