Client Safety Lecture

[Music] hi guys it&#39;s me professor D and welcome back to my channel if you haven&#39;t done so already please be sure to press that like and subscribe button below guys that is what keeps the content and videos coming so on this video I want to cover client safety with you okay so we&#39;re gonna practice questions on client safety let&#39;s jump right into it so the first question an ambit or a client is admitted to the extended care facility with a diagnosis of Alzheimer&#39;s disease usually excuse me in using a fall assessment tool the nurse knows that the greatest indicator of a fall risk is one confusion to impair judgment three sensory deficits for history of Falls and the correct answer is four and I made a mistake when I was reading the question I should have said in the greatest indicator of risk and I said fall risk so I kind of gave you a hand so guys the greatest indicator of risk is patient that has a history of Falls why any patient that has a history of Falls means there are three times more likely to have another false so that places them at grave danger and risk for having a fall okay next question the workmen caused an electrical fire when installing a new piece of equipment in the intensive care unit a client is on the ventilator in the next room the first action the nurse should take is to one pull the fire alarm to attempt to distinguish the fire three call the physician that obtained orders to take the client off the vet or for use an Ambu bag and remove the client from the area and the correct answer is four guys remember when there&#39;s a fire you want to do are a c e r stands for rescue the first thing you want to do is rescue the patient this patient happens to be on the vent so guess what they&#39;re gonna have to be off of that vent how are they gonna get oxygen by that Ambu bag that you&#39;re squeezing you&#39;re gonna be pushing air into their lungs with the Ambu bag so the first thing you do is are this in-race R stands for rescue you&#39;re gonna rescue your patient a stands for alarm after you rescue your patient you&#39;re gonna pull the alarm C stands for containment you need to contain that fire so it doesn&#39;t grow bigger how do you contain the fire close the doors close the windows so the fire chokes because it&#39;s not getting oxygen and remember oxygen is what makes fires grow and E is last the last thing you&#39;re gonna do is extinguish the fire okay next question a visiting nurse completes an assessment of the Ambu Tori client in the home and determines the nursing diagnosis of risk for injury related to decreased vision based on this assessment the client will benefit the most from one installing florescent lighting throughout the house to becoming oriented to the position of furniture and stairways three maintaining complete bed rest in the hospital sub bed with side rails or for applying physical restraints and the correct answer is to becoming oriented to the position of the furniture and stairways here&#39;s the thing guys patient with decreased vision you&#39;re going to have them fix their furniture you help them fix their furniture and that furniture does not move okay because if they know where that furniture is they know whether stairways are they&#39;re less likely to have a fall to trip over things what else do you want to do aside from making sure that that&#39;s furniture is safe and it stays in the place it&#39;s supposed to be you want to have good lighting you want to make sure there are no throw rugs on the floor you want to make sure there are no cords lying around on the floor you want to make sure there are handrails throughout the house you want to make sure that there are non-skid there&#39;s a non-skid mat in the tub if the patient has a history of Falls right but with decreased vision if the patient can&#39;t see you want to make sure that there&#39;s nothing that they can trip over okay next question which of the following statements by the parent of a child indicates that further teaching by the nurses required one not that my child&#39;s two years old I can let her sit in the front seat of the car with me too I&#39;ll make sure that my child wears a helmet when he rides his bicycle three I have spoken to my child about safe sex practices for my child&#39;s taking swimming classes at the community center and the correct answer guys is one that needs further teaching okay according to the CDC if that child is younger than 13 they need to be in the back seat okay so a child that&#39;s two years old they still need to be sitting in the back seat and on the front with mom next question the nurse&#39;s stress is that the client may need a restraint and recognizes that one an order for restraint may be implemented indefinitely until it&#39;s no longer required by the client to restraints may be ordered on an as-needed basis 3 no order or consent is necessary for restraint in long term so these or four restraints are to be periodically removed to have the client reevaluated and the correct answer guys is four so restraints and each of the states take this very seriously number one you need a doctor&#39;s order for restraint the order for restraint is not indefinite it&#39;s only good for 24 hours then in order to get another you need to keep that patient interest rates for more than 24 hours you need a doctor&#39;s order guess what that doctor has to have a face-to-face they have to have seen that patients I bought that patient seeing the patient&#39;s noted that patients still need restraints to give another order it&#39;s not indefinite guys when the patients and restraints you absolutely must as a nurse you have to be checking their circulation distal to the restraint because you got to make sure that the restraints aren&#39;t too tight that they&#39;re cutting off the patient&#39;s circulation right you have to make sure that you&#39;re offering that patient nutrition and not only are you offering nutrition you have to document that you offered the nutrition and how often you have to offer fluids to the patient you have to document how often you offered the fluids right you have to offer the patient the use of the restroom and you have to document how often you offered it to the patient and you also have to let your patient know the reason why they&#39;re in restraints you have to let them know what kind of behavior they have to exhibit in order to get out of the restraints so you can&#39;t just put the patient on restraints and definitely no they have to know why they&#39;re in restraints what they have to do to get out of restraints and once that patient demonstrates that behavior you have to take them off of the restraints if the patient cannot be in restraints indefinitely in definite no that&#39;s not Iran and definitely