Exam 2 module 3 part 4 Flashcards
Chapter 21 Safety - Falls
1
Q
3rd leading cause of injury related deaths in older adults
A
falls
2
Q
Risk factors of falls
A
History of falls, age 80+, impaired vision, dizziness/weakness, gait problems, balance problem, pain, hypotension, cognitive impairment, illness/conditions chronic, meds side effects, polypharmacy, home hazards, unfamiliar environment, alcohol useage.
KEY: clients have multiple risk factors for falls
3
Q
Falls complications
A
Serious injury, disability, loss of independance, death
4
Q
How many falls occur in the home?
A
more than a half
5
Q
_____ of adults have falls at home
A
80%
6
Q
____ adults 75+ have falls
A
three times more than 65+
7
Q
MC incident reported in hospitals and long term care facilities
A
Falls, and falling from a bed
MC on nights, weekends, and holidays
8
Q
What diagnosis do you assign to someone who could fall?
A
Fall Risk as a primary diagnosis
could also be fall related to self care deficit, injury risk, fear of falling, ADL alteration
9
Q
NOC outcomes for falls
A
Balance, fall prevention behavior, personal safety behavior, safe home environment
10
Q
Goal statements for falls
A
Remains injury free, maintain independance, home is free from fall hazards
11
Q
What is key in fall safety?
A
- Prevention.
- It should not stop them from being activie.
- Teach patient to create the safety of their home.
- Exercise at least 30 min daily
- use assistive devices with intact rubber tips and keep the walking aid by the bed.
12
Q
What factors increase the likelihood of falling?
A
Tiredness, sickness, rushing, emotional upset
These factors can impair balance and attention, leading to falls.
13
Q
How should one approach walking and using stairs to prevent falls?
A
Carefully, without hurrying, and without distractions
Focused attention helps maintain balance and awareness of surroundings.
14
Q
What is a recommended practice when getting out of bed or a chair?
A
Get out slowly and check balance before standing or walking
This is especially important for those taking blood pressure medications.
15
Q
How can loads be managed to prevent falls?
A
Carry several small loads instead of one large load
This allows for better visibility, particularly on stairs.
16
Q
What should be ensured about room lighting to prevent falls?
A
Rooms should be adequately lighted, with dim light at night
Turning on lights before entering a room can prevent accidents.
17
Q
What is important for maintaining eye health?
A
Get eyes checked at least once a year and clean eyeglasses frequently
Regular eye exams can help detect issues that affect balance.
18
Q
What type of footwear is recommended to prevent falls?
A
Shoes that fit properly and nonskid slippers
Avoid going barefoot to reduce the risk of slipping.
19
Q
What should be done with loose clothing to prevent tripping?
A
Avoid loose, trailing clothes and keep hems at a safe length
Proper fitting clothing minimizes the risk of tripping.
20
Q
What is a helpful mobility aid for older adults with stiffness or pain?
A
Use of a cane or walker
These aids can provide additional support and stability.
21
Q
What safety measure should be taken regarding ladders?
A
Use a ladder or step stool, and do not stand on the top step
Standing on the top step increases the risk of falls.
22
Q
What childproofing measures should be taken in the home?
A
Install window guards and gates at stairways
These measures protect young children from falls.
23
Q
What is a key practice when supervising young children?
A
Never leave a child alone on a changing table
Constant supervision is essential to prevent falls.
24
Q
What type of phone arrangement is recommended for older adults? What about the bed?
A
Keep a cordless phone in each room and by the bedside. Make bed height low. Get treatment for postural hypotension and CVD problems.
This ensures easy access to call for help if needed.
25
What should be done to stairs to enhance safety?
Keep stairs well lit and free of clutter. Install sturdy handtails. Slip resistant floor coverings. Fasten coverings securely. Paint the top and bottom steps white if they have vision problems or put white stripes on the front edges of steps.
## Footnote
Clear and well-lit stairs reduce the risk of falls.
26
What bathroom modifications can minimize hazards?
Use shower chairs, raised toilet seats, and install grab bars
## Footnote
These modifications help prevent slips and falls in the bathroom.
27
Fill in the blank: One should always check their _______ before standing or walking.
balance
28
True or False: It is safe to leave chairs near counters where young children can climb.
False
## Footnote
Chairs should be pushed under tables to prevent climbing.
29
What should you do with phone and electrical equipment cords to prevent falls?
Tape or otherwise fasten cords to the baseboard.
30
How should furniture be arranged to enhance safety?
Arrange furniture to provide wide walking areas.
31
What types of items should be kept out of walkways?
Clutter such as toys, magazines, and clothing.
32
What should be done with scatter or throw rugs?
Remove them or ensure they have nonskid padding.
33
What should be done immediately if foods or fluids are spilled on the floor?
Wipe up all foods and fluids immediately.
34
What products can be applied to icy surfaces to prevent slips?
Ice-melt product, salt, or sand.
35
What should be reviewed for patients in a healthcare facility to prevent falls?
Medications, especially psychotropic medications.
36
What is an important step regarding the call light for patients?
Place the call light within reach and have the patient demonstrate its use.
37
What should be done to orient disoriented patients?
Orient them to surroundings and label items as needed.
38
Where should disoriented patients be placed in a healthcare facility?
In rooms near the nurses' station.
39
What items should be kept within easy reach of patients?
Water, urinal, bedpan, and tissues.
40
What kind of lighting should be provided for patients?
A night-light.
41
What should be done to floors in a healthcare facility?
Keep floors dry and free of clutter.
42
What should be taught to patients and their families to prevent falls?
Fall prevention strategies.
43
What should be placed on the chart or door for patients at risk for falls?
A warning sticker.
44
What devices can be used for patients with altered levels of consciousness?
Bed and chair monitoring devices.
45
What is the first thing to do if a fall occurs?
Do not panic.
46
What should you do after a fall to recover?
Stay still for a few minutes to get over the shock.
47
If you think you are okay after a fall, what should you do?
Slide over to a sturdy piece of furniture and push yourself up.
48
What should you do if you cannot move after a fall?
Try to cover yourself to keep warm until help arrives.
49
How to childproof the home?
* Install window guards. never leave a window wide open.
* Use gates at the top and bottom of stairs.
* Never leave a kid alone on a changing table.
* Watch young walkers to keep them from falling.
* Remove chairs near counters if kids will be likely to climb.
* Teach kids to pick up their toys.
* Children wear helmets for bicycling, skateboarding or other active sports.
50
What should be assessed for all inpatients upon admission?
Falls risk
## Footnote
It is essential to evaluate the risk of falling for all patients admitted to the hospital.
51
What should be identified to help mitigate falls risk?
Modifiable risk factors
## Footnote
Different conditions require different nursing interventions to address these factors.
52
How frequently should the risk assessment be repeated for patients at risk for falls?
Every 8 hours
## Footnote
Increased frequency of monitoring is necessary for these patients.
53
Name three types of medications that can increase the risk for falling.
* Opioid analgesics
* Sedatives
* Antihypertensives
## Footnote
These medications may impair the patient's ability to maintain balance or respond to their environment.
54
What standardized tools can be used for fall risk assessment?
* Get Up and Go test
* Timed Up and Go test
* Morse Fall Scale
## Footnote
These tools help in evaluating a patient's risk for falls.
55
Is age alone a predictor of falls?
False
## Footnote
While age is a factor, the items scored by the Morse Fall Scale are more common in older adults.
56
What is the first question in the Morse Fall Scale assessment?
Does the patient have a history of falling?
## Footnote
This question helps to understand the patient's previous experiences with falls.
