Exam 1 (Modules 1-5)

What are the three forms of transmission and what is the PPE required?

1. Contact (increased spread with contact): gloves, gown, limit transport, single room, use disposable care equipment 2. Droplet (respiratory droplets like sneezing, coughing) : single room, mask and gloves 3. Airborne (tb, sars, measles, transport through the air) : AIIR room, door closed, respirator, limit transport, susceptible staff cannot enter, pt wears mask in transport

What are the different nursing care patterns and describe them?

1. Functional Nursing : focuses on tasks and jobs, each member has a certain task and job 2. Team Nursing: team of nurses lead by an RN, team leader delegates tasks based on the person's needs and the team members skills 3. Primary nursing: primary nurse is responsible for the persons total care, team assists as needed 4. Case Management: case manager coordinates care from admission through discharge and into the home or long term setting 5. Patient focused nursing: services are moved from dept to bedside, team performs basic skills usually done by other health care memebers

What are some standard precautions used to reduce the spread of pathogens?

1. Hand-washing 2. Personal Protective Equipment (PPE) 3. Gloves 4. Gowns 5. Mouth, eyes, and nose protection 6. Respiratory hygiene/ cough etiquette 7. Care equipment (the proper PPE) 8. Care of environment (wipe down, keep clean, disinfect items) 9. Textiles and Laundry (dont shake out) 10. Worker safety (no handling sharps or touching another persons bodily secretions without protection) 11. Patient or resident placement (private room for infected persons)

Alcohol Based Hand-Rub

1. apply hand sanitizer 2. rub palms together 3. rub palm of one hand over the back of the other and vice versa 4. interlace fingers and interlock them and rub 5. rub thumbs on palms 6. rub fingers on palms 7. rub fingertips on palms 8. continue rubbing until dry

Steps of Handwashing

1. make sure you have soap and paper towels 2. push watch and sleeves up arm 3. stand away from sink so that clothes are not touching sink but also faucet it easy to reach 4. use paper towel to turn on faucets and adjust to comfortable temp 5. wet wrists and hands, KEEP HANDS LOWER THAN ELBOWS 6. apply soap 7. rub palms together, interlace fingers, lather wrists, clean finger tips and nails on palm in circular motion 8. do that for 15 to 20 sec 9. rinse thoroughly, hand goes from wrists to finger tips 10. dry wrists and hands with clean towels and pat dry at finger tips 11. discard paper towels, 12. turn off faucets with clean paper towels 10.

What are the safety guidelines for restraints?

1. observe the individual for increased confusion and agitation 2. protect the person's quality of life 3. follow the manufacturer's instructions 4. apply restraints with enough help to protect the person and staff from injury 5. observe the person at least every 15min of as often as directed by the nurse and care plan 6. remove or release the restraint, re-position the person and meet basic needs at least every 2 hours or do so as often as noted in the care plan

What are the rules and regulations of restraint use?

1. restraints must protect the person 2. a doctor's order is required 3. the least restrictive method is used 4. restraints are used only after other methods fail to protect the person 5. unnecessary restraint is false imprisonment 6. informed consent is required

What are a patients/residents rights?

1. right to information: access to all records, health condition, how to contact MD 2. right to refuse treatment 3. right to privacy and confidentiality: minimal exposure, consent for others to be present, limited outsider view of medical history 4. right to make their own decisions: what to wear, doctors, visitors, promotes quality of life 5. right to grievance: voice dissatisfaction and complaints 6. right to work: if they want, do not need to work for care, 7. right to partake in resident groups: take part in social, cultural, and communal events 8. right to personal items: property treated with care and respect, protected property 9. right to be free from verbal, physical, sexual, or mental abuse or neglect, no seclusion or deprivation 10. right to have free body movement: no restraints unless ordered by docs and for patients interest not the nursing staff 11. right to quality of life: must be cared for in a manner that promotes dignity and self-worth

Rules of gloves

1. wear once 2. if ripped or broken, discard 3. put on new ones before touching mucus and when contaminated with bodily fluids 4. change gloves when going from dirty to clean 5. change when touching computer 6. put on last when donning PPE and take off first when removing PPE 7. make sure cover wrists in gown 8. wash hands post glove removal

How long do you wash your hands for?

