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Patient Care > Test 2 > Flashcards

Test 2 Flashcards

1
Q

What is a Health Care Associated Infection?

A

An infection acquired during a patient’s stay in a healthcare environment, that was not present at the time of admission

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2
Q

what can health care associated infection (nosocomial infection) lead to?

A
  • Increased length of stay
  • Increased wait times
  • Increased morbidity and mortality
  • Increased number of antibiotic resistant organisms
  • Decreased confidence in the healthcare system
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3
Q

What are Routine Practices?

A

Infection control measures that are to be used with EVERY patient during ANY/EVERY type of care

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4
Q

what is used to prevent and control the transmission of infections

A
  • Screening
  • Assessing the risk of infection before EVERY patient encounter
  • Performing hand hygiene at the correct times
  • Wearing appropriate PPE
  • Environmental and administrative controls
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5
Q

Personal Protective Equipment (PPE)

A

Equipment that you wear to help prevent the transmission of infections agents between staff and patient

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6
Q

how do you decide what PPE is required?

A

The choice of PPE to use is decided based on the risk assessment that is to be done before EVERY patient interaction.

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7
Q

when are gloves used?

A

possibility of coming into contact with:

  • Tissue, blood or body fluids
  • Non-intact skin
  • Mucous membranes
  • Soiled equipment or surfaces
  • Using cleaning chemicals
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8
Q

when do you wear a gown?

A

Used when you anticipate that your care activity may contaminate your clothing

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9
Q

yellow gowns

A

most commonly used

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10
Q

blue gowns

A

used for chemotherapy

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11
Q

when are masks and eye protection worn?

A
  • activities may generate splashes or sprays of blood or body fluids
  • within 2 meters of a coughing patient
  • high risk respiratory procedure
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12
Q

when MUST masks and eye protection be worn?

A

Must wear during high risk (aerosol generating) respiratory procedures regardless of whether or not the patient has symptoms of infection

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13
Q

what are examples of high risk respiratory procedure?

A
  • Use of bag-valve mask
  • Endotracheal intubation
  • Thoracostomy
  • Bronchoscopy/endoscopy
  • Tracheostomy suctioning/replacement
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14
Q

what are N95 masks worn?

A

specifically fit to the bone structure of your face. They have a tight seal that prevents any sort of droplets entering your respiratory system.

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15
Q

when are N95 masks worn?

A

airborne diseases

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16
Q

what is the paramount importance in health care to reduce the spread of germs and diseases?

A

hand hygiene

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17
Q

what is the single most important factor in preventing the spread of infection in healthcare?

A

HAND HYGIENE

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18
Q

Alcohol-based hand rub

A
  • more effective
  • faster (15 seconds)
  • easier on skin
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19
Q

soap and water

A
  • less effective
  • longer (20-25 seconds)
  • dries out skin
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20
Q

when would you use alcohol-based hand rub?

A

when hands are not visibly soiled

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21
Q

when would you use soap and water?

A
  • visibly soiled hands (blood, dirt)
  • exposure to spore forming bacteria
  • after using restroom
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22
Q

what is the first line of defence against organisms?

A

intact skin

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23
Q

how do you reduce skin dryness and irritation?

A
  • use warm (not hot) water
  • rinse thoroughly and pat hands dry instead of rubbing them
  • use facility provided lotion frequently
  • always protect your hands from chemicals and extreme conditions
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24
Q

why is using lotion at work required rather than your own lotion?

A

hospital lotion doesn’t break down the ABHR

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25
Q

what factors impact hand hygiene?

A
  • Skin condition
  • Keep nails short and clean
  • Remove rings and bracelets and watches
  • Do not wear artificial nails
  • Remove chipped nail polish
  • Make sure that sleeves are pushed up and do not get wet
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26
Q

In aseptic hand wash, what is the preparation?

A
  • remove watch, rings, e.t.c
  • get paper towel ready
  • position self so as to not touch the sink
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27
Q

In aseptic hand wash, what is the wash?

A
  • wet hands thoroughly
  • keep hands lower than elbow
  • apply soap
  • lather well using firm, circular motion
  • wash forearms, palms, back of hands, and wrists for 20 seconds
  • wash sides of fingers/thumbs (milking technique)
  • clean under fingernails using thenar eminence to rub nails
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28
Q

what is the clean area on the body when washing hands?

A

forearm

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29
Q

what is the dirty area on the body when washing hands?

A

fingers

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30
Q

in aseptic hand wash, what is the rinse?