excuse me next question mother of a child enters the kitchen and finds the child on the floor there&#39;s a bottle of cleanser next to the child and particles of the substance around the child&#39;s mouth the parents first action should be one called the poison control unit to provide epic AK serum check the child&#39;s airway breathing for remove the particles of cleanser from the child&#39;s mouth and I&#39;ll give you a moment to think of your answer okay guys so the correct answer the first thing you&#39;re gonna do is check that child&#39;s airway you want to make sure that that child&#39;s airway has not been obstructed that&#39;s ABC simple as that airway breathing circulation you make sure that airway has not been obstructed right after that the next thing you&#39;re gonna do is clear those um whatever that the patient the baby had in their mouth you&#39;re gonna remove it remove those particles then you&#39;re gonna call the Poison Control Center so the first thing you&#39;re gonna do is check their airway make sure that the patient has paetynn airway that they&#39;re breathing to you&#39;re gonna remove as much of the Florida whatever&#39;s in that patients mouth you&#39;re gonna remove it then three you&#39;re going to call the poison control center here&#39;s the reason you don&#39;t call the Poison Control Center before removing the substance from the patient&#39;s mouth and this is a Content concept that you guys are gonna have to know throughout all of your nursing career you never leave an offending agent inside of a patient while you&#39;re calling for help it makes no sense so while you&#39;re on the phone with the cook poison control center whatever it is that&#39;s harming your baby still in the baby&#39;s mouth does that make any sense no you&#39;re gonna remove as much as you can from the mouth first right so that while you&#39;re on the phone with the poison control center it&#39;s not still offending their mouth is still not causing or still not as harsh of an outcome as it would have been next question which of the following clients who&#39;s experiencing the heat of mid-august is a greatest risk for a heat stroke or heat exhaustion one a 65 year old diagnosed with COPD - a 35 year old novice marathon runner 3 a 15 year old playing an outdoor tennis tournament or for a nine month old whose bedroom is cooled with a mechanical fan and the correct answers 1 the 65 year old diagnosed with COPD so guys when it comes to heat exhaustion heatstroke let me tell you who&#39;s at risk anyone&#39;s who&#39;s very old the elderly the geriatric community anyone who is very very young such as infants anyone that has a chronic health condition such as COPD such as asthma such as diabetes so number one this patient has two of those factors they&#39;re elderly and they have a chronic condition which is a COPD okay so that&#39;s why that&#39;s the correct answer next question the nurse should recognize which of the following clients as being at greatest risk for an unintentional death one a 58 year old who skis rest regularly - a 44 year old alcoholic who lives alone three seventy two-year-old identified as high risk for Falls or four 34 year old diagnosed with chronic depression and the correct answer is three the 72 year old with a high risk for Falls they are at highest risk for unintentional death because what happens is those patient who have a history of Falls whenever I told you if they have a history of Falls they&#39;re more likely to have another fall right so what happens is that patient will have a fall and no one else is there and they&#39;re too far away from the phone to call for help so they end up starving to death or they end up on the floor they broke a leg they end up getting a clot the plot goes to their heart or their lungs they have embolism but the point is the patient that has a history of Falls they&#39;re more likely to have another fall and so what happens they&#39;re home alone they have a fall and they cannot call for help and they end up dying unintentionally next question the nurse recognizes that the leading cause of death for the otherwise healthy one-year-old is one physical abuse two accidental injury three contagious disease contagious diseases excuse me or four stranger abduction and the correct answer is accidental injury so let me explain to you guys why when these children they&#39;re 1 years old they&#39;re learning how to do walk right and not that age at 1 years old their head is much bigger than their body so they&#39;re learning to walk they&#39;re learning to run but they don&#39;t know how to stop quickly or if they do try to stop quickly what happens if they&#39;re running remember their heads bigger than the body so they&#39;re running and they try to stop quickly and they topple over so what happens with the accidental death they&#39;ll accidentally be running and they see the pool and they try to stop and then fall right into the pool because the head is bigger than the body right or because they&#39;re walking they can get into things so they get into the cabinet where all of the chemicals are and they ingest the chemicals and mom has no idea or they&#39;re walking and they&#39;re able to go out through the front door or the back door because the door was left open and they were fell into a pool or something like that so with with the 1 years one-year-old the biggest problem with that is because they&#39;re learning to walk and so they can get around and that&#39;s why they&#39;re there in the leading cause of death in that age group okay next question which of the following clients is at greatest risk for injury related to medical diagnosis and conditions one a history of asthma and alcohol abuse - a history of heart failure and urinary urgency three a history of hypertension and wearing corrective lenses or four a history of chronic bronchitis and impaired hearing and the correct answer guys is - a history of heart failure and urinary urgency and then explain that to you so patients who are on heart who have heart failure excuse me what happens is there&#39;s just too much fluid in the heart so they get medications to get rid of the fluid how are they getting rid of the fluid by urinating okay so the patient&#39;s going to the restroom a lot and they have urinary urgency remember urgency that&#39;s when they feel like they have to go right now they can&#39;t hold it you can&#39;t hold it so here you are within a patient who&#39;s running back and forth to the bathroom they&#39;re at risk for what Falls that&#39;s why I don&#39;t risk for injury okay so that&#39;s the answer to that question and make sense if you think about that patient who has heart disease and they need to get rid of all that fluid and they have urinary urgency in the question they kind of gave