Clinical Day #1

Question 1

What is safety?

Answer 1

Freedom from physical and psychological injury.

Question 2

Define: sentinel event

Answer 2

An unexpected occurrence involving death, serious physical or psychological injury, or risk thereof.

Question 3

Why are patients more vulnerable to injury?

Answer 3

Thought processes and coping mechanisms are affected by illness and its accompanying emotions.

Question 4

What causes most untoward events?

Answer 4

Failures in communication

Question 5

When must health care providers be most attentive toward a patient’s diversity? Why?

Answer 5

During the assessment. A nurse must use an approach that recognizes a patient’s cultural background so appropriate questions can be raised to clearly reveal health behaviors and risks.

Question 6

Where does a patient’s safety begin?

Answer 6

In their immediate environment.

Question 7

Who is responsible for making the patient’s bedside areas safe?

Answer 7

The nurse.

Question 8

What must always be checked on a bed?

Answer 8

Structural risks

Question 9

What are two strategies for patient safety?

Answer 9

Encouraging patients to be active participants in their care and improving communication between caregivers and patients.

Question 10

What is a “culture of safety”?

Answer 10

A safety concern can be voiced by anyone without fear.

Question 11

Why is patient identification a crucial key to safety?

Answer 11

The identification process is followed so patients get the right medications and treatments at the right times and do not suffer from injury associated with health care interventions.

Question 12

What interventions are used to decrease risk of a fall in an acute setting?

Answer 12

The use of a fall risk assessment tool, assessment and collaboration for the adjustment of medications, changes in the environment, staff education, use of alarm devices, and interventions for disorders contributing to the risk.

Question 13

What interventions are used to decrease risk of a fall in the community setting?

Answer 13

Home-based exercise, environmental adaptations, and community-based tai chi delivered in a group format are effective in reducing the risk for falls.

Question 14

What are the 7 National Patient Safety Goals for Hospitals?

Answer 14

• Improve the accuracy of patient identification.
• Improve the effectiveness of communication among caregivers.
• Improve the safety of using medications.
• Reduce the risk of health care–associated infections.
• Accurately and completely reconcile medications across the continuum of care.
• The organization identifies safety risks inherent in its patient population.
• Universal Protocol for Preventing Wrong-Site, Wrong-Procedure, and Wrong-Person Surgery.

Question 15

List 8 bedside items that help reduces risk to a patient:

Answer 15

• Bed trapeze
• Bed alarm
• Fall prevention poster
• Bedside commode
• Room well illuminated
• Bed controls within reach
• Non-exit side rails up for support
• Moveable handrail or walker

Question 16

What is the most common cause of nonfatal injury in adults over the age of 65 in the United States?

Answer 16

Patient falls.

Question 17

When do fall preventions programs work best?

Answer 17

Within the context of strong organizational support and broad interdisciplinary cooperation.

Question 18

What does the acronym SPLATT stand for?

Answer 18

Symptoms at time of fall

Previous fall

Location of fall

Activity at time of fall

Time of fall

Trauma after fall

Question 19

Why should we assess a patient for elimination patterns in regards to falls?

Answer 19

Incontinence or urgency and the attempt to rush to a bathroom or find a urinal may predispose a patient to falls.

Question 20

Why should we assess a patient for medications in regards to falls?

Answer 20

Certain medications may increase risk for falls and injury.

Question 21

Define: HAI

Answer 21

Health care Associated Infections (nosocomial infections) are infections that result from delivery of health services in a health care setting and were not present on admission.

Question 22

Why are health care workers required to use standard precautions to prevent exposure?

Answer 22

All patients are at risk for carrying an infection.

Question 23

What are the 6 principles of Medical Asepsis Principles (MAP)?

