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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
What are the safety guidelines when providing hygiene care?
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
What is the skin?
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
What are the functions of the skin?
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
What are common skin problems?
Dryness Acne Rashes Contact dermatitis Psoriasis Abrasions
29
What are risk factors for skin impairment?
Immobilization Reduced sensation Nutrition and hydration alterations Secretions and excretions on the skin Vascular insufficiency External devices Age
30
What are factors influencing personal hygiene preferences?
Social Body Health Beliefs and Motivation Personal Preferences Socioeconomic Status Physical and Mental Health
31
What are cultural considerations in bathing?
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
What is patient-centred care in bathing?
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
What are types of baths?
Cleansing bath Bed – complete or partial Tub or shower Sponge - at the sink Therapeutic bath Sitz Medicated
34
What are bathing principles?
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
Perineal care considerations
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
What is hair?
Grows from follicles Supporting structures Blood vessels Sebaceous glands Purpose is protection Condition indicates health
37
Hair care, combing and shaving
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
How to shampoo?
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
Nail and foot care
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
How to care for the eye and ears
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
Care of hearing aids
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
What are nonpharmacologic ways to manage pain when bathing?
Relaxation and Guided Imagery Heat and Cold Breathing exercises Distraction Massage
43
What is the mouth?
The oral cavity Teeth Gums Saliva Regular oral hygiene is necessary for health
44
Common oral problems
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
What is oral hygiene?
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
How to perform mouth care?
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
How to care for dentures?
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
How to preform denture care?
Review the fit, gum irritation, or tenderness. Remove to clean. Use tepid water (hot can cause warping, cold cracking). Brush. Apply.
49
Mouth care for unconscious or debilitated patients?
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
Feeding and nutrition
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
How to assist a patient with oral nutrition?
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
What are aspiration precautions?
Misdirection of oropharyngeal secretions or gastric contents into the larynx and lower respiratory tract Patients at risk include those with dysphagia (difficulty swallowing)
53
What are the different diet levels?
Thin Slightly thick Mildly thick Liquidized/moderately thick Pureed/extremely thick Minced and moist Soft and bite-sized Regular
54
Feeding tips
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
Monitoring tinkle and output?
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

Nursing Fundamentals (3 decks)

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