A
  • starting at forearms, allowing water to run down over hands
  • turn hands over (wrist side up) and repeat
  • remember to hold hands lower than elbows
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31
Q

in aseptic hand wash, what is the dry?

A
  • do not shake excess water
  • use paper towel to dry thoroughly from fingertips to elbows
  • turn off taps with paper towels
  • remember to stand away from sink, its contaminated
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32
Q

what is the ABHR handwashing technique?

A
  • Apply a dime-sized amount of product into the palms of DRY hands
  • Rub product into hands for 15 seconds
  • Continue rubbing until hands are dry
  • Do not wipe any off
  • Ensure hands are completely dry before performing another task
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33
Q

patient zone

A

Everything in immediate proximity to the patient.

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34
Q

healthcare zone

A

Everything outside of the patient zone.

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35
Q

what are the 4 moments of hand hygiene?

A
  • before initial patient environment contact
  • before aseptic procedure
  • after body fluid exposure risk
  • after patient environment contact
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36
Q

The most common mode of transmission of infectious organisms in a hospital setting is

A

contaminated hands of healthcare workers

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37
Q

what does additional precautions mean?

A

Infection prevention and control methods to be used in addition to the Routine Practices
-What is used is based on the mode of infection transmission

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38
Q

when do you start additional precautions?

A

as soon as the patient exhibits symptoms that are suggestive of an infection

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39
Q

when do you stop additional precautions?

A

they are to always be used in addition to Routine Practices and must remain in place until there is no longer any risk of transmission

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40
Q

why should AP patients be frequently assessed?

A

so your not using AP any longer than necessary

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41
Q

what are some examples of additional precautions?

A
  • special accommodations and signage
  • barrier equipment (PPE)
  • dedicated equipment
  • additional cleaning
  • limited transport
  • communication of the patient’s isolation status
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42
Q

what are some examples of special accommodations and signage?

A
  • single room with private bathroom
  • patient room with an anteroom
  • patients under the same precautions can be in the same room
  • signs are outside the room or on chart indicating types of precautions
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43
Q

what are the types of precautions?

A
  • Standard or Universal Precautions (Routine)
  • Contact Precautions
  • Droplet Precautions
  • Droplet/Contact Precautions
  • Airborne Precautions
  • Reverse Isolation
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44
Q

what is direct contact?

A

occurs through touching

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45
Q

what is indirect contact?

A

touching contaminated objects in the environment

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46
Q

what are examples of contact transmission diseases?

A
  • Antibiotic resistant organisms (MRSA, VRE)
  • Gastroenteritis (Rotavirus, C-diff)
  • Lice, Scabies
  • Viral meningitis
  • Hepatitis A
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47
Q

what PPE do you wear for contact transmission?

A

gloves and gown

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48
Q

what PPE do you wear for droplet-contact transmission?

A
  • mask with face shield or goggles when within 2 meters of patient
  • gloves and gown
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49
Q

what PPE do you wear for airborne transmission?

A
  • particulate respirator (N95)

- negative pressure room

50
Q

when a patient was on airborne precautions, why would the room need to sit for an hour before cleaning?

A

allow particles to settle

51
Q

what are some examples of airborne transmission diseases?

A
  • Measles
  • Chicken Pox (Varicella)
  • Tuberculosis (TB)
  • H1N1
52
Q

what is the order for Donning (putting on) PPE?

A
  • perform hand hygiene
  • gown (neck and waist)
  • mask/N95 (do seal check)
  • eye protection (if not attached to mask)
  • gloves (over cuff of gown)
53
Q

what is the order for Doffing (taking off) PPE?

A
  • gloves (glove to glove, skin to skin)
  • gown (neck then waist, full forward and turn inside out)
  • hand hygiene
  • eye protection (touch arms of goggles)
  • mask/N95 (touch only straps, bottom then top and lean over and allow mask to fall)
  • hand hygiene
54
Q

C-Diff additional cleaning

A

C-Diff requires a room to be cleaned twice a day with the use of sporicidal cleaner

55
Q

what additional cleaning must be done with a patient on additional precautions?

A

The room and equipment used will also need to be cleaned appropriately after any exposure to a patient on precautions

56
Q

what are routine practices used on?