57
What does the Morse Fall Scale assess regarding a patient's medical condition?
More than one medical diagnosis
## Footnote
Having multiple diagnoses can increase the risk of falls.
58
What type of aids are considered in the Morse Fall Scale?
Ambulatory aids
## Footnote
Examples include crutches or walkers that assist the patient in movement.
59
What does a saline lock or IV line indicate in the Morse Fall Scale?
Increased falls risk
## Footnote
Patients with these devices may have mobility limitations.
60
What aspects of a person's gait are assessed in the Morse Fall Scale?
Normal or stooped/impaired
## Footnote
Gait abnormalities can indicate a higher risk for falls.
61
What mental status evaluations are included in the Morse Fall Scale?
Disoriented or forgetful
## Footnote
Cognitive impairments can significantly influence a patient's risk of falling.
62
What does the nurse do after scoring the Morse Fall Scale?
Tally and record the variables on the patient's chart
## Footnote
This documentation is crucial for ongoing patient care and monitoring.
63
What should be assessed at least once a year in older adults?
Falls
## Footnote
It is important to ask older adults or their caregivers about their history of falls.
64
What test is used if there is a history of falls in older adults?
Get Up and Go test
## Footnote
This test helps assess the risk of falls.
65
What is the first step of the Get Up and Go test?
Move from sitting to standing without using arms to help them rise.
66
What does the Get Up and Go test require the patient to do after standing?
Walk several paces, turn, and return to the chair.
67
What is the final step of the Get Up and Go test?
Sit back in the chair without using arms for support.
68
What should be assessed if the patient has difficulty or unsteadiness?
Sit, stand without using arms for support, close eyes for a few seconds, walk a short distance, sit in the chair without using arms for support.
69
What is the purpose of the Timed Up and Go test?
To evaluate the patient's ability to get up and walk a short distance in a specified time.
70
What should be done if a patient is seeking care because of a fall?
Refer to a practitioner with advanced skills and experience for a Timed Up and Go and a comprehensive fall evaluation.
71
What is the time limit for the Timed Up and Go test?
8.5 seconds or less to walk 8 feet.
72
True or False: The Timed Up and Go test can be administered without prior assessment of falls.
False
## Footnote
A history of falls or observed difficulty with ambulation necessitates this test.
73
Is the patient seeking medical attention because of a fall?
Yes or No
74
What should be performed if the patient falls in the last year +/- feels unsteady when they walk
Perform get up and go test
75
What should be performed if the patient denies falls in the past year and ambulation is okay?
Ask/observe again in 1 year
76
What test should be performed to assess steadiness?
1st test = 'Get Up and Go' test
77
What should be done if the patient demonstrates gait or balance abnormalities?
Comprehensive falls evaluation by clinician specialist
78
What follow-up assessment should be performed alongside the 'Get Up and Go' test?
Timed Up and Go comes after if they aren't steady
79
What should you do in all cases of suspected poisoning?
Call 911 or the local emergency number right away
## Footnote
This is crucial regardless of whether symptoms are present.
80
What number should you call to reach the National Poison Control Center?
(800) 222-1222
## Footnote
This number connects you to a local Poison Control Center.
81
When should you not induce vomiting?
When the ingested material is acidic or caustic to the esophagus
## Footnote
Inducing vomiting in such cases can cause further harm.
82
What does the American Academy of Pediatrics recommend regarding inducing emesis?
They no longer recommend inducing emesis with syrup of ipecac
## Footnote
Some practitioners may still induce vomiting despite this guideline.
83
Is it recommended to stock ipecac in households with young children?
No, the National Poison Control Center does not support this
## Footnote
Ipecac should be given only on specific recommendation from a poison center or qualified medical personnel.
84
Under what condition should ipecac be administered?
Only on specific recommendation from a poison center or qualified medical personnel
## Footnote
This ensures safety and appropriateness of treatment.
85
What is a key focus of nursing interventions for children regarding poisoning?
Teaching parents how to childproof the home and actions to take if someone ingests a poisonous substance
## Footnote
Emphasis on preparing homes for emergencies related to poisoning.
86
What should all homes be equipped with to handle poisoning emergencies?
A way to handle an emergency if poisoning occurs
## Footnote
This includes having emergency contacts readily accessible.
87
What is crucial for parents to do if they suspect a child has ingested a poisonous substance?
Obtain help immediately
## Footnote
This minimizes the time for the substance to enter the child’s system.
88
Which age group has the highest unintentional poisoning death rates?
Middle-aged adults
## Footnote
This demographic is particularly vulnerable to unintentional poisoning.
89
What should clients be advised to do regarding their medications?
Take only medications prescribed by a healthcare professional
## Footnote
This helps prevent unintentional poisoning.
90
True or False: It is safe to take larger or more frequent doses of medications to achieve quicker relief.
False
## Footnote
This can lead to unintentional overdose and poisoning.
91
What should clients never do with their prescription drugs?
Share or sell them
## Footnote
This is crucial for preventing misuse and poisoning.
92
What should families with older adults use to prevent accidental overdose or misuse of medications?
A medication organizer with compartments for the days/times the pills are to be taken
## Footnote
Filling the organizer once a week can help manage medication schedules.
93
Fill in the blank: To prevent poisoning, families should refer to the Home Care box, ______.
Preventing Poisoning in the Home
## Footnote
This section provides guidelines for safety.
94
What actions should be taken if poisoning occurs at home?
Follow the steps outlined in the Home Care box for actions to take
## Footnote
Specific guidelines are provided for responding to poisoning incidents.
95
What should be done if carbon monoxide intoxication is suspected?
The person should be treated with 100% humidified oxygen
## Footnote
A simple blood test may be done to confirm CO levels in the blood.
96
What is one key prevention measure for carbon monoxide poisoning?
Buy, install, and maintain a home CO detector
97
How should gas or wood-burning appliances be managed to prevent carbon monoxide poisoning?
Ensure that they are adequately vented to the outside
98
What should be repaired in vehicles to prevent carbon monoxide exposure?
Rust holes or defects that could allow exhaust fumes to enter the passenger compartment
99
True or False: It is safe to use a gas oven to heat a house for a short time.
False
100
What should never be done with gasoline-powered engines to avoid carbon monoxide poisoning?
Never operate them in confined spaces or near open doors or windows
101
Fill in the blank: Never burn ______ inside a home, cabin, recreational vehicle, or tent.
charcoal
102
What is the consequence of burning charcoal inside a home?
It can lead to carbon monoxide poisoning
103
What is a key component of fire prevention in the home?
A warning system
## Footnote
This includes having working smoke alarms and changing batteries at least every 6 months.
104
How often should families practice their fire escape plan?
At least twice a year
## Footnote
Practicing the escape plan helps ensure everyone knows how to react in case of a fire.
105
What should be kept near the bed or chair for individuals with limited mobility?
A phone
## Footnote
This allows them to call for help in case of a fire.
106
What is crucial to have in the home for fire emergencies?
A fire extinguisher
## Footnote
It is important to know its location and how to use it.
107
How often should fire extinguishers be checked?
Regularly
## Footnote
They should be replaced when they become outdated.
108
Fill in the blank: Never leave burning ______ unattended.
candles
## Footnote
This is a safety measure to prevent fires.
109
What type of fluids should be used with charcoal grills?
Only charcoal starter fluids designed for barbecue grills
## Footnote
This ensures safe usage and minimizes fire risk.
110
True or False: It is safe to smoke in bed when oxygen is in use.
False
## Footnote
Smoking in bed is dangerous, especially in homes where oxygen is present.
111
What should be done if there is a grease fire?