Answer 23

• Use hand hygiene with an appropriate alcohol-based instant hand antiseptic or soap and water as an essential part of patient care and infection prevention.
• Always know a patient’s susceptibility to infection. Age, nutritional status, stress, disease processes, and forms of medical therapy place patients at risk.
• Recognize the elements of the chain of infection and initiate measures to prevent the onset and spread of infection.
• Consistently incorporate the basic principles of asepsis into patient care.
• Protect fellow health care workers from exposure to infectious agents through proper use and disposal of equipment.
• Be aware of body sites where nosocomial infections are most likely to develop (e.g., urinary or respiratory tract). This enables you to direct preventive measures.

Question 24

What are the 9 principles of Surgical Asepsis Principles (SAP)?

Answer 24

• All items used within a sterile field must be sterile.
• A sterile barrier that has been permeated by punctures, tears, or moisture must be considered contaminated.
• Once a sterile package is opened, a 2.5cm (1 inch) border around the edges is considered unsterile.
• Tables draped as part of a sterile field are considered sterile only at table level.
• If there is any question or doubt about the sterility of an item, the item is considered unsterile.
• Sterile persons or items contact only sterile items; unsterile persons or items contact only unsterile items.
• Movement around and in the sterile field must not compromise or contaminate the sterile field.
• A sterile object or field out of the range of vision or an object held below a person’s waist is contaminated.
• A sterile object or field becomes contaminated by prolonged exposure to air; stay organized and complete any procedure as soon as possible.

Question 25

What is the purpose of barrier protection?

Answer 25

Protects the health care worker from the patient’s blood and body fluids and helps prevent the transfer of organisms to other patients, health care workers, and the environment.

Question 26

What is an added benefit to barrier protection?

Answer 26

Protects patients who are immunosuppressed.

Question 27

Define: cohorting

Answer 27

Two patients with “like” infections can be placed in the same room.

Question 28

What is hand hygiene?

Answer 28

General term that applies to handwashing, antiseptic handwash, antiseptic hand rub, or surgical hand antisepsis.

Question 29

What is the difference between handwashing and aseptic handwashing?

Answer 29

Handwashing refers to washing hands thoroughly with plain soap and water. An antiseptic handwash is defined as washing hands with water and soap containing an antiseptic agent.

Question 30

What is an antiseptic hand rub?

Answer 30

An alcohol based waterless product that, when applied to all surfaces of the hands, reduces the number of microorganisms on the hands.

Question 31

What is surgical hand antisepsis?

Answer 31

An antiseptic handwash or antiseptic hand rub that surgical personnel use before performing a surgical procedure.

Question 32

What are the 4 factors that health care providers use to decide which hand hygiene to perform?

Answer 32

(1) the intensity or degree of contact with patients or contaminated objects
(2) the amount of contamination that may occur with the contact
(3) the patient’s or health care worker’s susceptibility to infection
(4) the procedure or activity to be performed.

Question 33

The presence of which two spore forming organisms require handwashing?

Answer 33

Clostridium difficile or Bacillus anthracis

Question 34

When does a health care professional have the option of washing hands with either plain soap and water or an antimicrobial soap and water?

Answer 34

When hands are visibly dirty, when soiled with blood or other bodily fluids, before eating, and after using the toilet.

Question 35

When can you use alcohol based based hand rub for routinely decontaminating hands? (7 scenarios)

Answer 35

1) Before and after having direct contact with patients
2) Before applying sterile gloves and inserting an invasive device such as indwelling urinary catheters and peripheral vascular catheters
3) After contact with body fluids or excretions, mucous membranes, or nonintact skin
4) After contact with wound dressings (if hands are not visibly soiled)
5) When moving from a contaminated body site to a clean body site during patient care
6) After contact with inanimate objects (e.g., medical equipment) in the immediate vicinity of the patient
7) After removing gloves

Question 36

Give 4 environmental requirements for handwashing:

Answer 36

• Easy-to-reach sink with warm running water
• Antimicrobial or nonantimicrobial soap
• Paper towels or air dryer
• Disposable nail cleaner (optional)

Question 37

What are the 3 steps for applying antiseptic hand rub?

