Study Guide Test 2 NUR 139

Basal Metabolism

Energy required to carry on involuntary activities of the body at rest

Afternoon Care (P.M. Care)

Ensure that the patient is comfortable after lunch and ---Offer assistance with toileting, hand washing, and oral care. -Straighten bed linens -Help patient with mobility needs to reposition self if lying down for a rest period - Remove clothing items per client pref.

True or False: When caring for patients, only the nurse needs to wear PPE and use universal precautions because she is the one providing direct care and the most at risk for infection

False

A nurse whose behavior is reasonable and prudent and similar to the behavior that would be expected of another nurse in similar circumstances is likely to be found liable if a client falls. True or false

False- A nurse whose behavior is reasonable and prudent and similar to the behavior that would be expected of another nurse in similar circumstances is unlikely to be found liable if a client falls even if injury occurs.

Is the following statement true or false? Among Adults older than 65, fires are the leading cause of injury fatality?

False- Falls are the leading cause of death

True or False: Wearing gloves is the most effective way to prevent the spread of organisms

False- hand washing

True or False: Using standard precautions means that the nurse should wear clean gloves for every aspect of patient care.

False.

A side rail is considered a restraint even if the client asked for it to be raised to assist in getting into and out of bed. True or false.

False. A side rail is not considered a restraint of the client requested it be raised to eat and getting into or out of bed. Some clients may request that side rails be used at night while they were sleeping so that may feel more secure. The client must be able to raise and lower the side rails him or herself

A nurse is providing instructions about foot care for a client with a history of poor circulation to the lower extremities. The nurse would know the teaching was effective when the client made which of the following statements?

I will avoid crossing my knees when in the seated position.

IWIPE

I- Identify self, position, and nursing school W- Wash your hands I- Identify client using two methods P- Provide for Privacy, PPE E- Explain and educate

What is the role of a chaplain or a spiritual care provider?

Identify and respond to the spiritual needs of patients, families, and other members of the inter-disciplinary team.

What are the outcomes for safety

Identify real and potential unsafe environmental situations. Implement safety measures in the environment. Use available resources for safety information. Incorporate accident prevention practice into ADLs. Remain free of injury.

What are teaching tips in regards to older adults?

Identify safety hazards in the environment. Modify the environment as necessary. Attend defensive driving courses or course is designed for older adults. Encourage regular vision and hearing test. If prescribed, ensure that I glasses and hearing aids are available and functioning. Wear appropriate footwear. Have operational smoke detectors in place. Objectively document and report any signs of neglect or abuse.

The nurse is assisting a client to eat and notes that the client is pocketing food in his mouth. The nurse understands this behavior may be a symptom of

dysphagia.

Palliative Care

evolved from the hospice experience but also exists outside of hospice programs. Not restricted to end of life and can be used from the point of initial diagnosis.

The nurse is reviewing a client's diet before assisting with the meal. The nurse understands the food nutrient that provides the greatest source of concentrated energy for the client is

fats

Developmental Considerations for Nutrition - Adults

fewer calories are required because of decreased BMR.

1 g of protein or cabrohydrate = ?kcal

four

Which age groups are more likely to fall?

Infants in older adults are more prone to fall and injure

Why is it important to know teaching tips for safety regarding infants?

Infants process from rolling over to sitting, crawling, and pulling up to stand. They are very curious and will explore everything in the environment that they can.

What are safety risks for a neonate?

Infection falls ASSB

Identify and briefly explain Inflammatory response vs. Immune response

Inflammatory Response: protective mechanism that eliminates the invading pathogen and allows for tissue repair to occur. Inflammation helps the body to neutralize, control and eliminate the offending agent and prepare the site for repair. Immune Response: normal immune response involves the collective response of the immune system to an invading organism. The complex mechanisms that constitute the immune response occur as the body attempts to protect and defend itself.

What is the purpose and function of an incident report

Informed administration of the incident so management can prevent similar incidents in the future. Alerts administration in the faculties insurance company to a potential claim in the need for investigation.

Module E MSLO8: Discuss the primary reimbursement methods utilized in the U.S.

Insurance will no longer reimburse for hospital acquired infections or errors, such as amputating the wrong leg.

What is nuclear terrorism?

Intentional release of radioactive materials for the purpose of injury or death

A nurse caring for a client diagnosed with diabetes is aware understands it is considered a chronic disease. Which of the following is a characteristic of chronic diseases?

It causes permanent alterations in anatomy or physiology.

Why do you never flush medicine down the toilet.

It pollutes our water supply with the medication.

The nurse is assisting a client to eat who is experiencing altered cognition at mealtimes. Which nursing intervention would be most appropriate during this activity?

Keep food as close as possible to its original form.

What are three ways to prevent accidents in the home regarding fire arm safety?

Keep guns and ammunition stored separately and locked up. Install trigger locks on all guns. Make certain that the key to the locked gun storage area is not available to each child.

What are three ways to prevent asphyxiation or choking in the home?

Keep plastic bags out of a child's reach. Check that crib slats are no more than 2 3/8 inches apart. Ensure that the mattress fits the sides of the crib snuggly. Keep small objects such as jewelry buttons and safety pins out of a child's reach. Cover waiting pools in sandboxes when not in use.

What are three ways of preventing Falls and other injuries in the home?

Keep stairway is clear and uncluttered. Maintain walkways, stairs, and railings in good repair. Install safety gates a bottom and top of stairways. Apply a nonslip adhesive strips to the bottom surfaces of the tub and shower.

What are three ways to reduce the risk of injury in the home regarding preventing poisoning.

Keep the phone number for the local poison control center next to the phone. Color code medication bottles for those who are visually impaired. Store all medicines and child resistant containers in a locked medicine cabinet. Do not ever flush medicine down the toilet.

What is an elbow restraint?

Keeps elbows Straight, can be used on pediatric patients

What is an example of a chemical restraint?

Medication.

Sling Lifts

Most common transfer device Excellent for non-combative, non-weight bearing clients May be available with a scale Requires up to 2 person assist Can lift from bed, chair or floor

Explain a sling lift and why it is used

Most common transfer device, excellent for non-combative and non-weight bearing clients. Must not be combative and must be completely non-weight bearing! Maybe available with a scale, requires up to two person assist, can Lift from bed chair or floor

What are the safety risks associated with adolescents?

Motor vehicle accidents. Drowning. Guns and weapons. Inhalation and ingestion.

What is an ABC fire extinguisher?

Multipurpose dry chemical? Used on class A,B,and C fires

Protecting the Health Care Provider

NIOSH recommends that no caregiver should manually lift more than 35 lbs of a person′s body weight for a vertical lifting task. NIOSH further recommends that when the weight to be lifted exceeds this limit, assistive devices should be used. (2010) • •National Institute for Occupational Safety and Health ( Part of the CDC)

What is the role of the nurse?

Nurses supervise and coordinate direct care to patients and families. They teach the patient in the family self-care and conduct research to ensure cost effectiveness and quality of care.

Food is broken down in the gastrointestinal system into small substances called

Nutrients

Detailed Assessment of Oral Cavity

Observe for oral problems: - Dental caries - periodontal disease - other oral problems Identify actual or potential oral problems that nurses can treat. identify appropriate nursing measures Carry out plan of care.

What is the role of an occupational therapist?

Occupational therapist evaluate the patient's functional level in teaching activities to promote self-care in activities of daily living.

What is the age range of a toddler?

One to three years old

A nurse is admitting a client to a geriatric medicine unit. Which nursing action would the nurse perform to reduce the client's risk for a fall?

Orient the client to the room and environment upon admission.

How do you prevent falls?

Orient to environment, assess abilities and risk, supervised ambulation, act accessible call light, personal items, bed and chairs in low in locked position, assistive devices lights and shoes, uncluttering the area, monitoring devices, restraints whether they be physical or chemical but only if necessary.

Where are places that you can drop off all the medications?

Pharmacy dropbox, Police Department

Module E MSLO4: Identify factors that affect health and illness.

Physical Emotional Intellectual Environmental Sociocultural Spiritual

Why is it important to teach about neonate safety risks.

Physical care for the newborn includes maintaining a patent airway, protecting the baby from infection and injury, and providing optimal nutrition.

What does the concept of mobility fall under?

Physiological integrity Basic care and comfort Mobility

Positioning Clients

Pillows Mattresses Adjustable Beds Bed Side Rails Trapeze bar Additional equipment

Why are falls the leading cause of accidents for older adults?

Poor vision, cognitive dysfunction, mobility and gait disturbances or debilitation. Dizziness, urinary urgency, medications. Age over 65, history of falls, impaired vision or balance, altered gait or posture or impaired mobility, medication regimen, postural or orthopedic hypotension, slow reaction time weakness reality, confusion or disorientation, unfamiliar environment.

What are some of the teaching tips regarding adults?

Practice stress reduction techniques such as meditation and exercise. Enroll in a defensive driving course. Evaluate the workplace for safety hazards and utilize safety equipment as prescribed. Practice moderation when it comes to alcohol. Avoid using illegal drugs. Provide options and referrals to domestic violence victims.

A nurse is explaining nursing interventions to break the chain of infection to a group of newly licensed nurses. Which intervention would the nurse describe as the most effective?

Practicing hand hygiene

What is the role of a pharmacist

Prepared at the doctorate level, is licensed to formulate and dispense medications.

A nurse is giving a talk to a local community group on the importance of proper diet and regular exercise. This is an example of which type of health promotion?

Primary

Disease

is a medical term, referring to pathological changes in the structure or functions of the body or mind.