you a hint they told you urinary urgency so that patients constantly running to the bathroom so they&#39;re the ones who are going to be at greatest risk for injury next question the nurse was discussing safety issues with the mother of three children which of the following statements has the greatest possibility for decreasing the potential for injury among the children one where do you see a need for safety improvement in your home to keep all toxic liquids capped and stored out of the reach of children three installing safety gates at the top and bottom of each set of stairs will help minimize Falls or four take great care to keep children away from kitchen appliances and tools that can hurt them and I&#39;ll give you a moment to think you answer guys the correct answer is one asking mom where does she see the greatest need for improvement guys this is a concept that goes across nursing and you&#39;re gonna need it for the rest of your nursing career before you can teach a patient you have to assess what they need to learn and the only way you know what they need to learn is asking them what do you know about XYZ when you ask them that open-ended question the patient starts talking and while they&#39;re talking you&#39;re listening and you&#39;re figuring out wow this patient knows a lot I was gonna start my teaching up here but it looks like I I need to start a little bit higher or while you&#39;re listening you&#39;re like wow this patient really doesn&#39;t know much I was gonna start my teaching down here but it looks like I need to start it a little bit lower so the first thing you always want to do is assess see what that patient knows let them talk because when they&#39;re talking that&#39;s giving you information on what you need to be teaching that patient so that&#39;s why it&#39;s a correct answer I want you to notice in all the other choices you are teaching how do you know what to teach if you don&#39;t ask the patient what they know okay next question when preparing a safety workshop for early teens 13 to 15 years old the nurse recognizes of which of the following active strategy topics has the greatest potential for decreasing injuries in this population by affecting lifestyle changes 1 avoiding the nicotine habit to keeping immunizations up to date 3 eating a well-balanced a low-fat diet or 4 wearing a seatbelt when riding in an automobile and I&#39;ll give you a moment to think of your answer [Music] and the correct answer is four guys the leading cause of death and teenagers are MVAs motor vehicle accidents now you gotta have to think about is the 13 14 15 year-olds they may not be drivers yet the 15 year-olds might be new drivers they might have permits right they might not be drivers yet but guess what their friends are their friends for 16 17 18 right so what happens is they go joyriding or you know the getting the part and they don&#39;t wear seatbelts the number one cause of death and the teenager in that age range for teenagers are automobile accidents so you&#39;re gonna teach them to make sure that they were seatbelt every single time that they ride in a car next question the nurse is discussing measures to minimize the risk of injury from an automobile accident with an 83 year old adult client who lives alone and claims to drive only to church the doctor&#39;s office and for groceries which of the following suggestions has the greatest potential for infecting this client safety one take public transportation whenever available to plan errands around church or doctor&#39;s appointments three plan driving for short trips and only during the daylight hours 4 arrange for family or friends to drive you whenever it&#39;s possible and I&#39;ll give you a moment to think of your answer and the correct answer is three planned driving for short trips and only during daylight hours guys this preserves that patience independence while securing safety because especially with the geriatric the elderly population one of their biggest fears is their independence being taken away okay a lot of these elderly patients they were lawyers and doctors and astronauts astronauts and they had all of these high functioning careers right and so now that they&#39;re older and maybe their vision has decreased they&#39;re scared to death of their independence being taken away so number three is the best answer where you&#39;re teaching them that they need to be taking short drives plan to take short drives but at the same time also during don&#39;t do it during daylight hour hours where visibility is best okay next question which of the following assessment findings is most critical in the client who&#39;s currently being restrained with mechanical wrist restraints one angry loud crying to urinary incontinence three reddened areas on the wrist or four hands are cool to touch and I&#39;ll give you a moment to think of your answer and guys what&#39;s most critical is number four hands are cool to touch remember a couple questions ago I was telling you in the patients and restraints you know when the important things you have to make sure is circulation right and you want to make sure it&#39;s not too tight whoa this answer hands are cool to touch that lets you know that those restraints are too tight and that patients not getting adequate circulation why because the extremities patients skin&#39;s supposed to be wet warm you want to know what makes that patient warm blood so if the patient&#39;s not getting blood flow instead of being warm it&#39;s gonna be cool which is bad what&#39;s another sign of good circulation color pinkness or redness right that pink that pink color that patient has that lets you know that there&#39;s circulation if there&#39;s not circular it&#39;s not gonna be the skins not gonna be nice and pink the skin it&#39;s gonna be what blanched white or blue cyanotic okay so our biggest concern in this situation restraints is cool to touch because that means decreased circulation and guys if you can recall circulation is a priority okay in my priority patients video I gave you guys a list of which patients took priority who you&#39;re going to run to first and circulation falls under physiologic integrity which means that is the priority patient so out of all of the lists that we saw with the patient you know crying or being incontinence what we care about the most is being cool to touch because we know that if their skin if their hands cool to touch that means they&#39;re not getting circulation and that&#39;s our biggest problem next question the nurse is discussing a newly ordered diuretic with an older client who is homebound which of the following suggestion has the greatest potential for minimising the client&#39;s risk for injury related to urinary urgency or incontinence one consider decreasing fluid