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Chapter 20 Blueprint

Basic Nursin Skills Blueprint. Cards with * are the ones she said remember

QuestionAnswer
What are some things that make up a person's environment? Walls, floors, lighting, & climate control
What colors promote a soothing effect? blue, mauve, & light green
Where should lighting be placed in a person's room? over the patient's bed
What should you do if the patient is c/o the room being too cold? adjust the thermostat & get the patient a blanket
***** What are some patients that might need the temperature adjusted? Infants & older adults might need warmer rooms
***** If your patient is congested what might you see ordered & why? A humidifier to moisten respiratory passages
If the room is not ventilated well what might that cause? Room will smell
What are some things that might cause odor in the hospital? Bedpans, urinals, wounds, body odor
What are some odors that linger? Cigarette smoke, strong foods (onions & garlic), perspiration
***** List some things you can do for noise control Avoid talking on the intercom, limit conversations in the halls, speak in lower voices, soft pleasant background noise, adjust t.v. volume
The bed being adjustable is a ______ and ______ factor. comfort & safety
What position should the bed remain in unless otherwise needed? Lowest
You have a confused patient, what should you do for this patient? Bring them to the nurses station or have a family member set with them
How thick is an eggcrate that relieves pressure? 4 inches
List some things that pillows are used for. Supporting body parts, keeping the body in position, and splinting a surgery site
List steps you will take before a linen change. Access what you will need, gather you linens, check the bed for loose articles, wear gloves, raise the bed
How do you apply linens? Top to bottom one side at a time
When changing an occupied bed describe how you position the patient. in the side lying position on the far side of the bed with the side rails raises
How would knowing the patient's diagnosis alter how the bed is changed? the patient may not be able to get up, the head of the bed may not be able to be adjusted, there may be special equipment that can't be moved.
What are some things that the overbed table is used for? Meals are served on it, sterile field is set up on it, activities (writing, reading, applying makeup)
What equipment might you find on the bedside stand? suction equipment, wound supplies, peri wash, any item that may be used on the patient for care or for specific purposes
What are some ways that you can protect the patient's safety? orient them to their room, call light, & hospital environment
****** What has safety guidelines that are required by OSHA to have on each unit? MSDS (Material Safety Data Sheet)
What is the leading cause of death in infant/toddlers and school age children as well as adolescents? Accidents
List some reasons why older adults are at an increased risk for falls. visual impairment, urinary urgency, reduced coordination, & impaired mobility.
What can you do if the patient is c/o being cold and their feet are cold? provide additional blankets & encourage the used of warm bed socks
What does all fire prevention include? good housekeeping, maintenance, & employee discipline
What are the different types of fire extinguishers and what are they used for? Type A- for wood, paper, cloth Type B- for flammable liquid fires (grease & anesthetics) Type C - for electrical fires Type ABC- for any type of fire
Describe what RACE stands for R- Rescue & remove individuals closest to the fire A - Activate the alarm C- Confine the fire by closing windows & doors. Turn of all oxygen & electrical equipment) E- extinguish the fire using a fire extinguisher
When using an extinguisher what does the word PASS refer to? P-Pull the pin A-Aim low S-Squeeze S-Sweep
What is asphyxiation? The inability to breath
What are some causes of asphyxiation? Food, inhalation of vomit or other liquids, smoke, carbon monoxide, swelling in the throat or mouth
What is carbon monoxide? odorless smokeless gas
Individuals that are suffering from carbon monoxide poisoning, their cells are starving for _______. oxygen
What are some of the s/s of carbon monoxide poisoning? headache, nausea/vomiting, dizziness, weak muscles, confusion, shortening of breath, cherry red skin
What is the first intervention when someone is suffering from carbon monoxide poisoning? get the person into fresh air
What is a much more radical treatment for carbon monoxide treatment? hyperbaric treatment
What are some safety precautions that could help prevent drowning? Never leave a child unattended around water, Enroll in a water safety program, learn to swim, wear water safety devices, Never go into the water alone
What is one thing we can do in our home to prevent electrical shock in our home where children are concerned? Make sure plug covers are in place
You have a patient admitted to the hospital that brings their electric razor in with them. What should you do? Let maintenance check it out for frayed cords or loose plugs
***** What is poison? any substance (solid, liquid, gas) that even in small amounts causes damage to the body or interferes with the function of it's system?