Illness

is the response of the person to a disease; it is a process in which the person's level of functioning is changed when compared with a previous level

What are some of the physiological hazards associated with restraints

Suffocation from entrapment, impaired circulation, altered skin integrity such as pressure ulcers, diminished muscle and bone mass, fractures, altered nutrition and hydration, aspiration and breathing difficulties, incontinence, changes in mental status.

What are teaching tips in regards to safety for infants

Supervise child closely to prevent injury. Select toys appropriate for developmental level use appropriate safety equipment in the home, locks for cabinets, gates, electrical outlet covers. Never leave child alone in the bathtub. Childproof the entire house.

The nurse is orienting a newly hired group of unlicensed assistive personnel (UAP). Which statement by the nurse related to positioning a client would be appropriate teaching?

Supported positioning promotes alignment and skin integrity.

True or False: Education of patients and health care workers as well as controlling all of the links in the chain of infection are methods that can significantly decrease and prevent HAI.

True

The nurse is providing dependent oral care to a non-responsive client. Which action would best protect the client's airway?

Turning the client to the lateral position

Factors Influencing PPE selection

Type of exposure anticipated - Splash/spray versus touch - Category of isolation precautions -Durability and appropriateness for the task -Fit

What is the role of an unlicensed assistant personnel?

UAP's help nurses provide direct care to patients.

How does environment affect safety

US residents at risk for exposure to potentially unhealthy substances in the environment. or high crime neighborhoods are more hazardous.

Many factors create health disparities in the United States (US). Which of the following is a continuing issue in the United States that contributes to health disparities?

Unequal access to health care for economically disadvantaged

What is a sentinel event

Unexpected occurrence involving death, serious injury such as loss of limb or function, or is it psychological injury, or the risk there of. Sentinel, signal need for immediate attention. Risk there of, any process variation that might cause serious adverse outcomes.

A nurse is caring for a confused client who is pulling on the indwelling urinary catheter. Which action would the nurse implement before calling the Primary Care Physician (PCP) for a restraint order?

Use a calm voice to distract and redirect client's behavior

What is inter-disciplinary collaborative care?

What happens when multiple health workers from different professional backgrounds work together with patients, families, carers, and communities to deliver the highest quality of care. The goal is to deliberately work together to build a safer and better patient centered and community or population oriented US healthcare system.

How does knowledge level affect safety?

an awareness of safety and security precautions is crucial for promoting and maintaining wellness throughout the lifespan.

Saturated fats are

animal fats, solid at room temperature, not good for you

How does sensory perception affect safety?

any impairment of the five senses

How it does mobility affect safety?

any limitation in mobility is potentially unsafe

How does communication ability affect safety?

basic for safety practices

What are nutrients?

biochemical substances used by the body

Examples of infections requiring droplet precautions

streptococcal pharyngitis or pneumonia, Haemophilus influenzae type B, scarlet fever, rubella, pertussis, mumps, mycoplasma pneumonia, meningococcal pneumonia and sepsis, pneumonic plague

How does psycho social state affect safety?

stressful situations tend to narrow a person's attention span and make the person more prone to accidents.

How does physical health state a fact safety

when a person is chronically ill or in a weakened state, the focus of health care includes preventing accidents as well as promoting wellness and restoring to a healthy state.

Six Classes of Nutrients

* Nutrients that supply energy carbohydrates, fats, proteins, * Nutrients that regulate body processes vitamins, minerals, water

Developmental Considerations for Nutrition - Infants

- Breastmilk is recommended for 6-12 months, or fortified formula. No cows milk before 12 months. Solid foods not introduced before 6 months. By 1 year of after typically eating table foods. Iron-fortified are recommended.

Demonstrate ability to feed the adult

- Involve person as much as possible - provide appropriate drinks - sit at eye level and make eye contact -place napkin over person's clothes - explain placement of food try - provide a straw - open containers, cut food, apply condiments - dentures, hearing aids, glasses needed

Nursing Interventions to assist clients in achieving an optimal nutrition status

- Provide proper and adequate nourishment to the patient is a collaborative effort, PCP, dietician, RN. - RN may be responsible for screening pts at home who are at nutritional risk, observing intake and appetite, evaluating the pts tolerance, and assisting the pt with eating. - Administering enteral and parenteral feedings, consulting with dietitian and PCP when dietary problems arise, addressing the potential drug-nutrient reactions, obtaining more food or snacks for the pt when appropriate, monitoring food brought by visitors, and participating in nutrition education efforts.

Enteral Feedings Pumps

- Regulates the amount of feeding solution delivered to the patient - Should be used for slow rates - Used in institutions or the home

Factors to reduce the incidence of healthcare-associated infection

- The best way to prevent is through frequent and effective hand hygiene. - constant surveillance by infection-control committees and nurse epidemiologists - written infection- prevention practices for all agency personnel. - infection control precaution techniques -keeping patient in best possible physical condition.

Contact precaution requirements:

- a private room or a room with other clients who have the same infection - gloves and gowns worn by the caregivers and visitors - disposal of infectious dressing materials into a single, nonporous bag without touching the outside of the bag.

As Needed Care (P.R.N. Care)

- offer individual hygiene measure as needed - change clothing and bed linens of diaphoretic clients - Provide oral care every 2 hours if indicated

CDC guidelines for maintaining infection control practices in the hospital

- use airborne precautions for patients who have infections that spread through the air such as TB, rubeola, and varicella. - droplet precautions should be used for patients with mumps, diphtheria, and pertussis. -use contact precautions when working with a patient with MRSA and VRE. - Wear a gown and gloves when you enter the room of a patient on contact precautions.

Reasons for Providing Back Massage

-Acts as a general body conditioner -Relieves muscle tension and promotes relaxation -Provides opportunity for nurse to observe skin for signs of breakdowns -Improves circulation -May decrease pain, distress, and anxiety -May improve sleep quality

Perineal and Vaginal Care

-Assess chart/history for perineal or vaginal problems and related treatments. -Perform a physical assessment of male and female genitalia. -Perform perineal care in matter-of-fact and dignified manner according to procedure. -Remember special considerations for uncircumcised males. -Cleanse vaginal area with plain soap and water.

Nail and Foot Care

-Assess nails for color and shape, intactness and cleanness, and tenderness. -Check for history of nail or foot problems. -Soak nails and feet and assist with cleaning and trimming nails (if not contraindicated). -Massage the feet to promote relaxation and comfort. -Provide diabetic foot care if indicated.

Care of Eyes

-Clean from inner to outer canthus with wet, warm cloth, cotton ball, or compress. -Use artificial tear solution or normal saline every 4 hours if blink reflex is absent. -Care for eyeglasses, contact lens, or artificial eye if indicated.

Indications of Parenteral Nutrition

-Clients who are unable to consume, digest, or absorb nutrients via the GI tract.

Identify factors that influence or affect personal hygiene

-Culture - socioeconomic class - health state -developmental level - personal preferences

Give an example of the following means of transmission: -Direct Contact Transmission - Indirect Contact Trasmission - Airborne

-Direct Contact Transmission: Human Immunodeficiency virus (HIV) Contact - Indirect Contact Trasmission: Borrelia burgdorferi, ticks, contact can be direect or indirect, Lyme disease - Airborne: cough, sneeze, talk, organism is attached to a dust particle.

Providing Scheduled Hygiene Care

-Gather info - make a plan of care - obtain needed supplies and equipment - collaborate with needed resources - integrate client's preferences/culture into the plan of care (POC)

Providing Hair Care

-Identify patient's usual hair and scalp care practices and styling preferences. -Note any history of hair or scalp problems such as dandruff, hair loss, or baldness. -Treat any infestations, such as pediculosis and ticks. -Groom and shampoo hair. -Care for beards and mustaches. -Assist with shaving, procedure in text, make note of precautions.

Statements regarding asepsis

-Includes all activities to prevent infection or break the chain of infection. - Surgical asepsis includes practices used to render and keep objects and areas free from microorganisms. - Medical asepsis techniques are appropriate for most procedures in the home. - Medical asepsis is known as "clean technique"

Denture Care

-Line the sink with a washcloth or soft towel - brush dentures-use cool or lukewarm water and special denture toothpaste - Dentures may be soaked in commercial preparation, brushed, and rinsed prior to use. - Allow client to brush gums and tongue prior to inserting dentures - Store dentures in cold water

When would you use surgical asepsis?

-OR, L&D -certain diagnostic testing areas -patient bedside (procedures that involves insertion of urinary cath, sterile dressing changes, or preparing and injecting medicines).

Care of Oral Cavity of a Dependent Client

-Provide oral care every 1-2 hours, as needed. - Place client in side-lying/ lateral position with head tilted forward - brush teeth, gums, and tongue carefully - Rinse with a toothette or syringe - Lubricate lips

Ear and Nose Care

-Wash external ear with washcloth-covered finger; do not use cotton-tipped swabs. -Perform hearing aid teaching and care if indicated. -Clean nose by having patient blow it if both nares are patent. -Remove crusted secretions around nose by applying warm, moist compress.

What do droplet precautions require?

-a private room or room with other clients who have the same infectious disease. Ensure the clients have their own equipment, -surgical masks for providers and visitors - Clients who have a this type of infection should wear a mask when outside of room/home.

