Exam 2 blue print and terms

Safety

Freedom from danger, risk, or injury.

Safety fundamentals

Priority of Care: Protecting clients from physical, chemical, and biological harm always comes first before proceeding with other interventions.

Error Prevention: Using systematic checks, clear communication, and safe environments to stop adverse events before they happen.

Modifiable Risks: Identifying individual and environmental risk factors (such as clutter, poor lighting, or lack of PPE) that nurses can actively control or change.

Patient Safety

The prevention of injury, harm, and errors during healthcare delivery.

- Promoting safety is a primary nursing responsibility and is essential for positive patient outcomes.

Developmental Considerations

Age-related factors that influence a person's safety risks.

- Different age groups face unique dangers such as choking in toddlers and falls in older adults.

Mobility (Safety)

A person's ability to move independently and safely.

- Decreased mobility increases the risk for falls and injury.

Sensory Perception

Ability to receive and interpret visual, auditory, tactile, and other sensory information.

- Impaired vision, hearing, or sensation increases safety risks.

Psychosocial State

The emotional and psychological condition of an individual.

- Stress and anxiety can impair judgment and increase accident risk.

Aphasia

Loss of the ability to understand or express speech.

- Communication barriers may prevent patients from expressing safety concerns.

Fall Risk

The likelihood that a patient will experience a fall.

- Falls can result in fractures, loss of independence, and increased healthcare costs.

Morse Fall Scale

A rapid tool used to assess a patient's risk of falling using factors such as fall history, diagnosis, ambulatory aids, IV access, gait, and mental status

- Identifies patients requiring fall-prevention interventions.

Hendrich II Fall Risk Model

A fall assessment tool based on factors such as dizziness, confusion, and mobility.

- Helps determine the patient's risk for falling and guides interventions.

DAME Assessment

Fall-risk acronym:

D = Drug and alcohol use

A = Age-related physiologic status

M = Medical problems

E = Environment

Identifies major factors contributing to falls in older adults.

Orthostatic Hypotension

A drop in blood pressure when changing positions, especially from lying to standing.

- Can cause dizziness and increase fall risk.

Polypharmacy

Use of multiple medications simultaneously.

- Increases risk for medication interactions, dizziness, and falls.

Home Safety

focuses on assessing, planning, and intervening to prevent injuries and manage health risks in a patient's home environment.

Environmental Safety

Modification of surroundings to reduce injury risk.

- Hazards such as poor lighting, rugs, and cords increase accident risk.

Non-Skid Footwear

Shoes or socks designed to improve traction.

- Helps prevent slips and falls.

Bathroom Adaptations

Safety equipment such as grab bars, shower rails, and non-skid mats.

- Reduces fall risk during toileting and bathing.

Alert Systems

Emergency devices such as Life Alert that summon help.

- Improve safety for patients living independently.

Acute Care Safety

involves core clinical interventions, surveillance protocols, and system safeguards designed to prevent harm in high-acuity hospital environments.

Medication Administration: Follow the "five rights" (right patient, drug, dose, route, and time) and verify allergies and dosages prior to administration.

Fall Prevention: Utilize bed alarms, non-slip footwear, hourly rounding, and keep hospital beds locked in their lowest positions.

Infection Control: Maintain rigorous hand hygiene, sterile line care, and appropriate isolation protocols.

Patient Identification: Use two distinct identifiers (such as name and birthdate) before giving medications, blood, or conducting procedures.

Surveillance and Communication

Clinical Surveillance: Continuously acquire, interpret, and synthesize patient data to recognize early signs of clinical deterioration.

Structured Handoffs: Use standardized communication tools like ISBARR (Introduction, Situation, Background, Assessment, Recommendation, Readback) during shift changes

Safety Huddle

A brief discussion among healthcare team members about potential safety concerns.

- Promotes communication and helps prevent errors.

Hourly Rounding

Regular checks on patients to assess needs and safety concerns.

- Reduces falls, improves comfort, and enhances patient satisfaction

Fall Precautions

Interventions used to prevent falls in high-risk patients.

- Reduces injury and promotes patient safety.

Fall Band

Wristband used to identify patients at risk for falls.

- Alerts staff to implement safety measures.

Seizure Precautions

Protective measures used for patients at risk of seizures.

- Prevents injury during seizure activity.

Rescue Equipment

Oxygen, suction, and padded side rails available for seizure management.

- Supports airway protection and patient safety during seizures.

