Safety and Inf control (remediation goal > 65%)

acronym for droplet precautions

"P.I.M.P." pertussis (whooping cough) influenza meningitis pneumonia

A client with Hepatitis C has returned from surgery with a total laryngectomy. The nurse knows that what personal protective equipment is necessary when providing trach care? (Select All That Apply). You answered this question Incorrectly 1. Face mask 2. Shoe covers 3. N-95 mask 4. Goggles 5. Gloves 6. Gown

1, 4, 5 and 6. CORRECT: The client has had a total laryngectomy which will initially produce large amounts of thick, bloody mucus. Hepatitis C is transmitted through blood and body fluids. During trach care, the nurse needs to be protected by specific personal protective equipment (PPE's). For this procedure, the nurse should utilize gown, gloves, goggles and face mask. N-95 face mask is a specially fitted mask used by nurses when providing care for clients with active tuberculosis. It is not necessary for a client with Hepatitis C.

A nurse is planning an educational session on safety for parents of young children. What safety points should the nurse include? You answered this question Incorrectly 1. Teach children the basics of swimming. 2. Plan an escape route in the event of fire. 3. Make sure that sand surrounds the playground equipment. 4. Gates should be placed at the top and bottom of stairs when toddlers are present. 5. Vitamins should be referred to as candy so that children will take them. 6. A child at age 7 may sit in the front seat of a car.

1., 2., 3., & 4. Correct: Everyone should know the basics of swimming (floating, moving through the water) and cardiopulmonary resuscitation (CPR). Create and practice a family fire escape plan and involve kids in the planning. Make sure everyone knows at least two ways out of every room and identify a central meeting place outside. Falls on playgrounds are common and can cause serious injury. Wood chips or sand, not dirt or grass should be under playground equipment. Having a gate at the top and bottom of stairs can prevent falls.

prior to ECT, the RN educates the client about which dietary interventions

The client should be NPO for 6-8 hours prior to the procedure.

Infants with myelomeningoceles can have problems with the normal flow of the cerebral spinal fluid around the defect. Which finding by the nurse would need to be reported to the primary healthcare provider immediately when caring for an infant who was born with a myelomeningocele? You answered this question Correctly 1. High pitched cry 2. Eyes fixed downward 3. Increasing head circumference 4. Decrease in a feeding by 30 mL 5. Projectile vomiting

1., 2., 3., & 5. Correct: Infants with myelomeningoceles can have problems with the normal flow of the cerebral spinal fluid around the defect. These are all signs of increasing intracranial pressure and development of hydrocephalus and should, therefore, be reported to the primary healthcare provider immediately. These are all signs of increasing intracranial pressure and development of hydrocephalus and should, therefore, be reported to the primary healthcare provider immediately.

Airborne precautions

remember MTV! (ASTRONAUTS ON THE MOON GET AIRBORNE) MMR TB Varicella (chicken pox / Herpes zoster/shingles)

droplet precautions are specific to what PPE item

surgical mask

Teast

teasssd

test 1

test2

test

tets

The basic principles of emergency preparedness are the same for all types of disasters. As a member of the emergency preparedness planning team at the hospital, which actions should the nurse encourage the team to implement? You answered this question Incorrectly 1. Developing a response plan for every potential disaster. 2. Providing education to employees on the response plan. 3. Practicing the response plan on a regular basis. 4. Evaluating the hospital's level of preparedness. 5. Assigning all client care duties to the Nursing Supervisor.

2., 3. & 4. Correct: Remember to DEP. Developing a single response plan educating individuals to the specifics of the response plan practicing the plan and evaluating the facility's level of preparedness - are effective means of implementing emergency preparedness. The response interventions are the only variables in a disaster situation. Depending on the type of disaster situation, specific needs of the situation will be addressed as an additional part of the initial basic plan for emergency preparedness.

What interventions should the nurse plan to implement when admitting a client diagnosed with measles? You answered this question Incorrectly 1. Admit to a semi-private room with a client diagnosed with tuberculosis (TB). 2. Place a surgical mask on the client when transferring to x-ray. 3. Initiate airborne precautions. 4. Wear surgical mask when entering the client's room. 5. Assign a nurse who has received the measles vaccine to take care of this client.

2., 3., & 5. Correct: If the client must leave the room, a surgical mask should be worn to prevent transmission to others. Measles can be transmitted via contact, droplet, and airborne methods, so airborne precautions are needed. Healthcare providers who are not immune to measles should not care for a client with measles.

The nurse is cleaning and dressing a foot ulcer of a diabetic client. Which actions are appropriate? You answered this question Incorrectly 1. Uses a clean basin and washcloth to clean the ulcer. 2. Wears sterile gloves to clean the ulcer. 3. Cleans ulcer with normal saline. 4. Warms saline bottle in microwave for 1 minute. 5. Cleans ulcer in a full circle, beginning in the center and working toward the outside.

2., 3., & 5. Correct: The nurse needs to wear sterile gloves when cleaning the wound. Normal saline solution is the preferred cleansing agent because, as an isotonic solution, it doesn't interfere with the normal healing process. Gently clean the wound in a full or half circle, beginning in the center and working toward the outside. Normal saline solution is the preferred cleansing agent because as an isotonic solution, it doesn't interfere with the normal healing process. Wear sterile gloves when cleaning the wound. The sterile gloves are to protect the client from acquiring an infection in the foot ulcer. A wound is to be cleaned from the least contaminated area such as from the wound to the surrounding skin. Gauze and salve should be used instead of a wash cloth.