Early Morning Care

-assist with toileting - provide comfort measures to refresh client and prepare for day - wash face and hands - provide mouth care

Risk factors that would indicate the need for the application of compression stockings

-deep vein thrombosis (DVT) - pulmonary embolism (PE) - prevent phlebitis-pain, redness, edema WHY? Increase the velocity of blood flow in leg veins - improve venous valve function - promotes venous return back to the heart

Statements that describe the processes of disinfection and sterilization

-disinfection destroys all pathogenic organisms except spores. - the process of sterilization destroys all pathogenic microorganisms including spores. - The CDC recommends that all supplies, linens, and equipment in a health care setting should be treated as if the patient were infectious.

isolation guidelines

-group of actions that include hand hygiene and use of barrier precautions, which are intended to reduce the transmission of infectious organisms. -apply to every client regardless of diagnosis, and must be implemented whenever contact with a potentially infectious material is anticipated. -PPE is changed after contact with each client and between procedures with the same client if in contact with large amounts of blood and body fluids. - clients in isolation are at a higher risk for depression and loneliness. Assist the client and their family to understand the reason for isolation and provide sensory stimulation.

Factors that effect host susceptibilty

-intact skin and mucous membranes -normal pH levels - body's WBCs - Age, sex, race, hereditary factors -immunizations, natural or acquired - fatigue, climate, nutritional and general health status - stress -use of invasive or indwelling medical devices

What factors determine the use of sterilization and disinfection methods?

-nature of organism present - number of organisms present - type of equipment - intended use of equipment - available means for sterilization and disinfection -time

What is the age range for an infant?

28 days to one year of age

What are factors that affect and organism's potential to produce disease?

1. number of organisms 2. virulence 3. competence of person's immune system 4. length and intimacy of contact between person and microorganism

Transmission Precautions (Tier 2)

1. Airborne 2. Droplet 3. Contact

What are the five steps to complete an incident report

1. Administer emergency care. 2. Notified charge nurse, unit manager, nursing supervisor, primary care provider, family members. 3. Follow PCP orders for follow up, x-rays or scans treatments and medications. 4. Document incident in the clients medical record incomplete facility report form. 5. Reassess client for further injuries and stability.

What are the 2 components of an immune response?

1. Antigen-antibody aka Humoral Immunity 2. Cell-mediated aka Cellular Immunity

Explain the body's natural defense against infection

1. Body system: skin, GI, respiratory, urinary, urinary, vaginal 2. Normal Flora 3. Inflammatory Response 4. Immune Response

Describe nursing interventions used to break the chain of infection

1. Frequent hand washing before and after care 2. Educate client about required and recommended immunizations and when to get them. 3. Educate the client, and ask for a return demonstration on oral hygiene. Can decrease the protein (which attract micro-organisms), in the oral cavity. 4. Encourage client to intake fluids. 5. For immobile patients, ensure that pulmonary hygiene is done every 2 hours. Coughing, turning, deep breathing, incentive spirometer). 6. Use of aseptic technique and proper PPE. 7. Teach the use of respiratory hygiene/cough etiquette. 8. Perform good hand hygiene.

What are the stages of an infection?

1. Incubation period: organisms growing and multiplying 2. Prodromal stage: person is most infectious, vague and nonspecific signs of disease. 3. Full stage of illness: presence of specific signs and symptoms of disease. 4. Convalescent period: recovery from the infection.

List the components in the Chain of Infection in the order in which an infection would occur

1. Infectious agent 2. Reservoir 3. Portal of exit 4. Means of transmission 5. Portal of entry 6. Susceptible host

What are the 6 components of the infection cycle?

1. Infectious agent (bacteria, viruses, fungi) 2. Reservoir (natural habitat of the organism) 3. Portal of exit (point of escape for the organism) 4. Means of transmission (direct contact, indirect contact, airborne route). 5. Portal of entry (point at which organisms enter a new host). 6. Susceptible host (must oversee resistance mounted by host's defense).

What factor predispose patients to healthcare- associated infections?

1. Nosocomial - hospital acquired caused by: - use of invasive medical devices - antibiotic resistant organisms developed in hospitals 2. exogenous- acquired from other people 3. endogenous- acquired from self 4. iatrogenic- treatment or diagnostic procedure.

stages of inflammatory response

1. Vascular Stage: dilation of small blood vessels causes redness and warmth. Histamine is released causing edema, pain, and loss of function. 2. Cellular Stage: leukocytes, neutrophils are released to fight infection and injury. By-product is exudate: clear-serous, red blood cells-sanguineous, pink drainage-serosanguineous, pus-purulent.

List three portals of exit in the human body

1. blood and tissue 2. respiratory, gastrointestinal, genitourinary 3. breaks in the skin

Removal of PPE

1. gloves 2.face shield or goggles 3.gown 4. mask or respirator 5. Hand Hygiene

Proper technique for application and removal of gloves

1. hand hygiene 2. put on gloves 3. grasp outside of glove with opposite gloved hand, turn inside out, slide two fingers into gloved hand removing at wrist not touching the outside of the glove, soiled glove goes in palm of hand still gloved, pull glove off inside out, disgard in container 4. perform hand hygiene

Proper application and documentation of extremity restrains

1. pt family must be consulted and told about facility policy. 2. Family must sign release form -have order from PCP -Provide supervision, justification, type of restraint, form of removal. -no PRN orders. -emergency case: order obtain immediately from PCP, must include duration, pt must be monitored and assessed every hour (different for every facility), if psych related must monitor every 15 minutes, document date, time, type, alternatives that were tried, notification of the family, notify PCP, frequency of assessment, time of restraint removal, all nursing interventions.

What is proper technique for handwashing?

1. remove jewelry 2. turn on water, adjust, regulate temp 3. wet hands and wrist area, keep hands lower than elbows 4. One full pump of liquid soap, cover all areas 5. firm rubbing, rub in circular motion, wash at least one inch above area of contamination. 6. wash hands for 20 seconds 7. clean under fingernails 8. rinse toward fingertips 9. pat hands dry with paper towel, throw out paper towel 10. get new paper towel to turn off water

List four factors that influence the susceptibility of a host

1. stress levels 2. level of fatigue, general and nutritional health, pre-exsisting conditions 3. Age, sex, race, and hereditary 4. Integrity of skin and mucous membranes.

Ideal Body Weight (Females)

100 lbs (for ht. of 5 ft.) + 5 lbs for additional inch over 5 ft.

Ideal Body Weight (Males)

106 lbs (for ht. of 5 ft.) + 6 lbs for additional inch over 5 ft.

What is the age range of adolescence?

12 years of age to 18

Lab Values: Hemoglobin (Hgb)

12-18 g/dL

Lab Values Sodium (Na+)

135-145 mEq/L

What is the age range of an adult?

18 years of age to 65

Lab Values: Prealbumin

23-43 mg/dL

What is the age range of a preschooler?

3 to 5 years of age

Lab Values: Serum Albumin

3.5-5.5 g/dL

Lab Values: Potassium (K+)

3.8-5 mEq/L

1 g of carbohydrate = ___ calories

4

What is the age range of a school age child?

5 to 12 years of age

Lab Values: Hematocrit (Hct)

40-50%

Lab Values: Fasting Glucose

60-100 mg/dL

What is the age range of an older adult

65 and older

The nurse is documenting the fluid intake of his client for the shift. The client consumed: 2 cups of coffee, 180 mLs of juice and 3 ounces of Milk of Magnesia. What is the client's total fluid intake in milliliters for this shift?

750 mLs

1 g of fat = ___ calories

9

What is continuation of care?

A process by which healthcare providers give appropriate, uninterrupted care and facilitate a patient's transition between different settings and level of care. Continuation of care in shares a smooth transition between care facilities.

What is a vail bed

A bed that looks like a tent, zips from the outside. Used for patients that wander at night, wander in to other patients rooms. This is a less restrictive than wrist restraints in for an adult.

Which risk factor would be the greatest threat to the client's skin integrity?

A decreased ability to move

Medicaid

A federal and state assistance program that pays for health care services for people who cannot afford them.

Medicare

A federal program of health insurance for persons 65 years of age and older

What is a restraint used on a baby in when would it be used?

A money restraint, would be used if baby how to get head sutured

What is the role of a physical therapist?

A physical therapist PT seeks to restore function or to prevent further disability in a patient after an injury or illness.

What is the role of a physician assistant?

A physician assistant or PA has completed a specific course of study and a licensing examination in preparation for providing support to the physician. The PAs responsibilities usually depend on the supervising physician and might include conducting physical examinations and suturing lacerations.

After finishing a lecture on sentinel and never events The nurse educator knows that the students understand the material when the students recognize which of the following never events? Select all that apply. A. A baby leaves the hospital with the wrong parents B. The wrong medication is given to the client C. A surgeon mistakenly operates on the wrong arm D. The client is left alone and falls breaking a hip

A, C

What are some teaching tips to reduce safety risk for a fetus

Abstain from alcohol and caffeine while pregnant. Stop smoking or reduce the number of cigarettes smoked per day. Avoid all drugs including over-the-counter drugs and less prescribed by healthcare provider. Avoid exposure to pesticides and certain environmental chemicals. Avoid exposure to radiation.

fat soluable vitamins are

A, D, E, K

To prevent falls in the elderly a nurse should? Select all that apply. A. Apply non skids socks or shoes to client B. Uncluttered the room C. Keep bed in high position D. Orient client to environment

A,B,D

What are some of the characteristics that may put a client at high risk for falls? Select all that apply. A. Confusion B. Wearing non-skid foot socks C. Medications D. Age

A,C,D

A nurse is assessing fire safety in a home in which a single mother and young children live. What information would the nurse include in teaching the mother on how to prevent injury from fires and burns? Select all that apply.

A. Cook on back burners on the stove, and keep handles turned toward the back. B. Practice a fire escape plan with your children and set a meeting place. C. Teach your children to stop, drop, and roll if clothing catches on fire. E. Set the temperature of the water heater to 120 °F (49 °C) or less.

A nurse is conducting a prenatal class for expectant parents. What is one topic that should be addressed to promote safety in the developing fetus?

