Special Considerations Flashcards
What are some considerations for Lines, tubes, and other equipment in acute care?
- identify all equipment prior to moving patient
- assess location of equipment in relation to planned patient movement
- ensure adequate slack with all lines and tubes
- know what can be unplugged, stopped, or removed
- consult nursing with questions
What are some considerations for fall prevention in acute care?
- Always have appropriate footwear prior to standing
- Check bed alarms
- Determine fall status of patient
- Leave call bell within patient’s reach
- Make sure patient can use the call bell
What two things should you always do when checking the bed alarms
- disarm before getting the patient up
2. always re-arm the alarm when putting the patient back in bed
What should you keep in mind when determining the fall status of a patient?
Never leave fall-risk patients unattended in a wheelchair alone in their room
What should you keep in mind when communicating with the patient
Cognitive level
education
understanding of condition
What should you report to nursing
unusual vital signs or behaviors
amount voided (if required)
when patient is out of bed
plans for returning pt to bed
What should you report to the physician
concerns that require change in care plan
What should you report to the case manager
Concerns about D/C plans, equipment, or other special needs for home
What should you report to the rehab team
patient progress toward D/C
What are the goals of Standard Precautions?
control nosocomial infections by:
- decreased risk of transmission of BBP
- decreased risk of transmission of pathogens from moist body substance
Standard Precautions apply to
Blood
bodily fluids/secretions (not sweat)
non-intact skin
mucous membrane
When would you use contact precautions?
known or suspected infectious microorganisms that are transmitted by direct or indirect contact
ex: MRSA, VRE, noravirus, C. Diff, chicken pox
Contact precautions include
- private room
- gloves and gown prior to entering room, remove and place in designated container before leaving room
- Dedicate non-critical client care items to patient
- Disinfect all equipment and surfaces with approved disinfectant before use by others
What are enteric precautions
additional contact precautions used for C-diff, norovirus, and rotovirus
- Hand washing with soap and water (not alcohol)
- all equipment must be cleaned using chlorine-based disinfectant
When would you use droplet precautions?
Involves pathogens larger than 5 microns that travel in droplets
droplets travel no further than 3 ft and infect conjuctivae or mucous membranes
ex: pneumonia, influenza, whooping cough
Droplet precautions include
- Private room
- Face mask (including visitors or if pt leaves room
- Goggles or face shield in case of potential spray
When would you use airborne precautions?
Involves pathogens smaller than 5 microns that can remain suspended in the air for several hrs and are displaced by air currents
infect host via inhalation or direct transmission
Ex: TB, measles, chicken pox
Airborne precautions include
- Don and doff respirator outside of room
- Isolation room with negative pressure
When would you use neutropenic precautions?
protect immunocompromised patients
chemo, immunosuppressive drugs, etc
Neutropenic precautions include
- careful attention to washing hands and equipment before interacting with the patient
- don mask when in patients room
- patient wears mask leaving their room
- restrictions on diet: avoid uncooked fruits and vegetables, tap water, and ice from machine
- no fresh flowers
- restriction on # of visitors and no visitors who feel ill
What WBC count is considered Neutropenia?
<1500 / mm3