A

every patient

57
Q

_______ of the sonography workforce report experiencing pain while scanning

A

75%

58
Q

______of sonographers sustain career-ending injuries.

A

25%

59
Q

bad ergonomics accounts for _____ of all workplace illnesses

A

60%

60
Q

MSK injury-wrist

A

59%

61
Q

MSK injury-neck

A

74%

62
Q

MSK injury-back

A

58%

63
Q

MSK injury-hands

A

55%

64
Q

MSK injury-shoulder

A

76%

65
Q

what are the cause and mechanisms of MSK Injuries

A
  • Repetitive strain injuries (RSI) result from minuscule, cumulative trauma to human tissue.
  • Performing ultrasound studies causes muscle fatigue and possible injury.
  • As your muscles get more and more fatigued they are more likely to get injured.
66
Q

what are sonography risk factors for occupational injuries?

A
  • Improper scanning technique
  • Poorly designed workstations leading to awkward and prolonged static postures
  • Repetitive motions
  • “Pinch” grip of transducers
  • High-performance pressure (not enough time allotted to complete scan)
  • Heavy workloads (staffing shortages, lack of breaks)
  • Patient population is growing (literally) Increase in BMI
  • Specialty Techs (cardiac, high-risk OB)
  • Insufficient rest and recovery
  • Age (30-60 year olds)
  • Gender (female)
67
Q

work related sonographer repetitive strain injuries?

A
  • Tendonitis and tenosynovitis
  • Thoracic Outlet Syndrome
  • Bursitis
  • Epicondylitis (Tennis/Golfer’s Elbow)
  • Carpal Tunnel Syndrome
  • Lower Back Pain
  • Plantar Fasciitis
68
Q

Tendonitis and tenosynovitis

A
  • neck
  • shoulder
  • wrist
  • hand
  • elbow
69
Q

what are the most common sites of injury or pain?

A
  • neck
  • back
  • hips
  • shoulder
  • wrist
  • hands
  • fingers
  • feet
70
Q

what are the primary causes of MSK injuries?

A
  • repetition
  • force
  • awkward posture
71
Q

when does risk of injury increase?

A

number of times and greater length of time that s joint deviates from its natural position

72
Q

Shoulder pain is associated with abduction of the shoulder more than ______

A

30 degrees

73
Q

Reducing abduction of the shoulder can help reduce muscle activity of the shoulder by _______

A

88%

74
Q

how can a decrease from 75 to 30 degrees be obtained?

A

supporting forearm using cushions of various angles

75
Q

bursitis

A

Inflammation of the small sac of fluid (bursa) that cushions and lubricates an area between tendon and bone or around a joint.

76
Q

what are the causes of bursitis?

A
  • chronic overuse
  • repetitive motions
  • trauma
  • gradual degeneration
  • aging
  • rheumatoid arthritis
  • gout,
  • infection.
77
Q

what are the symptoms of bursitis?

A
  • joint pain
  • tenderness
  • swelling
  • warmth over the joint
  • stiffness near the affected bursa
78
Q

what is the treatment of bursitis?

A
  • temporary rest or immobilization of the affected joint
  • applying ice
  • taking NSAIDs
79
Q

what does upper neck and back pain result in?

A
  • muscle spasms
  • inflammation and swelling
  • loss of sensation
  • numbness
  • burning/tingling and clumsiness
80
Q

what is upper back and neck pain resistant to?

A
  • painkillers
  • physical therapy
  • surgery
81
Q

how do you prevent upper back and neck pain?

A
  • adjust monitors
  • head and screen should be in the same axis
  • eye-screen distance should be a minimum of 60cm
  • screen must be at 0-30 degrees angle below eye level
82
Q

what incline is recommended for your seat?

A

between 10 and 20 degrees

83
Q

what is lower back pain caused by?

A
  • sitting incorrectly on the seat

- leaning with a slouched back

84
Q

Thoracic Outlet Syndrome (TOS)

A

group of disorders brought on by compression of blood vessels or nerves in the space between the clavicle and first rib

85
Q

what are the symptoms of thoracic outlet syndrome?

A
  • pain in neck and shoulder area

- numbness and weakness in the arm/hand

86
Q

how does an elbow injury occur?

A

poorly designed transducers or improperly holding or excessively griping the transducer

87
Q

what injuries in the elbow can cause pain and numbness down to the hand?

A

-Tendonitis
-tenosynovitis
-or tunnel -syndromes
-damage to the elbow
-epicondylitis (Tennis or Golfer’s
elbow)
-posterior impingement syndrome of the elbow

88
Q

how is carpal tunnel syndrome caused?

A

compression of the median nerve at the wrist, causing numbness, tingling, weakness or pain in the fingers

89
Q

what can increase pressure within the carpal tunnel?