Alcohol consumption and smoking

A Unlicensed assistive personnel (UAP) has bathed a client who is in bilateral wrist restraints. Upon assessing the client on hourly rounds, the nurse determines the client's wrist restraints pose a risk for injury to the client. What assessments would lead the nurse to reapply the wrist restraints? Select all that apply.

A. One finger can be inserted between the restraints and the client's wrists. B. The restraints are tied to the side rail of the bed. C. The client's hands have decreased circulation, movement and sensation (CMS).

What are safety risk factors for a fetus?

Abnormal growth and development

Why is it important to teach older adults about safety risks?

Accidental injuries occur more frequently in older adults because of decreased sensory abilities. Slower reflexes in reaction time, changes in hearing and vision, and loss of strength and mobility. Collaboration between family and health care providers can ensure a safe, comfortable environment and promote healthy aging.

When a person is exposed to an act of bioterrorism healthcare professionals should

Adhere to standard precautions recommended by the CDC.

Why is it important to teach safety for adolescence?

Adolescence is a critical period in growth and development. The adolescence needs increasing freedom and responsibility to prepare for adulthood. During this time the mind has a great ability to acquire and use knowledge. The teens pure group is a greater influence than parents during this stage.

A nurse is caring for a hospitalized client who has decided to refuse future resuscitation efforts because of the irreversible nature of her diagnosis. The client's family is not in agreement with this decision and is attempting to persuade the client to "do everything" to live. The nurse meets with the client's family in order to explain the client's perspective and choices related to this illness. What best describes this role of nursing?

Advocate

Morning Care (A.M. Care)

After breakfast, nurse completes morning care: Toileting Oral care Bathing Shaving Special skin measures Hair care, cosmetics Dressing Positioning for comfort Refreshing or changing bed linens Tidying up bedside Empty trash if needed

Tertiary Health Promotion Definition and Example

After diagnosis and treatment, goal of reducing disability. Ex. teaching pts. with diabetes how to recognize and prevent complications, using physical therapy to prevent contractures in a pt who has had a stroke or spinal injury, and referring a woman to a support group after removal of a breast because of cancer.

Factors that decrease BMR

Aging, prolonged fasting, and sleep

What are the three most common types of fire extinguishers,

Air pressurized water, CO2, and dry chemical

A nurse is caring for a client who has a high fever and is coughing and sneezing. If the nurse becomes infected from the client what is the most likely means of transmission?

Airborne route

The nurse is reviewing the lab values of a client who is diagnosed with chronic malnutrition and poor wound healing. Which lab value would be most appropriate for the nurse assess?

Albumin

Pureed Diet

Also known as a blenderized liquid diet because the diet is made up of liquids and foods blenderized to liquid form. All foods are allowed.

Exogenous

An infection caused by an organism acquired from another person

endogenous

An infection in which the causative organism is normally harbored within the patient.

Iatrogenic

An infection that occurs as a result of a treatment or a diagnostic procedure.

Why is it important to protect the fetus and learn safety risks?

Any factor chemical or physical can adversely affect the fertilized ova them embryo in developing fetus. A fetus is extremely vulnerable to environmental hazards

What is a restraint?

Any method (chemical or physical), Of restricting in individuals freedom of movement, physical activity, or normal access to the body

An orienting nurse is applying thigh high graduated compression stockings to a client at risk for lower extremity blood clots. Which action by the nurse would need corrective feedback by her manager?

Assisting the client to ambulate or sit in chair before applying the stockings.

Purposes of Bathing

Cleans/ Conditions the skin Decreases infection Promotes circulation Musculoskeletal exercise Stimulates quality of breathing Relaxation/Comfort Increase sensory input Enhance Self Image May strengthen nurse- patient relationship

Standard Precautions (Tier One)

Applies to all body fluids (except sweat), non-intact skin, and mucous membranes. b) Hand hygiene using alcohol based waterless product is recommended after contact with client, body fluids, and contaminated equipment. c) Alcohol-based waterless antiseptic is preferred unless hands are visible dirty, because alcohol based product is more effective in removing micro-organisms. - using non-antimicrobial or antimicrobial soap and warm water is recommended when visibly soiled with blood or bodily fluids. - Minimum of 15 seconds d) Clean gloves are worn when touching body fluids, non-intact skin, mucous membranes, and contaminated equipment e) Gloves are removed and hand hygiene performed between each client. f) Masks, eye protection, and/or face shield are required when care may cause splashing or spraying of body fluids. g) Hand hygiene is required after removal of the gown. A sturdy moisture-resistant bag should be used for soiled items and the bag should be tied securely in a knot at the top. h) All equipment used for client care is to be properly cleaned, one time use should be disposed accordingly. i) Contaminated laundry should be bagged and handled to prevent leaking or contamination of clothing or skin j) Safety devices on all equipment/supplies must be enabled after use; sharps must be disposed of in a puncture-resistant container k) A private room is not needed unless the client is unable to maintain appropriate hygiene practices.

Why is it important to teach adults about safety risks?

As people progress through the adult years, visible signs of aging become apparent. Lifestyle behaviors and situational or family crises can also impact in adults overall health and cause stress. Preventative health practices help adults improve the quality and duration of life.

What are safety tips for nurses to prevent back injuries, ergonomics?

Assess amount of assistance that is required, no lifting clients who can bear own weight, erect posture, broad base of support, use pelvic girdle, thighs and arms, not your back! Work closely to the body, slide roll poll or push but avoid lifting! Use gravity, gait belt and clients ability to assist, transfer on strong side and support clients weak side. Go slow! Use lift devices as needed.

What are five alternatives to restraints

Assess for pain and treat appropriately. Ask family members or significant others to stay with the patient. Reduce stimulation noise in light. Distract and redirect using a calming voice. Use low height beds. Provide a warm beverage. Provide comfortable rocking chairs. Use therapeutic touch.

A nurse enters a client's room and finds that the client has fallen on her way to the bathroom. What is a prudent nursing intervention for this client?

Assess the client's condition and provide emergency care for any injuries.

Dietary Data

Assessing Dietary Intake: o24 Hour Recall Method oFood Diary/Calorie Count oFood Frequency Record oDiet History Anthropometric Data includes: oHeight oWeight oTriceps Skin Fold Measurement oMid-Arm Circumference

The nurse is assisting a client to transfer from the bed to the chair. Which nursing action is a priority to address the client's safety?

Assessing for client for dizziness when sitting on the edge of the bed.

How do you as a nurse prevent injury to clients in the healthcare setting?

Assist patient when ambulating, can use lift devices, can use restraints ONLY WHEN INDICATED, Follow standard safety precautions for facility

water soluble vitamins

B and C

Appropriate teaching tips for adults with toddlers in the home would include all of the following except: A. Have poison control number available B. Make sure toddler is placed in seatbelt in backseat C. Make sure hot pans on stove cannot be reached D. Never leave the child alone outside

B. Make sure toddler is placed in seatbelt in the backseat. Toddler needs to be in a car seat in the middle of the back seat.

A client who has had abdominal surgery develops an infection in the wound while still hospitalized. Which agent is most likely the cause of the infection?

Bacteria

What are types of infectious agents?

Bacteria: most significant and most prevalent in hospital settings, aerobic/anaerobic. Virus: smallest of all micro-organisms Fungi: plantlike organisms present in air, soil, and water.

What is the responsibility of the nurse in operating, maintaining, and reporting defective equipment.

Be familiar with all equipment in use only for its intended use. Do not use any equipment you have not received training on. Handle equipment with care so as not to damage it. Use three prong plugs. Do not twist or bend electrical cords. Be alert to signs at equipment is faulty, tag equipment and take out of service is faulty. Take to soil utility room and call engineering or maintenance to report the defective equipment. Be alert to wet surfaces

Hours of Sleep (H.S. Care)

Before Client Retires: - offer assistance with toileting, washing face, and hands, and oral care. - offer a back massage, if applicable - Change any soiled bed linens or clothing - Position patient comfortably - Ensure that call light and other objects patient requires are within reach.

Developmental Considerations for Nutrition - Pregnancy and Lactating Women

Breast milk production depends on calorie intake. Should have protein, calories, iron, folic acid, calcium, and iodine.

Care of Oral Cavity

Brush teeth and tongue with soft bristled toothbrush immediately after eating or drinking. Place brush at a 45 degree angel to gum line. - brush from gum line to crown of teeth - inner and outer surfaces -back and forth across biting surface of each tooth Floss once per day - move floss up and down on both sides of each tooth Mouth wash -client pref. Lubricate lips

What are the safety risks for school age children?

Burns, drowning, broken bones, concussions TBI, inhalation or ingestion, guns and weapons, substance abuse.

Considerations when feeding client with cognitive impairment

COGNITIVE IMPAIRMENT -Change the environment in which meals occur - assess the area where meals are served, create homelike environment. - hand-washing, blessing, preform rituals - avoid clutter or distraction - maintain a pleasant well lit room, calm music. -Mealtime, same time, same place - Check food temps - Assist as needed - Provide one food item at a time - Glasses, hearing aids, dentures - demonstrate what you want the client to do - provide foods that are easy to use with just hands - adaptive feeding equipment - promote family involement

Developmental Considerations for Nutrition - Older Adults

Calorie needs decrease. Need protein, vitamin B and calcium.

Developmental Considerations for Nutrition - Toddlers and Preschoolers

Can feed themselves, verbalize likes and dislikes, can use food to manipulate parents. Don't inappropriately use food (punish, reward, bride, covey love). Often lack fruits and veggies & drink too much juice.

What is a type B fire extinguisher?

Carbon dioxide, used on flammable liquids and gases.