15-20sec

Abbreviations ADL PRN NOP I A T

Abbreviations activities of daily living as needed nothing per oral/mouth independent assist total care

What is an enabler?

An enabler is a device that limits freedom of movement but is used to promote independence, comfort, or safety eg tray on wheel chair, bed rails

What does asepsis mean? What does sepsis mean? What does antisepsis mean? What is medical asepsis? and surgical asepsis?

Asepsis : absence of disease producing microbes sepsis: infection antisepsis: the process, procedures, and chemical treatments that kill microbes or prevent them from causing an infection medical asepsis: practices used to reduce the number of microbes and prevent the spread, clean technique surgical asepsis: practices used to remove ALL microbes aka sterile technique

What is assault?

Assault is intentionally attempting or threatening to touch a person's body without the person's consent can result in both civil and criminal charges

What are qualities and traits for good work ethics?

Being caring (concerned for a persons well being), considerate (respectful of a persons feeling), cheerful (pleasant), having empathy (seeing stuff from another's point of view), trustworthy (no gossip), respectful (no judgement), courteous (polite), conscientious (careful and alert), honest (accurate), cooperative (willing to help the team), enthusiastic (eager and interested), AND patience (staying calm and not rushing)

What do you do if a person starts to fall?

DONT try to prevent the fall Ease the person to the ground which lets you control the direction of the fall back straight and bring the person close let the person buttocks and body slide down your leg and lower them to the flor Don't let the person get up until a nurse comes to check for injuries

What are work ethics?

Deals with behavior in the workplace, judgement and choices. How you dress, what you say, how you behave, how you treat others, how you work with others

Donning and Removing PPE Steps

Donning 1. wash hands 2. gown 3. mask 4. gloves Removing 1. gloves (inside out) 2. gown (front is contaminated so unfasten ties and pull off from the ties and pull off from inside and turn gown inside out) 3. masks from the sides 4. wash hands

What is HIPAA? What is protected health information?

HIPAA is a federal law that protects privacy and security of someones health information Health Insurance Portability and Accountability Act of 1996 protected health information is any identifying information and information about a person sent in any form

What are HAIs?

Healthcare Associated infection is an infection that develops in a person cared for in any setting where health care is provided, infection related to receiving healthcare eg influenza, tb, c-diff

Maneuver used when someone is choking

Heimlich Maneuver

Who are CNAs under the supervision of?

Licensed nurses eg: LPB/LVN and RN

What is OBRA?

OBRA is the Omnibus Budget Reconciliation Act of 1987. It is a federal law that applies in all 50 states. It requires that nursing centers provide care in a manner and setting that maintains or improves the persons quality of life., health and safety. It sets reqs for CNA training and competency exam at the end, at least 75 hours of instruction and 16 hours of supervised clinical with certain skills eg: infection control, residents rights, skin care, communication, basic nursing skills, nurse training program

How do you use a fire-extinguisher?

PASS P: pull pin, this will unlock the handle A: aim low, the base of the fire NOT over the top S: squeeze lever to start stream S: sweep stream from side to side, back and forth

Can a CNA perform these tasks? Part 1 1. measure and record temp, pulse, respiration, and blood pressure 2. measure height and weight 3. collect specimens 4. perform assesments 5. give drugs 6. measure intake and outake 7. insert catheters and other tubing or remove them 8. supervise others 9. provide oral, hair, perineal, and general hygiene care 10. take oral or phone orders from MDs

Part 1 1. yes 2.yes 3. yes 4. no 5. no 6. yes 7. no 8. no 9. yes 10. no

Can a CNA perform these tasks? Part 2 1. evaluate response to care 2. assist with walking 3. give back massage and help with range of motion 4. provide teaching to the person and family 5. answer call lights 6. serve food 7. make beds, clean furniture, and stock linens 8. perform procedures needed sterile technique 9. ignore requests to do something 10. post-mortem care 11. assist with transportation and turning person 12. assist with coughing and deep breathing exercises

Part 2. 1. no 2.yes 3. yes 4. no 5.yes 6. yes 7. yes 8. no 9. no 10. yes 11. yes 12. yes

