Ch 14: Safety Flashcards

1
Q

aging and risks for safety

A

Unintentional falls are the leading type of injury in the ER, premature institutionalization, and long-term disability
Atypical symptoms _ delayed diagnosis
Altered pharmacokinetics, self-administration problems, and polypharmacy _ med safety risks
Loosing balance, less ability to tolerate activity _ falls
Less ability to sense pain and pressure _ pressure injuries, skin breakdown, burns
Periodontal disease _ aspiration
Inability to recall information _ lessened self-care treatment, interruption in care and follow-up

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2
Q

immediate surroundings

A

microenvironment

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3
Q

Elements in the larger world that affects us
Less easily manipulated

A

macroenvironment

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4
Q

Higher level of satisfaction from the environment cannot be achieved unless:

A

lower-level needs are fulfilled (Maslow’s)

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5
Q

things to consider in older adults environment for safety and function

A

Lighting
Temperature
Colors
Scents
Floor Coverings
Furniture
Sensory stimulation
Noise control
Bathroom hazards
Psychosocial factors

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6
Q

lighting considerations for safety and function

A

Light affects function, orientation, and mood/behavior
Home needs several diffuse lighting sources vs. a few bright ones
Assess environment for glare in different positions
Nightlights
Exposure to natural light helps regulate body temp., sleep cycle, and hormone production

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7
Q

temperature considerations for safety and function

A

Older adults are sensitive to lower temperatures
Recommended room temp is 75°F or higher
Temps <70°F  hypothermia; temps >106°F  brain damage
Assess heating and cooling system and window functionality

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8
Q

color considerations for safety and function

A

Different colors produce different emotions and feelings
Contrasting colors help define doors, stairs, and level changes in an area
Colors should be a similar pattern when not trying to draw attention to an area
Wavy patterns and diagonal lines  dizziness and can worsen confusion for cognitively impaired persons
Use a simple pattern on walls

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9
Q

scent considerations for safety and function

A

Aromatherapy is the therapeutic use of essential oils
Memories from scents can lie dormant for years
Oils can cause psychological and physiological effects

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10
Q

floor covering considerations for safety and function

A

Carpeting
-Sound absorber
-Represents warmth, comfort, and homelike atmosphere
-Cons: static electricity and clinging, difficult wheelchair mobility, difficulty with cleaning, holds odors, pests can reside
Scattered and area rugs should be avoided
Tiled floors with wood underneath for better insulation
Avoid bold designs (can cause dizziness and confusion)
Nonglare, nonslip surface

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11
Q

furniture considerations for safety and function

A

Chairs
-Firm with arm rests and support
-Avoid low, sinking cushions
-Appropriate heights
-Upholstery should be easy to clean and fire resistant with a firm surface
Other
-Tables, bookcases, etc. should be sturdy and able to withstand weight from person leaning for support
-Small pieces of furniture should be in low-traveled areas
-People in wheelchairs need lower height
-Check drawers for ease of use
For cognitive impairment, leave furniture simple

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12
Q

sensory stimulation

A

Create an environment that is appeasing to the senses
Textured wall surfaces
Soft blankets and spreads
Differently shaped and textured objects
Murals, pictures, sculptures, and wall hangings
Plants
Coffee brewing, food cooking, perfumes, and oils
Birds to listen to
Soft music
Change wall hangings

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13
Q

noise control in the environment for safety and function

A

Sounds can create difficulties for an older person
Unwanted, disharmonic, chronic noise can be a stressor and compete against sounds the older adult wants to hear
Careful landscaping and walls can buffer noise
Acoustical ceilings, drapes, and carpeting
Turn off electronics not in use
Earphones
Use of pocket pagers/phones rather than intercoms in healthcare setting

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14
Q

bathroom hazards

A

Place small, constant light in the bathroom for nocturia
Keep bathroom floor clutter-free
Correct leaks
Be mindful of temperature of water; control water temp centrally
Color coding with water faucet
Nonslip surfaces, grab bars, shower/bath seat
Raised toilets
Avoid electrical appliances in the bathroom