Module E MSLO3: Understand the causative factors and effects of health disparities

Causative Factors: Influenced by many different factors including race and ethnicity, poverty, biological sex, age, mental health, educational level, disabilities, sexual orientation, health insurance, and access to health care. Effects: certain groups would be looked over, lack medical care, would have an increase in preventable diseases, etc.

Graduated Compression StockingsTED hose/Antiembolism Stockings Steps for Application

Check MD order Preform hand hygiene Assess legs-skin condition/circulation Measure legs for proper size Turn the stockings inside to the heel Put the stocking on the client's foot Pull the remainder of the stocking over the client's heel and up the leg Smooth any creases or wrinkles

The nurse is administering an enteral feeding to a client with a feeding tube. What is the priority nursing action for this intervention?

Check for appropriate tube placement.

Developmental Considerations for Nutrition - Adolescents

Childhood nutrition problems often worsen through adolescence. Tend to skip breakfast, low-quality diet. Consumer inadequate amounts of fruits and veggies, whole grains, and dairy products. Nutrition needs especially for calories, protein, calcium, and iron increase to support growth. Girls might be more weight conscious and may develop eating disorders. Other unhealthy behaviors include diet pills, fasting, and laxative abuse.

A nurse has completed morning care for a client. There is no visible soiling on the nurse's hands. What type of technique is recommended for hand hygiene?

Clean hands with an alcohol-based handrub.

The nurse is assessing the bathing technique of an unlicensed assistive personnel (UAP). Which action by the UAP would require corrective feedback from the nurse?

Cleaning the upper leg then moving towards the ankle to clean

Ensure bedside safety

Client call light is functioning and within reach Bed is positioned properly, at appropriate height, wheels locked Side rails are safely used when indicated Principles of medical asepsis are followed Electrical equipment is safely grounded Walk space is uncluttered

How should a nurse identify clients risk to suffocation and choking?

Common causes of suffocation or drowning choking on a form of substance in health into the trachea and gas or smoke poisoning. An infant may suffocate on a pillow or a piece of plastic in advertently covers the nose and mouth. Infants are most at risk of suffocation when they are sleeping. Young children may be strangled accidentally by the shoulder harness of a seatbelt and become trapped while playing in a discarded refrigerator and suffocate. Drowning is a form of suffocation approximately one in five people who die from drowning are children age 14 and younger. Assess the knowledge level of people especially parents is vital

Voluntary facilities

Community facilities are often nonprofit voluntary facilities. Ex. Meals on Wheels, American Heart Association, American Lung Association. Voluntary facilities may also provide a setting for support groups such as AA, Cancer support groups, and Reach to Recovery.

What should be in an incident report?

Complete name of person and names of witnesses. Objective description of the event. Pertinent characteristics of person involved. Any equipment or resources being used. Any other important variables. Documentation by physician of medical examination of person involved. Reviewed by committee to prevent reoccurrence of incident.

Clear Liquid Diet

Composed only of clear fluids or foods that become fluid at body temperature. Requires minimal digestion and leaves minimal residue. Includes clear broth, coffee, tea, clear fruit juices (apple, cranberry, grape), gelatin, popsicles, commercially prepared clear liquid supplements.

What does this acronym stand for CUS

Concerned, uncomfortable, safety issue.

What is an incident report?

Confidential document, may be used later in litigation. Not part of the medical record and should not be mentioned in the nursing note documentation. Objectively describes the circumstance of the incident. Date, time, place of incident. Details the client/visitor response, examination, treatment. Reviewed by committee to prevent reoccurrence of

How should the nurse identify a client risk to poisoning?

Consider a persons developmental stage when making a safety assessment. Younger children are more apt to ingest household chemicals due to unsafe storage whereas older adults may swallow medicines in an attempt suicide. Adolescents and young adults may experiment with drugs and ask lead to accidental poisoning and death. Talk to toxic substances include unsafe storage in the home, spending time in environment other than the home, lack of attention on the caregiver, rise in multi generationalFamilies.

What are the modes of transmission?

Contact Routes: -direct: touch, kiss, sexual intercourse -indirect: fomites (inanimate objects) such as surgical instruments and needles, other things such as water and food. - vector: animal or insect Airborne: droplets of dust

What are the contaminated and clean areas of PPE?

Contaminated: outside, front Clean: inside, outside back, ties on head and back

A nurse walks into a clients room and sees a smoldering fire coming from the trashcan. The first thing the nurse should do is: A. Take the trashcan into the hallway B. Put out the fire using the best method C. Notify the charge nurse that there's a fire in the clients room D. Remove the client from the room

D

A physician writes in order to apply wrist restraints to a client who is very agitated in pulling on his IV which of the following is the correct order for applying restraints? A. Explain the procedure and reason for application B. Wrap restraints around wrist with soft part towards the skin and secure it C. Inspect the condition of the skin on the wrist D. Identify the client

D, A, C, B

Supine Slide Boards

Decreases friction significantly Usually used in bed- to- stretcher transfers Useful for bridging small gaps Reduces friction during transfers Requires at least 2 person assist Requires good use of body mechanics

What is a supine slide board and what is it used for

Decreases friction significantly, usually used in bed to a stretcher for transfers, useful for bridging small gaps, reduces friction during a transfer, requires at least two people, requires good use of body mechanics.

What is bioterrorism?

Deliberate spell spread of pathogens to cause widespread illness, fear, panic

How can the nurse best ensure continuation of care?

Depends on excellent communication as patients move from one caregiver or healthcare site to another. Too often communication breakdown among caregivers results and medical errors and deficient care plans.

Normal/regular or house diet

Designed to achieve optimal nutritional status by providing adequate amounts of all nutrients. No food excluded. Portion sizes not limited. All selected by patient. Adjusted to meet age specific needs throughout life cycle.

Factors that affect safety and an individual's environment

Developmental considerations, lifestyle, mobility, sensory perception, knowledge, ability to communicate, physical health state, psychosocial health state

The nursing instructor has given an assignment to a group of nurse practitioner students. They are to break into groups of four and complete a health-promotion teaching project, then present a report back to their fellow students. Which project is the best example of health-promotion education?

Discussing the importance of preventing sexually transmitted infections (STIs) to a group of 12th-grade students

What is a type C fire extinguisher?

Dry chemical powder, used on electrical fires.

For whom should we use standard precautions?

Everyone

MSLO2: Identify client at risk for injury

Everyone is at risk for injury from fetus to older adult.

What are personal risk factors of back injury for a nurse?

Excessive weight, poor posture, excessive stress or lack of rest, not using proper equipment, smoking could lead to a decrease in bone density, this was talked about in the PowerPoint regarding evidence-based practice, sedentary lifestyle, improper body mechanics, not using safety standards.

What is a never event

Extremely rare medical errors that should never happen. Surgery on incorrect body part or patient. Foreign objects left inside after surgery. Infant discharged to wrong family.

What are the safety risks for a preschooler?

Falls, cuts, burns, drowning, inhalation or ingestion, guns and weapons

What are the safety risks associated with an infant?

Falls, injuries from toys, burns, suffocation and drowning, inhalation or ingestion of foreign bodies.

What are some of the safety risks associated with older adulthood

Falls, motor vehicle accidents, elderly abuse, sensory motor changes, fires.

What are the safety risks associated with a toddler?

Falls. Cuts from sharp objects. Burns. Suffocation or drowning. Inhalation or ingestion of foreign bodies/poisons.

What is a neonate?

First 28 days of life

Protective Positioning

Fowler's position Supine or dorsal recumbent position Side-lying or lateral position Modified Lateral or oblique position Prone position

Explain a patient discharging.

From a healthcare facility when the expected outcomes of care are met and the patient or caregiver has the necessary knowledge and skills to provide any additional care still needed. In meeting the needs of the patient being discharged from the healthcare setting the nurse considers at the person may be expecting a change from a dependent role to a more independent role. Involves discharge planning, education, setting goals for patient, evaluating discharge planning effectiveness.

Module E MSLO9: Understand basic nursing strategies for providing cost effective healthcare.

Frontline workers are able to eliminate unnecessary supplies, advocate against unnecessary treatment and medication.

Clinical Data - Signs and Symptoms of Altered Nutrition

General Vitality Hair Skin Gums Muscles

Physical Assessment for Mobility

General ease of movement and gait Alignment Joint structure and function Muscle mass, tone, and strength Endurance

Discuss the content and purpose of a safety data sheet information.

Gives information about a product and how to handle safely, what to do if spill or exposure occurs. Each area should have SDS for products used in area. Master list of SDS kept in certain areas online or hardcopies. Purchasing department usually responsible for obtaining and routing SDS to proper areas.

A nurse has finished a wound irrigation for a client who requires contact precautions. Which of the following items of personal protective equipment (PPE) should the nurse remove first?

Gloves

Types of PPE used in the Healthcare Setting

Gloves: protect hands Gowns/aprons: protect skin and/or clothing Masks and respirators: protect mouth and nose Respirators: protect respiratory tract from airborne infectious agents Goggles: protect eyes Face Shields: protect face, mouth, nose, and eyes.

PPE for standard precautions

Gloves: use when touching blood, body fluids, secretions, excretions, contaminated items, for touching mucus membranes and non-intact skin. Gowns: use during procedures and patient care activities when contact of clothes and exposed skin with blood/body fluids, secretions or excretions is anticipated. Mask, and googles or face shield: use during patient care activities likely to generate splashes or sprays of blood, body fluids, secretions or excretions.

