FINAL EXAM MDC 1, MDC 1 FINAL Q & A PERFECTLY SOLVED!!

FINAL EXAM MDC 1, MDC 1 FINAL Q & A PERFECTLY SOLVED!! 1. Fall Prevention a. In Homes: i. Remove items that could cause the client to trip(throw rugs and loose carpets) ii. Place electrical cords and extension cords against a wall behind furniture iii. Monitor gait and balance, and provide aids as needed iv. Make sure that steps and sidewalks are in good repair Place grab bars near the toilet and in the tub or shower and install a stool riser Fall Prevention In Hospitals i. Fall bracelets and yellow socks ii. Bed alarm iii. Remove clutter iv. Keep items within reach(call light, personal items) v. Gait Belts vi. "Call, don't fall" 1. Orient them to the call light and educate them to use call light to get help rather than getting up without assistance. Nurses should respond to call light in a timely manner vii. Put them in room close to nurses station viii. Have good lighting (especially at night) ix. BEDS: 1. Put in low position 2. Lock wheels 3. Use side rails appropriately 1. Home Safety a. Preschoolers and School Age Children i. Firearms 1. Keep firearms unloaded, locked up, and out of reach 2. Teach to never touch a gun or stay at a friend's house where a gun is accessible 3. Store bullets in a different locations from guns 1. Home Safety a. Preschoolers and School Age Children i. Poison 1. Teach child about the hazards of alcohol, cigarettes, and prescription, non-prescription, and illicit drugs 2. Keep potentially dangerous substances out of reach Have the poison control hotline number available 1. Home Safety a. Preschoolers and School Age Children i. Motor Vehicles 1. Use booster seats for children who are less than 4ft 9in tall and weigh less than 40lbs(usually 4 to 8 years old) 2. If the care has a passenger air bag, place children under 12 yrs in the back seat 3. Use seatbelts properly after booster seats are no longer necessary 4. Use protective equipment when participating in sports, riding a bike, or riding as passenger on a bike 5. Supervise and teach safe use of equipment 6. Teach the child to play in safe areas and never run after a ball or toy that goes into a road 7. Teach child safety rules of the road. a. Look both ways before crossing road a. Fire Safety i. Elements of Home Safety Plan 1. Where the exit plan in 2. Oxygen safety measures 3. Fire extinguishers and everyone knows there location Smoke detectors need batteries checked every 6 mos 1. Center of Gravity a. should be close to the base of support (below the umbilicus at the top of the pelvis) b. spread feet, wide base of support c. hold objects close to you Bathing a. Bathe clients to cleanse the body, stimulate circulation, provide relaxation, and enhance healing. b. Bathing clients is often delegated to the assistive personnel. However, the nurse is responsible for data collection and client care c. Bathe clients whose health problems have exhausted them or limited their mobility. i. Give a complete bath to clients who can tolerate it and who hygiene needs warrant it ii. Allow rest periods for clients who become tired during bathing iii. Partial baths are useful when clients cannot tolerate a complete bath, need particular, cleansing of odorous or uncomfortable areas, or can perform part of the bath independently. iv. Therapeutic baths are used to promote comfort and provide treatment (soothing itchy skin) Bed Bath: i. Ensure privacy ii. Start with face then arms and chest, then go to legs and feet, and then finally perineal. iii. Encourage patient to participate: 1. Wash their face and perineal area 2. usually set up the washcloth for them and allow them to do what they can and help with what they can't allowing them the independence they still have. "we'll work together" 3. Brush their own teeth Foot Care a. Prevents skin breakdown, pain, and infection b. Is extremely important for clients with diabetes mellitus and a qualified professional must perform it. c. Scrub between toes d. Don't clip nails but file if needed. e. Check for sores, signs of cyanosis, and skin breakdown 1. Pain Assessment a.P:provoking/relieving; what makes it worse and better b. Q: quality; how the pain feels: throbbing, aching, burning c. R: radiate; does the pain radiate anywhere else d. S: severity; on a scale of 1 to 10 how much does it hurt T: timing; onset, duration, and frequency 1. Pain Medication Administration a. Asses before giving pain meds: i. PQRST ii. Possible drug interactions, allergies iii. Correct orders iv. Correct dosage and medications 1. Pain Medication Administration (PT.2) a. Analgesics are the mainstay for relieving pain. The three classes of analgesics are non-opioids, opioids and adjuvants i. Concerns when taking Opioids: 1. Lower BP and HR a. Orthostatic hypotension (fall risk) 2. Constipation 3. Urinary retention 4. Respiratory depression a. S&S i. Bradypnea, RR less than 8 per min, and are shallow Low O2 saturation Pain Medication Administration (PT.3) a. Before giving more pain medications reassess vitals (look at quality of respirations) and another pain assessment Pain Medication Administration (PT.4) a. After giving medication: i. Reevaluate pain level in: 1. IV: 30 min 2. Oral: 1 hour ii. Check vitals b. The parenteral route is best for immediate, short-term relief of acute pain The oral route is better for chronic, non-fluctuating pain 1. Culture a. Is what people in a group have in common and it changes over time. a. Can be adopted by assimilation b. Effect on healthcare: i. What treatments they accept ii. How they view healthcare iii. How they view illness/disease/health/pain iv. How often or when they access health care v. Death rituals Time Orientation a. some cultures tend to be past, present, or future oriented b. may be late to appointments because their culture (don't wear watches) c. they value traditions and relationships over time and deadlines they might not take medications on time 1. Health Disparities (pg. 302) a. Health Status i. Higher rates of illness and death in minority groups ii. African American: higher maternal death rates Health Disparities (pg. 302 a. Quality of Care Blacks receive worse care compared to white Health Disparities (pg. 302 a. Access to Care Lack of access to preventative healthcare and language barriers can account for differences in the health status of racial and ethnic groups SBAR Communication a. S: situation b. B: background c. A: assessment d. R: recommendations 1. Body Mechanics a. Body Alignment i. Places the spine in a neutral (resting) position. ii. Allows the bones to be aligned, reduces stress and fatigue, & muscles, joints, and ligaments can work efficiently. Body Mechanics When lifting something: i. Keep feet apart ii. Lift with legs, not back iii. Keep it close to you Don't have bed in lower position, stand close to the bed, angle the body toward direction your moving the patient to(avoid twisting Body Mechanics Balance i. Line of gravity should pass through the center of gravity ( imaginary vertical line drawn from the head through the center gravity.) ii. Gravity of center should be close to the base of support (below the umbilicus at the top of the pelvis) iii. Base of support is what holds your body up (feet) iv. The body is balanced when your line of gravity must pass through your center of gravity, and your center of gravity must be close to your base of support Body Mechanics Coordination i. Smooth movements require coordination between nervous system and musculoskeletal system. ii. Voluntary movements are initiated in the cerebral cortex. iii. Damage the motor cortex, cerebellum, or basal ganglia affects coordination of movements. iv. Cerebral Cortex = Voluntary Movement v. Cerebellum = Coordination (proprioception = awareness of posture, movement and position sense).