Chapter 10: safety

1. ___________ is a violent or dangerous act used to intimidate or coerce a person or government to further a political or social agenda.

Terrorism Terrorism is a violent or dangerous act used to intimidate or coerce a person or government to further a political or social agenda. pg 252

2. To decrease the risk for injury to the patient, the nurse determines if the patient: a.can read English. b.is left-handed. c.is able to eat unassisted. d.can dress independently

b.If patient is left-handed A left-handed patient will twist to accommodate, which places them at risk for injury.

3. The nurse conducting a seminar on bioterrorism reviews several types of agents that may be used as weapons. An agent that does not seriously damage or kill the target population but only impairs it is classified as _____________.

incapacitating The agent that only impairs the target rather than killing or seriously damaging it is classified as an incapacitating agent. High risk syndromes for bioterrorism: 1. Anthrax 2. Botulism 3. Plague 4. Smallpox

2. When reinforcing the PASS acronym for fire extinguisher use, the nurse reminds the staff that the final "S" stands for ______________

sweep The acronym stands for: P = pull pin A = aim S = squeeze S = sweep. pg 249 Box 10.10

4. The nurse explains that the measurement of radiation exposure is in multiples of Gy. The number of Gy an individual may absorb before becoming ill with radiation syndrome is _______.

0.75 The amount of radiation absorbed is measured by the Gy. 1 Gy is equal to 100 rad. Absorption of 0.75 Gy will cause the individual to develop acute radiation syndrome. -less than 0.75 Gy absorbed: no symptoms -8 Gy absorbed usually die -30 Gy absorbed is fatal pg 255 *The nurse should also keep a great distance and use shielding devices such as lead aprons.

3. A long-term care facility is committing to a restraint-free environment. What will the health care workers implement to encourage this environment? (Select all that apply.) a.Frequent orientation to surroundings. b.Explain all procedures and treatments. c.Discourage visitors. d.Maintain toileting routines. e.Minimize exercise and ambulation.

a.Frequent orientation to surroundings. b.Explain all procedures and treatments. d.Maintain toileting routines. To encourage a restraint-free environment health care workers should provide: -frequent orientation to surroundings -thoroughly explain all procedures and treatments -maintain toileting routines. Visitors should be encouraged so they may sit with the residents, and frequent exercise and ambulation also should be encouraged.

8. A disaster situation occurs and involves an explosion in a hospital laundry. What would this be classified as? a. Active b.External c. Life-threatening d. Internal

d. Internal Internal disaster often threatens the safety of patients and staff. Disasters referred to External and Internal External: outside of the facility and results in an influx of casualties brought to the facility Ex. Tornado, chemical plant explosion, train accident Internal: extraordinary situations that is brought within the facility. Ex. Fire pg 251

4. Important safety precaution the home health nurse teaches parents in order to prevent burns to small children? a.Never leave them unattended. b.Turn pot handles on stoves away from reach. c. Turn hot water on first when filling the bathtub. d. Keep side rails up on the crib

b.Turn pot handles on stoves away from reach. To protect infants and children from burns, turn the pot handles on stoves away from the child's reach. accidents involving children are largely preventable. parents and caregivers need to be aware of specific dangers at each stage of growth and development. many dangers exist in a child's environment -oral stage -infants & toddlers: falling from bed, keep side rails up, place hand on child to when gathering supplies to prevent falls. -crawling: electrical sockets and cords -toddlers: pots, pool & bath water due to burns pg 237

11. What should a nurse do when encountering a mercury spill? a.Vacuum the spill. b.Open interior doors. c.Close all outside windows. d.Open any outside windows.

d.Open any outside windows. In the event of a mercury spill, interior doors should be closed and outside windows should be opened. The spill should not be vacuumed. -Mercury enters the body though inhalation and absorption through the skin. 1. evacuate room 2. ventilate the area. Close interior doors and open outside windows 3. Do not vacuum the spill After mercy is recover: 4. mop the floor with mercury specific cleanser 5. dispose of collected mercury according to local safety guidlines pg. 245 Box 10.6

3. To decrease the risk for falls, the nurse holds frequent in-services to ensure that staff has competent skills for: a. Bathing b. Feeding c. Transferring d. Ambulating

c. Transferring The majority of patient falls occur during transfer.