Sequence for donning PPE

Gown first Mask or respirator Goggles or face shield Gloves * Combination of PPE will affect sequence - be practical

Factors that increase BMR

Growth, infections, fever, emotional tension, extreme environmental temperatures, elevated levels of certain hormones

What is an example of a physical restraint?

Hand mitts, quick release wrist restraints, wrist restraints with locks.

What are three ways to reduce injury at home in regards to fire and burn safety?

Have a list of emergency phone numbers posted near the phone. Install smoke detectors in each room with a minimum of one on each floor. Have a fire extinguisher available on each floor and know how to use it.

What are strategies to reduce the risk of injury in the home?

Have fire and burn safety, electrical safety preventative poisoning, preventing Falls and other injuries, fire arm safety, preventing asphyxiation or choking.

What are teaching tips regarding safety for toddlers?

Have poison control center phone number in readily accessible location. Use appropriate car seat for toddler. Supervise child closely to prevent injury. Childproof house to ensure that poisonous products, drugs, guns, and small objects are out of the toddler his reach. Never leave the children alone and unsupervised outside. Keep all hot items on stove out of child reach.

Vegitarian diets

Have this diet for a variety of reasons such as personal preference, religious reasons, ethical beliefs, fear of contamination of pesticides, health concerns about cholesterol and saturated fats. Can just avoid red meat, or no animal product at all.

A client reports to the nurse he becomes short of breath when attempting to bath every morning. This client is experiencing which type of factor related to personal hygiene?

Health state

A nurse is caring for a client who has been place on Tier 2 precautions. During this hospitalization, the client has been diagnosed with a methicillin-resistant Staphylococcus aureus (MRSA) infection after for hip replacement surgery. What is the term given to this type of infection?

Healthcare-associated (HAI)

Unsaturated fats? Healthy or unhealthy Liquid or solid

Healthy, liquid at room temp

What are involuntary actions?

Heartbeat, hiccups, digestion, coughing, sneezing.

The dietitian is reviewing types of modified consistency diets with the nursing staff. Which of the following would not be discussed?

High fiber

What are the joint commission safety goals?

Improve patient identification. Improve communication among caregivers. Improve safety of high alert medications. Illuminate wrong site wrong patient wrong procedure in wrong surgery. Improve safety using infusion pumps. Improve effectiveness of clinical alarm systems. Reduce risk of healthcare acquired infections.

A nurse knows that a health care facility should determine its disaster-preparedness plan for delivering care in the event of an emergency or disaster?

In advance of a possible emergency or disaster

What are the different names for an incident report

Incident, event, a regular occurrence, variance report.

Assessment of Oral Cavity

Lips Buccal mucosa Color and surface of gums Teeth Tongue Hard and soft palates Oropharynx

List three ways to reduce the risk of injury in the home in regards to electrical safety?

Maintain electrical cords in good condition. Protect unused electrical outlets with safety covers. Use the proper replacement for a blown fuse.

A nurse makes a medication error and fills out an incident report. What will the nurse do with the incident report once it is filled out?

Maintain it according to agency policy.

Which patients do you take first if a fire occurs?

Make sure ambulatory patients are the first to leave. Ambulatory patients can also help wheelchair-bound patients therefore getting twice as many patients out as once. Bedridden patients require more than one nurse therefore you are helping less people.

How can the nurse identify a client Risk with fire arm injuries

Make sure gun is stored properly, guns can be extremely dangerous. Young children are curious and like to explore their surroundings when they encounter a loaded gun the outcome is often tragic having guns in the house increases the risk for domestic homicide threefold. Nurses need to approach the topic in a nonjudgmental manner with the focus on injury prevention. The intent is to inform families about the risks of firearm injury and discuss appropriate safety measures.

What is the role of a dietitian?

Managers and plans for the dietary needs of patience, based on knowledge about all aspects of nutrition.

Nothing By Mouth

NPO. Prevent aspiration related to anesthesia and after surgery until bowel sounds return. May be necessary for patients undergoing certain medical tests; for pts experiencing severe nausea and vomiting, an inability to chew or swallow, or various acute or chronic GI abnormalities; for those who are comatose; and women in L&D.

Where should an incident report never be documented

Never ever ever document that there is an incident report in the medical record do not mention in a nursing note! Not part of the client record! Never say you completed an incident report.

Does wearing gloves eliminate the need for proper hand hygiene?

No it does not.

An infection that was not present or incubating at the time of admission to the hospital or in a health care setting is known as ______ or more recently the term is called ________

Nosocomial Healthcare- associated Infection

What are some of the dangers of restraints, think of the pictures in the PowerPoint.

Patient could get hurt with restraints, fall out of the bed and get tied up in them, legs hanging off the body hanging off slouching out of chair.

When is an incident report appropriate?

Patient falls, wrong medication given, postpartum hemorrhage. Monitoring air, wrong patient, wrong time, wrong route, wrong dose, medication DC but given, wrong drug, medication ordered, wrong drug preparation, wrong rate of and ministration, given to patient with known allergy

Developmental Considerations for Nutrition - School Aged Children

Permanent teeth erupt. Focus on health promotion. Increased energy requirements, need foods with high nutritional value. Parent's role as the primary regulator of food intake diminishes, and advertising has made more impact on the child's food choices.

Module E MSLO1 : Summarize the nurse's role in promotion of health and prevention of illness.

Promote Health: - health literacy - healthy people 2020 - ex. Increase pt. awareness that health is more than just not being ill, teach behaviors and factors that can contribute to or diminish health. Serve as a role model Prevent Illness: - Anticipatory Care - Education - Ex. Educational programs such as prenatal care for pregnant women, smoking cessation programs, and stress-reduction seminars. Community programs.

Primary Health Promotion Definition and Example

Promote health, prevent disease development. Ex. immunization clinics, family planning services, providing poison control info, and accident prevention education. Teach about healthy diet, importance of exercise, safety in industry and farms, using seat belts, and safe sex practices. Health risk assessments are an important part of primary health promotion and preventative care.

And awareness of safety and security precautions is crucial for

Protecting clients and maintaining personal wellness

Providing a bed bath

Provide articles for bathing on overbed table or bedside stand. Provide privacy for patient. Remove top linens and replace with bath blanket. Place cosmetics in convenient place. Assist patients who cannot bathe themselves completely.

Standing Transfer Device

Pt must be weight bearing Pt involvement and cooperation required Dressing and bathing may be accomplished Walking is possible May be difficult to move on carpeted surfaces Device very maneuverable Excellent for use on a commode and transfer to a wheelchair May be used by a single operator

What are chemicals used for mass destruction

Pulmonary agents, blood agents, vesicants, nerve agents, incapacitating agents

What are the steps to follow in a fire

Put out small fires if possible, call fire department. Evacuation. Alarm. Notify hospital switchboard. Close windows and doors in the area. Turn off oxygen and electrical appliances. Clear exits and fire doors. Contain smoke and protect patients from inhaling smoke. Do not use the elevator during a fire.

What is the most important step to complete an incident report?

Re-assess the client for further injury instability. Ex. A bruise may not show up right away but after reassessment you might be able to see a bruise.

What are the hallmark signs of infection?

Redness Heat Swelling Pain Loss of Function

Mechanically Altered Diet

Regular diet with modifications for texture. Excludes most raw fruits and vegetables and foods with seeds, nuts, and dried fruits. Foods are chopped, ground, mashed or soft.

What does race stand for?

Rescue, activate the alarm, confine, extinguish

The nurse is assisting with the hygiene of an uncircumcised client. Which of the following would be the most important nursing action?

Returning the client's foreskin to the appropriate position after retracting.

Where does the concept of safety fall under?

Safe and effective care Safety infection and control Safety

A student nurse is preparing to do a health fair project aimed at drug and alcohol abuse. For which group of clients should this education begin?

School aged children

Why is it important to teach tips regarding school age children safety?

School-age children have developed more refined muscular coordination, but increasing involvement in sports and play activities increases the risk of injury. TBI can cause disruption and brain function and death. Cognitive maturity improves their ability to understand safety instructions

Secondary Health Promotion Definition and Example

Screen for early detection, and prompt diagnosis and treatment. Ex. screenings (BP, cholesterol, skin cancer), recommending gyneco. examinations and mammograms for women at appropriate age, and teaching testicular self examination for males. Assessing children for normal growth and development, and encouraging regular medical, dental, and vision examinations. Direct nursing care interventions at the secondary level include administering medications and caring for wounds.

What is an SBAR? I&Q?

Situation background assessment recommendation. This should be given when patients move from one Nurse to another or one facility to another. I is for introduction. Q is for a question and answer.

What is the role of a social worker?

Social workers assist patients and families in dealing with the social, emotional, and environmental factors that affect her well-being.

What are some of the safety risks that are associated with adults?

Stress, domestic violence, motor vehicle accidents, industrial accidents, drug and alcohol abuse.

What are teaching tips regarding school age children safety

Teach accident prevention at school and home. Teach children to our safety equipment when playing sports. Reinforced teaching about symptoms that require immediate medical attention. Continue immunization as scheduled. Provide drugs, alcohol, and sexuality education. Reinforce the use of seatbelts and pedestrian safety.

What are teaching tips regarding safety risks with adolescents?

Teach responsibilities of new freedoms that a company being a teenager. Enroll team and safety course at such as drivers education water safety and emergency care measures. Emphasize gun safety. Get physical examination before participating in sports. Make time to listen to and talk with your adolescence this helps with stress reduction. Follow healthy lifestyle such as nutrition rest and more. Teach about sexuality sexually transmitted infections and birth control. Encourage child to report any sexual harassment or abuse of any kind.

What is the role of an advanced practice registered nurse?

The advanced practice registered nurse APRN is a registered nurse educated at a masters or post masters level in a specific role and for a specific population.