Define R A C E in fire safety

RACE R rescue any people in immediate danger A alarm, sound the nearest alarm and call operator C confine, close doors, windows, turn off o2 or electrical equipment E extinguish, pull pin and sweep

True or False A registered nurse delegates tasks to CNAs CNAs are not responsible for their actions because registered nurse is ultimately in charge

True they do delegate False. CNAs are responsible for their actions

Chemical Restraints vs Physical Restraints

a chemical restraint is any drug used for discipline or convenience and not required to treat medical symptoms a physical restraint is any manual method or physical or mechanical device, material, or equipment attached to or near the persons body that he or she cannot remove easily and that restricts freedom of movement or normal access to one's body

What is as gait/transfer belt?

a device applied around the waist used to support a person who is unsteady or disabled when its to help walk, its a gait belt when its to transport its a transport belt

what is a bed rail?

a device that serves as a guard or barrier along the side of the bed, helps prevent falls if all 4 are up, its considered a restraint

What is a communicable disease?

a disease caused by pathogens that spread easily, very contagious

What is medicare and who qualifies for it?

a federally funded agency that gives health care to those who are 65 and older

What is a local infection? What is a systemic infection?

a local infection is in a body part a systemic infection involves the whole body

What is a need? What are the basic needs according to Abraham Maslow?

a need is something necessary or desired for maintaining life and mental well-being. Maslow said they must be met for person to survive and function. top are the most important needs but the bottom must be met before the higher up needs from bottom to top the basic needs are physical safety and security love and belonging self-esteem self-actualization

What does it mean to be a pathogen and what does it mean to be non-pathogenic?

a pathogen is a microbe that causes infection and are harmful nonpathogens are microbes that do not usually cause an infection

What are vaccines?

a preparation containing dead or weakened microbes

What are ethics? What is a code of ethics?

acknowledging what is right and wrong code of ethics has rules or standards of conduct for group members to follow, must maintain professional boundaries

Types of illnesses Terminal

an illness or injury from which the person will not likely recover. The person will die eg: cancers not responding to treatment

Types of illnesses Chronic

an ongoing illness that is slow or gradual in onset. There is no known cure. The illness can be controlled and complications prevented with proper treatment eg: diabetes

What are antibiotics and what is the issue with them?

antibiotics are drugs used to kill certain microbes that cause infections MDROS (multi-drug resistant organisms ) that wont get killed from antibiotics, caused by over-prescribing or not taking the full prescription eg MRSA (methicilan resistant staph aureus, usually found in skin and nose) eg VRE (vancomycin resistant enterocci, usually in intestine or feces)

What are some way to maintain professional boundaries? Rule of thumb to ask yourself it its boundary crossing?

avoid caring for people you do business with or family and friends, do not make sexual comments or jokes, no offensive language, no extra time spent with them, no flirting Who is this action helping? If its you, its wrong.

What is battery?

battery is touching a person's body without his or her consent

What is a civil law and what is an offense called that violates a civil law?

civil laws are concerned with relationships between people a wrong committed a against a person or their property is called a tort

What is criminal law and what is an offense called violating a criminal law?

criminal laws are concerned with offenses against the public and society in general an act that violates a criminal law is a crime

What are love and belonging needs?

emotional needs that relate to love, closeness, and affection. meaningful relationships with others, can die from a lack of love or belonging

What are self-esteem needs?

esteem is worth, value or opinion one has of a person. self-esteem is to think well of one's self and to see oneself as useful and having value people who are ill, injured, older, disabled often lack this so much treat everyone with respect and encourage people to do as much as they can for themselves for esteem

What is false imprisonment?

false imprisonment is the unlawful restraint or restriction of a person's freedom of movement includes threats, restraint, and preventing a person from leaving an agency

How do you do the Heimlich Maneuver

for adults one year and older 1. stand or kneel behind person 2. wrap arms around the persons waist 3. make a fist with one hand 4. place thumb inside of fist against abdomen, slightly above the navel and well below the breast bone 5. grasp fist with other hand 6. press fist into abdomen with all your might

what do you do if you find a person on the floor?

