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nursing safty #2
test 3
| Question | Answer |
|---|---|
| precautions | standard *isolation *transmission based precautions (airborne, droplet, contact) |
| antiseptic | also can be bactericidal(destroys bacteria) and bacteriostatic(prevents growth of bacteria) |
| disinfectant | also can be bactericidal(destroys bacteria) and bacteriostatic(prevents growth of bacteria) |
| penicillins *Ampicillin (Unasyn) uses: side effects: | uses: anti-infective used in the tx of skin infections, soft-tissue infections, ear infections... side effects: diarrhea, rash, ANAPHYLAXIS(life threatenting), PSEUDOMEMBRANOUS COLITIS (life threatenting) |
| penicillins *Ampicillin (Unasyn) Nursing Implications | assess for infection(vital signs, wound appearance, & WBC) at the begining and throughout therapy *assess for allergy to penicillins *obtain specimens for c &s before therapy *observe pt for S/S of anaphylaxis-D/C & notify MD immediately |
| penicillins *Ampicillin (Unasyn) Nursing Implications PO | adm around the clock on an EMPTY stomach at least 1 hour before or 2 hours after meals with a FULL GLASS OF WATER. capsule may be opened and mixed with water |
| Sulfonamides *Trimethoprim/Sulfamethoxazole (Bactrim, Septra) Uses and side effects | uses:anti-infective used in the tx of infections of the bowel, resp tract, urinary tract, possibly MRSA(if sensitive) SIDE effects:nausea,vomiting, rashes, phlebitis. ERYTHEMA MULTIFORME (life threat) & STEVEN JOHNSONS SYNDROME(LIFE THREATING) |
| Sulfonamides *Trimethoprim/Sulfamethoxazole Nursing Implications | assess pt for allergy to slufonamides/sulfa drugs *monitor I&O (encourage fluid intake to prevent kidney stones)*inspect IV site frequently, phlebitis is common |
| Sulfonamides *Trimethoprim/Sulfamethoxazole Nursing Implications on ROUTES | do not confuse with double strength (DS) formulations with single strength *do NOT administer IM!! PO Admin. with a full glass of water |
| Glycopeptides *Vancomycin (Lyphocin, Vancocin, Vancoled) uses and side effects | uses: IV:anti-infective often used as a last resort for MRSA. PO:treatment of staphylococcal enterocolitis or clostridium difficile, etc. Side effects: nephrotoxity, phlebitis, ANAPYLAXIS (life threating) |
| Glycopeptides *Vancomycin (Lyphocin, Vancocin, Vancoled) Nursing implications | assess for infection before, during therapy & obtain culture before therapy. *monitor for & report dizziness, tinnitus (ringing in ears), vertigo(ototoxicity) & I&O, daily weight, cloudy or pink urine(nephrotoxicity) |
| Glycopeptides *Vancomycin (Lyphocin, Vancocin, Vancoled) Nursing implications | also monitor IV site closely, irritating to tissues, causes necrosis, severe pain with extravastion, route infusion sites. Peak & trough will be drawn per agency policy, monitored closely |
| Glycopeptides *Vancomycin (Lyphocin, Vancocin, Vancoled) Nursing implications | assess for signs of superinfection (black furry growth on tongue, vaginal itching or discharge, loose or foul smelling stools)report occurence *assess for "Red Man Syndrome"associated with fast infusion rates |
| Glycopeptides *Vancomycin (Lyphocin, Vancocin, Vancoled) Nursing implications ROUTES: | PO: IV dosage form may be diluted in 30 ml of water for oral or NG tube administation (has bitter, unpleasant taste, may mix with a flavored syrup) IV: must be DILUTED well and infused over ATLEAST 60 minutes to prevent Red Man Syndrome |
| aminoglycosides *Gentamicin (Garamycin) uses and side effects | uses: PO:anti-infective used for serious enteroccoccal infections; IV:used to prevent infective endocarditis Side effects: ataxia(unsteady gait), ototoxicity(vertigo), nephrotoxicity(pink or cloudy urine) |
| aminoglycosides *Gentamicin (Garamycin) nursing implications | monitor for & report dizziness, tinnitus, vertigo(ototoxicity),and I&O, daily weight, cloudy or pink urine (nephrotoxicity) |
| aminoglycosides *Gentamicin (Garamycin) nursing implications | also assess for superinfection:fever, upper respiratory infection, vaginal itching, malaise diarrhea-report to physcian. |
| aminoglycosides *Gentamicin (Garamycin) nursing implications | encourage fluids throughout therapy IM injections should be given deep into a well developed muscles (no deltoid) alternate injections sites |
| Nitromidazoles *Metronidazole *FlagylUses and side effects` | anti-infective used in the tx of a variety of anaerbic infections such ad C.diff and bone and joint infections, etc. Side effects: dizziness, headache, abd pain, anorexia, nausea, SEIZURES(life threatening) |
| Nitromidazoles *Metronidazole *Flagyl nursing implications: | *monitor for numbness, pareshesia(numbness,prickly,stinging or burning feeling) weakness, ataxia(lack of muscular coordiantion), or seizures occur *monitor I&O, daily wt, esp for pt on sodium restriction (Flagyl contains sodium) |
