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Concepts Exam 1 > Safety, Activity, Mobility > Flashcards

Safety, Activity, Mobility Flashcards

1
Q

What is violence?

A

Aggression, verbal abuse, threatening behaviour and/or physical assault.

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2
Q

What do you do when a patient gets violent?

A

Remain calm, communicate in short, clear sentences

Listen attentively and validate patients feelings

Don’t respond to aggression with aggression

Get help!

Document occurrences in hospital incident report

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3
Q

How would you move a patient if they cannot bear weight

A

Use a mechanical lift

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4
Q

What are some barriers to the mechanical lifts?

A

Patient aversion (fear) to equipment

Time constraints like if the patient needs to use the bathroom asap! (Using hoyer lift)

Weight limitations

Cleaning/infection control

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5
Q

Ratio of falls every year of people over 65?

A

1 out of every 4 older people, but fewer than half of them tell their provider.

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6
Q

Why do many falls at home go unreported?

A

They do not cause injuries requiring medical attention

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7
Q

Why would injuries from falls go unreported?

A

Older adults fear activity restrictions, loss of independence, or placement in a long-term care facility

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8
Q

What should you note when doing a risk for falling assessment?

A

Note any assistive devices that the patient uses a cane or Walker

Be alert to any history of drug or alcohol used disorder

Consider comorbidities, such as obesity, osteoarthritis, diabetes, hypertension, chronic pain, depression, and any associated medication’s

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9
Q

What characteristics of older adults are most strongly associated with fall risks?

A

Depression

Difficulty completing routine errands

Difficulties with ADLs

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10
Q

What are accidental falls?

A

Falls of low risk adults

Clutter or a spill causes a person to trip

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11
Q

What are anticipated physiological falls?

A

A direct consequence of gait imbalances, effects of medication, or dementia

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12
Q

What are unanticipated physiological falls?

A

Caused by unknown or unexpected medical issues, such as stroke or seizure

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13
Q

What is HAC?

A

Hospital acquired condition

The joint commission requires hospitals implement fall prevention assessments and programs.

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14
Q

How do you prevent falls?

A

Orient patients to surroundings*

Remind patient to call for assistance

Bed rails*

Call light and possessions in reach

Bed in lowest position

Purposeful hourly rounding!
5Ps

Alarms for beds, chairs, commodes*

Lock the wheels on bed and chairs

Slip resistant socks

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15
Q

How many bed rails can we have up?

A

There are 4 rails.. but we can only have 3 up at the most

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16
Q

What are the 5 Ps?

A

Potty (do you need to use the bathroom?)

Pain (are you in pain? Scale from 1-10?)

Positions (are you in a comfortable position?)

Possessions (put within arms reach personal belongings)

Pumps (limit clutter of medical equipment at the bedside that may create a fall hazard)

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17
Q

What is the least to most restrictive restraints?

A

Mitt

Wrist

Vest and jacket restraints

Wrist and ankle restraints

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18
Q

What are mitt restraints?

A

Limits use of fingers, prevent removal of tubes, lines and catheters.

Prevent scratching

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19
Q

What are wrist restraints?

A

2 point restraints

Prevents removal of tubes, lines, and catheters

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20
Q

What are vest and jacket restraints?

A

Prevent getting out of bed or chair, permits turning from side to side. Used with violent behavior.

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21
Q

What are wrist and ankle restraints?

A

4 point restraints

Prevent hitting, or kicking others

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22
Q

What is a good reason to put a person in restraints?

A

Trying to pull out a tube they need

Criminal

Dementia

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23
Q

Do you need a doctors order for restraints

A

Yes, and it cannot be PRN. If it’s a medical need, the order has to be on the chart within an hour. If it’s behavior (threatening to harm themselves or someone else) the doctor must come and see the patient face to face within the hour

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24
Q

Do you need to involve family before putting on restraints?

A

Yes and the restraints have to be tied to the bed frame, not side rail!

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25
Q

How often do you have to remove and assess the restraints

A

Every 2 hours

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26
Q

What are the different kind of restraint orders

A

Situational

Medical

Behavioral

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27
Q

How long is a restraint order good for?

A

24 hours

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28
Q

What are the functions of the skeletal system?

A

Supporting the soft tissues of the body (maintains body form and posture)

Protecting crucial components of the body, like the brain, heart, lungs, and spinal cord

Furnishing surfaces for the attachments of muscles, tendons, and ligaments, which in turn, pull on the individual bones and produce movement

Providing storage areas for minerals, (such as calcium) and fat

Producing blood cells

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29
Q

Define abduction

A

Lateral movement of a body part away from midline

30
Q

Define adduction

A

Lateral movement of a body part towards the midline of the body

31
Q

Define Circumduction

A

Turning in a circular motion. Example: circling the arm at the shoulder.

32
Q

Define flexion

A

The state of being bent

33
Q

Define extension

A

The state of being in a straight line. Example: A persons cervical spine is extended when the head is held straight on the spinal column.

34
Q

Define hyperextension

A

The state of exaggerated extension. It often results in an angle greater than 180°. Example: A persons cervical spine is hyperextended when looking overhead, towards the ceiling.

35
Q

Define dorsiflexion

A

Backward bending of the hand or foot. Example: a persons foot is in dorsiflexion when the toes are brought up as though to point them at the knee.

36
Q

Define planter flexion

A

Flexion of the foot. Example: a persons foot is in planter flexion in the foot drop position.