Never pour water on it
## Footnote
Water can cause the fire to spread.
112
What action should be taken for an oven fire?
Turn off the heat and keep the door closed
## Footnote
This prevents oxygen from fueling the fire.
113
What is a preventive measure regarding electrical safety?
Make sure electrical outlets have covers
## Footnote
This helps prevent accidental shocks or fires.
114
Fill in the blank: Do not place electrical cords under ______.
carpets
## Footnote
This can cause overheating and increase fire risk.
115
What should be done if there is a microwave fire?
Keep the door closed and unplug the microwave
## Footnote
This prevents the fire from spreading.
116
What should be stored in appropriate containers to prevent fire hazards?
Flammable materials
## Footnote
For example, oil-soaked rags should be stored in a metal container with a tight lid.
117
What should be checked regularly for safety in the home?
Electrical appliances for damaged cords
## Footnote
Frayed cords should be replaced to prevent fires.
118
What is a key action to take if the house is on fire?
Follow your escape plan
## Footnote
Crawling or staying low to the floor helps avoid smoke inhalation.
119
What is a key method to prevent children from tipping over pots on the stove?
Turn pot handles toward the back of the stove
## Footnote
This helps to keep hot pots out of reach of children.
120
What type of clothing should be avoided while cooking to prevent burns?
Loose-fitting clothing (e.g., wide sleeves)
## Footnote
Loose clothing can easily catch fire or come into contact with hot surfaces.
121
True or False: It is safe to warm infant formula and food in the microwave without checking the temperature.
False
## Footnote
Warming in the microwave can create hot spots; always check the temperature before serving.
122
What should parents always do before giving warmed infant formula or food to a child?
Check the temperature carefully
## Footnote
Many parents overlook this precaution, which is crucial for safety.
123
What age group is most at risk for accidental poisoning?
Children younger than the age of 5 years
## Footnote
Most victims of accidental poisoning are in this age group.
124
What should you never do with small children around household cleaning supplies or medicines?
Never leave them unattended
## Footnote
Children can act quickly, leading to accidental poisoning.
125
Why should you avoid taking medicines in front of children?
Children tend to imitate adults
## Footnote
This can lead them to mimic the behavior of taking medicine.
126
What is the correct way to refer to medicines to prevent children from thinking they are candy?
Use the correct name (e.g., 'cough medicine')
## Footnote
This helps children understand the difference between medicine and candy.
127
Where should medicines and household chemicals be stored?
On high shelves or in locked cabinets and drawers
## Footnote
Storing them out of reach helps prevent accidental poisoning.
128
What should you avoid doing with household chemicals and food?
Store all household chemicals away from food
## Footnote
This prevents contamination and accidental ingestion.
129
What should you do with the original containers of medicines and chemicals?
Keep them in their original containers and leave the labels on
## Footnote
This ensures proper identification and safety.
130
What type of packaging should be used for medicines and household chemicals?
Child-resistant packaging
## Footnote
This provides an additional layer of safety for young children.
131
True or False: You can assume a child is safe around substances in child-resistant containers.
False
## Footnote
Research shows that many toddlers and preschoolers can open child-resistant containers.
132
Fill in the blank: Always close the container _______ after each use.
securely
## Footnote
Ensures that the contents are not easily accessible to children.
133
What should clients do to safely dispose of medications?
Take advantage of community programs that take back medications for safe disposal
## Footnote
Clients can call the local trash service or a local pharmacy for options in their area.
134
How can clients safely dispose of outdated prescription medications?
Crush the medication or add water to dissolve it
## Footnote
This makes the medication easier to mix with other substances.
135
What should be mixed with medications to make them less desirable for pets and children?
An undesirable substance such as kitty litter or used cooking grease
## Footnote
This discourages accidental ingestion.
136
What is the recommended method for disposing of the medication mixture?
Place the mixture in an empty can or resealable bag and put it in the trash
## Footnote
This ensures safe disposal.
137
What should be done with prescription labels before disposal?
Remove all identifying information from prescription labels
## Footnote
This prevents identity theft and protects personal information.
138
What should clients do if disposal options are not available?
Certain medicines can be flushed down the sink or toilet
## Footnote
This is applicable when they are no longer needed.
139
Who provides recommendations for medicines that can be disposed of by flushing?
U.S. Food and Drug Administration (FDA)
## Footnote
The FDA provides a list of specific medicines recommended for flushing.
140
What should be verified about houseplants?
Houseplants should be verified as nontoxic
## Footnote
Examples of toxic plants include rhododendron, philodendron, English ivy, holly, mistletoe, and lily of the valley.
141
What action should be taken if there are poisonous plants in the yard?
Remove them
## Footnote
It's important to identify and eliminate any poisonous plants to ensure safety.
142
What should children be taught regarding wild plants?
Children must never eat berries, wild mushrooms, or other edible-looking plants
## Footnote
These plants can cause illness and even death in young children.
143
What warning should be given to parents about children's behavior towards windowsills?
Keep children from chewing on windowsills
## Footnote
It's important to clean up flakes of paint to prevent ingestion.
144
What advocacy should be made regarding lead-based paint?
Advocate for clients to have lead-based paint replaced
## Footnote
Lead-based paint can still be found in older homes and poses health risks.
145
Why should young children be monitored around dirt and furniture?
Young children often put dirt in their mouths and chew on furniture and windowsills
## Footnote
This behavior is especially common when they are teething.
146
Fill in the blank: It is crucial to teach children that they must never eat _______ or other edible-looking plants.
berries, wild mushrooms
147
What should you do when removing coverings from microwaved food?
Remove coverings carefully
## Footnote
This prevents burns or spills.
148
What should you avoid doing while holding an infant?
Do not smoke, use matches, or drink hot liquids
## Footnote
These actions can pose safety risks to the infant.
149
How should burning cigarettes be handled?
Do not leave burning cigarettes unattended
## Footnote
This helps prevent fire hazards.
150
What precaution should be taken when checking bath water for children and older adults?
Always check bath water temperature
## Footnote
This helps prevent scalds.
151
What should be set low enough to prevent scalds?
Water heater temperature
## Footnote
Setting it low reduces the risk of burns.
152
What safety measures should be taken around radiators and fireplaces?
Place guardrails in front of them
## Footnote
This prevents accidental contact and injuries.
153
What protective measures should be taken when outside?
Wear protective clothing and sunscreen
## Footnote
This protects against sunburn and skin damage.
154
What is an essential intervention to prevent unintentional firearm injuries involving children?
Education
## Footnote
Education efforts are primarily aimed at parents to promote gun safety.
155
What organizations have mounted efforts to educate parents about gun safety?
American Academy of Pediatrics and other groups
## Footnote
These organizations focus on informing parents to make smart choices regarding gun safety.
156
What is the recommended way to store firearms when not in use?
Unloaded and in a secure, locked container
## Footnote
Ammunition should be stored in a different location from the firearm.
157
Name one of the rules for safe gun handling.
Always keep the gun pointed in a safe direction
## Footnote
This rule ensures that even if the gun were to go off, it would not cause injury or damage.
158
What should you never do until you are ready to shoot?
Put your finger on the trigger
## Footnote
This rule emphasizes the importance of trigger discipline.
159
What should always be done before cleaning a gun?
Make absolutely sure that it is unloaded
## Footnote
If unsure how to inspect the chamber, seek help.
160
What should parents teach children about encountering firearms?
Safe behavior around firearms
## Footnote
Children should know what to do if they see a gun in various places.
161
List the four steps children should follow if they see a gun.