Answer 37

1) Dispense ample amount of product into palm of hand.
2) Rub hands together, covering all surfaces of hands and fingers with antiseptic
3) Rub hands together until the alcohol is dry. Allow hands to dry completely before applying gloves.

Question 38

What are the 10 basic steps for handwashing?

Answer 38

1) Stand in front of sink, keeping hands and uniform away from sink surface
2) Turn on water
3) Avoid splashing water against uniform
4) Regulate flow of water so temperature is warm.
5) Wet hands and wrists thoroughly under running water. Keep hands and forearms lower than elbows during washing
6) Apply 3 to 5mL of soap and rub hands together vigorously, lathering thoroughly
7) Perform hand hygiene using plenty of lather and friction for at least 15 seconds. Interlace fingers and rub palms and backs of hands with circular motion at least 5 times each. Keep fingertips down to facilitate removal of microorganisms
8) Clean under fingernails
9) Rinse hands and wrists thoroughly, keeping hands down and elbows up
10) Dry hands thoroughly from fingers to wrists and forearms with paper towel or warm air dryer.

Question 39

Why are sterile gloves important?

Answer 39

They act as a barrier against the transmission of pathogenic microorganisms.

Question 40

What glove application method do you use for most sterile procedures not requiring a sterile gown?

Answer 40

Open glove application method.

Question 41

What must you do if the glove becomes contaminated or torn?

Answer 41

Change it immediately.

Question 42

Once gloved, where must your hands remain until the procedure is performed?

Answer 42

Keep your hands clasped about 12 inches in front of your body, above waist level and below the shoulders.

Question 43

What are the 3 types of latex allergies in order of their severity?

Answer 43

1) Irritant dermatitis
2) Type IV hypersensitivity (cell-mediated)
3) Type I allergic reaction

Question 44

What are the 10 steps for sterile gloving?

Answer 44

1) Perform hand hygiene
2) Place glove package near work area.
3) Open sterile gloves by carefully separating and peeling open adhered package sides
4) Grasp inner glove package and lay it on a clean, dry, flat surface at waist level. Open package, keeping gloves on wrappers inside surface
5) Identify right and left glove. Each glove has a cuff approximately 5cm (2 inches) wide. Glove dominant hand first.
6) With thumb and first two fingers of nondominant hand, grasp edge of cuff of glove for dominant hand. Touch only inside surface of glove
7) Carefully pull glove over dominant hand, leaving cuff and being sure cuff does not roll up wrist
8) With gloved dominant hand, slip fingers underneath cuff of second glove
9) Carefully pull second glove over fingers of nondominant hand
10) Interlock fingers of gloved hands and hold away from body, above waist level, until beginning procedure

Question 45

What are the 2 steps for removing gloves?

Answer 45

1) Grasp outside of one cuff with other gloved hand; avoid touching wrist. Pull glove off, turning it inside out. Discard in proper receptacle
2) Take fingers of bare hand and tuck inside remaining glove cuff. Peel glove off inside out. Discard in trash receptacle

Question 46

Define: ROM

Answer 46

Range of Motion: the amount of movement that a person has at each joint

Question 47

What are the 3 types of ROM exercises? Describe each.

Answer 47

1) active: patient is able to perform the exercise independently
2) passive: the exercises are performed for the patient by the caregiver
3) active assisted: patient is able to perform exercises with assistance

Question 48

When can you easily incorporate passive ROM exercises into ADL?

Answer 48

bathing and feeding activites

Question 49

How do you support a joint/extremity when performing active assisted or passive ROM exercises?

Answer 49

support joint by holding distal and proximal areas adjacent to joint, cradling distal portion of extremity, or using cupped hand to support joint

Question 50

What must be assessed before performing ROM exercises? (4 primary)

Answer 50

1 Review patient’s chart for physical assessment findings, physician or health care provider orders, medical diagnosis, medical history, and progress.

