Fundamentals of Nursing: Chapter 27 Flashcards

• Oxygen-can be low concentration & high concentration : supplemental O2 for low concentration to help patient breath. prevent low concentration due to open fire and smoking.
• Carbon monoxide- especially during winter and warming cars in closed garage can cause low concentration
• Nutrition- food needs and must have proper storage
• Temperature (heat and humidity)- a normal comfort zone of 65-75 degrees

Nutrition: needs proper storage and house without vermin. Proper refrigeration- do patients have refrigeration. Proper preparation area- is it clean and do moms know how to prepare formula..

Temperature : too much or too little temperature : Hypertherma- fever, lack of electricity, air conditioning. At higher risk- elderly, babies and chronically ill.

Hypothermia- core body temperature 95 f or below. At risk people: homeless, elderly. babies and can be caused by alcohol or drug ingestion

social service assistance may be needed to meet basic human needs and help those unable to pay bills for electric/gas and vermin control (rats, bugs, roaches)

1. Falls: increased incidence dependent on previous falls, age, vision, balance problems. walkers, Make a patient assessment daily.

2. Transmission of pathogens: need infection control measure: isolation. gloving, washing hands before and after each patient procedure including:

• dressing changes, emptying urinary catheter bags, use gloves, wash hands after removing gloves and follow isolation procedure.

3. Pollution: environmental, smoking esp. in cars w/ children

5. Disasters: * natural- tornado snow storms flooding or *manmade: bioterrorism ect.

1. ex. choking

2. Bike safety and head gear to prevent injuries

1. risk taking behaviors: car accidents, drug overdose and most are due to peer influences

2. lifestyle habits, smoking drinking, drug use that can cause cardio and pulmonary diseases

3. physiological changes: sight, hearing, reflexes, falls chronic disease, become a "polyfarm"-multiple medications

• has issued a list of "never events" or "serious reportable events"
• Surgical events: wrong part, side or procedure, foreign object left, mark a site with ink
• Product or device event: contaminated drugs, pumps, devise not function- Report and remove any questionable devise . ( Equipment related accidents).
• Patient protection events: elopement, suicide, infant to the wrong person
• Care management events: medication, blood error, maternal death, pressure ulcer, wrong sperm donor- ID checked, personnel double check blood
• Environmental events: O2 and gas mix up, electrical shock, burn death or serious injury- restraint checks and surgical suite errors
• Criminal events: abduction, sexual assault, by a person impersonating a Health care professional (HCP). Should introduce self to staff and ask for credentials

• "never events" -should NEVER OCCUR
• CMS: denies hospital payments resulting from or complicated by a never event.
• Many hospital-acquired conditions are nurse sensitive indicators
• The National Quality Forum has issued a list of "never events" or "serious reportable events" pertaining specifically to maternal and child health.

• 8th leading cause of death and includes:
• Nurses assesses for potential problems
• 1.medical errors in: medication errors, infection, bed sores, failure to diagnose and treat in time
• 2.Falls

Nurses assesses for potential problems:

1. Patient-inherent accidents: self induced injury: cut burn, setting fire

2. Procedure-related accidents:occurs during therapy, improper use of external devices

3. Equipment-related accidents: results from the malfunction, misuse or disrepair og equipment

4. Falls- that can result in broken hip and head trauma

Development of a individualized care plan includes;

1. Assessments- though the patient's eyes and patients home environment because patient view of safe may not be the same as the standards. use of wheel chairs, walkers?

2. Assessments Questions- ask about: activity and exercise, medication history, history of falls and home maintenance and safety. medications? have you fallen, who shovels?

3. Nursing history-

• Restraints as a last resort: when patients behavior puts them at risk for injury or falls
• Restraints as an alternative: to keep them safe for those who repeatedly fall. restraints are any manual method, physical or mechanical that reduces a patients ability to arms & legs or head freely. used when moving patients, can include safety bars on bed to prevent falls

• evaluate for seizures
• poisoning (accidential)
• prevention and elimination of electrical hazards
• disasters
• Hospitals must have an emergency management plan

• a safe physical environment
• a patient whose knowledge about safety factors and precautions
• a patient free of injury