* Stop
* Do not touch it
* Leave the area
* Tell an adult
## Footnote
These steps are crucial for ensuring children's safety around firearms.
162
True or False: It is only necessary to teach children safe behavior around firearms if they have guns in their home.
False
## Footnote
Children may encounter guns in other locations, making it important for all parents to educate them.
163
What is the universal sign for choking?
Grasping the neck between the thumb and index finger or clutching the neck with both hands
## Footnote
This sign should be recognized and taught to children.
164
What should be inspected to prevent suffocation?
Toys for small, removable parts
## Footnote
Regular inspection can help avoid choking hazards.
165
What should not be attached to pacifiers or rattles?
Ribbons or strings
## Footnote
This prevents potential choking hazards.
166
What type of clothing should be avoided for infants to prevent suffocation?
Sweatshirts or jackets with necktie strings
## Footnote
Such clothing can pose a strangulation risk.
167
When should mobiles be removed from a crib?
Once the baby begins to push up on hands and knees or by age 5 months
## Footnote
Mobiles should be positioned well above the crib.
168
What should be kept out of a child's reach to prevent suffocation?
Window blind cords
## Footnote
These cords can pose strangulation risks.
169
Where should plastic bags be stored?
Away from young children in a secure place
## Footnote
This helps prevent suffocation hazards.
170
What are the federal regulations regarding crib slats?
Less than 2 3/8 in. (6 cm) apart
## Footnote
Compliance ensures child safety in the crib.
171
What must fit snugly in a crib according to safety regulations?
The mattress
## Footnote
A snug fit helps prevent entrapment.
172
How should firm foods be prepared for young children?
Cut into very tiny pieces
## Footnote
This reduces the risk of choking.
173
What foods should not be given to young children due to choking hazards?
Hard candy, chewing gum, nuts, popcorn, grapes, or marshmallows
## Footnote
These foods pose significant choking risks.
174
What should be done during children's balloon play?
Supervise and dispose of burst balloons promptly
## Footnote
This prevents choking on balloon pieces.
175
What is the universal sign for choking?
A hand placed on the throat
## Footnote
This sign is recognized universally to indicate that someone is choking.
176
What is the recommended method for teaching choking rescue skills?
Supervised practice with a mannequin
## Footnote
This method ensures learners can effectively practice the techniques in a controlled environment.
177
Which organizations are recommended for attending classes on choking rescue?
* Red Cross
* American Heart Association
## Footnote
These organizations provide certified training in first aid and choking rescue techniques.
178
What is the most important action to take when someone is choking?
Call 911 immediately
## Footnote
This is critical as professional help is often needed in choking emergencies.
179
True or False: Choking rescue can be effectively taught without hands-on practice.
False
## Footnote
Hands-on practice is essential for mastering choking rescue techniques.
180
What is the purpose of the choking rescue maneuver?
To remove a foreign object lodged in the airway
## Footnote
It lifts the diaphragm and forces air from the lungs to create an artificial cough.
181
What technique does the Heimlich maneuver primarily use?
Abdominal thrusts only
## Footnote
This method aims to expel the obstruction from the airway.
182
How does the American Red Cross recommend alternating the choking rescue procedure?
Five back blows with five abdominal thrusts
## Footnote
This cycle continues until the blockage is dislodged.
183
What is drowning classified as?
A form of suffocation
## Footnote
It is discussed separately for convenience.
184
What is a critical water safety measure for supervising children?
Supervise activity when the child is near any source of water
## Footnote
This includes bathtubs, hot tubs, swimming pools, and other water sources.
185
Children up to what age should never be left unattended in or near water?
4 years
## Footnote
This includes bathtubs, hot tubs, swimming pools, and even small bodies of water.
186
What should be done to prevent children from accessing a pool?
Install a barrier, such as a tall fence
## Footnote
This helps keep children safe from potential drowning.
187
What type of flotation devices should children use?
Personal flotation devices, like life jackets
## Footnote
Float toys are considered less safe as they provide false security.
188
Fill in the blank: Some authorities regard flotation devices as _______.
toys that provide false security
## Footnote
Others believe they can reduce a child's fear of water.
189
True or False: It is safe to allow children to run around a pool.
False
## Footnote
Running around a pool increases the risk of accidents.
190
What is the main concern regarding children's fear of water?
It can lead to drowning
## Footnote
Reducing fear may help improve safety around water.
191
What is the first preventive measure for toxins after leaving work?
Remove work clothing and shower before leaving work
## Footnote
Preferably in an open-air shower
192
What should workers do if they have not showered at work before entering their home?
Remove their clothing and shower immediately
## Footnote
This helps prevent bringing toxins home
193
What should be worn when handling contaminated clothes or objects?
Gloves
## Footnote
To reduce the risk of skin transmission
194
True or False: Laundering is always effective in removing toxins from clothes.
False
## Footnote
Laundering may not be effective for certain toxins
195
What action may be appropriate if shower facilities are not available at work?
Patient advocacy
## Footnote
Refer to Chapter 40 for more information on advocacy
196
What are the 4 Cs of food safety?
Clean, Cook, Combat cross contamination, Chill
197
What does the 'Clean' aspect of food safety refer to?
Maintaining hygiene in food handling
198
What is the importance of 'Cook' in food safety?
Ensuring food is cooked to safe temperatures
199
What does 'Combat cross contamination' mean in food safety?
Preventing harmful bacteria from transferring between food items
200
What does 'Chill' refer to in food safety?
Storing food at safe temperatures to prevent spoilage
201
Fill in the blank: The 4 Cs of food safety are _______.
Clean, Cook, Combat cross contamination, Chill
202
True or False: The 4 Cs of food safety include only cooking and cleaning.
False
203
What is the purpose of teaching clients about food safety?
To promote safe food handling and prevent foodborne illnesses
204
What age-related change increases the risk for injury in car crashes?
Increased risk for injury or death in a car crash, especially after age 70 years
205
Why is driving important for older adults?
Driving helps older adults maintain mobility and independence
206
What should older adults do to ensure safe driving?
Have regular vision checks and leave a large distance between themselves and the car in front of them
207
True or False: The risk of injury in car crashes decreases after age 70.
False
208
Fill in the blank: Driving helps older adults maintain _______.
mobility and independence
209
What type of car seat is recommended for infants younger than age 1 year?
Infant only car seat
## Footnote
These seats are small and may have carrying handles or be part of a stroller system.
210
What is the recommended position for infants in a car seat?
Rear-facing position
## Footnote
This position is advised from birth to ages 2 to 4 years old or until they reach specified limits.
211
What type of car seat should toddlers and preschoolers use?
Convertible or forward-facing car seat
## Footnote
Convertible seats can be used rear-facing and then converted to forward-facing.
212
Until what age should children ride in a rear-facing car seat?
Up to age 4 years
## Footnote
It is best to ride rear-facing as long as possible, until height and weight limits are reached.
213
What type of seat should school-age children use after outgrowing their car safety seat?
Booster seat
## Footnote
Booster seats are safer than using a seat belt alone.
214
At what height and age should children transition from a booster seat to seat belts?
4 ft 9 in. tall and ages 8 to 12 years
## Footnote
Children should stay in a booster seat until seat belts fit properly.
215
Where should all children younger than 13 years ride in a vehicle?
In the back seat
## Footnote
This is a safety recommendation for younger children.
216
When can children start using a regular seat belt?
Once it fits them properly
217
What is the proper placement of the lap belt in a seat belt system?
Across the upper thighs (not the stomach)
218
What is the proper placement of the shoulder belt in a seat belt system?
Across the chest (not the neck)
219
What weight is recommended for children to ride in the back seat?