2 Obtain data on patient’s baseline joint function.

a Observe patient’s ability to perform ROM exercises during ADLs.

b Observe for limitations in joint mobility, redness or warmth over joints, joint tenderness, deformities, or crepitus produced by joint motion.

3 Determine patient’s or caregiver’s readiness to learn. Explain all rationales for ROM exercises and describe and demonstrate exercises to be performed.

4 Assess patient’s level of comfort (on a pain scale of 0 to 10) before exercises.

Question 51

List the 6 steps for proper body mechanics:

Answer 51

• Before lifting tighten stomach muscles and tuck pelvis to provide balance and protect the back.
• Bend at the knees to help maintain your center of gravity. Let the strong muscles of the legs do the lifting.
• Keep the weight (patient) to be lifted as close to the body as possible; this action places the weight in the same plane as the lifter and close to the center of gravity for balance.
• Maintain the trunk erect and knees bent so multiple muscle groups work together in a synchronized manner.
• Avoid twisting. Twisting your spine can lead to serious injury.
• The best height for lifting vertically is approximately 2 feet off the ground and close to the lifter’s center of gravity.

Question 52

Define: Body Mechanics

Answer 52

The coordinated effort of the musculoskeletal and nervous systems to maintain balance, posture, and body alignment during lifting, bending, moving, and performing (ADLs)

Question 53

How does body mechanics facilitate body movement?

Answer 53

Helps a person can carry out a physical activity without using excessive muscle energy

Question 54

Define: Orthostatic Hypotension

Answer 54

Drop in blood pressure when standing up caused by decreased ability for autonomic nervous system to equalize blood supply. When a patient stands, blood shifts from the thorax to the pelvis and lower extremities because of gravity. A drop in blood pressure results from the redistribution of blood

Question 55

What are the signs and symptoms of orthostatic hypotension?

Answer 55

dizziness, light-headedness, nausea, tachycardia, pallor, and fainting

Question 56

What can be done to reduce risk of orthostatic hypotension?

Answer 56

Advise patients to exercise calf muscles and to sit on the edge of the bed for 1 minute before standing up.

Question 57

What equipment can be used to assist in patient transfer?

Answer 57

• Transfer belt, sling, or lap board (as needed)
• Nonskid shoes, pillow, bath blanket
• Slide board (friction-reducing board)
• Stretcher
• Option: Mechanical/hydraulic lift, stand assist lift device
• Chair with arms or wheelchair

Question 58

List the steps to assist patient to sitting position on side of bed:

Answer 58

a. With patient in supine position, raise head of bed 30 degrees and place bed in low position.
b. Turn patient onto side facing you on side of bed on which patient will be sitting
c. Stand opposite patient’s hips. Turn diagonally to face patient and far corner of foot of bed.
d. Place feet apart in a wide base of support with foot closer to head of bed in front of other foot
e. Place arm nearer head of bed under patient’s shoulders, supporting head and neck.
f. Place other arm over and around patient’s thighs
g. On the count of three, have patient push down on mattress with upper arm (left arm in illustration) and move patient’s lower legs and feet over side of bed. Pivot toward rear leg, allowing patient’s upper legs to swing downward

Question 59

List the steps to assist patient to transfer from bed to chair:

