Which of the following safety measures is appropriate to emphasize to the young adult?
a. Follow safety precautions when operating machinery
.b. Avoid excessive sun radiation by wearing protective clothing and using sun-blocking agents.
c. Make certain that stairways are well lighted and uncluttered.
d. Encourage frequent and regular vision checks.
Rationale: Young adults need to know to avoid excessive sun radiation bywearing protective clothing and using sun-blocking agents to prevent cancerousgrowths. Encouraging frequent and regular vision checks is a measure that isneeded by elders. For middle-aged adults, it is important to highlight the necessityfor stairways to be well lighted and uncluttered as well as using safety precautionswhen using machinery.
The CDC (2001) defined three categories of biological pathogens that can be used in terrorism. Thepathogens of highest concern are:
plague
botulism
anthrax
staph aureus
plague, botulism, anthrax
In evaluating the effectiveness of the restraint, it is important that the nurse
:a. Document the response of the client's family to the use of the restraint on the client
.b. Observe the family's behavior while the client is in restraints.
c. Document the exact times the restraint is applied and removed
.d. Observe the client's behavior while in the restraint and document the behavior.
d. Observe the client's behavior while in the restraint and document the behavior.
Rationale: Documentation is important but evaluation of the effectivenessof the restraint needs to focus on the behavior of the client while in restraint.The nurse needs to observe how the client is responding to the restraint.The family’s response or the family’s behavior is to be observed but theseare not ways of evaluating effectiveness. Documenting the exact times therestraint is applied and removed is important, but it is not the primarynursing focus for determining restraint effectiveness.
The nurse assesses a cyanotic appearance and cool temperature in the hand of a client wearing awrist restraint. The client complains of numbness and tingling in the hand. What should the nurse dofirst?
.d. Reapply the restraint in a different area of the wrist
B. Loosen the restraint and exercise the limb
Rationale: The assessment indicates a compromise in the circulation of the hand.Loosening the restraint and exercising the limb will reestablish circulation.Removing the restraint and leaving is not safe. Reapplying to a different area ofthe wrist will not increase circulation right away. Leaving the restraint in placewhile notifying the primary care provider will cause continued circulatorycompromise.
Medication errors can place the client at significant risk. Which of the following practices will helpdecrease the possibility of errors?
E. Rationale: Establish a reporting system for “near misses,”communicating effectively, and creating a culture of trust would helpdecrease the possibility of errors. Reviewing near misses could identifyflaws in the system or practices that placed the client at risk.Communication among staff and with clients will increase efficiency andcreate an atmosphere where nurses are willing to discuss errors openly sothat the flaws in the system can be corrected. A competent nurse maymake medication errors. Evidence is needed to support these conclusions.
A client fell while trying to get out of bed. What is the nurse’s most appropriate initial intervention?
a. Put the client to bed and do a thorough assessment.
b. Assess the client’s injuries and notify the primary care provider.
c. Assess the client and modify the environment
.d. Notify the primary care provider and the family.
Rationale: The first duty of the nurse is to the client so it is important to assessthe client for injuries and then notify the primary care provider. Moving the clientbefore assessing for injuries can potentially hurt the client if there are any fractures.It is important to notify the family but it is not the first priority. Modifying theenvironment is not the priority.
According to the 2000 Institute of Medicine report, To Err is Human: Building a Safer Health System, morepeople die from ____________than from motor vehicle crashes, breast cancer, or AIDS.
B. Medical errors
National patient safety goals:
why are they impt?
why do people stray from these guidelines?
these goals are impt. to create environment of learning and improvement
80% of medical errors is system derived-- meaning that system flaws set good people up to fail.
fail due to:
limited short term memory
being late or in a hurry (cutting corners)
limited ability to multi-task
interruptions
stress, fatigue
environmental factors
long work hours
physical design of the workplace
more people die from _____ that from motor vehicle, breast cancer, and HIV
medical errors
restraint order must be renewed every
24 hrs
prn order is
prohibited
pcp must see the client within ____ hr. for evaluation
1 hour
a written restraint order is valid only for ________ hrs.