intake after 6:00 p.m. to illuminate the path to the bathroom at night 3 encourage Clyde to urinate immediately before bed 4 encourage a client to take medication early in the morning and I&#39;ll give you a moment to look at you think of your answer [Music] okay guys and by the way all of these choices are excellent choices you want to teach the patient all of these choices but which one would be most significant and the correct answer is for encouraging the client to take the medication early in the morning why you don&#39;t want the client is taking diuretics to be waking up in the middle of the night to use the medication why they&#39;re waking up from their sleep they&#39;re groggy they&#39;re sleepy their vision isn&#39;t up to par and so them trying to rush to get to the restroom to urinate it&#39;s easy for them to have a fall so that&#39;s why number four is the correct answer by the way guys what patients are taking diuretics that&#39;s why they need to take it early in the morning so they&#39;ll have all day to use the restroom if they need to by the time they go to bed at night they won&#39;t be having that urgency or frequency next question a nurse caring for an elderly client who has had surgery and is in the hospital knows that the client is at high risk for developing a nosocomial infection one of the most important things that the nurse can do to prevent this client from obtaining a nosocomial infection is to one practice appropriate hand hygiene to request prophylactic antibiotics for the client three place the client in isolation or for encourage a client to turn turn cough deep breathe every two hours and I&#39;ll give you a moment to think of your answer and the correct answer guys is number one you want to practice hand hygiene the number one way to prevent infections in the facility is to wash your hands hand hygiene you&#39;re not going to ask for an order for prophylactic antibiotics are you the doctor so why are you asking for antibiotics okay you can&#39;t play doctor right so you&#39;re not going to do that let&#39;s see what if our other choices were you&#39;re not going to place the client into isolation to place your client in isolation you have to have an order for the client to be in isolation right and for encouragement trying to turn cop debrief that is wonderful for preventing post-op infections right after a patient has an effect on an infection after a patient has surgery and you don&#39;t want them to get infection you don&#39;t want them to get a DVT or pulmonary embolism you encourage them to turn coffee breathe that&#39;s wonderful but for preventing nosocomial infection the number one thing that you can do is hand hygiene okay guys second to last question a confused client needs to have restraints to prevent him from pulling out his Foley catheter which of the following can the nurse delegate to the nursing assistant personnel one apply restraints to obtain a physician&#39;s order to restrain the client three document events that led to restraining the client or for evaluating the effectiveness of the restraints now give you a moment to think of your answer correct answers one applying restraints that is the only thing that the system personnel can do in these choices okay they can apply the restraints that you tell them to apply but the system personnel has to be trained in applying restraints but they are allowed to do that two three and four only the RN can do obtaining the order it&#39;s our end it&#39;s going to be calling the doctor and the RN has to tell the doctor what&#39;s going on with the patient that they&#39;re requesting the order three documenting the events the RN is the one who&#39;s going to be doing documenting the events scuse me and the number four evaluating the effectiveness that requires critical thinking only the RN can do that again guys if you guys have trouble with delegation because this is a delegation question what can the r RN do versus the LPN versus the CNA if you guys are kind of iffy on delegation please be sure to watch my delegation video I go very in-depth on what the RN absolutely must do they can&#39;t delegate it to anyone else versus what the LPN is allowed to do versus what the CNA or assistive personnel is allowed to do and in this question absolutely number one is answer the assistive personnel is allowed to apply restraints please don&#39;t forget just like I told you my previous video on delegations what else can the CNA or such a personnel do they&#39;re allowed to do vital signs they&#39;re allowed to check the patient&#39;s glucose they&#39;re allowed to record and report what does that mean they&#39;re allowed to take the vital signs or Ino and report it to the nurse they&#39;re allowed to gather quit med their lot to do ADL&#39;s and the list goes on if you have any questions about that watch my delegations video and last question a nurse finds an electrical cord has shorted out in a client&#39;s room causing a fire the nurse should do which of the following actions first one activate the alarm to confine the fire by closing clients door three remove the client from the room or four extinguish the fire and as I said in my last on my last video but a couple questions ago I told you guys when it comes to a fire you want to do race are AC e okay our stands for rescue the first thing you&#39;re gonna do is rescue the client you&#39;re gonna get the client out of there you&#39;re gonna get them out of harm&#39;s way the second thing you want to do after you rescue the client then you&#39;re gonna pull the lar okay I&#39;m gonna activate the learn C it&#39;s confined you want to confine that fire so you&#39;re gonna close the doors and windows make sure this as least sake as least oxygen as possible because remember oxygen that&#39;s what fuels the fire it helps it grow and the last thing you&#39;re gonna do is extinguish the fire so guys I hope that you found this video to be helped if you guys have anything that you guys want me to talk about that you&#39;d like me to do questions on any demonstrations please make sure that you leave a comment and I will make sure that I make a video for you last and not leat last and not leave please be sure to press that like and subscribe button below guys that is what fuels me to keep the contents coming and to keep the videos coming so thank you for joining me and I&#39;ll see you next time

