Safety, Security, and Emergency
PART A a. Fetus
b. Infant
c. Toddler and preschooler d. School-aged child e. Adolescent
f. Adult g. Older adult PART B
6. This age group needs assistance to evalu-ate activities that are potentially danger-ous and to discuss specific interventions that provide for safety at home, at school, and in the neighborhood.
7. Falls, fires, and motor vehicle crashes are significant hazards for this age group, and safety measures should be directed toward preventing these injuries.
8. Education for this group must focus on safe driving skills, the dangers of drug and alcohol use, and creation of a healthy lifestyle as a way to respond to the stress of daily living.
9. A pregnant student requires
reinforcement about the risks associated with alcohol consumption, smoking, drug use, and exposure to dangers in the environment.
10. This group needs education about ways to handle the stresses of daily life (e.g., raising a family, handling a demanding career) without relying on drugs and alcohol.
11. Vigilant supervision by parents and guardians is required to anticipate hazards and provide protection for this group, with precautionary devices.
12. Safety care for this group entails never leaving them unattended, using crib rails, and monitoring objects that may be placed in the mouth and swallowed.
CORRECT THE FALSE STATEMENTS
Circle the word “true” or “false” that follows the statement. If you circled “false,” change the underlined word or words to make the statement true. Write your answer in the space provided.
1. Nearly one third of older adults fall at home each year.
True False
2. According to The Joint Commission,
caregivers must use at least two patient iden-tifiers (neither to be the patient’s room num-ber) whenever administering medications and providing treatments or procedures.
True False
3. A person with a history of falling is at great risk to fall again.
True False 154 UNIT VI ACTIONS BASIC TO NURSING CARE
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing:
The Art and Science of Nursing Care, 7th Edition.
LWBK696-C26_p151-157.qxd 9/2/10 9:35 AM Page 154 Aptara Inc
CHAPTER 26 SAFETY, SECURITY, AND EMERGENCY PREPAREDNESS 155
4. Most exposures to toxic fumes occur in the workplace.
True False
5. Asphyxiation may occur in any age group, but the incidence is greatest among older adults.
True False
6. Keeping a gun in the home increases the risk for domestic homicide.
True False
7. A rear-facing safety seat is recommended for infants who are younger than 1 year old and weigh less than 20 pounds.
True False
8. For the school-aged child, the focus of parental responsibility is on childproofing the environment.
True False
9. As the primary reason for applying restraints, nurses consistently cite the risk for injury to patients and healthcare workers from irrational behavior.
True False
10. Using a restraint on an older person who tends to wander is justified to ensure his/her safety.
True False
11. Nearly half of all drowning victims are teenagers.
True False
12. The number of deaths from accidental poisoning has decreased over the years.
True False SHORT ANSWER
1. Identify two safety risks for each of the following age groups.
a. Neonates and infants:
b. Toddler and preschooler:
c. School-aged child:
d. Adolescent:
e. Adult:
f. Older adult:
2. List two examples of how the following factors can affect safety.
a. Developmental considerations:
b. Lifestyle:
c. Limitation in mobility:
d. Limitation in sensory perception:
e. Limitation in knowledge:
f. Limitation in ability to communicate:
g. Limitation in health status:
h. Limitation in psychosocial state:
3. Briefly explain why the following information is necessary when assessing the patient for safety.
a. Nursing history:
b. Physical assessment:
c. Accident-prone behavior:
d. The environment:
LWBK696-C26_p151-157.qxd 9/2/10 9:35 AM Page 155 Aptara Inc
4. Mrs. Vogel, age 72, fell when getting out of bed to use the bathroom in her nursing home. List four characteristics that should be assessed to determine whether this patient is at a greater risk for falls.
a.
b.
c.
d.
5. You are visiting a homebound patient who is staying with her daughter, who also has a toddler at home. You notice that the house is not childproofed and watch in horror as the toddler pulls a bottle of disinfectant out from under the sink while the mother is busy car-ing for her own mother. How would you pre-pare and present a plan for this mother to childproof her home?
6. List three questions you could ask a patient to assess for hazards that may cause a child to asphyxiate or choke.
a.
b.
c.