Less than 110 lb
220
What is the reduction in risk of fatal injury when riding in the back seat?
40%
221
What is the reduction in risk of fatal injury in cars with airbags when riding in the back seat?
Up to 46%
222
True or False: Riding in the back seat is safer than riding in the front seat for children.
True
223
What is the first step in food safety?
Wash hands and surfaces often
## Footnote
Always wash your hands with soap and water before handling or preparing food and before eating.
224
What should you avoid if you have a diarrheal illness?
Preparing food for others
## Footnote
Avoid changing a baby’s diaper while preparing food.
225
How should you wash fresh fruits and vegetables?
Rinse in running tap water
## Footnote
This removes visible dirt.
226
What should you do with the outermost leaves of lettuce or cabbage?
Remove and discard them
## Footnote
This helps reduce contamination.
227
What should you do before using a cutting board or knife that was used for meat?
Wash it thoroughly in hot, soapy water
## Footnote
Prevents cross-contamination.
228
True or False: Bacteria do not grow on the cut surface of fruits or vegetables.
False
## Footnote
Bacteria can grow well on cut surfaces.
229
When should you wash your hands after handling reptiles or birds?
After handling them or contact with pet feces
## Footnote
This helps prevent the spread of bacteria.
230
What is the minimum internal temperature for ground beef?
160°F (71°C)
## Footnote
This temperature is sufficient to kill bacteria.
231
What internal temperature should leftovers and casseroles be cooked to?
165°F (74°C)
## Footnote
Ensures they are safe to eat.
232
What is the safe cooking temperature for whole poultry?
180°F (82°C)
## Footnote
This includes thighs.
233
What is the minimum cooking temperature for pork?
160°F (71°C)
## Footnote
This applies to both pork and ground beef.
234
What should the internal temperature of poultry breasts reach?
170°F (77°C)
## Footnote
This ensures they are properly cooked.
235
How should eggs be cooked for safety?
Until the yolk is firm
## Footnote
Raw or partially cooked eggs should not be eaten.
236
What temperature should hot food be held above?
140°F (60°C)
## Footnote
Hold for no more than 2 hours.
237
What is the first step to avoid cross-contaminating foods?
Wash hands, utensils, and cutting boards after contact with raw meat or poultry
## Footnote
This prevents harmful bacteria from spreading to other foods.
238
Where should cooked meat be placed?
On a clean platter rather than back on one that held raw meat
## Footnote
This practice helps to prevent cross-contamination.
239
How long should leftovers be refrigerated after cooking?
Within 4 hours
## Footnote
Bacteria multiply quickly at room temperature.
240
What should be avoided with cut produce?
Leaving it at room temperature for a prolonged time
## Footnote
This can lead to bacterial growth.
241
How should cooked foods be chilled?
Rapidly in a shallow container, 2 inches in depth
## Footnote
Dividing large volumes of food into several shallow containers helps with cooling.
242
What should you check before buying frozen items?
Ensure they are frozen solid
## Footnote
Avoid purchasing partially thawed items.
243
What should be used to transport foods when the temperature is above 80°F (27°C)?
A cooler
## Footnote
This helps to maintain safe food temperatures.
244
How long should deli meat be stored?
For only 1 or 2 days
## Footnote
This minimizes the risk of spoilage and foodborne illness.
245
What temperatures should the freezer and refrigerator be maintained at?
Freezer: 0°F (–18°C) or below; Refrigerator: 40°F (4°C) or below
## Footnote
These temperatures prevent bacterial growth.
246
How should foods be thawed?
In the refrigerator or under cold running water
## Footnote
Use the microwave only if you will continue cooking the food immediately.
247
What is a good practice for packing lunches?
Use insulated containers and refrigerate or freeze sandwiches before packing
## Footnote
This helps to keep the food cold until consumption.
248
What should be done to food before storing it?
Cover and date food.
249
How should vegetables and fruit be stored in relation to uncooked meats?
Store vegetables and fruit separately from uncooked meats.
250
What is important to check when using decorative containers for food storage?
Ensure they are labeled safe for food.
251
Why should some crystal and pottery not be used for food storage?
They may have high lead content.
252
Where should cleaning supplies be stored in relation to food?
Store cleaning supplies away from food.
253
What should you do if you suspect a foodborne illness?
Report it to your local health department.
254
Why are calls from concerned citizens important in food safety?
They are often how outbreaks are first detected.
255
What should you never eat?
Any food that has an odor or that might be spoiled.
256
What should you be aware of regarding some imported folk remedies?
They may be contaminated with lead.
257
What should you observe when selecting eating establishments?
Sanitation reports.
258
What are public strategies to control mosquitoes?
Spraying programs and digging ditches to promote drainage from stagnant areas
## Footnote
These strategies aim to reduce mosquito populations and their breeding sites.
259
How can individuals help control mosquito populations?
Remove sources of stagnant water, empty standing water in containers, change water in birdbaths and fountains weekly, keep rain gutters unclogged, treat swimming pools properly
## Footnote
These actions disrupt mosquito habitats and breeding conditions.
260
What is a recommended frequency for changing water in birdbaths?
At least once a week
## Footnote
This helps destroy mosquito habitats.
261
What are two methods to kill or repel mosquitoes?
Use bug zappers or citronella candles
## Footnote
These methods can be effective during outdoor evening activities.
262
What should be checked on the label of repellents and pesticides?
The name and amount of active ingredient
## Footnote
This ensures proper usage and safety.
263
True or False: No pesticide is 100% safe.
True
## Footnote
Caution is advised when using pesticides.
264
What is one way to avoid attracting mosquitoes to outdoor areas?
Replace outdoor lights with yellow bug lights
## Footnote
These lights attract fewer mosquitoes but do not repel them.
265
What clothing items are recommended for areas with high mosquito populations?
Head nets, long sleeves, and long pants
## Footnote
These provide physical barriers against mosquito bites.
266
What action should be taken during a mosquito-borne disease alert?
Stay indoors during the evening
## Footnote
Mosquitoes are most active during this time.
267
What should be used when walking in tick-infested areas?
DEET-containing insect repellant
## Footnote
This is effective in preventing tick bites.
268
What is the recommended concentration of DEET for adults and children over 2 months?
Up to 50%
## Footnote
Higher concentrations may provide longer-lasting protection.
269
What should be done with repellent when wearing sunscreen?
Apply sunscreen first and then repellent
## Footnote
This ensures both products are effective.
270
What should be done with repellent before going to bed?
Wash off repellent
## Footnote
This reduces skin exposure to chemicals overnight.
271
What type of clothing treatment can provide additional protection from ticks?
Treat clothing with permethrin-containing insect repellent
## Footnote
This provides a barrier against ticks that may come into contact with clothing.
272
What color clothing should you wear to avoid ticks?
Light-colored clothing
## Footnote
Ticks are attracted to dark colors, making it easier to spot them on light fabrics.
273
What type of shirts should you wear to protect against ticks?
Long-sleeved shirts, tucked in
## Footnote
This helps to minimize skin exposure.
274
What should you do with your socks to prevent ticks?
Pull socks up over pant legs
## Footnote
This creates a barrier to prevent ticks from crawling up the legs.
275
When should you inspect your body for ticks?
After walking in wooded areas
## Footnote
Focus on areas such as hair and skinfolds.
276
What is a recommended method for inspecting your body for ticks?
Use a mirror to view all parts of your body
## Footnote
This ensures you do not miss any areas.
277
What should you do if you find a tick attached to your body?
Remove ticks right away
## Footnote
This can prevent infections like Lyme disease or Rocky Mountain spotted fever.