A
  • gripping
  • flexing
  • hyperextending of the hand and wrist tendons
90
Q

what is the treatment for carpal tunnel syndrome?

A
  • splints to immobilize the area
  • ice reduce the swelling
  • NSAIDs for pain relief and to control swelling
  • injections of steroids
  • surgery.
91
Q

what does plantar fasciitis result from?

A

Plantar fasciitis results from overuse and repeated stress on the foot, typically produces heel pain with the first few steps in the morning

92
Q

what is the treatment for plantar fasciitis?

A
  • rest
  • ice
  • taping
  • strengthening and flexibility exercises
  • orthotic devices
93
Q

how do you prevent plantar fasciitis?

A

Wear shoes with good arch support, adequate cushioning and enough flexibility to easily bend under the ball of the foot.

94
Q

what can headaches and migraines be caused by?

A
  • light
  • screens
  • smells
  • hunger
  • fatigue
  • tension
  • stress
95
Q

how can you prevent glare on a screen?

A

Position the imaging equipment parallel to windows

96
Q

what is the treatment for headaches/migraines?

A
  • Every 20 minutes or so, look away off in the distance (20 feet) for 20 seconds.
  • eyes checked regularly
97
Q

what is an injured muscles best friend?

A

oxygen

98
Q

a strong what is essential for good posture?

A

strong core

99
Q

how do you prevent work related Injuries?

A 
Constant Vigilance!
Be aware of what causes injury
Be aware of the force you exert
Be aware of your position – use proper posture
Modify your behavior accordingly
more on Moodle slide 24
100
Q

how do you cope with workplace stress?

A
  • take responsibility for improving physical and emotional well being
  • identify and avoid knee-jerk reactions, habits, negative attitudes
  • improve communication skills to ease approaches
101
Q

Effective, short-term ways to deal with job stress

A 
Have a positive attitude
Speak to your employer 
EAP
Get extra sleep 
Engage in regular exercise.
Talk to co-workers or friends about problems
Video games
Don’t get into a negative cycle of dependences
102
Q

what are a sonographers general responsibilities?

A
  • responsibility to colleagues
  • responsibility to yourself
  • responsibility to the profession
  • responsibility to the patient
103
Q

what are the steps to preforming an exam?

A
  1. review requisition
  2. introduce yourself
  3. verify identity
  4. ask questions
  5. listen
  6. Give clear instructions
  7. perform exam
  8. Give patient clear discharge instructions
104
Q

what is required on a requisition?

A
  • clinical indication
  • patient name
  • exam
  • doctors signature
105
Q

how many identifiers are used to know the patient?

A

2

106
Q

what things must you mention to patient when introducing yourself?

A
  • name
  • occupation
  • exam you intend to do on them
107
Q

what questions could you ask your patient?

A

Why did you see your doctor?
Do you have pain?
If yes, where and when?
Have you had previous surgery?

108
Q

what is the most crucial step in preforming an exam?

A

listen

109
Q

what are some clear instructions to give your patients?

A
  • what and where to change
  • what do to with valuables
  • where to wait when their ready
110
Q

when do you ask for informed consent from the patient?

A

before and during the exam

111
Q

when will the doctor receive the results from the exam?

A

10 business days

112
Q

what information is given to a patient when changing?

A
  • types of gowns used
  • directions for changing
  • where to go and what to do with clothing
  • patients that require assistance
113
Q

how do you speak to a patient when giving instructions?

A

slowly and clearly

114
Q

what do you tell patients before they change?

A
  • tell them exactly what to take off
  • what to put on
  • how to put it on
  • confirm that they understand
  • ask if they have any questions
115
Q

what shall you do before helping a patient undress/dress?

A
  • explain procedure fully be sure they understand

- ensure door or curtain is closed

116
Q

what shall you do while helping a patient dress/undress?

A

talk to the person to alleviate any anxieties and embarrassment during the process

117
Q

what is the rule of thumb when giving assistance to a patient dressing/undressing?

A

The most disabled/affected limb should be dressed first and undressed last.
(example on Moodle)-look at it

118
Q

are we allowed to operate pumps or remove a bag?

A

no, call a nurse

119
Q

where must chest tubes be kept?

A

below chest at all times so fluid stays in receptacle and doesn’t flow back into pleural space

120
Q

where do you empty bed pans?

A

in the dirty sink

121
Q

Foley Catheters & Urinary Drainage Bags

A
  • keep below bladder level
  • do not let it get caught or pull on it
  • inpatients for pelvic ultrasounds

Patient Care (3 decks)

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