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N106 > Binders, restraints, catheter and condom care > Flashcards

Binders, restraints, catheter and condom care Flashcards

1
Q

What is the definition of a restraint?

A

a chemical, mechanical/physical, environmental device used to restrict the behavior or actions of a person

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2
Q

What is the optimal goal regarding restraints?

A

provide a restraint-free environment

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3
Q

What are some methods to protect pts and to prevent accidents?

A

Orientation of patients (show them what is around them, keep items in reach)

Call bell in reach

Dec hazardous objects/situations

Assess risk for falls

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4
Q

What are some ways that restraints may be avoided?

A

orient pt to surroundings

communication aids (to help them tell you what they would like)

sensory aids

ROUTINE TOILETING

exercise/ambulation regimes

Consult other HCPs

Medication review

door guard

increased observation

encourage family to visit

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5
Q

What are some complications that come from restraint use?

A

Agitation, humiliation, fear, dec self-esteem

disorientation

contractures, nerve dmg, circulatory impairment

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6
Q

What happens to the amount of care the pt receives when they are restrained? what can this lead to?

A

Tend to get less care

Can result in:

  • pressure ulcers
  • constipation
  • incontinence
  • pneumonia
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7
Q

What are the 3 indications for restraint use?

A

decrease risk of injury to pt and others. (must be a significant risk)

prevent interruption of therapy

prevent confused or combative pt from removing life-support equipment

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8
Q

What are the 6 criteria for restraint selection?

A

1) least restrictive of movement
2) least obvious to others
3) noninterfering with treatments
4) readily changeable
5) safe
6) agency policy

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9
Q

If a restraint is put into place, what should you make sure you check?

A

that it is quick to remove

maintains skin integrity and circulation

ends are tied to appropriate place

knots do not tighten and when pulled

it is the correct fit

remove q2-4 hrs for ROM and skin care

Reassess need for continuation

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10
Q

What guidelines should be followed

A

ensure you know policies

assess underlying reasons for need of restraint

never apply for convenience

do not be influenced by family to take of restraints (can not legally pass on care to a family member)

try to obtain a phys. order prior to implementing

Recognize competent adults right to choose

principle of least restraint

proper fit

documentation

re-assess the need

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11
Q

What data should be included in your documentation if a restraint is applied?

A 
type
time of application
response to treatment
skin condition
frequency of removal
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12
Q

what are the 5 type of restraints?

A

Soft hand mit

Freedom arm splint

Pelvic soft belt

Segufix or Pinel (this is used in acute)

Chemical

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13
Q

When would you use a soft hand mitt?

A

when scratching is a problem and needs to be prevented

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14
Q

When would you use a freedom arm splint?

A

when IVs need to be protected from being pulled out

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15
Q

When would you use a pelvic soft belt?

A

when a sitting restraint is needed (usually to prevent falls from chairs/WC)

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16
Q

What is the purpose of bandages and binders? (7)

A

Create pressure

Immobilize body part

Provide support

Dec/prevent edema

Secures splints and dressings

Applies warmth

Shapes or molds stump

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17
Q

What are the principles relevant to the application of bandages and bindings? (4)

A

microorganisms flourish in warm, damp environment

pressure upon tissues can affect circulation (esp excessive/uneven)

friction can cause trauma to skin

natural anatomical position must be maintained

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18
Q

When applying a bandage which direction do you work in?

A

distal to proximal

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19
Q

What do you need to have before you can apply a bandage?

A

a dr order

20
Q

What are the 5 types of bandage turns?

A 
Circular
Spiral
Spiral-reverse
Figure 8
Recurrent
21
Q

Describe a circular turn

A

each turn completely covers the last

22
Q

When would a circular turn be used?

A

to initiate/terminate a bandage

to cover a small part; finger or toe

23
Q

Describe a spiral turn

A

angles slightly upward overlapping 1/2 to 2/3

24
Q

What is the use of a spiral turn?

A

used to ascend a cylindrical body part (ex wrist, arm)

25
Q

describe a spiral reverse turn.

A

same as spiral, but requires a twist of the bandage 1/2 through each turn

26
Q

When would you use a spiral reverse turn?

A

on cylindrical parts with varying circumferences (lower leg)

27
Q

Describe a figure 8 turn

A

overlapping turn, alternating between ascending and descending over bandaged area

28
Q

when would you use figure 8 turns?

A

for joints or for full extremity

29
Q

What is a recurrent turn?

A

anchored with a circular turn, then turned across the center of tip then alternates right and left followed by circular turns to secure.

30
Q

When would you use recurrent turns?

A

for uneven body parts (head, stump, finger, toe)

31
Q

What should be assessed prior to application of bandages/binders?

A 
CWMS
Swelling
Wound status
Drainage
Pain
Pts ability to reapply bandage/binder
32
Q

What should be assessed after applying bandages for ongoing assessment?

A 
CWMS
pain
swelling
drainage
effectiveness
status of bandage
33
Q

What should be considered in terms of safety for bandaging?

A

be careful for pins and clips that the pt may harm themselves on

be aware of what pressure can cause and reassess

34
Q

What information should be documented when applying a bandage?

A 
application of the bandage/binder
alignment
circulatory status
tolerance of the individual
pt teaching performed
35
Q

What should be done/checked to ensure proper functioning of a catheter?

A

gravity aids flow; no looping of tubing, bag lower than bladder

secure connection

secure tubing to thigh to prevent pull on catheter

36
Q

What is assessed in on-going catheter care?

A

Skin (peri, urinary meatus)
Thigh

Output: amount, characteristics

Intake: 1500ml/day for normal, need 2000 for a person on catheter

emotional/social support

37
Q

What output characteristics should raise concern?

A

low volume

amber colour

odour

sediment

blood

38
Q

What should be assessed after removal of the catheter?

A

Voiding; time of first void, amount, discomfort, frequency

Signs of distension; unable to void, burning/pain on voiding, signs of fullness

39
Q

What can be done to help reduce the chance of infection when a pt has a catheter?

A

Increase fluid intake

Acidify urine to inhibit growth (cranberry juice)

Clamp tubing to prevent back flow if bag/tubing will be elevated

Pericare (BID min)

Hand-washing

Proper positioning

Empty bag regularly

Maintain closed system

Individual measuring containers

40
Q

What sites are risk for causing infection when a pt has a catheter?

A

catheter insertion

drainage bag

spigot on bag

tube junction with bag

41
Q

Describe the correct method for emptying a catheter bag

A

put on gloves
use a measurement container
clean spigot after
record time, amount, and urine characteristics

42
Q

How do you perform pericare and catheter care?

A

do pericare first

clean catheter; avoid pull, wash proximal 1/3 of cath

43
Q

What should you ensure there is when taping a catheter?

A

that there is slack

44
Q

What equipment do you need to remove a catheter?

A

sterile syringe, receptacle, disposable gloves

45
Q

How do you remove a catheter?

A

remove tape

deflate bulb fully

pinch tubing to prevent backflow, withdraw the catheter in a smooth quick motion (do not rip it out, but do not go slowly)

46
Q

If a person is using a condom catheter, how much space should there be between the tip of the penis and the condom?

A

at least 1 inch

47
Q

What is the minimum volume of urine that should be voided with a catheter per hour?

A

30mL/hr

N106 (8 decks)

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