[Music] hi guys it&amp;#39;s me professor D and welcome back to my channel if you haven&amp;#39;t done so already please be sure to press that like and subscribe button below guys that is what keeps the content and videos coming so on this video I want to cover client safety with you okay so we&amp;#39;re gonna practice questions on client safety let&amp;#39;s jump right into it so the first question an ambit or a client is admitted to the extended care facility with a diagnosis of Alzheimer&amp;#39;s disease usually excuse me in using a fall assessment tool the nurse knows that the greatest indicator of a fall risk is one confusion to impair judgment three sensory deficits for history of Falls and the correct answer is four and I made a mistake when I was reading the question I should have said in the greatest indicator of risk and I said fall risk so I kind of gave you a hand so guys the greatest indicator of risk is patient that has a history of Falls why any patient that has a history of Falls means there are three times more likely to have another false so that places them at grave danger and risk for having a fall okay next question the workmen caused an electrical fire when installing a new piece of equipment in the intensive care unit a client is on the ventilator in the next room the first action the nurse should take is to one pull the fire alarm to attempt to distinguish the fire three call the physician that obtained orders to take the client off the vet or for use an Ambu bag and remove the client from the area and the correct answer is four guys remember when there&amp;#39;s a fire you want to do are a c e r stands for rescue the first thing you want to do is rescue the patient this patient happens to be on the vent so guess what they&amp;#39;re gonna have to be off of that vent how are they gonna get oxygen by that Ambu bag that you&amp;#39;re squeezing you&amp;#39;re gonna be pushing air into their lungs with the Ambu bag so the first thing you do is are this in-race R stands for rescue you&amp;#39;re gonna rescue your patient a stands for alarm after you rescue your patient you&amp;#39;re gonna pull the alarm C stands for containment you need to contain that fire so it doesn&amp;#39;t grow bigger how do you contain the fire close the doors close the windows so the fire chokes because it&amp;#39;s not getting oxygen and remember oxygen is what makes fires grow and E is last the last thing you&amp;#39;re gonna do is extinguish the fire okay next question a visiting nurse completes an assessment of the Ambu Tori client in the home and determines the nursing diagnosis of risk for injury related to decreased vision based on this assessment the client will benefit the most from one installing florescent lighting throughout the house to becoming oriented to the position of furniture and stairways three maintaining complete bed rest in the hospital sub bed with side rails or for applying physical restraints and the correct answer is to becoming oriented to the position of the furniture and stairways here&amp;#39;s the thing guys patient with decreased vision you&amp;#39;re going to have them fix their furniture you help them fix their furniture and that furniture does not move okay because if they know where that furniture is they know whether stairways are they&amp;#39;re less likely to have a fall to trip over things what else do you want to do aside from making sure that that&amp;#39;s furniture is safe and it stays in the place it&amp;#39;s supposed to be you want to have good lighting you want to make sure there are no throw rugs on the floor you want to make sure there are no cords lying around on the floor you want to make sure there are handrails throughout the house you want to make sure that there are non-skid there&amp;#39;s a non-skid mat in the tub if the patient has a history of Falls right but with decreased vision if the patient can&amp;#39;t see you want to make sure that there&amp;#39;s nothing that they can trip over okay next question which of the following statements by the parent of a child indicates that further teaching by the nurses required one not that my child&amp;#39;s two years old I can let her sit in the front seat of the car with me too I&amp;#39;ll make sure that my child wears a helmet when he rides his bicycle three I have spoken to my child about safe sex practices for my child&amp;#39;s taking swimming classes at the community center and the correct answer guys is one that needs further teaching okay according to the CDC if that child is younger than 13 they need to be in the back seat okay so a child that&amp;#39;s two years old they still need to be sitting in the back seat and on the front with mom next question the nurse&amp;#39;s stress is that the client may need a restraint and recognizes that one an order for restraint may be implemented indefinitely until it&amp;#39;s no longer required by the client to restraints may be ordered on an as-needed basis 3 no order or consent is necessary for restraint in long term so these or four restraints are to be periodically removed to have the client reevaluated and the correct answer guys is four so restraints and each of the states take this very seriously number one you need a doctor&amp;#39;s order for restraint the order for restraint is not indefinite it&amp;#39;s only good for 24 hours then in order to get another you need to keep that patient interest rates for more than 24 hours you need a doctor&amp;#39;s order guess what that doctor has to have a face-to-face they have to have seen that patients I bought that patient seeing the patient&amp;#39;s noted that patients still need restraints to give another order it&amp;#39;s not indefinite guys when the patients and restraints you absolutely must as a nurse you have to be checking their circulation distal to the restraint because you got to make sure that the restraints aren&amp;#39;t too tight that they&amp;#39;re cutting off the patient&amp;#39;s circulation right you have to make sure that you&amp;#39;re offering that patient nutrition and not only are you offering nutrition you have to document that you offered the nutrition and how often you have to offer fluids to the patient you have to document how often you offered the fluids right you have to offer the patient the use of the restroom and you have to document how often you offered it to the patient and you also have to let your patient know the reason why they&amp;#39;re in restraints you have to let them know what kind of behavior they have to exhibit in order to get out of the restraints so you can&amp;#39;t just put the patient on restraints and definitely no they have to know why they&amp;#39;re in restraints what they have to do to get out of restraints and once that patient demonstrates that behavior you have to take them off of the restraints if the patient cannot be in restraints indefinitely in definite no that&amp;#39;s not Iran and definitely excuse me next question mother of a child enters the kitchen and finds the child on the floor there&amp;#39;s a bottle of cleanser next to the child and particles of the substance around the child&amp;#39;s mouth the parents first action should be one called the poison