NUR2356 Multidimensional Care I Exam 3 /
MDC I EXAM III FINAL
How to avoid falls in the home (Answer)- remove throw rugs provide adequate lighting extension cords along walls or behind the furniture assist gait educate how to use assistive devices install grab bars The call light is going off what do you do (Answer)- Assist in a timely manner Cognitive dysfunction in the hospital (Answer)- confused patient, dementia, won't call for help be sure to provide regular toileting Fall prevention in the hospital (Answer)- fall bracelet yellow socks remove environmental hazards keep personal items within reach provide good lighting, nightlight Patient is an extreme fall risk where to do you put them (Answer)- close to the nursing station how to keep beds safe (Answer)- put in low position lock wheels use side rails appropriately You walk in the room and patient is on the floor what do you do first (Answer)- assess the patient the patient has a small cut from the fall, what do you do (Answer)- do a full neuro check, pupils, vision, carinal nerves, call the physician and report your findings, know their neuro status before you move the patient patient is immobile (Answer)- this decreases their strength 1 / 3
intervention for impaired balance (Answer)- provide exercise to work on strength and balance the patient keeps getting out of bed, besides your regular interventions what should you do (Answer)- do hourly rounding and offer to assist the the bathroom when transferring patients what should be locked (Answer)- all the wheels on the bed, chair, wheel chair call light (Answer)- educate the patient how to use the call light, to call for assistance, nurses should respond in a timely manner what can be used to assist in moving the patient to the chair (Answer)- gait belt, a lift is the right answer for moving patient when testing with NCLEX Where do you keep you bullets (Answer)- separate from the firearm and out of reach do you keep your firearm and bullets together (Answer)- no, and keep out of reach poison control (Answer)- keep medication, alcohol, cleaning supplies out of reach, have number to poison control, teach teens about drug and alcohol safety pool safety (Answer)- fence, safety devices around the pool, supervision, swimming lessons risk for falls in the home (Answer)- cords, throw rugs, install hand rails, provide adequate lighting, educate on using assistive devices correctly booster seat (Answer)- children who are less than 4ft 9in weigh less than 40lbs typically 4-8 yrs old 12 year old has to ride where (Answer)- in the back seat, make sure to wear seatbelts corectly sporting safety (Answer)- wear protective gear for sports, riding your bike or other activities road safety (Answer)- do not run after the ball, look both ways before crossing the road 2 / 3
you are on fire what do you do (Answer)- stop drop and roll, put out the fire how often to change the batteries in the smoke detector (Answer)- every 6 months, when you change the time elements of home safety plan (Answer)- have an exit plan, where do you meet outside, you have fire extinguishers and you know where they are at and how to use them how to use a fire extinguisher (Answer)- Pull, Aim, Squeeze, Sweep oxygen safety (Answer)- No smoking, no wool, check cords, no smoking signs, no acetone center of gravity (Answer)- the point around which an object's weight is evenly distributed.feet apart, wide pass of support hold objects close to you lifting an object (Answer)- lift object close to you, do not lift over 30 pounds, use your major muscles, your legs not your back best way to move a patient (Answer)- if needing to lift the patient, they NCLEX will always say use a lift (hoyer) to slide a patient in bed use a sliding device like a plastic sheet, have the patient cross their arms, and tuck their chin to avoid friction and shearing, and never do it alone benefits of bathing (Answer)- stimulate circulation, healing, helps with well being, promotes relaxation, decrease contaminates on the skin delegation for bathing (Answer)- nurses can delegate bathing to assistive personnel however it is the nurses responsibility for data collection and client care complete bath (Answer)- bathe clients who can tolerate it and who hygiene needs warrant it, allow rest periods for those that become tired partial bed bath (Answer)- useful when clients who cannot tolerate a complete bed bath, need particular cleansing of odorous or uncomfortable area, or can provide a part of the bath independently
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