leave them and call a nurse to check for injuries

if the person choking becomes unresponsive

lower person to the ground and place supine (laying on back), make sure EMS or EMR was called start CPR with compression and tilt chin up and open mouth remove object if see it and give breaths if need it

What is the need for self-actualization?

means experiencing ones potential learning, understanding, and creating to the limit of ones ability. the highest need and rarely if every, totally met

What is objective data? What is subjective data?

objective data (signs) are seen, heard, felt, or smelled by an observer such as feeling a pulse, or seeing urine color subjective data (symptoms) are things a person tells you about that you cannot observes such as pain, fear, or nausea

What are physical needs?

oxygen, food, water, elimination, rest and shelter. must have to survive. will die without these

Names of people receiving health care in: the hospital the nursing home the at home network

patients residents clients

What are safety and security needs?

person needing to feel safe from harm, danger, and fear so must inform people of what is the procedure, why it is needed, who will be performing it, how it will be done, and what it will feel like

What to do if the choking person is obese or pregnant? What changes?

place arms under the other person underarms and wrap arms around their chest

What is empathy?

seeing things from the person's point of view, putting yourself in another person's shoes

What to do if a person under 1 year is choking?

sit them on your lap and face down on your forearm and begin back blows (up to 5) if that doesnt work flip over and do up to 5 chest thrusts (quick and downward) and alternate between the two

What is an ombudsman?

someone who supports or promotes the needs and interests of another person state employees or volunteers that act on behalf of persons receiving health care. they protect the persons rights, safety, welfare, and health. they investigate complaints, assist persons, provide info about long term care facilities. monitor nursing homes and conditions, help families resolve conflicts.

Name examples of each step in the chain of infection?

source: pathogen carrier/vector: mosquito, ticks, mites reservoir: human body portal of exit: respiratory, GI tract, urinary, reproductive tracts, breaks in skin, blood, method of transmission: sneeze, bodily fluids, cough, from an object portal of entry: same as portal of exits susceptible host: persons at risk for infection, so very young or old, immuno compromised, already ill, high exposure, burn patients, transplant patients, and chemo patients most susceptible

Sterilization vs Disinfecting

sterilization kills all microbes, pathogenic or non pathogenic using an autoclave which uses high temperatures and high pressure disinfecting reduces the number of pathogenic microbes in an area, spores are not destroyed

if person is lying down but responsive

straddle the persons thighs and place heel of hand against abdomen in the middle slightly above the navel place second hand on top press hands quick upward thrusts repeat until object expelled

Types of illnesses Acute

sudden illness from which the person is expected to recover eg: heart attack

What is the nursing care plan?

the GPS on how to care for a person a written guide about the person's nursing care

What is contamination? What is cross contamination?

the process of becoming unclean. the passing of microbes from 1 person to another by hands, equipment or supplies

What is the chain of infection?

the process that involves the source/pathogen entering a reservoir via a carrier. A carrier can also be known as a vector (does not develop the dz). Once in the reservoir, it grows, replicates and proliferates. It then finds a way to leave the reservoir via the portal of exit. It is then transmitted to another host via a vehicle or substance that moves it from point A to point B. it then enters another host via the portal of entry of a susceptible host where it grows again and becomes the source of an infection to a new person

24 hour clock. what is 5:00am 3:30pm 7:15pm 9:00am 12:05 am

trick, for PM times remove the colon and add 1200 to the time AM times are the same but with a 0 in front if single digit, just remove colon for double digits AM 0500 1530 1915 900 0005 or 2405

What is an observation?

using the senses of sight, touch, hearing, and smell to collect information eg: see how a person walks, touch the skin to feel the temperature, smell for urine or BMs

How to put on a transfer/gait belt

wash hands assist the person to sitting position apply the belt over the person's clothing with the buckle in the back belt is inserted into the buckle with the teeth first and then into the smooth side tighten so its snug (should be able to slide an open palm around it and make sure no breasts are caught under it) put the buckle off center in the back or the middle tuck excess strap into belt

Donning and Removing gloves

wash hands put on gloves use one hand to take off one glove and crumple into other hand with bare hand, put 2 fingers inside glove (b/c outside is contaminated) and flip glove inside out then throw them both out