control unit to provide epic AK serum check the child&amp;#39;s airway breathing for remove the particles of cleanser from the child&amp;#39;s mouth and I&amp;#39;ll give you a moment to think of your answer okay guys so the correct answer the first thing you&amp;#39;re gonna do is check that child&amp;#39;s airway you want to make sure that that child&amp;#39;s airway has not been obstructed that&amp;#39;s ABC simple as that airway breathing circulation you make sure that airway has not been obstructed right after that the next thing you&amp;#39;re gonna do is clear those um whatever that the patient the baby had in their mouth you&amp;#39;re gonna remove it remove those particles then you&amp;#39;re gonna call the Poison Control Center so the first thing you&amp;#39;re gonna do is check their airway make sure that the patient has paetynn airway that they&amp;#39;re breathing to you&amp;#39;re gonna remove as much of the Florida whatever&amp;#39;s in that patients mouth you&amp;#39;re gonna remove it then three you&amp;#39;re going to call the poison control center here&amp;#39;s the reason you don&amp;#39;t call the Poison Control Center before removing the substance from the patient&amp;#39;s mouth and this is a Content concept that you guys are gonna have to know throughout all of your nursing career you never leave an offending agent inside of a patient while you&amp;#39;re calling for help it makes no sense so while you&amp;#39;re on the phone with the cook poison control center whatever it is that&amp;#39;s harming your baby still in the baby&amp;#39;s mouth does that make any sense no you&amp;#39;re gonna remove as much as you can from the mouth first right so that while you&amp;#39;re on the phone with the poison control center it&amp;#39;s not still offending their mouth is still not causing or still not as harsh of an outcome as it would have been next question which of the following clients who&amp;#39;s experiencing the heat of mid-august is a greatest risk for a heat stroke or heat exhaustion one a 65 year old diagnosed with COPD - a 35 year old novice marathon runner 3 a 15 year old playing an outdoor tennis tournament or for a nine month old whose bedroom is cooled with a mechanical fan and the correct answers 1 the 65 year old diagnosed with COPD so guys when it comes to heat exhaustion heatstroke let me tell you who&amp;#39;s at risk anyone&amp;#39;s who&amp;#39;s very old the elderly the geriatric community anyone who is very very young such as infants anyone that has a chronic health condition such as COPD such as asthma such as diabetes so number one this patient has two of those factors they&amp;#39;re elderly and they have a chronic condition which is a COPD okay so that&amp;#39;s why that&amp;#39;s the correct answer next question the nurse should recognize which of the following clients as being at greatest risk for an unintentional death one a 58 year old who skis rest regularly - a 44 year old alcoholic who lives alone three seventy two-year-old identified as high risk for Falls or four 34 year old diagnosed with chronic depression and the correct answer is three the 72 year old with a high risk for Falls they are at highest risk for unintentional death because what happens is those patient who have a history of Falls whenever I told you if they have a history of Falls they&amp;#39;re more likely to have another fall right so what happens is that patient will have a fall and no one else is there and they&amp;#39;re too far away from the phone to call for help so they end up starving to death or they end up on the floor they broke a leg they end up getting a clot the plot goes to their heart or their lungs they have embolism but the point is the patient that has a history of Falls they&amp;#39;re more likely to have another fall and so what happens they&amp;#39;re home alone they have a fall and they cannot call for help and they end up dying unintentionally next question the nurse recognizes that the leading cause of death for the otherwise healthy one-year-old is one physical abuse two accidental injury three contagious disease contagious diseases excuse me or four stranger abduction and the correct answer is accidental injury so let me explain to you guys why when these children they&amp;#39;re 1 years old they&amp;#39;re learning how to do walk right and not that age at 1 years old their head is much bigger than their body so they&amp;#39;re learning to walk they&amp;#39;re learning to run but they don&amp;#39;t know how to stop quickly or if they do try to stop quickly what happens if they&amp;#39;re running remember their heads bigger than the body so they&amp;#39;re running and they try to stop quickly and they topple over so what happens with the accidental death they&amp;#39;ll accidentally be running and they see the pool and they try to stop and then fall right into the pool because the head is bigger than the body right or because they&amp;#39;re walking they can get into things so they get into the cabinet where all of the chemicals are and they ingest the chemicals and mom has no idea or they&amp;#39;re walking and they&amp;#39;re able to go out through the front door or the back door because the door was left open and they were fell into a pool or something like that so with with the 1 years one-year-old the biggest problem with that is because they&amp;#39;re learning to walk and so they can get around and that&amp;#39;s why they&amp;#39;re there in the leading cause of death in that age group okay next question which of the following clients is at greatest risk for injury related to medical diagnosis and conditions one a history of asthma and alcohol abuse - a history of heart failure and urinary urgency three a history of hypertension and wearing corrective lenses or four a history of chronic bronchitis and impaired hearing and the correct answer guys is - a history of heart failure and urinary urgency and then explain that to you so patients who are on heart who have heart failure excuse me what happens is there&amp;#39;s just too much fluid in the heart so they get medications to get rid of the fluid how are they getting rid of the fluid by urinating okay so the patient&amp;#39;s going to the restroom a lot and they have urinary urgency remember urgency that&amp;#39;s when they feel like they have to go right now they can&amp;#39;t hold it you can&amp;#39;t hold it so here you are within a patient who&amp;#39;s running back and forth to the bathroom they&amp;#39;re at risk for what Falls that&amp;#39;s why I don&amp;#39;t risk for injury okay so that&amp;#39;s the answer to that question and make sense if you think about that patient who has heart disease and they need to get rid of all that fluid and they have urinary urgency in the question they kind of gave you a hint they told