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Various nursing care practices and procedures, including ambulating patients, positioning patients, making occupied beds, toileting patients, bathing patients, transferring patients, and feeding patients. It also discusses important healthcare concepts such as aidet, hcahps surveys, incident reporting, fire safety, stroke recognition, hipaa regulations, and patient risk factors across different age groups. Additionally, the document provides information on healthcare accreditation agencies, their standards, and their relevance to health scholars. The document serves as a comprehensive guide for healthcare professionals, particularly nursing students and health scholars, covering a wide range of topics related to patient care, safety, and regulatory compliance.
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What do you check for after log-rolling a patient? - ✔✔Bedsores Things to remember when ambulating a patient - ✔✔Check outside door for "High Fall Risk" sign. Check for yellow socks, indicating high fall risk. Ask 3 questions: Have you walked within the last 12 hours? Have you walked on this floor before? Where would you like to walk? Ask the patient if they are dizzy when you help them stand up from the bed. Report to the nurse the distance walked and the patient's overall mobility/speed. Things to remember when positioning a patient - ✔✔Never leave the bedside unattended without putting up the rails. Never have 4 rails up at a time, even for a second. Ask the CNA to put down a rail, and you should immediately put up your rail. When log-rolling the patient, ALWAYS check for bedsores. Things to remember when making an occupied bed - ✔✔Always change gloves before handling clean bed-sheets, pillow cases, etc. Always check for bedsores when log-rolling the patient. Wipe down the mattress and pillow with Sani-wipes, and leave for 2 minutes.
Tuck clean linen UNDERNEATH dirty linen. Things to remember when toileting a patient - ✔✔Close the curtains to ensure patient privacy. Catch the filled bedpan when log-rolling the patient to prevent spillage. Wipe from front to back, with one wipe per swipe. Check for bedsores when log-rolling. Change the trash bag after depositing used wipes. Things to remember when bathing a patient - ✔✔Close the curtains. Ask the patient whether the water is too hot. Use the backhand technique when washing underneath the breasts. Always change wipes after washing the genitals, the legs, the back, and the anal area. Things to remember when transferring a patient from the bed to the wheelchair - ✔✔Wipe the wheelchair before and after use. Lock the wheelchair. Ask the patient if they're dizzy after doing the swivel technique and after helping them stand. Ask the patient if they have left any of their belongings in the room.
The tubing of the pulse ox should be on the top. The red light of the pulse ox should be on the top of the fingernail. The pulse ox should be placed on the opposite arm as the blood pressure monitor. Rolling machines should be wiped down, since they're transportable. The temporal thermometer should be wiped down with alcohol wipes. When the pain level is high, ask if it's a new pain and where it's located. AIDET - ✔✔ACKNOWLEDGE the patient. INTRODUCE yourself as a Health Scholar. DURATION of task should be communicated. EXPLAIN the task as you're doing it. THANK the patient. SKAHI - ✔✔SIGNS outside the door. KNOCK on the door. ASSESS patient surroundings to understand their state. HAND HYGIENE (gel and gloves). IDENTIFY the patient in 2 ways. HCAHPS - ✔✔Survey: Hospital Consumer Assessment of Healthcare Providers and Systems Measures:
Code Pink - ✔✔Infant abduction. Guard entrance/exit. Look for suspicious items Nurses must use bassinets. Visitors must have badge. Code Purple - ✔✔Missing child patient. Report to security/public safety. Look for suspicious situations. Code Yellow - ✔✔Bomb threat. If called, get information about location, appearance, and when it will go off. Look for suspicious situations. Code Silver - ✔✔Person with weapon, or hostage situation. DO NOT go to location. Follow instructions from nurse. Triage - ✔✔Disaster internal -- hospital full Disaster external -- lots of incoming patientes RRT - ✔✔Rapid Response Team. Use when patient status changes quickly/significantly but Code Blue is not required. Code Jack - ✔✔Patient/visitor has fallen. If called, get as much information as possible. Class A Fire - ✔✔Ordinary combustibles (wood, etc.) Class B Fire - ✔✔Flammable liquids (gasoline, etc.) Class C Fire - ✔✔Electrical
Class D Fire - ✔✔Combustible metals Class K Fire - ✔✔Cooking oils/greases PASS - ✔✔PULL pin out of extinguisher. AIM extinguisher at base of fire. SQUEEZE handle. SWEEP back and forth. CVA - ✔✔Cerebral Vascular Accident (aka stroke). Leading cause of serious long-term disability in U.S. Ischemic stroke - ✔✔Blockage of vessel to brain Hemorrhagic stroke - ✔✔Bursting of vessel in brain causing bleeding FAST - ✔✔FACE -- does one side droop when smiling? ARMS -- does one arm droop when both are raised? SPEECH -- is speech slurred or strange? TIME -- note when symptoms began, and quickly call nurse Tier I of Infection Prevention - ✔✔Standard Precautions: All bodily fluids are potentially infectious! Standard Precautions must be followed by ALL personnel at ALL times with ALL patients when there is potential for contact with bodily fluids. Are Health Scholars allowed to handle blood? - ✔✔We can only take blood samples to the lab. We cannot bring bags of blood back to the patient.
