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ADULT 1 > EXAM 2 - Safety and Sensory > Flashcards

EXAM 2 - Safety and Sensory Flashcards

1
Q

What is the ANA’s definition of a culture of safety?

A

an organizational environment where “cores values and behaviors–resulting from a collective and sustained commitment by organizational leadership, manager, and workers—emphasize safety over competing goals’”

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2
Q

What are the attributes of a positive safety culture?

A
  • Openness and trust, without individual blame;
  • Appropriate resource allocation;
  • A learning environment for health care professionals where errors are explored and systemic weaknesses identified;
  • Transparency and accountability
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3
Q

How does QSEN minimize risk of harm to patients and providers?

A
  • System effectiveness

- Individual performance

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4
Q

What accredited bodies creates the standards for nurses?

A
  • ANA

- TJC

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5
Q

What are the outcomes of safety in the health care setting?

A
  • Reduces the incidence of illness and injury
  • Prevents extended length of treatment/stay
  • Improves or maintains functional status
  • Increases patient’s sense of well-being
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6
Q

What are the basic human needs?

A
  • Oxygen
  • Nutrition
  • Temperature
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7
Q

What are some things to keep in mind with a patient on oxygen?

A
  • highly flammable
  • should not smoke around them
  • furnaces and stoves need proper ventilation or carbon monoxide can build up
  • low concentration of O2 causes: dizziness, nausea, fatigue and headache
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8
Q

What are some things to keep in mind with nutrition?

A
  • improper food preparation and storage presents a r/f infection and food positioning
  • fridge should be kept <40F
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9
Q

Who is at the highest risk for experiencing hypothermia?

A
  • older adults
  • the young
  • those with CVD
  • those with excessive drug/alcohol use
  • the homeless
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10
Q

Who is at the highest risk for experiencing hyperthermia?

A
  • chronically ill
  • older adults
  • infants
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11
Q

Who is carbon monoxide poisoning most common in?

A

toddlers

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12
Q

Who is MVA most common in?

A

young adults

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13
Q

What factors influence safety and quality in a patient?

A
  • Developmental stages
  • Individual risk factors
  • Mobility, sensory, and cognitive status
  • Impaired mobility
  • Lifestyle choices
  • Lack of safety awareness
  • Risks in the health care agency
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14
Q

What are considered some serious reportable events?

A
  • Surgical events
  • Product or device events
  • Patient protection events
  • Care management events
  • Environmental events
  • Criminal events
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15
Q

What is the 8th leading COD in hospitals?

A

medication errors

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16
Q

What are some medical errors that often occur in the hospital?

A
  • Medication errors-8th. Leading cause of death
  • Infection-Hospital Acquired Infections- (CAUTI)
  • Bed sores-Decubitus Ulcers-(HAPU)
  • Failure to diagnose and treat in time
  • Falls
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17
Q

What are some classifications of health care agency accidents?

A 
- Patient-inherent accidents
     > seizures 
- Procedure-related accidents
     > giving wrong meds
- Equipment-related accidents
     > faulty equipment
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18
Q

How do you report a SRE?

A

The nurse or provider involved completes an incident report. IR is a confidential document that describes any patient accident and focuses on the root cause of the event, not the person involved.

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19
Q

What are some examples of never events?

A
  • pressure ulcers (stage 3 or 4)
  • falls/trauma like fractures
  • foreign objects in the body post-op
  • CAUTIS
  • blood incompatibility
  • air embolism
  • surgical site infection
  • DVT/PE following ortho procedure
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20
Q

What increases a patients risk for falls?

A
  • muscle weakness (lower body)
  • paralysis
  • abnormal gait/balance
  • poor coordination
  • poor vision
  • problems with feet/shoes
  • medications
  • dizziness
  • hazards/obstacles
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21
Q

What predisposes a patient to physical deconditioning and emotional hazards?

A

immobilization

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22
Q

What should you always do before using a restraint?

A

try restraint alternatives (restraint should ALWAYS be a LAST resort)

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23
Q

What are some ways to implement fall prevention?

A
  • yellow wristbands = fall risk
  • bedside commode (for those with urgency)
  • safety bars near toilet
  • 2 bed rails up
  • remove tripping hazards
  • call light within reach
  • orient patient to room
  • keep room well lit
  • use non-slip socks
  • bed alarms
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24
Q

When should discharge planning start?

A

on admission and it should include the family

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25
Q

What are some things that can be done to promote fire safety?

A
  • keep equipment from blocking fire doors
  • direct all ambulatory patients to walk themselves to a safe place
  • move patients who cant get out of bed with a stretcher
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26
Q

What does PASS stand for?

A
  • pull pin
  • aim at base
  • squeeze
  • sweep from side to side
27
Q

What does RACE stand for?

A
  • rescue/remove
  • alarm
  • confine
  • extinguish
28
Q

What are some seizure precautions?

A
  • never put anything in their mouths while seizing
  • turn patient to the side and lower them to the ground
  • do not restrain the patient
  • loosen restrictive clothing
  • if the seizure is longer than 5 minutes, call rapid response (status epilepticus)
  • pad side rails
29
Q

What are the different types of reception senses?

A
  • Visual (Vision)
  • Auditory (Hearing)
  • Olfactory (Smell)
  • Gustatory (Taste)
  • Tactile (Touch)
30
Q

What is stereognosis?

A

The perception of solidity, size, shape & texture of objects

31
Q

What is kinesthetic?

A

The perception of body position & movement

32
Q

What is visceral?

A

The perception of inner organ response

33
Q

What is proprioception?

A

The subconscious level movement of the body-(limbs)

34
Q

What are the 3 components of the sensory pathway?