you urinary urgency so that patients constantly running to the bathroom so they&amp;#39;re the ones who are going to be at greatest risk for injury next question the nurse was discussing safety issues with the mother of three children which of the following statements has the greatest possibility for decreasing the potential for injury among the children one where do you see a need for safety improvement in your home to keep all toxic liquids capped and stored out of the reach of children three installing safety gates at the top and bottom of each set of stairs will help minimize Falls or four take great care to keep children away from kitchen appliances and tools that can hurt them and I&amp;#39;ll give you a moment to think you answer guys the correct answer is one asking mom where does she see the greatest need for improvement guys this is a concept that goes across nursing and you&amp;#39;re gonna need it for the rest of your nursing career before you can teach a patient you have to assess what they need to learn and the only way you know what they need to learn is asking them what do you know about XYZ when you ask them that open-ended question the patient starts talking and while they&amp;#39;re talking you&amp;#39;re listening and you&amp;#39;re figuring out wow this patient knows a lot I was gonna start my teaching up here but it looks like I I need to start a little bit higher or while you&amp;#39;re listening you&amp;#39;re like wow this patient really doesn&amp;#39;t know much I was gonna start my teaching down here but it looks like I need to start it a little bit lower so the first thing you always want to do is assess see what that patient knows let them talk because when they&amp;#39;re talking that&amp;#39;s giving you information on what you need to be teaching that patient so that&amp;#39;s why it&amp;#39;s a correct answer I want you to notice in all the other choices you are teaching how do you know what to teach if you don&amp;#39;t ask the patient what they know okay next question when preparing a safety workshop for early teens 13 to 15 years old the nurse recognizes of which of the following active strategy topics has the greatest potential for decreasing injuries in this population by affecting lifestyle changes 1 avoiding the nicotine habit to keeping immunizations up to date 3 eating a well-balanced a low-fat diet or 4 wearing a seatbelt when riding in an automobile and I&amp;#39;ll give you a moment to think of your answer [Music] and the correct answer is four guys the leading cause of death and teenagers are MVAs motor vehicle accidents now you gotta have to think about is the 13 14 15 year-olds they may not be drivers yet the 15 year-olds might be new drivers they might have permits right they might not be drivers yet but guess what their friends are their friends for 16 17 18 right so what happens is they go joyriding or you know the getting the part and they don&amp;#39;t wear seatbelts the number one cause of death and the teenager in that age range for teenagers are automobile accidents so you&amp;#39;re gonna teach them to make sure that they were seatbelt every single time that they ride in a car next question the nurse is discussing measures to minimize the risk of injury from an automobile accident with an 83 year old adult client who lives alone and claims to drive only to church the doctor&amp;#39;s office and for groceries which of the following suggestions has the greatest potential for infecting this client safety one take public transportation whenever available to plan errands around church or doctor&amp;#39;s appointments three plan driving for short trips and only during the daylight hours 4 arrange for family or friends to drive you whenever it&amp;#39;s possible and I&amp;#39;ll give you a moment to think of your answer and the correct answer is three planned driving for short trips and only during daylight hours guys this preserves that patience independence while securing safety because especially with the geriatric the elderly population one of their biggest fears is their independence being taken away okay a lot of these elderly patients they were lawyers and doctors and astronauts astronauts and they had all of these high functioning careers right and so now that they&amp;#39;re older and maybe their vision has decreased they&amp;#39;re scared to death of their independence being taken away so number three is the best answer where you&amp;#39;re teaching them that they need to be taking short drives plan to take short drives but at the same time also during don&amp;#39;t do it during daylight hour hours where visibility is best okay next question which of the following assessment findings is most critical in the client who&amp;#39;s currently being restrained with mechanical wrist restraints one angry loud crying to urinary incontinence three reddened areas on the wrist or four hands are cool to touch and I&amp;#39;ll give you a moment to think of your answer and guys what&amp;#39;s most critical is number four hands are cool to touch remember a couple questions ago I was telling you in the patients and restraints you know when the important things you have to make sure is circulation right and you want to make sure it&amp;#39;s not too tight whoa this answer hands are cool to touch that lets you know that those restraints are too tight and that patients not getting adequate circulation why because the extremities patients skin&amp;#39;s supposed to be wet warm you want to know what makes that patient warm blood so if the patient&amp;#39;s not getting blood flow instead of being warm it&amp;#39;s gonna be cool which is bad what&amp;#39;s another sign of good circulation color pinkness or redness right that pink that pink color that patient has that lets you know that there&amp;#39;s circulation if there&amp;#39;s not circular it&amp;#39;s not gonna be the skins not gonna be nice and pink the skin it&amp;#39;s gonna be what blanched white or blue cyanotic okay so our biggest concern in this situation restraints is cool to touch because that means decreased circulation and guys if you can recall circulation is a priority okay in my priority patients video I gave you guys a list of which patients took priority who you&amp;#39;re going to run to first and circulation falls under physiologic integrity which means that is the priority patient so out of all of the lists that we saw with the patient you know crying or being incontinence what we care about the most is being cool to touch because we know that if their skin if their hands cool to touch that means they&amp;#39;re not getting circulation and that&amp;#39;s our biggest problem next question the nurse is discussing a newly ordered diuretic with an older client who is homebound which of the following suggestion has the