Answer 59

a. Determine if patient can bear weight.
b. If patient has partial weight bearing with upper body strength and caregiver must lift more than 35 pounds of patient’s weight, use a bariatric transfer aid with minimum of two or three caregivers
c. If patient has partial weight bearing, is cooperative and able to stand, and has upper body strength, use stand-and-pivot technique.
d. Place chair with arms in position at 45-degree angle to bed on patient’s strong side. Assist patient to sitting position on side of bed (see Steps 2a to 2h). Allow patient to sit on side of the bed (dangling) for a few minutes before transferring to chair. Ask if patient feels dizzy. Do not leave patient unattended during dangling. Provide patient his or her glasses.
e. Apply transfer belt or other transfer aids. Patient’s arm should be in sling if flaccid paralysis is present.
f. Assist patient in applying stable nonskid shoes. Have patient place weight-bearing or strong leg forward, with weak foot back.
g. Spread your feet apart, flex hips and knees, and align your knees with patient’s knees
h. Grasp transfer belt at patient’s side
i. Rock patient up to standing position on count of three while straightening hips and legs and keeping knees slightly flexed. Have patient push up with hands and knees (see illustration). While rocking the patient back and forth, make sure that your body weight is moving in the same direction as the patient’s to ensure that you and the patient are moving in the same direction simultaneously
j. Pivot and turn patient toward chair; pivot on your foot farther from chair.
k. Instruct patient to feel back of chair against legs and to use armrests on chair for support. Have patient ease into chair
l. Help patient shift to back of chair. Assess patient for proper alignment for sitting position. Provide support for paralyzed extremities. Lap board or sling will support flaccid arm. Stabilize leg with bath blanket or pillow.
m. Proper alignment for sitting position: head is erect, and vertebrae are in straight alignment. Body weight is evenly distributed on buttocks and thighs. Thighs are parallel and in horizontal plane. Both feet are supported on floor, and ankles are comfortably flexed. A 2.5- to 5-cm (1- to 2-inch) space is maintained between edge of seat and popliteal space on posterior surface of knee.
n. Praise patient’s progress, effort, and performance. Place call light in reach

Question 60

List the steps to perform lateral transfer from bed to stretcher using slide board or friction-reducing board

Answer 60

1) Determine if patient can assist
2) Determine number of staff required to laterally transfer patient safely (less than 200 pounds nurse can transfer using friction-reducing device, greater than 200 pounds use device with three caregivers)
3) Place bed at working height. Lower head of bed as much as patient can tolerate
4) Cross patient’s arms on chest
5) To place slide board under patient, position two nurses on side of bed to which patient will be turned. Position third nurse on the other side of bed.
6) Fanfold the drawsheet on both sides of patient.
7) On the count of three, turn patient onto side toward the two nurses. Turn patient as one unit with a smooth, continuous motion.
8) Place slide board under drawsheet
9) Gently roll patient back onto slide board.
10) Line up stretcher with bed. Lock brakes on stretcher and bed.
11) Two nurses position themselves on the side of the stretcher while the third nurse positions self on the side of the bed without the stretcher.
12) Fanfold drawsheet; on the count of three the two nurses pull drawsheet with patient onto stretcher while the third nurse holds the slide board in place
13) Position patient in center of stretcher. Raise head of stretcher if not contraindicated. Raise side rails of stretcher.

Question 61

List the steps to transfer a patient from bed to chair using a hydraulic lift device:

Answer 61

1) Determine if patient can bear weight and is cooperative.
2) Bring lift to bedside.
3) Position chair near bed and allow adequate space to maneuver lift.
4) Raise bed to high position with mattress flat. Lower side rail. Have a nurse stand on each side of patient’s bed.
5) Roll patient onto side.
6) Place hammock or canvas strips under patient to form sling. With two canvas pieces, lower edge fits under patient’s knees (wide piece), and upper edge fits under patient’s shoulders (narrow piece). Hooks should face away from patient’s skin. Place sling under patient’s center of gravity and greatest portion of body weight.
7) Roll patient to opposite side and pull hammock (strips) through.
8) Roll patient supine onto canvas seat.
9) Remove patient’s glasses if appropriate
10) Place horseshoe bar or base of lift under side of bed (on side with chair).
11) Lower horizontal bar to sling level by releasing hydraulic valve. Lock valve.
12) Attach hooks on strap (chain) to holes in sling. Short chains or straps hook to top holes of sling; longer chains hook to bottom of sling.
13) Elevate head of bed. Fold patient’s arms over chest.
14) Pump hydraulic handle using long, slow, even strokes until patient is raised off bed
15) Use steering handle to pull lift from bed and maneuver to chair. Have a nurse move on each side of patient.
16) Roll base of lift around chair.
17) Release check valve slowly (turn to left), and lower patient into chair
18) Close check valve as soon as patient is down and straps can be released.
19) Remove straps and mechanical/hydraulic lift.
20) Check patient’s sitting alignment and correct if necessary.