What measures should the school nurse implement for a child diagnosed with peanut allergies? You answered this question Incorrectly 1. Keep a lidocaine auto-injector readily available. 2. Obtain assessment data about visual acuity, and health conditions that might affect food allergy management. 3. Maintain contact information for parents and primary healthcare provider. 4. Review history of known food allergens and the severity of previous reactions. 5. Train designated personnel to administer prescribed medication in an anaphylaxis emergency.

3, 4, & 5. CORRECT: Schools should maintain parent/legal guardian and primary healthcare provider contact information, including a prescribed emergency plan of care for all students with known food allergies. Food allergy information should be completed for every child identified with a food allergy and maintained in the student health record. A licensed health care professional such as a registered nurse, doctor, or allergist should train, evaluate, and supervise unlicensed assistive personnel or delegated non-health professionals. This training should teach staff how to recognize the signs and symptoms of a reaction, administer epinephrine, contact EMS, and understand state and local laws and regulations related to giving medication to students. 1. INCORRECT: Injectable lidocaine is not a recommended or effective treatment for anaphylaxis. 2: INCORRECT. Allergic reactions can cause the eyes to become red, itchy, burning and watery, along with swollen eyelids. They pose no threat to eyesight, other than possible temporary blurriness.

anemia and renal function is often due to a lack of...

EPO production

Droplet precautions are for what 2 diseases?

All meningitis and all influenza

AIRBORNE prec's are synonymous with which PPE

N95

TB and measles require airborne precautions, but can a charge RN let them share a room?

NO!

Normal ANC range & WBC range

Normal WBC range: 4,500-10,000 cells/mcL Normal range ANC: 1.5 to 8.0 (1,500 to 8,000/mm3)

A client is to be discharged following treatment for hepatitis A. The nurse knows teaching was successful when the client makes what statement? You answered this question Incorrectly 1. "I should never eat fresh salad in a restaurant." 2. "I must wait two years before traveling abroad." 3. "I will need blood work once a month for a year." 4. "I will be able to donate blood when I am well."

Hepatitis A is a virus acquired from food or water contaminated with fecal material, causing inflammation in liver cells. Though some antibodies will remain in the blood permanently, an individual can donate blood once fully recovered from the illness.

Which observations should the home health nurse discuss with the parents of a two year old regarding potential safety threats in the home? You answered this question Incorrectly 1. Security gates at the stairs. 2. Cleaning supplies under sink cabinet. 3. No blinds on windows. 4. Use of space heaters. 5. Water heater temperature 140°F (60°C) 6. Use of tablecloths

The key words in this question are 2 year old, safety threats, and home. Each option stands alone with the question. After reviewing the question, look at each option and identify if it is true or false. 2, 4, 5 & 6 Correct: Cleaning supplies should be placed high away from child's reach. Cabinets should have childproof locks. Space heaters need to be checked every year prior to use. Additionally, small children can be burned by space heaters if they get too close. A guard should be applied. Water heaters should be set at no higher than 120°F (48°C). Burns may occur with a 6 second exposure to 140°F water temperature. Children can pull on table cloths and spill hot food or break dishes which could lead to injury.

An unlicensed assistive personnel (UAP) is asked to transfer a client with left hemiplegia from the bed to a wheelchair. The nurse tells the UAP the safest approach for this transfer is what method? You answered this question Incorrectly 1. Lift client from edge of bed, supporting under arms and pivot to chair. 2. Utilize a slide board to transfer client from bed to the wheelchair. 3. Apply an ambulation belt around client's waist and pull into the chair. 4. Use a mechanical lift to move client from the bed into the wheelchair.

a client with hemiplegia cannot stand independently. 4. Correct: When transferring a large or physically impaired client out of bed to a wheelchair, safety for both staff and client is most important. The UAP should use a mechanical lift, first rolling the client onto the sling, attaching the lift loops, and allowing the machine to do the work of lifting the client. This provides a safe, gentle lift for the client and protects the UAP from injury. 2. Incorrect: A slide board is utilized when a client is lying flat and needs transferred between two flat surfaces, such as bed to stretcher. A slide board requires several people to utilize safely, and is not appropriate from bed to chair.

a client who is undergoing ECT (electroconvulsive therapy) for depression needs an RN who understands their priority for the patient is

airway (suctioning PRN)

when given the choice to ensure informed consent or confirm allergies for a client who is about to undergo a procedure with contrast which is the priority intervention

confirm allergies

PIMP acronym first thing that you think of

droplet precautions / specific diseases

Avoiding venipunctures of any type, including IM injections, is an important precaution for neutropenia, in which infection is the main concern. However, the word "ALL" makes this statement to definite. The client may need an IV. Remember, nothing is that definite in the world. Although it's important to put a client on neutropenic prec's on bleed prec's the priority for this patient is to avoid

intake of fresh fruits and veggies

MgSO4 can often be confused with MSO4 which is the abbreviation for

morphine. always question any orders for these two drugs in the form of an abbreviation

when you care for a client after initiating airborne precautions, remember that the RN wears the N95 in the room and the patient must

wear a mask outside the room. The whole point of a negative pressure room is to keep the air inside the room, from escaping!