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Nursing Fundamentals > Weeks 1-4 Lab > Flashcards

Weeks 1-4 Lab Flashcards

1
Q

What is the chain of infection?

A

Transmission
Portal of entry
Host susceptibility
Infection agent
Reservoir
Portal of exit

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2
Q

Infection control

A

Provides measures that reduce or eliminate sources and transmission of infection.

Protects patients and health care providers from disease.

All parents in any setting are at risk.

Health care-associated infections (HAIs) are acquired in health care settings.

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3
Q

What are the 5 moments of hand hygiene?

A
  1. Before initial patient/patient environment contact.
  2. Before aseptic procedures.
  3. After body fluid exposure risk.
  4. After patient contact.
  5. After contact with patient surroundings.
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4
Q

What is hand hygiene?

A
  • Most important technique for infection control and prevention
    -Hand hygiene
    • Handwashing
    • Antiseptic hand rub
  • Decision to perform hand hygiene based on:
    • Intensity or degree of contact with pts or contaminated objectives
    • Amount of contamination with contact
    • Susceptibility of infection
    • Procedure/activity to be performed
  • Wash hands with soap and water when hands visibly soiled or in contact with bodily fluids, and if exposed to spore-forming organisms (Cdiff)
  • If hands not visibly soiled, use an alcohol-based hand rub
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5
Q

What is asepsis?

A
  • Asepsis is the absence of pathogenic (disease-producing) microorganisms
  • Medical asepsis (clean technique)
    • Reduces organisms
    • Prevents transfer
  • Surgical asepsis (sterile technique)
    • Destroys microorganisms and their spores
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6
Q

Evidence-based practice in hand washing

A

Alcohol-based hygiene products more effective than soap; reduce infections
- With emollients, cause less skin irritation and dryness than soap
Soap and water still necessary
- For visibly soiled hands
- When caring for patients with Clostridium difficile or multidrug-resistant organisms (MDROs)

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7
Q

What is the nurse’s role in infection control?

A

Role modelling
Patient education
Vital role in breaking the chain of infection

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8
Q

What are the safety guidelines in hand hygiene?

A
  1. Hand hygiene with an appropriate alcohol-based hand antiseptic or soap and water is an essential part of patient care and infection prevention.
  2. Always know a patient’s susceptibility to infection.
  3. Recognize the elements of the chain of infection and initiate measures to prevent its onset and spread.
  4. Consistently incorporate the basic principles of asepsis into patient care.
  5. Ensure that patients cover the mouth and nose when coughing or sneezing; and use and dispose of tissues properly.
  6. Use clean gloves when you anticipate contact with body fluids, nonintact skin, or mucous membranes when there is a risk of drainage.
  7. Use gown, mask, and eye protection when there is a splash risk.
  8. Protect fellow health care workers from exposure to infectious agents through proper use and disposal of equipment.
  9. Be aware of body sites where HAIs are most likely to develop (e.g., urinary or respiratory tract, wounds). This enables you to direct preventive measures.
  10. Practice fingernail hygiene
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9
Q

What items are part of PPE?

A

Gown
Masks
Goggles
Face shield
Gloves
Bootie covers

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10
Q

Care for a patient under isolation precautions

A

Use procedures to reduce cross-contamination to other patients
Use standard precautions
All body substances contain potentially infectious organisms
Use recommended isolation precautions

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11
Q

Precautions for normal patients

A

Used for all patients, regardless of risk or presumed infection status
Apply to blood, blood products, all body fluids, secretions, excretions (except sweat), nonintact skin, and mucous membranes
How does the nurse teach cough etiquette?

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12
Q

Precautions for tier 2 patients

A

Use for care of patients who are known or suspected to be infected, or colonized, with microorganisms transmitted by the contact, droplet, or airborne route

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13
Q

What is a safe patient environment?

