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Patient Care Unit #7
Terms in this set (59)
List three reasons that patients may have difficulty donning or doffing their hospital gown.
1. Cast or brace
2. Extreme contracture
3. Age (young, older)
True or false: If you must cut off a trauma patient's clothing, it should be promptly disposed of.
If you must cut off a trauma patient's clothing, it should NOT be disposed of. It should be placed with their belongings.
When removing a soiled gown, remove the ______________ side first and then the ______________ side.
Answer: unaffected, affected
If you are assisting a patient with a lower extremity injury with removal of garments, what procedure should be followed to remove lower garments?
To remove pants:
1. Cover patient with long examining gown
2. Have pt. unbuckle/unbutton pants and pull them down over hips; sit down, and then remove them completely (assist if necessary)
When assisting patients with lower extremity injuries, clothing is removed from the ______________ of the body first.
If a patient requests water, check the chart before allowing them to have any as they may have an ______________ order.
An NPO order means the patient may not have what?
Food, liquid or ice chips
The patient may experience ______________ if the need to void is ignored.
Name the two different types of bedpans. Which is used for patients who have difficulty lifting their hips?
Answer: Regular bedpan and fracture/slipper pan.
A fracture pan is used for patient's who have difficulty lifting their hips.
When using a bedpan, the patient's torso should be ______________.
True or false: When using a bedpan, the side rails of the patient's bed should remain in down position.
When using a bedpan, the side rails of the patient's bed should be placed in the UP position.
The most common catheter type is the ______________ catheter.
Explain the difference between a Foley and a straight catheter.
The Foley catheter has a balloon on the inserted end that can be inflated using a dedicated inflation lumen to ensure it does not become dislodged from the bladder. The straight catheter has only one lumen which functions in fluid removal from the bladder.
Explain the correct method for transporting a patient who has a retention catheter in place.
Before transporting the patient, you should ensure that the catheter line is not tangled in the side rails of the bed or elsewhere. The line should be placed on top of the mattress beside the patient. The catheter bag should be kept below the level of the bladder to ensure that backflow does not occur, typically on a dedicated hanger on the bed or stretcher.
Explain the need for infection control when caring for patient's who have urinary procedures.
A urinary tract infection is the biggest cause of nosocomial infections. Patient's who have urinary procedures are at an increased risk of acquiring a UTI as the pathogens have a portal of entry to the bladder via catheter.
When a urinary catheter reservoir are emptied, the volume of urine should be measured as the ______________ and ______________ fluid volumes may be being monitored.
Answer: intake, output (I&O)
What is a cystogram?
Answer: A radiographic study of the bladder using fluoroscopy.
What does VCUG stand for and what does it test for?
Answer: Voiding Cystourethrogram; used in children with recurring UTIs to determine if vesicouretral reflux is occurring.
What is a retrograde pyelogram?
Answer: A radiographic study of the kidneys, ureter and bladder.
A catheter inserted above the pubic symphysis that enters the bladder through the abdomen is called a ______________ catheter. Why would it be used?
Used for long term catheter use such as chronic incontinence, urethral injury, or obstruction.
A type of catheter used exclusively by male patients is called a ______________ catheter.
Female catheters fall within the range of ______ and _____, and are inserted ______ cm to reach the bladder.
Answer: 12-14F, 1.2cm
Male catheters fall within the range of ______ and ______, and are inserted ______ cm to reach the bladder.
Answer: 16-20F, 20cm
Childrens catheters fall within the range of ______ and ______.
For infants, ______________ are used in place of a catheter due to their small size.
Answer: feeding tubes
What is a colostomy (also called ilestomy)?
Answer: A surgically formed fistula that is an external opening from the large bowel through the abdominal wall.
After what procedure may we be required to give a patient sanitary supplies?
What 3 advantages are there of the Sims' position?
1) Promotes drainage from the mouth
2) Prevents aspiration
3) Reduces pressure on the sacrum/greater trochanter
What radiographic exam is the Sims' position used for?
Answer: Barium enema
What type of patients can the Fowler's position benefit?
Answer: Those with respiratory problems
What does the Trendelenburg position promote?
Answer: Venous return in patients with inadequate peripheral perfusion
What radiographic procedure is the Lithotomy position used for?
Answer: Hysterosalpingogram and retrograde pyelography
To take pressure off the ischial tuberosities, a patient should be positioned in either the ______________ or the ______________ positions.
Answer: lateral recumbent or supine
If a patient has abdominal pain, they should have their head ______________ and a ______________ under their knees.
Answer: elevated, bolster
If a patient is nauseated, their head should be ______________.
A fiberglass cast should be used when the bone is not ______________.
A plaster cast is used when the bone needs to be ______________ or when ______________ will occur.
Answer: re-positioned, frequent cast changes
One disadvantage of a plaster cast is that it is ______________.
What are 4 signs of impaired circulation in an extremity that has been casted?
4) Burning or tingling
6) Skin colour changes
7) Inability to move finger/toes
8) Decrease/absence of pulse
How does a decubitus ulcer form?
They form due to pressure on an area of tissue. This pressure inhibits circulation and deprives the cells of the oxygen and nutrients they require, and in turn the cells die. The central portion of cells can die within a few minutes of circulatory deprivation.
Decubitus ulcers can be prevented by changing the patient position every ______ minutes.
What are the three pressure-related factors that affect ulcer formation?
3) Tissue tolerance
What are the three external factors that affect ulcer formation?
Any device that restricts or reduces voluntary movement or freedom, implemented to ensure safety of self, others or physical environment.
What are the three categories of restraints?
In what two situations would restraints be used?
Emergent (in the presence of imminent danger)
Non-emergent (in situations where other methods are not effective)
True or false: Application of restraints requires a physicians order.
Why should a restrained patient never be left alone?
Should the need to cough, vomit, etc. they may be unable to move into a position that would allow them to do this safely.
What is the difference between immobilization and restraints?
Immobilization does not prevent the patient from moving freely; immobilization devices simply assist the patient in holding still for a radiographic procedure. They do not require a physician's order.
Restraints prevent free movement and do require a physician's order.
What are three immobilization methods used for children?
2) Mummy wrap (or bunny wrap)
4) Papoose board
What are the 5 rules for restraint application?
1) Patient must be allowed as much safe mobility as possible
2) Restraints must be padded to prevent skin injury
3) Normal anatomic position must be maintained
4) Use half knots for quick removal
5) Circulation and respiration must not be impaired
When observing for signs of abuse in children, the term used is ______________ ______________ ______________.
Answer: Non-Accidental Trauma (NAT)
Shaken baby syndrome may be indicated by what symptoms?
Answer: Separated skull sutures and unexplained unconsciousness in an infant.
Name four types of elder abuse.
5) Emotional abuse
If signs of NAT are present in a child or elder, what should your course of action be?
Answer: While the patient is still in the department, notify your supervisor immediately and follow the protocol for your facility with regard to reporting.
True or false: The responsibility to report child abuse overrides the responsibility of confidentiality.
Failure to report child abuse can carry up to a $______________ fine.
Answer: 10 000
True or false: Reporting spousal or elder abuse is mandatory.
Reporting spousal or elder abuse is NOT mandatory.
Where is the primary target zone for child abuse?
Answer: Bruising on the buttocks
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