***** What information do you need when you call a poison control center? weight & age of the patient, substance ingested, inhaled, or injected, how much, when taken, if other drugs were taken, and by what route, status of the patient at the present time.
You have a patient that ARS (Acute Radiation Sickness) what is one thing you may have to limit? the amount of time you are in the room (limit you exposure to radiation)
What is the most common route of poisoning? by mouth
***** What is the first step you should do when poisoning has occurred? Assess the patient, obtain a history, call poison control
What should you do first when a patient comes in with suspected poisoning? Assess the patient & obtain a history
What are some things that we can do to prevent accidental poisoning? Don't keep medicine in your purse, Don't call medicine candy, keep chemicals in their original container, keep toxins stored & clearly labeled, check carbon monoxide detectors to make sure they are working
When would you not induce vomiting on a patient suffering from poisoning? if the victim is having a seizure, if they are semiconscious or unconscious, if nurse suspects caustic or corrosive substance, serious heart condition, later stage of pregnancy, or under 9 months old
What is the most frequent cause of injury in the hospital? Falls
What type of patients are at an increase risk for falls and what can you do to reduce the chances of this occurring? confused, taking narcotics, weak. You should assess them often & remind them to get help when up.
If a fall occurs for one of your patients what would you do first? Check the condition of the patient
What is the principle behind using protective devices? Use the least amount of immobilization as needed for the situation
***** What are the 2 types of restraints? physical & chemical
What is the purpose of a restraint? To prevent the patient from injuring themselves or others
You have a confused patient, what do you need to do before applying a restraint? talk with the patient and determine the cause of the problem
What are some of the problems that may occur when restraints are used? more confusion, chronic constipation, incontinence, upper respiratory infection, pressure ulcers, UTI
What is OBRA and what does it define? Omnibus Budget Reconciliation Act - it defines the rights & choices of clients & also states acceptable reasons for the use of physical restraints
What are some of the restraint regulations according to OBRA? Only as a last resort, only applied under a Dr.'s order that specifies why & for how long, the patient agrees, the patient be free of physical restraints not required to treat their medical symptoms
You as the nurse can't _____ delegate responsibility to the family to monitor the patient. legally
When are some times when a restraint might be necessary? protecting the patient from falls, protect a body part, keep the patient from interfering with therapies (pulling out tubes, disconnecting IV's, removing wound coverings, reduce risk to others)
If unable to obtain a doctor's order prior to applying restraints how soon do you need to get an order & how often does it need to be renewed? 24 hours, 24 hours
How often do you monitor a patient in restraints? Frequently
When using restraints what are some things you would assess? vital signs, circulation, skin condition, behavior
What are some general things you would document concerning the use of restraints? behavior that made restraints necessary, type of restraint, explanation given to the client & support person, client's consent, time restraint was applied & removed, client's behavior, frequency of care, circulation, ROM, notification of Dr., reevaluation
What are 2 things that you need to assess when using restraints? circulation & ROM
What are some things that you can do before using restraints? Assign nurses in pairs, place patient close to supervision, prepare patient for a move, stay w/ patient, monitor meds, lower bed, use rocking chairs, wedge pillows/pads, lap tray, warm drink, soft lights, back rub, walk, environmental restraints, etc.
What are some possible causes of wandering disorientation & combativeness? poor hearing, poor eyesight, pain, frustration
List some reasons why you wouldn't use restraints. patient constantly calling for assistance, short handed, patient getting up & you don't have time to watch them
What must you do to bony prominences when applying restraints? pad them
How often does the restraint need to be removed? Every 2 hours
Describe how you would apply a w/c restraint. under the w/c to the back, tie the straps in a 1/2 bow knot
Describe how you would secure a wrist or posey restraint. Tie it to the movable part of the bed frame
If using a posey vest, besides v/s, circulation, and performing ROM, what else do you need to assess? agitation
What type of restraints might you use for a patient that is pulling at their IV's, dressing, or scratching a wound? Mitten restraints or Wrist restraints
If wrist restraints are used what would you need to evaluate to assess circulation of an extremity? color, warmth, pulse distal to the device
During your assessment you notice the s/s that indicate impaired circulation. What would you do? Release restrain & notify the Dr.
How would you make sure that a vest restraint is not applied too tight? place you hands under the vest
If you apply a restraint and the patient becomes more confused what should you do? remove the device, stay with the patient, talk to them to calm them down
Created by: Jacksonville VNE