Whittier Precautions

Question 1

Sternal Precautions

Answer 1

-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

Question 2

Cardiac Precautions

Answer 2

-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%

Question 3

Neuro Precautions

Answer 3

-note communication
-always support the affected side
-get patients up for self care and feeding
-educate families

Question 4

Falls Prevention

Answer 4

-always use gait belt
-place in lowest postion in bed
-clutter free
-careful of 02 lines
-

Question 5

Spinal Precautions

Answer 5

no BLTS
no lifing >10 lbs
log roll
must have brace on for OOB activity

Question 6

abdominal precautions

Answer 6

no lifting >10 lbs
no twisting or bending
log roll
protect incision area
no abdominal muscle activities
no BLT

Question 7

Total Hip Precautions

Answer 7

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

Question 8

Swallow Precautions

Answer 8

90 degrees for all meals
***watch for aspiration (coughing, wheezing, blue,

Question 9

1:1 S

Answer 9

staff must be present for intake of food and liquids and should not have food and drink left in the room

Question 10

1:1 A

Answer 10

1-1 assistance, patient requires physical assistance to consume liquids and meals

Question 11

Constant S

Answer 11

constant supervision, staff must be present, may be in a group setting

Question 12

Int S

Answer 12

Intermittent Supervision - staff should check in w/ patient during meal to ensure that they are eating safely

Question 13

Ind w/ Lix

Answer 13

independent with liquids w/ out staff

Question 14

Chin tuck

Answer 14

patient should be cued to tuck chin to chest and then swallow w/ each bite

Question 15

Reg

Answer 15

regular solid food

Question 16

MS CUT

Answer 16

mechanical soft cut

Question 17

GRD

Answer 17

ground food

Question 18

Puree

Answer 18

Pureed Food

Question 19

LIx

Answer 19

liquid

Question 20

NPO

Answer 20

nothing by mouth

Question 21

MBSS

Answer 21

modified barium swallow study

Question 22

Oral Care Protocol

Answer 22

-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

Question 23

Pulmonary Precautions

Answer 23

monitor o2 sats w/ rest and activity
titrate o2 to doctor’s orders
energy conservation
check 02 tanks

Question 24

HFC

Answer 24

high flow nasal cannula, runs at greater than normal (6 L) =, pt must stay in room for treatment

Question 25

oxygen tanks

Answer 25

portable tanks, filled from concentrator, need to be stored upright, can burn skin if leaks

Question 26

titrating oxygen

Answer 26

MD order, SpO2 specified o2 parameters, consistenly in the mid to high 90s w/ activity

Question 27

Co2 retainer

Answer 27

body has lost the ability to expel Co2 hypoxic drive- retains C02 --SENSITIVE TO HIGH LEVELS OF O2

Question 28

tracheostomy cuff

Answer 28

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

Question 29

Inflated cuff

Answer 29

seals off the airway, pt can only breathe through the trach, pt cannot vocalize

Question 30

deflated cuff

Answer 30

air can pass through the trach, pt can vocalize using natural airway to breathe

Question 31

PMV

Answer 31

used w. MD order when pt is ready to begin speaking/swallowing trials must be able to tolerate deflated cuff