greatest potential for minimising the client&amp;#39;s risk for injury related to urinary urgency or incontinence one consider decreasing fluid intake after 6:00 p.m. to illuminate the path to the bathroom at night 3 encourage Clyde to urinate immediately before bed 4 encourage a client to take medication early in the morning and I&amp;#39;ll give you a moment to look at you think of your answer [Music] okay guys and by the way all of these choices are excellent choices you want to teach the patient all of these choices but which one would be most significant and the correct answer is for encouraging the client to take the medication early in the morning why you don&amp;#39;t want the client is taking diuretics to be waking up in the middle of the night to use the medication why they&amp;#39;re waking up from their sleep they&amp;#39;re groggy they&amp;#39;re sleepy their vision isn&amp;#39;t up to par and so them trying to rush to get to the restroom to urinate it&amp;#39;s easy for them to have a fall so that&amp;#39;s why number four is the correct answer by the way guys what patients are taking diuretics that&amp;#39;s why they need to take it early in the morning so they&amp;#39;ll have all day to use the restroom if they need to by the time they go to bed at night they won&amp;#39;t be having that urgency or frequency next question a nurse caring for an elderly client who has had surgery and is in the hospital knows that the client is at high risk for developing a nosocomial infection one of the most important things that the nurse can do to prevent this client from obtaining a nosocomial infection is to one practice appropriate hand hygiene to request prophylactic antibiotics for the client three place the client in isolation or for encourage a client to turn turn cough deep breathe every two hours and I&amp;#39;ll give you a moment to think of your answer and the correct answer guys is number one you want to practice hand hygiene the number one way to prevent infections in the facility is to wash your hands hand hygiene you&amp;#39;re not going to ask for an order for prophylactic antibiotics are you the doctor so why are you asking for antibiotics okay you can&amp;#39;t play doctor right so you&amp;#39;re not going to do that let&amp;#39;s see what if our other choices were you&amp;#39;re not going to place the client into isolation to place your client in isolation you have to have an order for the client to be in isolation right and for encouragement trying to turn cop debrief that is wonderful for preventing post-op infections right after a patient has an effect on an infection after a patient has surgery and you don&amp;#39;t want them to get infection you don&amp;#39;t want them to get a DVT or pulmonary embolism you encourage them to turn coffee breathe that&amp;#39;s wonderful but for preventing nosocomial infection the number one thing that you can do is hand hygiene okay guys second to last question a confused client needs to have restraints to prevent him from pulling out his Foley catheter which of the following can the nurse delegate to the nursing assistant personnel one apply restraints to obtain a physician&amp;#39;s order to restrain the client three document events that led to restraining the client or for evaluating the effectiveness of the restraints now give you a moment to think of your answer correct answers one applying restraints that is the only thing that the system personnel can do in these choices okay they can apply the restraints that you tell them to apply but the system personnel has to be trained in applying restraints but they are allowed to do that two three and four only the RN can do obtaining the order it&amp;#39;s our end it&amp;#39;s going to be calling the doctor and the RN has to tell the doctor what&amp;#39;s going on with the patient that they&amp;#39;re requesting the order three documenting the events the RN is the one who&amp;#39;s going to be doing documenting the events scuse me and the number four evaluating the effectiveness that requires critical thinking only the RN can do that again guys if you guys have trouble with delegation because this is a delegation question what can the r RN do versus the LPN versus the CNA if you guys are kind of iffy on delegation please be sure to watch my delegation video I go very in-depth on what the RN absolutely must do they can&amp;#39;t delegate it to anyone else versus what the LPN is allowed to do versus what the CNA or assistive personnel is allowed to do and in this question absolutely number one is answer the assistive personnel is allowed to apply restraints please don&amp;#39;t forget just like I told you my previous video on delegations what else can the CNA or such a personnel do they&amp;#39;re allowed to do vital signs they&amp;#39;re allowed to check the patient&amp;#39;s glucose they&amp;#39;re allowed to record and report what does that mean they&amp;#39;re allowed to take the vital signs or Ino and report it to the nurse they&amp;#39;re allowed to gather quit med their lot to do ADL&amp;#39;s and the list goes on if you have any questions about that watch my delegations video and last question a nurse finds an electrical cord has shorted out in a client&amp;#39;s room causing a fire the nurse should do which of the following actions first one activate the alarm to confine the fire by closing clients door three remove the client from the room or four extinguish the fire and as I said in my last on my last video but a couple questions ago I told you guys when it comes to a fire you want to do race are AC e okay our stands for rescue the first thing you&amp;#39;re gonna do is rescue the client you&amp;#39;re gonna get the client out of there you&amp;#39;re gonna get them out of harm&amp;#39;s way the second thing you want to do after you rescue the client then you&amp;#39;re gonna pull the lar okay I&amp;#39;m gonna activate the learn C it&amp;#39;s confined you want to confine that fire so you&amp;#39;re gonna close the doors and windows make sure this as least sake as least oxygen as possible because remember oxygen that&amp;#39;s what fuels the fire it helps it grow and the last thing you&amp;#39;re gonna do is extinguish the fire so guys I hope that you found this video to be helped if you guys have anything that you guys want me to talk about that you&amp;#39;d like me to do questions on any demonstrations please make sure that you leave a comment and I will make sure that I make a video for you last and not leat last and not leave please be sure to press that like and subscribe button below guys that is what fuels me to keep the contents coming and to keep the videos coming so thank you for joining me and I&amp;#39;ll see you next time

Transcript for:Client Safety Lecture

Transcript for:
Client Safety Lecture