Question 62

List the steps for transferring a patient from a bed to a wheelchair (patient is weight bearing and able to cooperate

Answer 62

a Adjust the height of the bed to the level of the seat of the wheelchair if possible.
b Position the wheelchair at a 45-degree angle next to the same side of the bed as the patient’s strong side.
c Face the wheelchair toward the foot of the bed midway between the head and foot of the bed.
d Lock the wheelchair. Locks are located above the rims of the wheels. Push handle forward to lock. Raise the foot plates.
e Sit patient up on side of the bed (see Skill 15.1).
f Place transfer belt on patient and assist patient to move to the edge of the mattress.
g Position yourself slightly in front of patient to guard and protect patient throughout the transfer.
h Coordinate transfer to chair with patient by counting to three (see Skill 15.1, Steps 3c(1-13).
i Lower foot plates and place patient’s feet on them.
j Unlock wheelchair. Pull lock toward you to release.
k Ensure that patient is positioned well back in the seat and ready to use wheelchair.

Question 63

List the steps for transferring a patient from a wheelchair to bed

Answer 63

a Adjust the height of the bed to the level of the seat of the wheelchair if possible.
b Position the wheelchair at a 45-degree angle next to the bed.
c Face the wheelchair toward the foot of the bed midway between the head and foot of the bed.
d Lock the wheelchair. Locks are located above the rims of the wheels. Push handle forward to lock.
e Raise the foot plates and place the transfer belt on patient (if not already in place).
f Assist patient to move to the front of the wheelchair.
g Position yourself slightly in front of patient to guard and protect patient throughout the transfer.
h Coordinate transfer to the bed by having patient stand and then pivot to the side of the bed. Then have patient sit on the side of the mattress (see Skill 15.1).
i With patient sitting on side of the bed, place your arm nearest the head of the bed underthe person’s shoulders while supporting the head and neck. Take your other arm and place it under the person’s knees. Bend your knees and keep your back straight.
j Tell patient to help lift the legs when you begin to move. On a count of three, standing with a wide base of support, raise patient’s legs as you pivot his or her body and lower the shoulders onto the bed. Remember to keep your back straight.

Question 64

List steps for assisting a patient in ambulating

Answer 64

1) Remove SCD if present.
2) Encourage patient to move slowly at own pace, maintain erect posture, and look straight ahead.
3) Follow Skill 15.1, Step 2, for assisting patient to side of bed. With patient sitting, wait a few minutes and ask if he or she feels dizzy. Have patient dangle legs on side of bed and take a few deep breaths until balance is gained. Have patient move legs and feet while dangling
4) Decide with patient how far to ambulate. Assist patient with putting on shoes or slippers with nonskid soles.
5) Ask if patient feels dizzy or light-headed. If patient appears light-headed, recheck blood pressure
6) Apply transfer (gait) belt around patient’s waist. Be sure belt is snug but not too tight.
7) Assist patient to stand at the bedside. Encourage to stand fully erect with shoulders back and looking ahead (not at the floor).
8) If patient is unstable, seat him or her in chair or return to bed immediately. Consider need for additional help. If patient is very heavy, unstable, or fearful, use a sit-to-stand lift.
9) If patient has an IV line, place the IV pole on the same side as the site of infusion and instruct patient to hold and push the pole while ambulating.
10) If a Foley catheter is present, patient or nurse carries the bag below the level of the bladder and prevents tension on the tubing.
11) Stand on patient’s strong side. Take a few steps, supporting patient with one arm grasping the gait belt and the other under the elbow of the flexed arm (see illustration). Option: Use ambulation lift/ceiling lift with gait harness for more dependent patients who are now walking for first time after being in bed.
12) When ambulating in a hallway, position patient between yourself and the wall. Encourage patient to use hand rails if available