278
Where can you find instructions on how to remove an attached tick?
CDC Web site at https://www.cdc.gov/ticks/removing_a_tick.html
## Footnote
This site provides detailed guidance for tick removal.
279
What is one method to control rodents and small animals?
Remove food and water sources
## Footnote
This discourages animals from nesting in the area.
280
What should clients do with food after meals to control pests?
Cover food and clean up immediately after meals
## Footnote
This prevents attracting rodents and other pests.
281
What should you do with unwashed dishes to prevent pest attraction?
Do not leave unwashed dishes on counters and in sinks
## Footnote
Clean dishes reduce food sources for pests.
282
How should garbage be stored to control pests?
Keep garbage in closed containers that cannot be overturned
## Footnote
This prevents access to food waste by rodents.
283
What structural repairs should be made to control pests?
Repair holes and cracks in the exterior structure of the home
## Footnote
This includes walls, closets, attic, around sinks, and cabinets.
284
What are two methods for pest control mentioned in the text?
Use commercial traps or hire professional exterminators
## Footnote
These methods can effectively reduce pest populations.
285
What community action can help control pests?
Participate in neighborhood cleanup projects
## Footnote
Collective efforts can reduce pest habitats and food sources.
286
What can rat and mice poisons and baits be fatal to?
Humans
## Footnote
These substances should not be used in areas accessible to children and pets.
287
What are two types of pollution families can help reduce?
* Solid pollution
* Hazardous wastes
* Air pollution
* Noise pollution
## Footnote
Families can take actions to minimize these types of pollution.
288
What is one way to help reduce air pollution?
Participate in carpools or use public transportation
## Footnote
These methods decrease the number of vehicles on the road.
289
What should individuals pay attention to in order to reduce exposure to air pollution?
Air quality warnings
## Footnote
This helps to restrict time spent in high-traffic areas.
290
What is one intervention to help prevent irreversible hearing loss?
Avoid exposure to high noise levels
## Footnote
This is crucial for maintaining hearing health.
291
What protective device can be worn in high noise environments?
Earplugs
## Footnote
These devices help to reduce noise exposure.
292
What should you do for proper disposal of hazardous waste?
Contact the local refuse disposal company for instructions
## Footnote
This includes items like paints, solvents, pesticides, and cleaners.
293
What is a tip for using hazardous products?
Use nonhazardous or less hazardous products
## Footnote
Only use the amount necessary for a project.
294
What should you never do with motor oil?
Dump it into storm drains
## Footnote
Instead, seek proper disposal methods through local waste management.
295
What should you do with car and other batteries?
Talk to an automotive dealer or repair service about recycling or trading them in
## Footnote
This helps to ensure proper disposal and recycling.
296
What are the 4 Rs for solid waste management?
* Reduce
* Reuse
* Recycle
* Respond
## Footnote
These principles help to minimize waste and pollution.
297
What is one way to reduce the amount of trash discarded?
Do not buy products that have unnecessary packaging
## Footnote
This reduces solid waste at the source.
298
How can you reuse materials instead of throwing them out?
Sell or donate items
## Footnote
This promotes resourcefulness and reduces waste.
299
What should you do to recycle effectively?
Use and buy recyclable and recycled products
## Footnote
Composting yard trimmings is also part of effective recycling.
300
What does it mean to respond in the context of waste management?
Educating others and expressing preferences for less waste
## Footnote
This involves communicating with manufacturers and merchants.
301
What is the importance of being aware of impending weather events?
Increased likelihood of survival.
302
What should clients develop to prepare for severe weather?
A disaster plan at home, work, school, and outdoors.
303
Where can clients find planning tips for disaster preparedness?
American Red Cross website: https://www.redcross.org/
304
What is crucial to identify for safety during severe weather?
A safe place to take shelter.
305
Where can information on building a Safe Room be found?
Federal Emergency Management Agency website: https://www.fema.gov/safe-rooms
306
Why is it important to know your county or parish during severe weather?
Severe weather warnings are issued on a county/parish basis.
307
What should you keep nearby to track storm movement?
A highway map.
308
What device is recommended for receiving weather warnings?
A Weather Radio receiver unit with a warning alarm tone and battery backup.
309
What should you do before leaving for extended periods outdoors?
Check the weather forecast.
310
Who should you check on if severe weather threatens?
Older individuals, very young children, and those with physical or mental impairments.
311
True or False: Pets and farm animals should be included in safety checks during severe weather.
True.
312
What are electrical hazards a major cause of in healthcare agencies?
Fires
## Footnote
Electrical hazards can lead to significant safety risks in healthcare settings.
313
What is the first intervention to reduce electrical hazards?
Have all electrically powered equipment and accessory equipment evaluated by facilities management before use
## Footnote
This ensures that equipment is safe and compliant with standards.
314
What do The Joint Commission standards mandate regarding electrical safety?
All employees participate in education and training programs for electrical safety
## Footnote
This training is essential for maintaining a safe environment.
315
What should you do if you suspect an electrical safety hazard?
Clearly label the malfunctioning equipment and send it for inspection
## Footnote
This helps prevent accidents and alerts others to the danger.
316
What type of electrical plugs should be used whenever possible?
Three-pronged electrical plugs
## Footnote
These plugs provide better grounding and reduce the risk of electrical shock.
317
What should be observed for in electrical cords?
Breaks or frays
## Footnote
Damaged cords can lead to electrical hazards and should be addressed immediately.
318
What does R-A-C-E stand for in fire response procedures?
Rescue, Activate, Confine, Extinguish
## Footnote
R-A-C-E is an acronym used to outline the steps for responding to a fire.
319
What is the first step you should take if you discover a fire?
Rescue the patient
## Footnote
This involves removing the patient from immediate danger.
320
After rescuing the patient, what should you do next?
Activate the nearest alarm
## Footnote
You should report the location and kind of fire and identify yourself.
321
What is the purpose of confining the fire?
To prevent it from spreading
## Footnote
This includes closing all doors and windows and turning off oxygen valves after coordinating with the charge nurse.
322
What should you do to extinguish the fire?
Use the proper extinguisher and stay between the fire and the path to safety
## Footnote
Keeping low can help reduce smoke inhalation.
323
True or False: You should try to extinguish the fire before completing the R-A-C steps.
False
## Footnote
Your first action is to rescue the patient, and extinguishing the fire should only be done after the R-A-C steps are completed.
324
Fill in the blank: If the fire gets out of control, you should _______.
leave the area immediately
## Footnote
Safety is the priority in fire situations.
325
What should you do with doors after rescuing patients?
Close doors to the affected area
## Footnote
This helps confine the fire and smoke.
326
When is it appropriate to attempt to extinguish a fire?
Only if it is a small fire that is contained to one area
## Footnote
For example, a small fire like one in a trash can.
327
What are the main types of fire extinguisher classifications?
Class A, Class B, Class C, Class D, Class K
## Footnote
These classifications are used to identify the type of fires each extinguisher is effective against.
328
What materials does Class A fire extinguishers combat?
Wood, paper, rubber, textiles, plastics
## Footnote
Class A extinguishers are suitable for fires involving ordinary combustibles.
329
What types of fires are Class B extinguishers used for?
Flammable liquids, gases, oils, solvents, paints, or greases
## Footnote
Class B extinguishers are effective against fires involving flammable substances.
330
What is the primary use of Class C fire extinguishers?
Live electrical wires or equipment
## Footnote
Class C extinguishers are specifically designed for electrical fires.
331
What types of materials are associated with Class D fire extinguishers?
Combustible metals (e.g., potassium, magnesium, titanium)
## Footnote
Class D extinguishers are used for fires involving certain metals.