A
  • reception
  • perception
  • reaction
35
Q

What is reception?

A

stimulation of a receptor such as light, touch, or sound. the nerve (receptor) is stimulated and travels to the spinal cord, then to the brain

36
Q

What is perception?

A

integration and interpretation of stimuli. it is being aware of the stimuli occurring and happens when a person is conscious of the stimuli; each person integrates and interprets the stimuli based on past experience

37
Q

What is reaction?

A

moving away from harm; only the most important stimuli will elicit a reaction

38
Q

What factors affect sensory stimulation?

A
  • Developmental considerations
  • Cultural considerations
  • Personality and lifestyle
  • Stress and Illness
  • Medications
  • Consciousness
  • Unconsciousness
39
Q

What is locked in syndrome?

A

patient can see but cannot respond

40
Q

What is vegetative state?

A

no brain activity

41
Q

What is stupor?

A

unconscious but aroused with vigorous stimulation

42
Q

What is coma?

A

unconscious and cant be aroused (one step closer to vegetative state)

43
Q

What dBA is annoyingly loud?

A

70+ dBA

44
Q

What dBA is during the day? What dBA is at night?

A

35 dB; 30 dB

45
Q

What noise level can damage hearing if exposed too long?

A

> 80 dB

46
Q

What factors affect sensory function?

A
  • Age
  • Number of stimuli
  • Environmental factors
  • Meaningful stimuli
  • Social interaction
  • Cultural factors
47
Q

What is a sensory deficit?

A

Deficit in the normal function of sensory reception and perception

48
Q

What is sensory deprivation?

A

Inadequate quality or quantity of stimulation

49
Q

What is sensory overload?

A

Reception of multiple sensory stimuli

50
Q

What area do most sensory deficits occur?

A
  • Sight
  • Hearing
  • Balance
  • Taste
  • Speech
51
Q

What is aphasia?

A

has varied degrees of inability to speak, interpret, or understand language.

52
Q

What is expressive aphasia?

A

a motor type of aphasia, is the inability to name common objects or express simple ideas in words or writing

53
Q

What is sensory or receptive aphasia?

A

the inability to understand written or spoken language (cant receive what is being said)

54
Q

How should you care for a patient with aphasia?

A
  • give them extra time to communicate
  • do not shout or speak loudly
  • use simple, short sentences
  • ask simple yes/no questions
  • offer pictures so they can point
  • only one person speak at a time
  • tell the patient when you don’t understand them
55
Q

What is the nursing care provided when tending to a patient with sensory deprivation?

A

provide meaningful stimuli:

  • provide stimulation with as many senses as possible
  • encourage physical activity and ROM exercises
56
Q

What are the effects of sensory deprivation?

A
  • Perceptual
    > person cant contain 5 senses (don’t know what a puzzle is)
  • Cognitive
    > unable to to control direction of thought (confused; don’t know where to put puzzle piece)
  • Emotional Disturbances
    > PTSD, fear, anger, pain
57
Q

What is sensory overload?

A

when a person receives too much stimuli and the brain cannot process it all. patient may have a increased HR, inattention, anxiety and restlessness

58
Q

What is the nursing care for a patient experiencing sensory overload?

A
  • dim the lights, close the door, silence alarms early
  • cluster care
  • quiet time
  • turn off bedside equipment not in use
  • orient the person to patient, place or time
  • decrease environmental noise
  • encourage the patient to participate in nursing care
59
Q

What factors can maintain orientation to person, place and time?

A

clock and a white board in patients room

60
Q

What should your nursing care be for a patient with impaired vision?

A
  • alert the patient when you enter the room
  • explain what you are going to do before you do it (esp. if touching)
  • orient them to the environment
  • have safety bars near the toilet
  • speak in a normal tone of voice
  • keep call light within reach
  • keep side rails in up position and have patient call for help
  • assist with ambulation by walking slightly ahead of patient
  • stay in field of vision for patients with partial vision
  • provide diversion by using other senses
  • tell them when interaction has ended and when your about to leave the room
61
Q

What should your nursing care be for a patient with impaired hearing?

A
  • do not approach from behind
  • face the patient and stand/sit on their level
  • check hearing aids
  • use a lower tone of voice
  • speak so they can see your mouth movement
  • speak slowly and enunciate (do not yell)
  • use an interpreter, NOT family/friend
  • write down things if needed
  • orient patient to your presence before speaking
  • decrease background noises before speaking
  • position yourself so that light is on your face
  • talk directly to the patient while talking to them
  • use sign language, as appropriate
62
Q

What should your nursing care be for a patient with confusion?

A
  • Use face to face contact to communicate social process
  • Speak calmly, directly, & simply to patient***
  • Orient & re-orient patient to environment
  • Communicate expectations to patient
  • Offer explanation for care delivered
  • Reinforce reality if delusional***
63
Q

What should your nursing care be for a patient who is unconscious?

A
  • Be careful what is said in patient’s presence….Hearing is the LAST sense that is lost!***
  • Assume patient can hear you. Talk in a normal voice
  • Speak to patient before touching them
  • Control environmental noises- low level
64
Q

What should your nursing care be for a patient who has tactile alterations?

A

They have a reduced sensation/decrease in touch in extremities so they are at a increased risk for impaired skin integrity:

  • temp. on home water heater should be no higher than 120F
  • label hot and cold faucets if they also have a visual impairment
  • discourage heating pads
  • encourage wear of closed toed shoes
  • inspect all body parts at risk
  • protect the patients skin from temp. extremes
  • assess the extremities for breaks in the skin, blisters, drainage or open wounds
  • ensure that the patient is ambulating w/assistive devices

ADULT 1 (9 decks)

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