A
  • accurate patient identification is crucial to their safety before carrying out any procedures – use at least two person-specific identifiers
  • safety begins with pts immediate environment – bed in low positions, bed alarm activated, use necessary fall prevention strategies, call-light and bed control system allows for some pt autonomy – explain to pts and visitors how to operate the system (use teach back/demonstration)
  • be alert to conditions within a pt’s environment that pose risk for injury, items out of reach, hazards along walking paths, liquids spilled on floor, poorly functioning equipment
  • do not use work-arounds –
  • communicate clearly an in a timely manner to other members of the HC team re plan of care, results, pt response, etc (documentation)
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14
Q

What type of assessment data should you collect about the environment before making a bed?

A

Bed height
Placement of furniture/chairs/equipment
Curtain open or closed
Wheels on bed-locked?
Check floor for any slip hazards
Adequate lighting

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15
Q

What should we be aware of while changing a bed for the patients environment?

A

Safety
Comfort
Emotional well-being

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16
Q

Why should nurses be aware of body mechanics?

A

Musculoskeletal disorders (MSD) are the leading cause of health care provider (HCP) injury (Ontario Nurses Association [ONA], 2016, para 2)

Nurses who handle/move patients are almost 4 times more likely to suffer from low back pain than those nurses who do not handle patients (Yassi & Lockhart, 2013)

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17
Q

What are body mechanics?

A

Wide stance
Bend at the knees
Keep back, neck, pelvis and feet in alignment
Tighten stomach muscles
Keep weight to be lifted as close as possible to your body
Face direction of movement

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18
Q

Why is bed making important?

A

Provides comfort for patient
Provides clean environment
Allows for social interaction for patient
Opportunity for assessment

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19
Q

Key concepts in bed making

A

Raise bed to comfortable working height
Keep clean linens separate from soiled linens
Ensure wrinkles are removed (significant for bed rest only patients)
Maintain privacy of patient
Apply appropriate and safe body mechanics

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20
Q

What are common bed positions?

A

Supine – bed horizontal with floor

Semi-fowler’s – head of bed (HOB) 30-45 degrees

Fowler’s – HOB 45-90 degrees

Trendelenburg – bedframe tilted with head of bed down

Reverse Trendelenburg – bedframe tilted with foot of bed down

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21
Q

Important things in occupied bed making

A

This skill is easiest with two people
Position the patient safely while the bed linens are changed
Try to conserve the patient’s energy
Use safe handling techniques
Be aware of any position restrictions (pain, ability, clinical condition)
Be aware of any tubing (IV or wound)

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22
Q

Types of bedmaking

A

Unoccupied bed
Postoperative surgical bed
Closed bed

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23
Q

Why is bathing scientifically important?

A

Personal hygiene affects an individual’s comfort, safety, and physical and psychological well-being.
People who are well are capable of meeting their own hygiene needs.
People who are ill or have disabilities may require various levels of assistance.
A variety of personal, social, and cultural factors influence hygiene practices.

24
Q

What is a nurses role in care and hygiene?

A

Therapeutic communication skills build a caring therapeutic relationship during care.
When performing hygiene, the nurse can:
Discuss health-related concerns
Perform a physical assessment
Provide patient education.
Independence is encouraged and promoted.
Privacy is ensured, respect is conveyed, and the patient’s physical comfort is fostered.

25
Q

What are the safety guidelines when providing hygiene care?

A
  1. Patients who are totally dependent on someone else require assistance with personal hygiene or must learn or adapt new hygiene techniques.
  2. Keep all personal hygiene care items within a patient’s reach.
  3. Use clean gloves when you anticipate contact with nonintact skin or mucous membranes or when there is or may likely be contact with drainage, secretions, excretions, or blood.
  4. Always perform hygiene measures moving from cleanest to less clean or dirty areas.
  5. When using water or solutions for hygiene care, be sure to test the solution temperature to prevent burn injury.
  6. Use principles of body mechanics and safe patient handling.
  7. Assess and evaluate a patient before and after care.
26
Q

What is the skin?