7. Write a sample nursing diagnosis for each of the following situations.
a. A mother refuses to use a car seat for her child:
b. An older patient has poor vision and cannot read the label on her medication bottle:
c. A mother leaves her child unattended in the bathtub while she answers the phone:
d. A patient tells you she is “clumsy” and has fallen several times in the past few years:
e. The windows and doors do not operate properly in the home of an older couple, but they cannot afford repairs:
8. List three opportunities a nurse can use to teach students about safety.
a.
b.
c.
9. List five risks associated with the use of restraints.
a.
b.
c.
d.
e.
10. Mrs. Bender is a patient who has been placed in restraints to protect her from falling after other methods have failed. She refused to listen to information about the dangers of falling and repeatedly attempted to go to the bathroom on her own. How would you docu-ment the use of restraints on this patient?
11. List the information that should be included on a safety event report, when it should be filled out, and who is responsible for record-ing the event.
156 UNIT VI ACTIONS BASIC TO NURSING CARE
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing:
The Art and Science of Nursing Care, 7th Edition.
LWBK696-C26_p151-157.qxd 9/2/10 9:35 AM Page 156 Aptara Inc
CHAPTER 26 SAFETY, SECURITY, AND EMERGENCY PREPAREDNESS 157
12. Describe how you would assess a patient for risk for falling by using the Get Up and Go test (Hendrich, 2007). State the time parameters for full mobility, almost complete independence, and impaired mobility.
APPLYING YOUR KNOWLEDGE
CRITICAL THINKING QUESTIONS
1. Visit the homes of friends or relatives who have children of different ages living with them. Ask for permission to inspect their home for safety features that are appropriate to the ages of the children. Check for poison control, fire prevention, fall protection, burn and shock protection, and so on. Share your results with the family, and explain to them what they need to do (if anything) to improve safety in their home. Reflect on the importance that dif-ferent families attach to safety and its implica-tion for your nursing practice.
2. Many people tend to take safety measures for granted. Draw on your experiences in conver-sations with nurses to identify safety risks for both nurses and patients in different practice settings. What can you do to minimize these risks?
REFLECTIVE PRACTICE USING CRITICAL THINKING SKILLS
Use the following expanded scenario from Chapter 26 in your textbook to answer the questions below.
Scenario: Bessie Washington, age 77, was recently discharged to her home after suffering a cerebrovascular accident (brain attack). She lives alone in a small one-bedroom apartment and uses a walker to ambulate. A visiting nurse performing a safety assessment notes that she has hardwood floors with throw rugs covering the traffic areas, and old newspapers and mag-azines are stacked in piles close to heating vents. There are no fire alarms visible in the room. Mrs. Washington tells you, “I have so much stuff crammed into this apartment, I almost fell this morning going from my bed-room to the kitchen.”
1. What safety interventions might the nurse implement for this patient?
2. What would be a successful outcome for Mrs. Washington?
3. What intellectual, technical, interpersonal, and/or ethical/legal competencies are most likely to bring about the desired outcome?
4. What resources might be helpful for Mrs. Washington?
LWBK696-C26_p151-157.qxd 9/2/10 9:35 AM Page 157 Aptara Inc
158
PRACTICING FOR NCLEX
MULTIPLE CHOICE QUESTIONS
Circle the letter that corresponds to the best answer for each question.
1. Spherical bacteria belong to which of the following groups?
a. Bacilli b. Cocci
c. Spirochetes d. Vacillates
2. Which of the following is the smallest of all microorganisms and can be seen only through an electron microscope?
a. Cocci b. Spirochetes
c. Fungi d. Virus
3. When an organism is transmitted through per-sonal contact with an inanimate object, such as contaminated blood, the route of transmis-sion is which of the following?
a. Direct contact b. Vectors
c. Indirect contact d. Airborne
4. During which stage of infection is the person most infectious?
a. Incubation period b. Prodromal stage
c. Full stage of illness d. Convalescent period
5. Which of the following is a protective mecha-nism that eliminates the invading pathogen and allows tissue repair to occur?
a. Inflammatory response b. Immune response
c. Cellular immune response d. Humoral immune response
6. Which of the following is a natural reservoir for tetanus?
a. Humans b. Animals
c. Soil d. Food
7. Mrs. Teal is to have an indwelling urinary catheter inserted. Which of the following would be the precaution taken during this procedure?
a. Surgical asepsis technique b. Medical asepsis technique
c. Droplet precautions d. Strict reverse isolation