37
Q

Define rotation

A

Turning on an axis; the turning of a body part on the axis provided by its joint. Example: a thumb is rotated when it is moved to make a circle.

38
Q

Define internal rotation

A

A body part turning on its axis towards the midline of the body. Example: A leg is rotated internally when it turns inward at the hip and the toes point towards the midline of the body.

39
Q

Define external rotation

A

A body part turning on its axis away from the midline of the body. Example: a leg is rotated externally when it turns outward at the hip and the toes point away from the midline of the body.

40
Q

Define pronation

A

The prone position. Example: a person is in the prone position when lying on the abdomen; a persons palm is prone when the forearm is turned, so that the palm faces downward

41
Q

Define supination

A

The assumption of the supine position

42
Q

Define inversion

A

Movement of the sole of the foot inward (occurs at the ankle)

43
Q

Define eversion

A

Movement of the sole of the foot outward (occurs at the ankle)

44
Q

Define opposition

A

Rotation of the thumb around its long access (movement of the thumb across the palm to touch each fingertip of the same hand)

45
Q

What are four functions of the muscles?

A

Motion

Maintenance of posture

Support

Heat production

46
Q

What are some examples of ADLs?

A

Activities of daily living, include eating, bathing, dressing, and toileting

47
Q

What are some examples of IADLs?

A

Examples of instrumental activities of daily living, include housekeeping, meal preparation, management of finances, and transportation

48
Q

Effects of exercise on the cardiovascular system

A

Increases efficiency of heart

Increases blood flow and oxygenation of all body parts

Decreases resting heart rate and blood pressure

49
Q

Effects of immobility on the cardiovascular system

A

Increase cardiac workload

Increase risk for orthostatic hypotension

Increase risk for venous thrombosis

50
Q

Effects of exercise on the respiratory system

A

Increases depth of respiration

Increases respiratory rate

Increases gas exchange at alveolar level

Increases rate of carbon dioxide excretion

51
Q

Effects of immobility on the respiratory system

A

Decrease depth of respiration

Decrease rate of respiration

Pooling of secretions

Impaired gas exchange

In PowerPoints

Atelectasis

Pneumonia caused by buildup on secretions, patient’s inability to cough, bacterial growth

52
Q

Effects of exercise on the gastrointestinal system

A

Increased appetite

Increased intestinal tone

53
Q

Effects of immobility on the gastrointestinal system

A

Disturbances in appetite

Altered protein metabolism

Altered digestion, and utilization of nutrients

Decreased peristalsis

Constipation*

54
Q

Effects of exercise on the urinary system

A

Increase blood flow to kidneys

Increase efficiency in maintaining fluid and acid base balance

Increase efficiency in excreting body wastes

55
Q

Effects of immobility on the urinary system

A

Increased urinary stasis

Increase risk for renal calculi

Decrease bladder muscle tone

From power points

Risk of UTI due to
Decreased fluid intake
Use of indwelling catheters
Poor perineal care post bowel elimination (e.coli)
Urine becomes more alkaline

56
Q

Effects of exercise on the musculoskeletal system

A

Increase muscle efficiency

Increase coordination

Increase efficiency of nerve impulse transmission

57
Q

Effects of immobility on the musculoskeletal system

A

Decrease muscle size, tone, strength

Decrease joint mobility, flexibility

Bone demineralization

Decrease in endurance, stability

58
Q

Effective exercise on the metabolic system

A

Increases efficiency of metabolic

Increases efficiency of body temp regulation

59
Q

Effects of immobility on the metabolic system

A

Increase risk for electrolyte imbalance

Altered exchange of nutrients and gases

60
Q

Effects of exercise on the integumentary system

A

Improved toned, color, and turgor, resulting from improved circulation

61
Q

Effects of immobility on the integumentary system

A

Increase risk for skin breakdown, and formation of pressure injuries

62
Q

How does a persons, mental health influence body appearance and movements?

A

Body processes tend to slow down with depression, and there is a lack of visible energy and enthusiasm

63
Q

What does stasis mean

A

A stopping or slowing down of fluid in the body

64
Q

Most dangerous complication of immobility

A

Thrombus formation
May become emboli

65
Q

How do you assess for a DVT (deep vein thrombosis)

A

Swelling of leg (or arm)

Red or discolored skin (especially on posterior side of leg)

Pain/tenderness, warmth, or swelling (typically unilateral)

66
Q

How do you assess for a pulmonary embolism?

A

Sudden shortness of breath (SOB) (most common)

Chest pain- sharp, stabbing, usually worse with deep breaths

Unexplained cough- may have bloody mucus

Rapid or irregular HR, feelings of anxiety

67
Q

DVT prevention for immobile patients

A

Continued bed rest- encourage leg exercises and frequent position changes (if no DVT symptoms)

Ambulate (walk) as soon as possible (if no DVT symptoms)

68
Q

How to treat edema in patients who are immobile?

A

Elevate extremities above heart level. This allows blood to circulate back to heart without fighting gravity.

69
Q

How do pressure injuries form?

A

External pressure over area results in occluded blood capillaries and poor blood circulation to tissues

Friction and shearing forces tear and injured blood vessels and abrade top layer of skin

**do not massage over bony prominences!

70
Q

What is the Braden risk assessment used for?

A

Skin and pressure injuries

71
Q

Which side of the body does the cane go on?

A

Strong

72
Q

If patient has balancing issue, which device is best

A

Walker, wheels in front and no wheels in the back

Concepts Exam 1 (7 decks)

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