A

The largest human body organ
Three primary layers
Epidermis: shields underlying tissue
Dermis: contains bundles of collagen, nerve fibres, blood vessels, sweat glands, sebaceous glands, and hair follicles
Subcutaneous: contains blood vessels, nerves, lymph, and loose connective tissue filled with fat cells

27
Q

What are the functions of the skin?

A

Protection from heat, injury, and infection
Secretion – sebum lubricates and softens skin and hair
Excretion - perspiration
Temperature regulation
Sensation of pain and other stimuli

28
Q

What are common skin problems?

A

Dryness
Acne
Rashes
Contact dermatitis
Psoriasis
Abrasions

29
Q

What are risk factors for skin impairment?

A

Immobilization
Reduced sensation
Nutrition and hydration alterations
Secretions and excretions on the skin
Vascular insufficiency
External devices
Age

30
Q

What are factors influencing personal hygiene preferences?

A

Social
Body
Health Beliefs and Motivation
Personal Preferences
Socioeconomic Status
Physical and Mental Health

31
Q

What are cultural considerations in bathing?

A

People from diverse cultures practice different hygiene rituals.
Maintain privacy, especially for women from cultures that value female modesty.
Provide gender-congruent caregivers as needed or requested.
Do not cut or shave hair without discussing with the patient or family.
Some cultures consider the top parts of the body cleaner than lower parts.

32
Q

What is patient-centred care in bathing?

A

Accommodate patient’s preferences and culture when performing hygiene
Consider patient’s normal oral and bathing hygiene routines:
Preferred products
Preferred time of day
Encourage patients to participate

33
Q

What are types of baths?

A

Cleansing bath
Bed – complete or partial
Tub or shower
Sponge - at the sink
Therapeutic bath
Sitz
Medicated

34
Q

What are bathing principles?

A

Clean skin regularly and at time of soiling
Avoid extreme water temperatures
Avoid use of force or friction
Maintain an ideal room temperature
Assess patient during the bath
Assist with range-of-motion (ROM) exercises during the bath
Keep patient limitations in mind

35
Q

Perineal care considerations

A

Self-care ability of patient
Reduction of embarrassment
Asepsis
Clean from front to back
Performed during a complete bed bath
May be performed more frequently on patients with fecal or urinary incontinence, an indwelling Foley catheter, or rectal or genital surgery
Wear gloves
Always act in a professional manner
Provide privacy at all times

36
Q

What is hair?

A

Grows from follicles
Supporting structures
Blood vessels
Sebaceous glands
Purpose is protection
Condition indicates health

37
Q

Hair care, combing and shaving

A

Brushing, combing, and shampooing are basic measures for all patients unable to provide self-care
Many factors can influence the health of the scalp and the condition of the hair
Dependent patients with beards or mustaches need assistance keeping facial hair clean; keep cultural considerations in mind and obtain consent as needed

38
Q

How to shampoo?

A

Frequency of shampooing depends on the condition of the hair and the person’s daily routines and cultural preferences
Two types of shampooing are available:
Traditional soap and water
Disposable dry shampoo cap

39
Q

Nail and foot care

A

Best time is during a daily bath
Many HC facilities require an order to trim nails or a special certification to provide foot and nail care
Feet and nails often require special care to prevent infection, odours, pain, and injury to soft tissues

40
Q

How to care for the eye and ears

A

Risks to patients’ eye or ear structure or function can alter independence, safety, body image and self confidence
Eye
Wash from inner to outer canthus
Use different sections of the washcloth for each eye
Unconscious patients require more frequent eye care

41
Q

Care of hearing aids

A

Hearing impairment is most common in older persons
Hearing loss has social implications, and a person may not engage in social activities
Safety considerations with hearing loss
Nursing role in understanding function and helping the patient to care for the hearing aid

42
Q

What are nonpharmacologic ways to manage pain when bathing?