| Nitromidazoles *Metronidazole *Flagyl Implementations: | PO: may give with or without food. Tablets may be crushed |
| When providing oral medications for a pt with C.diff, it is most important for the nurse to wear? | gown and gloves |
| what type of precaution is most appropriate for a pt with MRSA? | Contact |
| It is important to maintain what technique throughout a foley catheter insertion to prevent infection? | aseptic tech. |
| factor affecting safty: | *age & devel. *lifestyle *mobility &health status*sensory perceptual awareness/alteration *cognitive awareness *psychosocial/emotional state *ability to comm. *safety awareness *enviro factors * home*workplace *community *healthcare setting *bioterrorism |
| age and development factors affecting safety | difficulty with movement, diminished sensory acuity, falls, burns, automobile/pedestrian accidents |
| lifestyle factors affecting safety | ETOH use, unsafe home/work enviro., high crime neighborhoods, insufficient income for necessary home repairs, illicit drug use |
| mobility and health status factors affecting safety | paralysis, muscle weakness, poor balance/coordination, chronic disease (osteoarthritis, spinal cord injury, diabetes) |
| sensory/perceptual factors affecting safety | touch, hearing, taste, smell, vision |
| cognitive awareness factors affecting safety | insomnia, unconsciousness/semiconsciousness, confusion/disorientation, hallucinations,medications (can alter cognitive awareness) |
| emotional state factors affecting safety | stess(reduces level of concentration), depression, exacerbation of mental illness |
| ability to communicate factors affecting safety | confusion, culture/lang. barriers, inability to read, aphasia (can be receptive cant respond or expressive:cant form words) |
| safety awareness factors affecting safety | patient education:equipment, water safety, car safety, fire precautions, chemicals. Ability to learn |
| Internal enviroment factors affecting safety | *VSS:fever, hypertension *Free from mental defect:stress, disorientation *Free from infection:sepsis, MRSA, VRE, C.diff *Electrolyte status/ dehydration:sodium,potassium, magnesium |
| External enviroment factors affecting safety | *safe home:lighting, floors *safe workplace: machinery, pollution *noise: interferes with hearing and concentration *temperature: older adults more sensitive to heat and cold *chemicals:labeled clearly and stored safe |
| An older adult patient is confused and is in a weakened condition. the pt is at most risk for | falls |
| healt care setting factors affecting safety | human error, limited short term memory, being late or in a hurry, limited ability to multitask, interrruptions, stress, fatigue, enviromental factors (to hot or cold) |
| bioterrorism | *intentional attack using weapons of viruses, bacteria, and other germs *nuclear *biological *chemical |
| different biological pathogens | anthrax, botulism, plague, viral hemorrhagic fevers(VHF), smallpox, Tularemia |
| when providing a bath for the elderly the nurse makes sure to | remove his or her own jewelry to prevent skin tears |
| nursing assessment includes: | history and physical *patient safety goals *national patient safety goals *national patient safety goals |
| nursing history and physical includes: | general health status, mobility status, physicological/perceptual deficits, cognitive status, S/S of abuse/neglect, fall risk assessment, skin assessment(braden scale), home safety assessment |
| patient safety goals | agencies accredited by JCAHO must meet goals *focus is on finding why and how the problem occured -not who made the mistake *important to report error/safety issues/accidents so the system can be analyzed for issues and resolved * |
| National patient safety goals include | improve accuracy of patient identification *improve effectiveness of communication among caregivers *improve safety of using medications (10rights), reduce the risk of healthcare ass. infections, reduce the risk of patient harm resulting form falls |
| National patient safety goals include | reduce the risk of influenza and pneumococcal disease in the instutionalized older adult, reduce the risk of surgical fires, encourage active involvement of patient's car, prevent hc ass. pressure ulcers |
| by washing hands after client care, the nurse is meeting which national patient safety goal? | reduce the risk of healthcare associated infections |
| risk for falls interventions | maintain bed in lowest position, with wheels locked, SR up X2, call light within reach, encourage use of call light, ensure floor is uncluttered, free from liquid spills at all times. |