What is chemical terrorism?

The deliberate release of a chemical compound that has the potential to cause health problems

What is remission?

The disease is present, but the person does not experience symptoms.

What is the reason for the phrase "chain of infection"

The goal is to break the links of the chain to end the cycle.

Energy

The human body needs energy to function. Energy is obtained from ____ Energy in the diet is measured in the form of kilocalories, which is commonly abbreviated as calories.

Why is it important to note teaching tips regarding preschooler safety?

The more independent, preschooler still have an immature understanding of dangerous behavior. They may strive to imitate adult in this attempt dangerous behaviors

What is a standing transfer device?

The patient must be weight-bearing! Patient involvement and cooperation are required. Dressing and bathing may be accomplished. Walking is possible. May be difficult to move on carpeted surfaces, device very maneuverable, excellent for use on a commode and transfer to wheelchair, maybe used by a single operator.

What occurs during the prodromal stage of an infection?

The person is most infectious during this stage. Signs and symptoms are present, but they are often vague and nonspecific.

What is the role of a physician?

The physician is primarily responsible for the diagnosis of illness in the medical or surgical treatment of that illness.

What is the role of a speech therapist?

The speech therapist is trying to help here in impaired patients speak more clearly, to assist patients who have had a stroke to re-learn how to speak, and to correct or modify a variety of speech disturbances in children and adults.

What is exacerbation?

The symptoms of the disease reappear.

Why is it important to know teaching tips regarding toddler safety?

Toddler is accomplish a wide variety of developmental task and progressed to walking and talking. They become more independent and continue to explore their environment.

What is the role of a respiratory therapist?

Trained in techniques that improve pulmonary function and oxygenation.

What are airborne precautions and when do you use them?

Use to protect against droplet infections smaller than 5mcg (measles, varicella, pulmonary or laryngeal TB). Requirements: - private room - masks and respiratory protection devices for caregivers and visitors. ( Use N-95 or efficiency particulate air (HEPA) respirator if the client is known or suspected to have TB. - Negative pressure airflow exchange in the room of at least 6 to 12 exchanges per hour, depending on the age of the structure. - if splashing of spraying is possible then wear a full face shield (eyes, nose, mouth). - Client who have an airborne infection should wear a mask while outside of the room/home.

What are teaching tips to reduce safety risks for a neonate?

Wash hands frequently. Never leave infant unsupervised on a raised surface without rails. Use appropriate infant car seat that is secure in the backseat facing the rear of the car. Handle infant securely while supporting the head. Place infant on back to sleep.

What is a type a fire extinguisher

Water, used on paper word cloth plastic and people

Where do you patients transfer between?

Within the hospital. To and from acute care settings in long-term settings. From acute care settings to patient's home. From ambulatory care settings to acute care settings.

Do nutrient needs change throughout life?

Yes

health disparity

a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.

Health

a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

Wellness

a term often used interchangeably with health- is an active state of being healthy, including living a lifestyle that promotes good physical, metal, and emotional health.

Respite Care

a type of care provided for caregivers of homebound ill, disabled, or elderly patients. The main purpose is to give the primary caregiver some time away from the responsibilities of day to day care.

Explain the difference between vector and fomite (vehicle) indirect transmission

a vector is a living creature that transmits an infectious agent to a human, usually an insect. A fomite is an inanimate object such as equipment or countertops.

Standing transfer devices or stand assist lifts differ from other transfer equipment because they

can be operated by a single health care worker or operator.

Which nutrients provide energy?

carbohydrates, fats, proteins

How does lifestyle affect safety?

certain occupations and recreational activities place people in more hazardous situations.

The nurse has completed a client's bed bath except for the perineal area. To begin this part of the bath the nurse should first

change the bathing water, gloves and bathing cloth.

Discuss principles of basic skin assessment

cleanliness, color, temp, turgor, moisture, sensation, vascularity, evidence of lesions. Guidelines for assessing the skin: - proceed systematically in head-to-toe assessment - use good source of light, preferably daylight - compare bilateral parts for symmetry - use standard terminology to report and record findings - allow data obtained to direct skin assessment - identify variables known to cause skin problems.

Full Liquid Diet

clear liquids + liquid dairy products, all juice, strained fruits, vegetables, and cereals

Serum albumin

if decrease, malnutrition if over hydrated, numbers will be lower if dehydrated, number will be higher

Prealbumin

if decrease, means protein depletion/ malnutrition

Hematocrit

if decreased, anemia

What is morbidity?

how frequently a disease occurs

How does developmental level affect safety?

health care needs and safety risks change from infancy to adulthood.

The nurse is providing education about age related nutritional changes to a client. Which of the following would not be accurate? Older clients may experience

increased peristalsis.

Proper Application of Compression Hose

http://www.nrsg101.com/proper-application-of-ted-hose.html

How to change an Occupied Bed

https://www.google.com/search?rlz=1C1GCEA_en___US795&q=how+to+change+sheets+for+bedridden+person&sa=X&ved=0ahUKEwj_rcKB_rzbAhXQoFMKHZIfApMQ1QII2wIoAw&biw=1280&bih=918#kpvalbx=1

Stand Assist Lift

https://www.youtube.com/watch?v=frYlqJQmotQ https://www.youtube.com/watch?v=KICUlpmZsmk

What are possible reservoirs for micro-organisms

humans, animals, soil, food, water, milk, inanimate objects

Hemoglobin

if decrease, anemia measure of plasma protein and iron

Examples of infections requiring airborne precautions

measles, varicella, pulmonary or laryngeal TB

Intermittent Feedings

o are the preferred method. oFeedings are delivered at regular intervals, in equal portions, over a set amount of time. oBolus intermittent feedings may place the client at risk for aspiration (syringe). oProvide the client with a more normal pattern of intake. oAllow the client freedom of movement between feedings.

Cyclic Feedings

oAdministering continuous feedings for a portion of the 24 hour day... usually at night. oAllows the client to attempt to eat oral meals during the day.

Continuous Feedings

oMust use pump, risk for reflux and aspiration. oLimit the client's movement.

Enteral Feeding Formulas

oStandard formulas contain intact molecules of protein, carbohydrates, and fats... requiring client to have a functioning GI tract. oFeeding rate is increased based on client's tolerance.

Methods for confirming correct placement of Feeding Tube Placement

oX-Ray - Initially o*Aspirate pH level: •Stomach - pH less than 5.5 •Intestines - pH 7 or greater •Respiratory tract - pH 6 or greater oVisual assessment of aspirate oMeasurement of tube length and markings oCarbon Dioxide Monitoring - CO2 Detector

Explain and give an example of a reservoir

people, animals, soil, food, water, milk, inanimate objects

A college-aged student has influenza. At what stage of the infection is the student most infectious?

prodromal stage

Hospice

program of palliative and supportive care services providing physical, psychological, social, and spiritual care for dying people, their families, and other loved ones.

What are droplet precautions?

protect against droplets larger than 5mcg and travel 3-6 ft from the client (streptococcal pharyngitis or pneumonia, Haemophilus influenzae type B, scarlet fever, rubella, pertussis, mumps, mycoplasma pneumonia, meningococcal pneumonia and sepsis, pneumonic plague).

What are contact precautions?

protect visitors and caregivers when they are within 3 ft of the client against direct client and environmental contact infections (respiratory syncytial virus, shigella, enteric disease cause by micro-organisms, wound infections, herpes simplex, impetigo, scabies, multidrug-resistant organisms).

The nurse changing a client's brief understands resecuring or reattaching the undergarment tapes to the soiled brief surface

protects the client's skin.

Nursing Considerations and Interventions for Feeding Clients with Dsyphagia

provide at least a 30 minute rest period prior to mealtime, sit the pt upright at a 90 degree angle, provide mouth-care right before the meal, don't rush or force feed, collaborate with speech therapy to obtain a swallowing eval, initiate nutrition consult for appropriate diet modifications, some pts might not enjoy thickened liquids, reduce or eliminate distractions.

What is surgical aspepis

refers to the use of precise practices to eliminate all micro-organisms from an object or area and prevent contamination ("sterile technique").

What is medical asepis

refers to the use of precise practices to reduce the number, growth, and spread of micro-organisms ("clean technique").

Examples of infections requiring contact precautions

respiratory syncytial virus, shigella, enteric disease cause by micro-organisms, wound infections, herpes simplex, impetigo, scabies, multidrug-resistant organisms (MRSA).

Common portals of entry for Micro-organisms

respiratory, GI, genitourinary tract, breaks in the skin, blood and tissue. ** Often the same options for portal of exit

Nursing actions to stimulate appetite

serve small frequent meals, solicite food preferences, bring food from home, provide encouragement and a pleasant eating environment, attractive food, schedule procedures and meds when they are least likely to interfere with meds.

What is mortality?

the number of deaths resulting from a disease

What is comorbidity?

the simultaneous presence of two chronic diseases or conditions in a patient

Body Mass Index in kg

wt in kg. ________________________________ (ht. in meters) x (ht. in meters)

Body Mass Index in lb

wt in lbs _________________________ (ht in in) x (ht in in) MULTIPLY BY 703

Hosehold and Metric Measures

•1 teaspoon (tsp) = 5 ml •1 tablespoon (tbs) = 15 ml •1 cup (c) = 240 ml = 8 ounces •1 bowl = 240 ml = 8 ounces •1 fluid ounce (fl oz) = 30 ml

Visualize Portion Sizes

•3 oz of meat = deck of cards •¼ c of dried fruit = golf ball •1 ½ oz of cheese = nine volt battery •½ c ice-cream = racquetball •2 tbs peanut butter = ping pong ball

What is water

•Accounts for 50-60% of adult's total body weight •Two-thirds of body water is contained within the cells (ICF) •The remainder of body water is extracellular fluid (ECF), body fluids (plasma, interstitial fluid) •Provides fluid medium needed for all chemical reactions of the body •Acts as a solvent and aids digestion, absorption, circulation, and excretion

Promoting Client Comfort with Enteral Feedings

•Administer oral hygiene frequently (every 2-4 hours) to prevent drying of tissues and to relieve thirst. •Lubricate client lips with water soluble lip balm. •Keep nares clean, especially around the tube. •Help control local irritation from the tube in the throat... analgesic throat lozenges and anesthetic sprays. •Ensure tube is secured to client's nose and gown to prevent tension/tugging. •Support client's concerns/fears regarding tube placement.

