Whittier Precautions Flashcards
Sternal Precautions
-no lifting > 10 lbs
-no pushing or pulling
-no use of arms (bed rails, up from chair)
-no reaching or stretching arms above the shoulder height above or out the side
-no reaching behind head or back excessively
-no bilateral overhead activities
-use cough pillow as necessary
-no manual w/c propulsion
Cardiac Precautions
-no prolonged overhead activity
-monitor vitals
-SBP> 20 mmHG from baseline
HR- no more than 20 BPM from baseline
-O2 always at greater than 90%
Neuro Precautions
-note communication
-always support the affected side
-get patients up for self care and feeding
-educate families
Falls Prevention
-always use gait belt
-place in lowest postion in bed
-clutter free
-careful of 02 lines
-
Spinal Precautions
no BLTS
no lifing >10 lbs
log roll
must have brace on for OOB activity
abdominal precautions
no lifting >10 lbs
no twisting or bending
log roll
protect incision area
no abdominal muscle activities
no BLT
Total Hip Precautions
no bending at the waist past 90 degrees
no inward rotation
no crossing operated leg
abductor wedge on w/c and bed
abductor wedge when rolling
roll onto operated side
don’t sit in low chairs or toilets (use commode)
reachers for LE ADLs
kick the operated leg out to the side if painful
Swallow Precautions
90 degrees for all meals
***watch for aspiration (coughing, wheezing, blue,
1:1 S
staff must be present for intake of food and liquids and should not have food and drink left in the room
1:1 A
1-1 assistance, patient requires physical assistance to consume liquids and meals
Constant S
constant supervision, staff must be present, may be in a group setting
Int S
Intermittent Supervision - staff should check in w/ patient during meal to ensure that they are eating safely
Ind w/ Lix
independent with liquids w/ out staff
Chin tuck
patient should be cued to tuck chin to chest and then swallow w/ each bite
Reg
regular solid food
MS CUT
mechanical soft cut
GRD
ground food
Puree
Pureed Food
LIx
liquid
NPO
nothing by mouth
MBSS
modified barium swallow study
Oral Care Protocol
-suction for dysphagia and aspiration
-2X daily
-modified diet- brush teeth prior to meals, clean and moisturize after
-NPO and enteral feedings- oral care every 3 hours using suction kit
Pulmonary Precautions
monitor o2 sats w/ rest and activity
titrate o2 to doctor’s orders
energy conservation
check 02 tanks
HFC
high flow nasal cannula, runs at greater than normal (6 L) =, pt must stay in room for treatment
oxygen tanks
portable tanks, filled from concentrator, need to be stored upright, can burn skin if leaks
titrating oxygen
MD order, SpO2 specified o2 parameters, consistenly in the mid to high 90s w/ activity
Co2 retainer
body has lost the ability to expel Co2
hypoxic drive- retains C02 –SENSITIVE TO HIGH LEVELS OF O2
tracheostomy cuff
attached to the outside of trach by a pilot balloon, trach sits inside the airway and cuff is inflated or deflated w/ 100 cc syringe
Inflated cuff
seals off the airway, pt can only breathe through the trach, pt cannot vocalize
deflated cuff
air can pass through the trach, pt can vocalize using natural airway to breathe
PMV
used w. MD order when pt is ready to begin speaking/swallowing trials
must be able to tolerate deflated cuff