HIPAA - ✔✔Health Insurance Portability & Accountability Act Ensure privacy of information. Standardize healthcare. Insurance portability. HIPAA Rules - ✔✔Privacy Rule -- WHEN can PHI be disclosed? Security Rule -- safeguards to control WHO can access PHI Breach Notification Rule -- patient must be notified of breaches PHI - ✔✔Protected Health Information:
How long can a Leave of Absence be? - ✔✔ 14 - 180 days. A leave between 110-179 days requires re- training. What if a Leave of Absence is greater than 180 days? - ✔✔The scholar must re-apply to the program. How many days must the scholar work between Leaves of Absence? - ✔✔90 days, or 48 floor hours How many days maximum can a scholar take in a Leave of Absence during their first rotation? - ✔✔ 30 days max How far in advance should a scholar submit a Leave of Absence request? - ✔✔At least 2 weeks Who should the scholar submit a Leave of Absence request to? - ✔✔The Leave of Absence Coordinator (LOA Coordinator) What do you do when you are going to miss a shift? - ✔✔1. Call Charge Nurse at least 15 minutes prior
ACU - ✔✔Ambulatory Care Unit: Patients are able to walk, either assisted or unassisted ICU - ✔✔Intensive Care Unit Where unstable medical patients go for constant care NICU - ✔✔Neonatal Intensive Care Unit: Where premature and/or seriously ill or unstable babies are treated PACU - ✔✔Post-Anesthesia Care Unit: Provide care for patients recovering from anesthesia after undergoing surgery TKO - ✔✔to keep open; order to keep just enough flow through IV to keep vein open PO - ✔✔Per os: administer by mouth PR - ✔✔Per rectum: administer rectally PRN - ✔✔Pro Re Nata: Administer as needed Atherosclerosis - ✔✔Disease in which fatty material is deposited on the walls of the arteries MI - ✔✔Myocardial infarction: heart attack; loss of blood supply to the heart CHF - ✔✔Congestive heart failure: failure of the heart to pump blood effectively Stroke - ✔✔Brain attack; loss of blood supply to the brain Shock - ✔✔decreased perfusion of blood to body tissues
Symptoms of myocardial infarction - ✔✔Severe retrosternal pain Pain in left arm or jaw Dyspnea (labored breathing) Diaphoresis (sweating) Pressure, heaviness, tightness Nausea, vomiting Risk factors for myocardial infarction - ✔✔Smoking, atherosclerosis, hypertension, hyperlipidemia Complications from myocardial infarction - ✔✔Arrhythmias, CHF, stroke Pneumonia - ✔✔inflammation of the lungs by any microorganism Tuberculosis - ✔✔infectious disease caused by mycobacterium tuberculosis Asthma - ✔✔Chronic condition characterized by airway inflammation, bronchoconstriction, and hypersecretion of mucus COPD - ✔✔chronic obstructive pulmonary disease. due to a variety of pulmonary conditions Emphysema - ✔✔Chronic expiratory airflow obstruction accompanied by permanent enlargement of the airspace (alveoli); subset of COPD Neoplasia - ✔✔uncontrolled, disorderly proliferation of cells Benign neoplasia - ✔✔does not metastasize; can still be harmful (e.g. compress adjacent tissues)
Patients in the outpatient setting complain about? - ✔✔Wait times, short time with provider, inability to ask clarifying questions, lack of follow-up the 6 vital signs are - ✔✔Temperature, pulse (heart rate), blood pressure, respiratory rate, oxygen saturation, pain level Can health scholars take vital signs of newly admitted patients? - ✔✔No. They can only take vitals signs of patients whose signs have been taken before. What can increase body temperature? - ✔✔Exercise, digestion, drinking a warm beverage, illness, stress, taking a warm bath, high progesterone after ovulation What can decrease body temperature? - ✔✔Sleeping, fainting, illness, drinking a cold beverage, dehydration, fasting, high estrogen before ovulation Normal pulse/heart rate - ✔✔ 60 - 100 bpm adults 60 - 140 bpm children 100 - 190 bpm toddlers 100 - 205 bpm infants What vessel should be used to take the pulse when the patient is unconscious? - ✔✔Brachial artery What vessel should be used to take the pulse when the patient is conscious? - ✔✔Radial artery normal blood pressure - ✔✔120/80 mmHg What increases blood pressure? - ✔✔Pain, immediate exercise, stress, obesity, age, ethnicity, family history, sodium What decreases blood pressure? - ✔✔Shock, rest, low sodium, exercise, stopping smoking
Normal respiratory rate - ✔✔ 12 - 20 breaths per minute adults 15 - 30 breaths per minute children 25 - 66 breaths per minute newborns Normal oxygen saturation - ✔✔ 97 - 99% DNR - ✔✔(Do Not Resuscitate) An order that tells medical professionals not to perform CPR if patient goes into cardiac arrest Advanced directive - ✔✔a legal document prepared by a living, competent adult to provide guidance to the health care team if the individual should become unable to make decisions regarding his or her medical care because of a life-threatening scenario POLST - ✔✔Physician Orders for Life-Sustaining Treatment. A medical document completed by the patient that states the type of life-sustaining treatment(s) they may or may not want. An approach to end-of-life planning based on conversations between patients, loved ones, and healthcare providers. Signs of dying - ✔✔Lethargy, disorientation, incontinence, restlessness, reduced intake and output, temperature sensitivity, breathing changes Response to a dying patient - ✔✔Flexible -- allow more visitors into the room Accommodate -- increased staff support Communication -- more nonverbal than verbal, but increased communication overall Role of health scholar in death of patient - ✔✔Respect patient, show compassion towards family, assist staff in preparing body, assist staff in transport to morgue, be professional **Scholars will never be put in a situation in which they can cause a patient to lose their life.