Nursing Diagnosis related to nutritional problems with Older Adults

•Altered ability to chew •Loss of smell and taste •Slowed intestinal peristalsis •Reduction in appetite/thirst •Depression/Loneliness

Recommended Dietary Allowance (RDA)

•RDA is a reference value (that is a component of Dietary Reference Intakes). •Average daily intake of a nutrient that is sufficient to meet the requirement of nearly all (97%) healthy people. •www.nutrition.gov/smart-nutrition-101

Promoting Client Safety with Enteral Feedings

•Always check tube placement before administering any fluids/medications. •Check gastric residual before each feeding or every 4-6 hours for continuous feedings. •Check for bowel sounds at least every shift - for the presence of peristalsis/a functional GI tract. •Elevate the client's HOB at least 30 degrees during feedings and for 1 hour after feedings. •Prevent contamination during enteral feedings... always check facility policy regarding prolonged use of feeding equipment. •Always flush the tubing before, between, and after medication administration.

Concepts of Body Mechanics

•Body alignment or posture •Balance •Coordinated body movement •Wide base of support •Limit weight lifted to 35 pounds or less

Standard of Care for Enteral Feedings: Site Care

•Cleanse with NS Antibiotic ointment per policy / Rx Dress w/ 4 x 4 drain sponge & tape Initials/date/time

What is a carbohydrate

•Commonly known as sugars and starches •Compounds composed of carbon, hydrogen, and oxygen •Provide energy... 1 gram CHO yields 4 calories •Most abundant, least expensive source of calories in the world •Plant Sources: Fruits, Vegetables, Grains, Dried Beans, Sugars, Honey •Animal Source: Milk (Lactose) •Classified as Simple or Complex Sugars •Converted to glucose for transport through blood •Stored as glycogen in muscle and liver

What is a protein?

•Composed of Amino acids •9 amino acids are classified as essential - cannot be synthesized in the body and must be obtained from diet •Labeled as "complete" or "incomplete" based on amino acid composition ("Complete" contain all of the essential amino acids) •Animal proteins are complete and plant proteins are incomplete •1gm protein yields 4 calories of energy •Sources: Meat, Milk products, Eggs, Dried beans, Nuts •Plant sources include: Soy, Quinoa •Needed for tissue growth and repair •Component of bones, muscles, tendons, blood vessels, skin, hair, and nails •Recommended Daily Intake (RDA) = 0.8g protein/kg of desirable body wt.

Therapeutic Diets

•Consistent-Carbohydrate Diet •Fat-Restricted Diet •High-fiber •Low-fiber •Sodium-restricted •Renal diet

Tools for Planning a Healthy Diet

•Dietary Guidelines •Dietary Reference Intakes •MyPlate Food Guide •Food Labeling

Signs of Dsyphagia

•Difficulty swallowing •Choking •Runny nose •Pocketing food •Drooling

Enteral Feedings 101

•Explain the procedure. •Position patient upright (at least 30 degrees) during procedure and at least 1 hour after procedure. •Implement medical asepsis. •Confirm placement of tube - see previous slides. •Flush tube per PCP prescription/policy. •Administer feeding via syringe/bag/pump. •Flush tube per PCP prescription/policy. •Reassess client. •Clean supplies per policy. •Instruct client to keep HOB elevated at least 30 degrees for a minimum of 1 hour. •Continue to monitor client's measurements: weight, I&O, blood glucose.

Factors Affecting Nutrition:

•Gender •State of Health •ETOH Abuse •Medication •Mega Doses of nutrient supplementation •Economic Factors •Religion •Meaning of Food •Culture •Additional Factors

Standard of Care for Enteral Feedings: Assess

•Hydration Insertion site Respiration Gastric Motility

NURSING DIAGNOSES (from the Fundamental List) for Clients with feeding tubes:

•Impaired Swallowing •Altered Nutrition: Less than the body requirements •Risk for Aspiration

Developmental Considerations for Nutrition

•Infants •Toddlers and Preschoolers •School-Aged •Adolescents •Adults •Pregnant and Lactating Women •Older Adults

Potential Complications of Parenteral Nutrition

•Infection/ sepsis •Pneumothorax •Thromboembolism •Hyper and hypo-glycemia •Fluid and electrolyte imbalance

What is a mineral

•Inorganic elements found in all body fluids and tissues •Primarily help regulate body processes •Macrominerals include: calcium, phosphorous, magnesium, sodium, and potassium •Needed in amounts greater than 100 mg/day •Microminerals include: iron, zinc, iodine •Needed in amounts less than 100 mg/day

What is a fat/lipid

•Insoluble in water and blood •1gm fat = 9 calories of energy •95% of lipids in diet are triglycerides •Contain mixtures of saturated (raise cholesterol levels) and unsaturated (lower cholesterol levels) fatty acids -Most animal fats are saturated -Most vegetable fats are unsaturated •Most concentrated source of energy in the diet •Recommended Daily Intake (RDA) = is not established; should not exceed 20%-35% total calorie intake

Enteral Nutrition

•Involves passing a tube into the GI tract to administer a liquid formula containing nutrients. •Must have a functioning GI tract (digestion and absorption). •May deliver total or supplemental nutrition for short or long periods. •Short term use (less than 4 weeks) - Nasogastric tube or Nasointestinal tube. •Long term use (greater than 4 weeks) - Percutaneous endoscopic gastrostomy (PEG) tube.

Indications for Enteral Nutrition

•Moderate to Severe Dysphagia •Trauma/surgery to upper GI tract (mouth, jaw, esophagus, etc.) •↓ LOC •Eating disorder •Other...........

Two kinds of Enteral Nutrition

•Nasogastric (N/G) or Nasointestinal •Per-cutaneous Endoscopic Gastrostomy (PEG)Tube oPEJ

What is a vitamin

•Organic compounds needed by the body in small amounts •Most are active in the form of coenzymes •Needed for metabolism of carbohydrates, proteins, and fats •Sensitive to exposure & processing •Classified as "fat soluble" and "water soluble"

Parenteral Nutrition

•Parenteral nutrition is the administration of nutritional support via the intravenous route either peripherally or centrally. •Clients who cannot meet their nutritional needs via oral or enteral routes may require intravenous supplementation. Parenteral nutrition may be prescribed for clients who have a non-functioning GI tract

Potential Risks of Enteral Nutrition

•Pulmonary aspiration •Diarrhea •Constipation •Dehydration •Fluid overload •Other........

Food Labeling

•Regulations that control food labeling have always been controversial. •In 1975, FDA enacted legislation for a standardized food label format. •Food manufacturers began exaggerating health claims. •1990 Congress passed the Nutritional Labeling and Education Act...Which required all food to be labeled.

My Plate Food Guide

•Replaced My Pyramid in 2011. •Part of a communication initiative based on the Dietary Guidelines for Americans to help consumers make better food choices. •Illustrates the 5 food groups using a familiar mealtime visual. •Encourages consumers to eat less and avoid oversized portions. • •www.choosemyplate.gov

Height/Weight

•Routine admission procedure •Ongoing per policy-condition, etc •Clothing/Shoes may affect height/weight •Empty bladder- affects weight •Weight-standing, chair, lift scales •Same time, scale, clothing •Height- shoes off, facing forward, extend folding bar horizontal until touches head •Read measurement

Total Parenteral Nutrition (TPN)

•TPN is a highly concentrated, hypertonic solution that provides calories and replaces essential fluid and nutrients. •TPN formula is tailored to the client's individual needs. •The preferred route of administration is via a large vessel... Subclavien vein, Jugular vein, PICC (Peripherally Inserted Central-line Catheter). •TPN may be prescribed for clients who have a non-functioning GI tract.

Dietary Recommendations and Guidelines

•The Dietary Guidelines for Americans are science based strategies compiled by the Public Health Service of the Department of Health and Human Services and the US Department of Agriculture. •The guidelines provide advice to promote health and to reduce risk for major chronic diseases through diet and activity. •The guidelines are updated every 5 years. •Box 36-2: Key Recommendations of the Dietary Guidelines for Americans 2015-2020

Variables Leading to Back Injury in Healthcare Workers

•Uncoordinated lifts •Manual lifting and transferring of clients without assistive devices •Lifting when fatigued or after recent back injury recovery •Repetitive movements such as lifting, transferring, and repositioning clients •Standing for long periods of time •Transferring clients •Transferring/repositioning uncooperative or confused clients

•Confirmation of Feeding Tube Placement

•Verify correct placement of feeding tube: oAfter initial insertion oBefore beginning the administration of feeding or medication oAt regular intervals per policy/PCP prescription

Standard of Care for Enteral Feedings: Supplies

•gloves, stethoscope, formula, feeding tubing, syringe, alcohol prep, towel, pH paper, water, pump - if needed, etc.

How to change a brief

•https://www.youtube.com/watch?v=WgU5V4V83Lk