A

Relaxation and Guided Imagery
Heat and Cold
Breathing exercises
Distraction
Massage

43
Q

What is the mouth?

A

The oral cavity
Teeth
Gums
Saliva
Regular oral hygiene is necessary for health

44
Q

Common oral problems

A

Dental caries: chalky-white discolouration of tooth or presence of brown or black discolouration
Gingivitis: inflammation of gums
Periodontitis: receding gym lines, inflammation, gaps between teeth
Halitosis: bad breath
Cheilosis: cracking lips
Stomtatitis: inflammation of mouth tissues or structures
Mucositis: inflammation of oral mucous membrane
Dry, cracked, coated tongue

45
Q

What is oral hygiene?

A

Daily oral hygiene prevents and controls plaque-associated oral disease
Oral hygiene promotes health, comfort, nutrition, and verbal communication
Ill patients may require assistance with activities ranging from preparing supplies to brushing teeth

46
Q

How to perform mouth care?

A

Head of bed: At least Semi Fowlers
Towel over chest, apply gloves
Inspect oral cavity
Remember PRIVACY & allow patient to do as much as possible
Steps:
45-degree angle to gum line, brush inner and outer surfaces & clean biting surface
Brush tongue
Rinse mouth (with water)
Mouth Wash
Floss
Rinse mouth again

47
Q

How to care for dentures?

A

Clean dentures as often as natural teeth
Store in an enclosed, labeled cup and soak when not worn
Reinsert as soon as possible
When inserting, ensure a good fit
Loose dentures cause discomfort and make it difficult to chew food and speak clearly

48
Q

How to preform denture care?

A

Review the fit, gum irritation, or tenderness.
Remove to clean.
Use tepid water (hot can cause warping, cold cracking).
Brush.
Apply.

49
Q

Mouth care for unconscious or debilitated patients?

A

These patients are at risk for:
Alterations of the oral cavity
Infection
Aspiration
For safety, two nurses/ provide care
One nurse provides oral care, while the other suctions oral secretions
Assess for a gag
Inspect oral cavity
Side lying or Sims’ position
NO FINGERS in mouth
Toothette or toothbrush
Important to rinse patients’ mouth (use a toothbrush/water or toothette)
Water soluble lubricant to lips

50
Q

Feeding and nutrition

A

Integral role in the maintenance and restoration of health
Plays a role in healing
Provides needed energy for bodily functions and mobility/activity
Many medications/treatments/illnesses can impact nutritional status
Consider cultural influences and health beliefs relevant to nutrition and food practices

51
Q

How to assist a patient with oral nutrition?

A

Requires time & patience
Understand patients’ preference for food
Review patients diet orders
Clear fluids
Full liquid
Pureed
Mechanical/dental soft
Soft
Regular
Determine how much assistance the patient will require
High Fowlers Position/Chin in down position
If patient is at risk for aspiration, stay at the bedside
After the meal HOB remains at 45 degrees for 30-60 mins

52
Q

What are aspiration precautions?

A

Misdirection of oropharyngeal secretions or gastric contents into the larynx and lower respiratory tract
Patients at risk include those with dysphagia (difficulty swallowing)

53
Q

What are the different diet levels?

A

Thin
Slightly thick
Mildly thick
Liquidized/moderately thick
Pureed/extremely thick
Minced and moist
Soft and bite-sized
Regular

54
Q

Feeding tips

A

Upright position
Avoid mixing foods with different textures
Minimize distractions
Do not rush patient
Do not ask patient questions while patient is chewing
Verbal cueing
Alternate liquids & bites of food
Inspect mouth for pocketing of food
Thorough oral hygiene before and after meal

55
Q

Monitoring tinkle and output?

A

Part of assessment database for fluid and electrolyte balance
Accuracy critical; requires patient and family participation and cooperation
Used to monitor patients with fever, edema, IV fluids, diuretic therapy, and restricted fluids

56
Q
A

Nursing Fundamentals (3 decks)

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