332
Class K fire extinguishers are primarily used for which type of fire?
Kitchen fires involving cooking oils and fats
## Footnote
Class K extinguishers are specifically designed for kitchen environments.
333
True or False: Most agencies use multipurpose (Class ABC) extinguishers.
True
## Footnote
Class ABC extinguishers can handle a variety of fire types, making them versatile.
334
Fill in the blank: Class ______ extinguishers are suitable for wood, paper, rubber, textiles, and plastics.
A
## Footnote
Class A extinguishers are designed for ordinary combustibles.
335
What is the current standard of care regarding restraints?
Restraint free
## Footnote
Restraints are considered a last resort.
336
What should caregivers do to provide consistency for patients?
Encourage family and friends to:
* Remain with the patient around the clock for a few days after admission
* Help with the patient's care
* Bring familiar objects from home
337
What measures can relieve anxiety in patients and prevent wandering?
Try the following measures:
* Orient patients and families to their surroundings
* Provide consistency of caregivers and environment
* Use therapeutic touch and relaxation techniques
338
What is a less invasive method to deliver care for toileting?
Use a toileting schedule or provide a bedpan instead of inserting a urinary catheter
## Footnote
Encouraging oral fluids can avoid inserting an IV for hydration.
339
What should be done as soon as possible to prevent patient agitation?
Discontinue treatments that cause discomfort or agitation
## Footnote
Examples include indwelling catheters, IV catheters, and nasogastric tubes.
340
How can frequent assessment and surveillance be provided for patients?
Use one-to-one supervision and encourage family members to stay or hire sitters
## Footnote
Place patients near the nursing station and check on them frequently.
341
What is essential for communicating with patients who have cognitive deficits?
Assess the patient’s communication abilities and be alert for body language
## Footnote
Speak clearly, calmly, and slowly.
342
What environmental modifications can reduce agitation and confusion?
Reduce noise and provide adequate light, use music therapy, and use wedge cushions for good posture
## Footnote
Consider low beds for patients likely to fall.
343
What should be anticipated to prevent patients from trying to get out of bed?
Look for unmet needs and plan an elimination routine based on the patient's history
## Footnote
Provide pain relief and diversional activities.
344
When are restraints considered necessary?
To ensure the immediate physical safety of the patient or others
## Footnote
Always use the least restrictive restraint that ensures safety.
345
What is the consequence of not properly cleaning a mercury spill?
Mercury can remain in cracks and crevices, causing continuous exposure to vapors
## Footnote
Large spills must be cleaned by a pollution control agency.
346
What interventions help ensure safe use of medical equipment?
Follow these interventions:
* Seek advice if unsure about operation
* Ensure proper inspection of medical equipment
* Be alert to malfunction signs
347
What actions does the AACN suggest to reduce alarm fatigue?
Provide proper skin preparation for ECG electrodes and change them at least daily
## Footnote
Set alarm parameters to meet individual needs.
348
Fill in the blank: The current standard of care is _______ for patients who are confused or cognitively impaired.
restraint free
349
What should you wear for protection during a mercury spill cleanup if you do not have a spill kit?
Rubber gloves and eye protection
## Footnote
It is essential to protect yourself from exposure to mercury during cleanup.
350
What should you do to the area where a mercury spill has occurred?
Keep people and pets away
## Footnote
Ensuring safety by restricting access to the contaminated area is crucial.
351
What is the first step in cleaning up mercury beads from skin and clothing?
Wipe beads off with paper towels
## Footnote
Use disposable items for cleanup and place them in a sealed plastic bag.
352
How should you collect mercury beads on hard surfaces?
Use cardboard to scrape them up
## Footnote
After scraping, pour the beads into a can or jar with a lid.
353
What should you do after collecting mercury beads from hard surfaces?
Wash the area and shower
## Footnote
Ensure thorough cleaning to remove any residual mercury.
354
True or False: You should touch mercury droplets during a cleanup.
False
## Footnote
Touching mercury droplets is dangerous as they can vaporize and be inhaled.
355
What should you do if you are not trained in cleaning up a mercury spill?
Notify the environmental services department
## Footnote
Only trained personnel should handle mercury spills to ensure safety.
356
What is the recommended action for a healthcare facility regarding mercury spills?
Use a commercially made mercury spill kit
## Footnote
Facilities should be equipped with spill kits containing necessary cleaning materials.
357
What items should be included in a mercury spill kit?
* Gloves
* Protective glasses
* Mercury-absorbing powder
* Special mercury sponges
* Disposal bag
* Filtered vacuum equipment (optional)
## Footnote
These items help ensure safe and effective cleanup of mercury spills.
358
What should you do with contaminated clothing after a mercury spill?
Change clothing and follow agency policy for laundering
## Footnote
Proper disposal and laundering are essential to prevent further contamination.
359
What should you not use for cleaning up a mercury spill?
Broom or vacuum cleaner
## Footnote
These tools can spread mercury and become contaminated.
360
What is important to do to the area after a mercury spill to reduce vapor concentration?
Ventilate the area well
## Footnote
Promoting exhaust ventilation can help dissipate toxic vapors.
361
Fill in the blank: Do not flush mercury or cleaning materials down a _______.
toilet or drain
## Footnote
Flushing can lead to widespread contamination and health hazards.
362
What is a 'public safety room' used for?
For patients who have been arrested or those at risk of violence
## Footnote
It is designed to provide safe care for hostile patients undergoing testing.
363
What intervention can be used to relieve anxiety that may precede violent behavior?
Intervene to relieve anxiety
## Footnote
This can help prevent escalation to violence.
364
What should be monitored or treated to prevent violent behavior?
Underlying medical conditions
## Footnote
Examples include administering medications or checking blood glucose levels.
365
Name two sedatives that may be administered to prevent violence.
* Diazepam
* Lorazepam
## Footnote
There may be standing prescriptions for these medications.
366
What type of approach should be used when dealing with an angry patient?
A calm, reassuring approach
## Footnote
This can help de-escalate the situation.
367
True or False: It is advisable to use threatening body language to manage an angry patient.
False
## Footnote
Avoiding threatening body language is crucial for safety.
368
What should you avoid doing in response to an angry patient?
Do not respond to anger with anger
## Footnote
This can escalate the situation further.
369
If a patient is verbally aggressive, what should you not do?
Do not defend yourself
## Footnote
This could provoke further aggression.
370
What personal items should not be worn when dealing with potentially violent patients?
* Stethoscope around the neck
* Dangling jewelry
## Footnote
These items could be used as weapons against staff.
371
What is a key safety practice when entering a room with an angry patient?
Do not go alone into a room
## Footnote
This reduces risk and enhances safety.
372
What should you do with the room door when with an angry patient?
Keep the room door open
## Footnote
This allows for a quick exit if needed.
373
What is the recommended distance to maintain from an angry patient?
At least an arm’s length away
## Footnote
This helps to keep safe distance.
374
What should you not do regarding your position when with an angry patient?
Do not turn your back
## Footnote
This keeps you aware of the patient’s actions.
375
Under what condition should you touch an angry patient?
Only with permission or if intending to physically restrain
## Footnote
This is for safety and consent reasons.
376
What is the priority when managing potentially violent situations?
Your own safety and the safety of others
## Footnote
This is essential for effective intervention.
377
What should be followed to protect others in the environment?
The department’s safety guidelines
## Footnote
These guidelines are designed to enhance safety.
378
When should mechanical restraints be used?
As a last resort, if ordered and necessary
## Footnote
Restraints should be used in accordance with protocols.