| risk for poisioning interventions | ensure poisons are in locked cabinets at all times, provide patient education on 7am-3pm shift |
| risk for aspirations interventions | elevate HOB 30-45 degrees as tolerated, provide patient education on 7am-3pm shift |
| nursing inteventions must be relevent to: | age and ability considerations, hospital or other health care setting, specific hazards to which the patient is exposed*if restraints are used, must have interventions in place to help prevent injury |
| Restraints | Physical restraints: posey vests, belts, soft limb restraints Chemical restraints: neuroleptics, anxiolytics, sedatives, psychotropics |
| Legal implications for restraints | have to try alternatives to restraints first *NO PRN orders *New orders for every 24 hour period *must state reason and time period *Last resort ALWAys *Patient must be assess every 2 hours |
| An elderly patient continues to wander through the hospital even after the nurse has asked the patient not to. what is the nurses next step? | attemp to place the patient in a room near the nurse's desk |
| the nurse is caring for a patient in bilateral soft wrist restraints. the nurse should? | assess the patient atleast every 2 hours and PRN |
| before applying restraints | all other possible interventions should have been tried that are less restrictive. the pcp must be notified prior to using a restraint, unless there is a danger to self or others. |
| standard precautions | designed for ALL clients in hopital. these precautions apply to blood, all body excretions and secretions (except sweat), nonintact broken skin and mucous membranes. |
| standard precautions are designed to | reduced risk of transmission of microorganisms form recognized and unrecognized sources |
| standard precautions | perform proper hand hygiene after contact with blood, body fluids, secretions, excretions, and contaminated objects whether gloves are worn. Use antimicrobial agent or antiseptic agent for th econtrol of specific outbreaks of infection. |
| standard precautions | perform hand hygiene immediately after removing gloves. wear a mask, eye protection, or a face shield if splasher or sparys of blood, body fluids, secretions, or excretions can be expected. |
| standard precautions wear a clean nonsterile gown if | client care is likely to result in splashes or sprays of blood, body fluid, secretions, or excretions. the gown is intended for protecting the clothing. cleanse hands after removing the gown. |
| transmission based precautions | air borne precautions, droplet precautions, contact precautions |
| air borne precautions (illnesses transmitted by airborne droplet nuclei smaller than 5 microns) | place client in a private room that has negative air pressure, 6-12 air changes per hour, and either discharge of air to the outside or a filtration system for the air room. |
| air borne precautions | if private room is not available place client with another client who is infected with the same organism |
| what to wear with air borne precautions | wear a respiratory device (N95 repirator) when entering the room of a client who is known or suspected of having primary TB. Susceptible ppl should not enter the room of client w/rubeola (measles) or vaicella. if they must enter, wear a respirator |
| during transport of a client with airborne precautions | the client wears a surgical mask |
| droplet precations (illnesses transmitted by paricle droplets larger than 5 microns) | place the client in a private room. if private room not available place with a client infected with the same microorganism. Place a surgical mask on the client during transport. |
| what should the nurse wear when the client has droplet precautions | wear a mask when working within 3 feet of the client |
| contact precautions | place client in private room. if not available place with another client infected with the same micro. |
| contact precautions: wear gloves | as described with standard precautions. Change gloves after contact with infectious material. remove gloves before leaving client's room. cleanse hands immediately after removing gloves. use an antimicrobial agent. |
| contact precautions: wear a gown when | wear a gown when entering a room if there is a possibility of contact with infected surfaces or items, or if the client is incontinent, or has diarrhea, a colostomy, or wound drainage not contained by dressing. also use standard precautions. |
| contact precautions: romove gown | is patients room. make sure uniform does not contact possible conaminated surfaces. |
| contact precautions: | limit movement of client outside the room. dedicate the use of noncritical client care equipment to a single client or to clients with the same infecting microorganisms |
Created by:
chelsea309
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