Standard Precautions And Vital Signs Flashcards
involve washing hands before and after patient contact, whether or not gloves are worn. They involve wearing clean gloves when touching blood, body fluids, and contaminated items, as well as a clean, non-sterile gown and a mask, eye protection or face shield in the likely event of splashes or sprays. Soiled equipment and linen are carefully handled to prevent injuries from used equipment
Standard precautions
used in addition to Standard Precautions for patients who may be infected or colonized with certain infections, including the virus that causes COVID-19, for which additional precautions are needed to prevent infection transmission. Those include Contact Precautions, Droplet Precautions, and Airborne Precautions. Each have specific guidelines and applications which must be addressed in policy and followed by staff to avoid legal ramifications.
Transmission based precautions
absence of disease producing micro organisms
Asepsis
Hand washing should take at least
30-60 sec
Diseases most likely to affect us:
Hepatitis B (ABCDE)
AIDs (everyone is scared of this one, but the others are more likely)
Tuberculosis
Staphylococcal
Nosocomial
Many places are calling this HAI-healthcare-associated infection
Nosocomial
CDC
Centers for disease control
Occupational Safe and Health Administration
OSHA
EPA
Environmental protection agency
CARF
Commission on accreditation of rehabilitation facilities
NIOSH
National institution of occupational safety and health
Organizations we must answer to
CDC
OSHA
State health departments
EPA
CARF
Joint commission
NIOSH
Areas included in vital signs
HR or P
BP
RR
Os
T
the preventative steps needed to be taken by healthcare workers and staff to prevent the spread or transmission of infections
Isolation precautions
basic precautions used for all patients
Standard precautions
extra steps to follow in addition to the standard precautions in order to prevent the spread of certain infections
contact
droplet
airborne precautions
Transmission-based precautions
Measles (rubeola), Tuberculosis, and Varicella-Zoster virus which causes chickenpox and shingles.
MTV
M: Measles (rubeola)
T: Tuberculosis
V: Varicella-Zoster virus = chickenpox and shingles
Airborne precautions for varicella-zoster = chickenpox and those with disseminated herpes zoster (shingles) affecting 3 or more dermatomes.
Small episode of shingles in competent immune system does not require airborne precautions
V: Variola virus = smallpox
S: SARS
Airborne Precautions Mnemonic
ABCDEF
“A” for abscess - You can use standard precautions with minor drainage
“B” for bronchiolitis - RSV (respiratory syncytial virus); parainfluenza
“C” for cutaneous - diseases involving the skin
Herpes zoster (shingles), and varicella (chickenpox)
Herpes simplex, impetigo, lice, major pressure or decubitus ulcers, scabies, major staphylococcal or streptococcal skin wounds or burns, and diphtheria (not the pharyngeal form)
“D” for diarrhea - C. diff, norovirus, rotavirus, and hepatitis A.
“E” for eyes - conjunctivitis/pink eye caused by allergies, irritants, trauma, viral infections, and bacterial infections caused by adenovirus.
“F” for funky or feisty - multidrug-resistant organisms such as MRSA and VRE
Contact Precautions Mnemonic
Mycoplasma pneumoniae = pneumonia, walking pneumonia.
Pertussis = whooping cough, which is caused by a bacteria called Bordetella pertussis.
Mumps
Influenza or the flu, and diphtheria (pharyngeal form)
Streptococcal infections including pneumonia - streptococcal toxic shock syndrome, pharyngitis, and scarlet fever in infants and young children.
Meningitis - caused by either Haemophilus influenzae type b or Neisseria.
Pneumonic plague, parvovirus B19 also known as Fifth Disease
German measles - rubella, adenovirus, and pneumonia.
Epiglottitis - caused by Haemophilus influenzae type b.
Rhinovirus
“My perfect mum flew a dozen strong men on a plane to a park in Germany to add a new epic rhino”
Droplet Precautions Mnemonic
Contact precautions require
gown and gloves be worn in addition to following standard precautions
Standard precautions + a surgical mask, which is put on when entering the room
Droplet precautions
Standard precautions + N95 or higher level respirator is required for airborne precautions.
Airborne precautions
single-patient room with special air handling and ventilation.
It’s a negative pressure room with 6-12 air exchanges every hour depending on when it was built, and air is released directly to the outside or recirculated through a special filtration system.
Airborne Infection Isolation Room
Precaution based on infection
Transmission based precautions
Precaution based on basic cleanliness
Standard precautions
Precaution everyone uses
Universal precautions
Hand washing
30 - 60 seconds
No jewelry/watches
Faucet, soap, wash, towel, faucet - keep hands downward
Don and Doffing PPE
gown, mask, goggles, gloves (CDC)
60-100 bpm
bradycardia = slow (<60bmp); tachycardia = fast (>100bpm)
Heart rate
evenness of pulse rate
Regularity
HR Methods
palpation,auscultation, Doppler, pulse ox
hypoxemia
LOW O2 levels
O2
95-100%
Max heart rate =
220-age
Target heart rate =
what needs to be maintained during intervention (60%, 80%)
presence or absence of blood flow at point of pulse palpation
Arterial Patency
Rate of capillary refill
pressing o finger to see if its blanching
Too much = swelling, impacts ROM
Too little = pressures sores/skin breakdowns (15 min), numbness, tingling
openness/flow
Patency
measure of vascular resistance to blood flow
BP
when heart is contracting
Systolic
when heart is at rest
Diastolic
BP norms
180/20 mmHg
High BP
Hypertension
low BP
Hypotension
120+/less than 80
Prehypertension
130+/80+
Stage 1 hypertension
140+/120+
Stage 2 hypertension
Activity is contraindicated when….
Systolic does not rise w/ activity
Decrease in diastolic greater than 10-20 and systolic greater than 240
Sign of heart attack =
high bp, chest pain, need for bowel movement
BP method
pump until brachial or radial artery stops, pump 30ml of mercury, then release
BP site
Left upper arm
Flaccid UE can cause what type of BP?
Low
Rate of breathing
Respiration rate
Respiration rate
12-20 breaths per min
Less than 12
Bradypnea
More than 20
Tachypnea
RR methods
auscultation, observation, palpation
Normal temp
97.8-99.0
Purpose temp
metabolic state, infection, metabolic response to activity
Freezing
Hypothermia
Overheating (over 104)
Hyperthermia
subjective; VAS, Wong-baker
Pain