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15
Q

fire hazards in the home

A

80% of fire deaths occur in home; older adults have 2.5 greater risk of dying in a fire
Stay in the kitchen while cooking
Set a timer to check pot
Use microwave to heat liquids
Safe use and disposal of matches or cigarette butts
Inspection of space heater with appropriate outlet
Proper cleaning and care of fireplaces

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16
Q

psychosocial considerations for safety and function

A

We need to feel comfortable and independent in our space
Respect privacy and personal space
Define specific areas and possessions of the individual
Provide privacy areas for solitude (arrange furniture for privacy)
Request permission to enter personal space
Allow maximum control over one’s space
Use clocks, calendars, newspapers, magazines, books, games, hobbies
Nursing homes can’t offer same satisfaction as one’s own home
Include personal possessions
Recognize individuality
Max control over activities and decision making
Environmental modifications

17
Q

percentage of older adults experience falls each year

A

25%

18
Q

leading cause of fatal and nonfatal injuries in the older adult

A

falls

19
Q

risk factors for falls

A

Age-related changes
Improper use of mobility aids
Medications
Unsafe clothing
Disease-related symptoms
Environmental hazards
Distractions
Caregiver-related factors

20
Q

fall prevention

A

Upon awakening, rest in bed then rest on side of bed
Join an active program to prevent falls
Environmental assessment
Orient to new environments
Fall assessment tools
Others

21
Q

when a falls happens:

A

Assess the fall victim
Leave immobile until full exam of injury
Medical exam and x-ray required
Fractures can be delayed

22
Q

psychological trauma from falls

A

Feel vulnerable of losing independence
Unnecessary restriction of activity
Fear of falling
Offer suggestions for preventing falls while encouraging maximum activity

23
Q

anything restricting freedom of movement

A

restraint
-chemical
-physical

24
Q

risks with restraints

A

can increase fear and worsen behavioral symptoms
identify factors of agitation and mitigate FIRST

25
Q

alternatives to restraints

A

Room near nurses’ station
1:1 supervision
Bed/chair alarms
Comfort measures
Reality orientation
Diversion
Meet basic needs

26
Q

reducing intrinsic safety risks

A

Prevention is important b/c older adults take longer to heal
Reducing Hydration and Nutrition Risks
Addressing Sensory Deficits

27
Q

hydration considerations

A

Adequate fluid intake (1500 mL) unless…
Appropriate quantity and quality of food

28
Q

addressing sensory deficits:

A

Annual eye exams
Approach them from the front
Provide good lighting
Eliminate clutter
Contrasting colors
Labeled in large letters
Audiometric evaluation
Teach using verbal and written methods
Reduce tactile sensation
Specially trained dogs
Use of a stethoscope

29
Q

addressing mobility limitations

A

Encourage family members for transport and escort
Do not take risks
Use community resources

30
Q

monitoring body temperature

A

Temp fluctuations can be hazardous
Monitor closely for changes in temp fluctuations

31
Q

preventing infection

A

Avoid situations contributing to or predispose client to infection
Keep vaccines updated
Use of herbs and CAM

32
Q

medication safety considerations

A

Drugs should only be prescribed when nonpharmacological measures are ineffective
Beer’s Criteria

33
Q

avoid crime for safety

A

Reasonable discretion in traveling at night
Use caution in negotiating contracts
Crime prevention in the community

34
Q

promoting safe driving

A

Restrict driving to daylight, non-congested areas in good weather
Safe driving classes

35
Q

how to have early detection of problems

A

Regular professional assessment
Teach adults how to…
Perform vitals
Self-assessments
Medication education
Recognize danger s/s

36
Q

functional assessment to reduce intrinsic safety risks

A

Determine how ADLs are affected
Refer to OT, SLP, audiologist, ophthalmologist, psychiatrist, PT
Use of assistive devices
Help prepare and label meds
Arrange community resources
Instruct and support caregivers
Modify the environment PRN

37
Q
A