379
What is one safety activity that can be delegated to unlicensed assistive personnel (UAP)?
Applying restraints
## Footnote
Ensure UAP is competent to perform the skill.
380
Can the assessment of the patient’s status be delegated to unlicensed assistive personnel (UAP) when applying restraints?
No
## Footnote
The assessment and evaluation of the response to restraints cannot be delegated.
381
What should the UAP do regarding restraints to provide skin care?
Remove and reapply restraints
## Footnote
This allows for supervised movement and skin care.
382
What observation should UAP report regarding restraints?
Skin excoriation under or around the restraint location
## Footnote
UAP should monitor and report any skin issues.
383
What responsibilities should assistive personnel be aware of?
All safety measures and institutional procedures
## Footnote
This includes tasks like removing clutter and spills.
384
What should UAP provide to patients to enhance safety?
Nonskid slippers
## Footnote
This is part of promoting safety in patient care.
385
What should UAP do with beds and wheelchairs to ensure safety?
Lock them
## Footnote
Ensuring mobility aids are secure is crucial for patient safety.
386
What should guide the use of restraints?
Agency policy, professional guidelines, and state laws.
387
When should restraints be used?
Only for safety to ensure the immediate physical safety of the patient or others.
388
What is required before using restraints?
A medical prescription from a physician or other licensed care provider.
389
Are standing orders or 'as needed' orders for physical restraint allowed?
No.
390
How often must restraint prescriptions be renewed?
Every 24 hours (more often for behavioral restraints).
391
What must be modified to reflect the application of restraints?
The plan of care.
392
What should you explain if restraints are used?
The need for the restraints.
393
What is required when feasible regarding restraints?
Obtain consent from the patient and family.
394
When are medications considered a restraint?
When they are used to restrict the patient’s freedom of movement or to manage behavior.
395
Is physical holding of a patient always considered restraint?
No.
396
When might physical holding of a patient be necessary?
For routine physical examinations or tests.
397
How often should restraints be assessed?
Every 30 minutes (more frequently for patients with behavioral restraints).
398
When should restraints be removed for assessment, feeding, toileting, and skin care?
Every 2 hours.
399
How often should patients in medical-surgical restraints be evaluated by an RN?
At least every 2 hours.
400
How often do patients in behavioral restraints require monitoring?
More frequently than every 2 hours.
401
What is the principle for using restraints?
Always use the least restrictive restraint that ensures safety.
402
When should restraints be removed?
As soon as possible.
403
What is the primary purpose of the PUSH Tool?
To observe and measure pressure ulcers and track healing progress over time.
## Footnote
The PUSH Tool categorizes ulcers based on surface area, exudate, and type of wound tissue.
404
How do you calculate the total score for a pressure ulcer using the PUSH Tool?
Add the sub-scores for length, width, exudate amount, and tissue type.
## Footnote
The total score indicates improvement or deterioration in healing.
405
What measurements are taken to assess the length and width of a pressure ulcer?
Measure the greatest length (head to toe) and the greatest width (side to side) using a centimeter ruler.
## Footnote
The surface area is estimated by multiplying length and width.
406
What are the categories for the length of a pressure ulcer and their corresponding sub-scores?
* 0 cm - 0.3 cm: 1
* 0.4 cm - 0.6 cm: 2
* 0.7 cm - 1.0 cm: 3
* 1.1 cm - 2.0 cm: 4
* 2.1 cm - 3.0 cm: 5
* 3.1 cm - 4.0 cm: 6
* 4.1 cm - 8.0 cm: 7
* 8.1 cm - 12.0 cm: 8
* 12.1 cm - 24.0 cm: 9
* > 24 cm: 10
## Footnote
These scores guide the assessment of ulcer size.
407
What are the categories for the amount of exudate and their corresponding sub-scores?
* None: 0
* Light: 1
* Moderate: 2
* Heavy: 3
## Footnote
Exudate is assessed after removing the dressing.
408
What are the tissue types that can be present in a wound bed and their corresponding scores?
* 4 - Necrotic Tissue
* 3 - Slough
* 2 - Granulation Tissue
* 1 - Epithelial Tissue
* 0 - Closed/Resurfaced
## Footnote
These scores reflect the condition of the ulcer bed.
409
What is the definition of necrotic tissue in the context of the PUSH Tool?
Black, brown, or tan tissue that adheres firmly to the wound bed or ulcer edges.
## Footnote
Necrotic tissue may be firmer or softer than surrounding skin.
410
True or False: A superficial wound that is reepithelializing is scored as a '2' in the PUSH Tool.
False.
## Footnote
A superficial wound that is reepithelializing is scored as a '1'.
411
Fill in the blank: The PUSH Tool requires the use of a _______ to measure pressure ulcers.
centimeter ruler.
## Footnote
Consistent measurement methods are essential for accurate assessment.
412
What does the total score from the PUSH Tool indicate?
The improvement or deterioration in pressure ulcer healing.
## Footnote
Tracking scores over time helps assess treatment effectiveness.
413
What is the significance of the NPUAP Website in relation to the PUSH Tool?
It provides further information regarding the development and use of the PUSH Tool.
## Footnote
NPUAP stands for National Pressure Ulcer Advisory Panel.
414
What is the definition of a pressure injury?
Localized injury to the skin and underlying tissue usually over a bony prominence
## Footnote
Formerly called decubitus ulcers, pressure ulcers, bedsores.
415
How are pressure injuries staged?
Staged by degree of tissue involvement
## Footnote
Healing pressure injuries are not 'reverse' staged.
416
What happens to pressure injuries as they heal?
Become progressively shallow by filling with granulation tissue
## Footnote
Healing pressure injuries are described as 'stage 4 pressure injury: healing'.
417
What are the contributing factors to pressure injuries?
Pressure, friction, shear, moisture
## Footnote
Each factor plays a role in tissue ischemia and injury.
418
What is the effect of pressure on tissues?
Compresses small blood vessels, hindering blood flow and nutrient supply
## Footnote
Tissues become ischemic or injured.
419
What is shear in the context of pressure injuries?
When one layer of tissue slides horizontally over another, compressing adipose and muscle tissue
## Footnote
Shear is friction plus the force of gravity.
420
List some risk factors for developing pressure injuries
* Impaired circulation
* Reduced oxygen supply
* Limited mobility
* Reduced sensation
## Footnote
Conditions like diabetes, atherosclerosis, and nerve damage increase risk.
421
What health conditions increase the risk of pressure injuries?
Immobility, poor nutrition, fever, infection, dehydration, edema, impaired sensation
## Footnote
These conditions combined with unreleased pressure heighten risk.
422
Fill in the blank: A stage 4 pressure injury does not become a stage _____ when healing.
3
423
True or False: Moisture can contribute to the development of pressure injuries.
True
424
What are the consequences of friction on the skin?
When skin is moist, fragile, or rubbed against another surface
## Footnote
This can lead to increased risk of injury.
425
What role does moisture play in pressure injuries?
Macerates the skin
## Footnote
Urine, stool, and sweat can all contribute.
426
What types of patients are at higher risk for pressure injuries due to impaired circulation?
* Patients with diabetes
* Patients with atherosclerosis
* Patients with low blood pressure
## Footnote
These conditions can hinder blood flow.
427
What impact does limited mobility have on pressure injuries?
Increases risk due to prolonged pressure on certain areas
## Footnote
Limited mobility can be due to various health conditions.
428
What is the significance of reduced sensation in pressure injury risk?
Patients may not feel pressure points, leading to prolonged exposure
## Footnote
Conditions like spinal cord injury or stroke contribute to this.