10. A nurse instructs a nursing assistant about the proper use of a gait belt. The nurse should intervene after observing the nursing assistant: a.walking on the patient's strong side. b.walking to the side of the patient. c.securing the gait belt securely around the patient's waist. d.grasping the handles of the gait belt while the patient ambulates.

a. walking on the patient's strong side. -A gait belt should be securely applied around the patient's waist. (should be able to fit 2 fingers between belt and patient's waist.) -It has handles attached for the nurse to grasp (towards the back and other hand supports the arm or grasp the gait belt toward the side) while the patient ambulates. -The nurse should walk on the patient's WEAKER side so that assistance may be given if the patient starts to fall. -have pt support self by leaning on or holding your arm -walk slightly behind for better support -walk with your knees and hips flexed pg 237

2. The nurse assesses a patient in a Posey safety reminder device (SRD) for which problem that may increase because of the use of SRDs? (Select all that apply.) a.Immobility b.Lethargy c.Risk for impaired circulation d.Risk for skin impairment e.Incontinence

a.Immobility c.Risk for impaired circulation d.Risk for skin impairment e.Incontinence The use of SRDs increases a patient's immobility, risk for skin impairment, risk for impaired circulation, and incontinence. A SRD would not increase lethargy. Focus on patient's -behavior -activity -skin condition Interventions: -release q2hrs for 5 mins -frequent observation, mental status -Routine ROM exercises -asses for circulation and skin integrity -frequent bathroom assist -do not leave unattended during temporary removal

6. What should the nurse do when offering a cup of hot coffee to a frail, older adult patient? a. Give the patient a straw. b. Dilute the coffee with cold water. c. Fill the cup half full. d. Offer a bib or an apron.

c. Fill the cup half full Filling the cup half full promotes safety and does not change the flavor of the beverage, nor does it demean the patient as would making him or her wear a bib or apron. assist weak and disoriented older pt when drinking hot liquids, such as soups, coffee, or tea can prevent burns this age group vulnerable to burns from spilled hot liquids and from heating pads and electric blankets. pg 237

1. The nurse manager is providing an in-service regarding a "safe hospital environment." What will this education mainly focus on preventing? a.Falls b.Exposure to contaminants c.Injury d.Electric hazard

c. injury A safe environment implies freedom from injury. -freedom from injury and fall prevention -electrical injuries, fires, burns, and poisoning. safety is the primary concern of the nurse. -safe physical environment -safe administration of meds -helping pts feel safe pg 235

5. Before applying a safety reminder device (SRD), the nurse must: a.Get permission from the family. b.Assess patient's skin condition. c.Get a physician's order. d.Explain the SRD to the patient.

c.Get a health care provider's order. Initially, an order is necessary that specifies the type of SRD and the duration of its application. SRD increase: -restlessness -disorientation -agitation -anxiety -feeling of powerlessness contributes: -immobility -dehydration -incontinence -infection -decrease circulation pg 241

9. The emergency department nurse can receive assistance in dealing with a victim of poisoning by calling the: a.American Red Cross b.Fire department paramedics c.Poison control center d.Civil defense office

c.Poison control center The nurse can access the local poison control center for assistance in caring for a victim of poisoning. -more common household poisoning in children -elderly: changes in eyesight lead to accidental ingestion, memory impairment pg 250

7. What type of fire extinguisher should the nurse use when the oxygen concentrator machine malfunctions and causes an electric fire? a.Type A b.Type B c.Type C d.Type D

c.Type C Electric fires require type C fire extinguishers. Type A: paper, wood, and cloth Type B: Flammable liquid, grease, anesthetics Type C: Electrical Type ABC: any type of fires. pg 249

1. When the nurse ambulates with a patient who has left-sided weakness, what actions should the nurse take? (Select all that apply.) a.Walk on the patient's right side. b.Keep the patient away from heavy furniture. c.Hold the patient's arm securely. d.Keep the leg nearest the patient behind the patient's knee. e.Use a gait belt.

d.Keep the leg nearest the patient behind the patient's knee. e.Use a gait belt. -Ambulating with a person who has an identified weakness requires that the nurse walk on the same side as the weakness slightly behind the patient, with the nurse's near leg behind the patient's knee. The nurse should use a gait belt and hold the patient at the waist and the gait belt. Furniture can be used as support.