Question 65

List 3 reasons why body positioning is important:

Answer 65

1) crucial for maintaining body alignment and comfort
2) preventing injury to the musculoskeletal and integumentary systems
3) providing sensory, motor, and cognitive stimulation

Question 66

Define: body alignment

Answer 66

the conditions of the joints, tendons, ligaments, and muscles in various body positions

Question 67

How do you achieve body balance?

Answer 67

a wide base of support exists, the center of gravity falls within the base of support, and you can draw a vertical line from the center of gravity through the base of support

Question 68

List risk factors for complications in mobility:

Answer 68

a Paralysis: Hemiparesis resulting from CVA. Rationale: Paralysis impairs movement and muscle tone.
b Impaired mobility: Traction, arthritis, hip fracture, joint surgery, or other contributing disease processes. Rationale: Conditions result in decreased range of motion (ROM)
c Impaired circulation: Arterial insufficiency. Rationale: Decreased circulation predisposes patient to pressure ulcers.
d Age: Very young or older adult. Rationale: Premature and young infants require frequent turning because their skin is fragile. Normal physiological changes associated with aging predispose older adults to greater risks for developing complications of immobility.
e Sensation: Decreased from CVA, paralysis, neuropathy. Rationale: Because of poor awareness of body part or reduced sensation, patient is unable to protect and position body part from pressure.

Question 69

List devices used to help with patient body postioning:

Answer 69

• Pillows, drawsheet
• Friction-reducing device
• Therapeutic boots/splints (optional)
• Trochanter rolls
• Sandbags
• Hand rolls

Question 70

Describe the limitations in movement, and demonstrate proper positioning of the patient with a total hip replacement

Answer 70

unable to find info

Question 71

Describe Fowler’s position and at least one use:

Answer 71

position: Head of bed raised to angle of 45 degrees or more; semisitting position; foot of bed may also be raised at knee
uses: Used during meals, nasogastric tube insertion, and nasotracheal suction

Question 72

Describe the Trendelenburg position and at least one use:

Answer 72

position: Entire bed tilted with head of bed down

uses: Used for postural drainage.
Facilitates venous return in patients with poor peripheral venous perfusion

Question 73

Describe Reverse Trendelenburg postion and at least one use:

Answer 73

position: Entire bed frame tilted with foot of bed down

uses: Used infrequently
Promotes gastric emptying
Prevents esophageal reflux

Question 74

Describe Semi-Fowler position and at least one use:

Answer 74

position: Head of bed raised approximately 30 degrees; incline is less than Fowler’s position; foot of bed may also be raised at knee

uses: Promotes lung expansion
Used when patients receive gastric feedings to reduce regurgitation and risk for aspiration

Question 75

Describe Sim’s position and at least one use:

Answer 75

position: Patient lies on their left side. Patient’s left lower extremity is straightened. Patient’s right lower extremity is flexed at the hip, and the leg is flexed at the knee. The bent knee, resting against bed surface or a pillow, provides stability.

Uses: Post partum perineal examination
Per-rectal examination

Question 76

Describe the Supine position and at least one use:

Answer 76

position: lying down with the face up
uses: head to toe examinations

Question 77

Describe the Prone position and at least one use:

Answer 77

position: laying down with the face down
uses: Back or neck procedures (cervical to sacral). Procedures of the occipital or postero-lateral cranium. Sacral, perianal & perineal procedures

Question 78

Describe the Lateral (side-lying) position and at least one use:

Answer 78

position: The patient is turned to rest on one side of his or her trunk, with the dependent (down) side naming the position
uses: Surgical access to the hemithorax, kidney, retroperitoneal space