Ch. 27 Safety, Security, and Emergency Precaustions

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A nurse is filing a safety event report for an older adult client who tripped and fell when getting out of bed. Which action exemplifies an accurate step of this process? The nurse details the client's response and the examination and treatment of the client after the incident.

*An unintentional injury or incident that compromises safety in a health care agency requires the completion of a safety event report (incident report). *The nurse completes the event report immediately after the incident and is responsible for recording the circumstances and the effect on the client in the medical record. *The safety event report is not a part of the medical record and should not be mentioned in the documentation. *The physician is not responsible for filling out or signing the safety report unless she witnessed the incident. *The nurse reports factual information, not opinions.

A nurse is teaching parents about Internet safety for children. Which action(s) is a recommended guideline for Internet use? Select all that apply. *Use filtering software to block objectionable information. *Investigate any public chat rooms used by the children. *Be alert for downloaded files with suffixes that indicate images or pictures.

*Parents should keep identifying information private (e.g., full name, address, telephone number) *investigate filtering software or methods of blocking out objectionable information. *They should warn their children to avoid public chat rooms and forums and emphasize that everything said or anything read online may not be true. *They should also be alert for downloaded files with suffixes that indicate images or pictures (e.g., .jpg, .gif, .bmp, .tif, .pcx) *consider keeping the computer in a central location in the house, rather than in a child's bedroom

bullying

*form of direct or indirect aggression that includes hostile physical, verbal, psychological, and/or rational behaviors *results in immediate harm and/or negative social, mental health, and physical health consequences for the victimized children

asphyxiation aka suffocation common causes: -drowning -choking -gas or smoke poisoning

*may occur in any age but greatest in children *air doesn't reach the lung and breathing stops *adults 85+ more likely to die this way then 65-74 yr olds

preventing fires and maintaining fire safety

Rescue anyone in immediate danger Activate the fire code system and notify the appropriate person Confine the fire by closing doors and windows Evacuate patients and other people to a safe area

A child is playing soccer and is involved in a head-to-head collision with another player. Which assessment findings should the nurse be alert to that may indicate a concussion?

Symptoms of a concussion include: headache vomiting problems with balance fatigue dazed or stunned appearance difficulty concentrating and remembering confusion forgetfulness irritability nervousness very emotional behavior drowsiness difficulty falling asleep and sleeping more or less than usual.

What is the best short-term outcome for a client with the nursing diagnosis of Risk for Injury related to risk-taking behaviors? The client will identify behaviors that would decrease the risk for injury.

The best short-term outcome for a client with a Risk for Injury related to risk-taking behaviors would be to identify behaviors that would his or her risk for injury. Counseling and calling for help are long-term and unanticipated interventions that would not immediately address the identified problem.

Which safety tip could the nurse give to parents to help decrease the risk of the leading cause of injury or death in children 1 to 4 years of age? "Always provide close supervision for young children when they are in or around pools and bathtubs."

The leading cause of injury and death in children 1 to 4 years of age is drowning. Therefore, providing close supervision when children are in or around tubs and pools will help decrease and/or prevent this injury.

An older adult client with an unsteady gait has been experiencing urinary urgency after being diagnosed with a urinary tract infection. What is the nurse's best action for reducing the client's risk of falls? Provide a bedside commode and ensure adequate lighting.

The use of a commode can often reduce the risk of falls that is associated with ambulating to the bathroom. Falls reduction is not considered a justifiable rationale for catheter insertion. Toileting every 4 hours may or may not be adequate for the client's needs. Fluid intake should never be reduced for the sole purpose of reducing urine output.

safety event report

a confidential document, formerly referred to as an incident report, which objectively describes the circumstances of the accident or incident

disaster

a tragic event of great magnitude that requires the response of people outside the involved community

elder abuse

any knowing, intentional, or negligent act by a caregiver or any other person to an older adult; the act causes harm or serious risk of harm

chemical emergency

deliberate or unintentional release of a chemical compound that has the potential for harming people's health

intimate partner violence (IPV) aka domestic violence

involves "physical violence, sexual violence, stalking and psychological aggression by current or former intimate partner"

nuclear terrorism

involves intentional introduction of radioactive materials into the environment for the purpose of causing injury and death

cyber terror Difficult to secure due to: 1. ability of perpetrators to operate from anywhere in the world 2. linkages between cyberspace and physical systems, especially those involving critical infrastructure 3.difficulty of reducing vulnerabilities and minimizing consequences in complex cyber networks

involves the use of high technology to disable or delete critical infrastructure data or information

culture of safety

organizational environment where "core values and behaviors-- resulting from a collective and sustained commitment by organizational leadership, manager and workers--- emphasize safety over competing goals

restraint examples: -side rails -geriatric chairs w/attached trays -appliances tied @ wrist, ankle, or wait -drugs= chemical restraints

physical devices used to limit a patient's movement

poison control center

provide checklists for "poison-proofing" a home and provide lists of toxic household items

Bioterrorism

the deliberate spread of pathogenic organisms into a community to cause widespread illness, fear, and panic

sentinel event

unexpected occurrence involving death or serious injury


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