RACE (Fire Response)

R = Rescue

A = Alarm

C = Contain/Confine

E = Extinguish/Evacuate

- Provides a systematic approach to fire emergencies.

PASS (Fire Extinguisher)

P = Pull pin

A = Aim at base of fire

S = Squeeze handle

S = Sweep side to side

- Ensures safe and effective extinguisher use

Nonviolent Restraint

A restraint used to protect patients from harming themselves accidentally.

- Used only when less restrictive alternatives have failed.

Violent Restraint

A restraint used when a patient poses danger to self or others.

- Protects patients and staff from injury.

Chemical Restraint

Medication used primarily to control behavior rather than treat a medical condition.

- Requires careful monitoring and strict justification.

Procedure related safety

Requires clear, written step-by-step instructions and verified controls to prevent accidents, injuries, or catastrophic system failures during routine and nonroutine tasks.

Time-Out

A final verification process before procedures or surgery.

- Prevents wrong-patient, wrong-site, and wrong-procedure errors.

Patient Identification

Verification of the correct patient using approved identifiers.

- Prevents medication, procedure, and treatment errors.

Two Patient Identifiers

Verification using two identifiers such as name and date of birth.

- Reduces risk of incorrect patient care.

Alarm Fatigue

Desensitization to alarms due to frequent alarm exposure.

- Can lead to missed alarms and serious patient harm.

False Alarm Reduction

Adjusting monitor settings and ensuring proper equipment placement.

- Reduces unnecessary alarms and improves response to true emergencies.

Safety Event Report (incident report)

Confidential report completed following an accident, error, or safety event.

- Allows facilities to investigate events and improve patient safety systems.

Objective Documentation

Recording only facts and observations without opinions.

- Provides an accurate legal and clinical record of events

Joint Commission Patient Safety Goals

National Performance Goals (NPGs) for hospitals and critical access hospitals, organizing key safety and quality requirements into measurable topics

Medication Reconciliation

Verification and updating of a complete medication list.

- Prevents medication omissions, duplications, and interactions.

Hand Hygiene

Cleaning hands before and after patient care activities.

- Most effective method for preventing healthcare-associated infections.

Sterile Technique

Practices used to eliminate microorganisms during procedures.

- Prevents infection and protects patient safety.

Critical Lab Value Reporting

Prompt communication of dangerous laboratory results to providers.

- Allows rapid intervention and prevents patient harm.

Suicide Precautions

Safety measures for patients at risk of self-harm.

- Protects patients from injury and supports continuous monitoring.

Generic Name

The official, nonproprietary name of a medication.

- Provides a standardized name regardless of manufacturer.

Trade Name

The brand name assigned by a manufacturer.

- Helps identify specific marketed versions of a medication

Controlled Substance

A medication that has potential for misuse or dependence.

- Requires strict storage, documentation, and accountability procedures.

Therapeutic Range

Drug concentration in the bloodstream that produces desired effect without toxicity.

- Ensures the medication is both effective and safe.

Peak Level

The highest concentration of a drug in the bloodstream after absorption.

- Used to determine if medication levels are therapeutic and not toxic.

Trough Level

The lowest concentration of a drug before the next scheduled dose.

- Assesses whether adequate drug levels are maintained between doses.

Half-Life

The time required for a drug's concentration to decrease by one-half.

- Helps determine dosing frequency

Stat Order

A medication order requiring immediate administration.

- Used when rapid treatment is necessary.

PRN Order

Medication given as needed for a specific indication.

- Requires nursing judgment to determine appropriateness.

Medication Rights

Safety principles including right patient, medication, dose, route, time, etc.

- Reduces medication errors and promotes safe administration.

Medication Reconciliation

Verification of a complete and accurate medication list during transitions of care

- Prevents omissions, duplications, and drug interactions.

Peripheral IV Catheter

Short catheter inserted into smaller peripheral veins in hand or arm.

- Used for short-term fluid and medication administration.

Midline Catheter

Longer catheter inserted into brachial or cephalic vein with tip near axilla.

- Provides longer-term access than a peripheral IV and can be used for difficult venous access.

PICC Line

Peripherally Inserted Central Catheter; tip terminates in distal superior vena cava.

- Appropriate for long-term therapy and vesicant medications.

Central Venous Catheter

Catheter with tip in a central vein, usually the superior vena cava.

- Allows administration of vesicants, rapid infusions, and long-term access.

Phlebitis

Inflammation of a vein characterized by redness, warmth, pain, and edema.

- Requires prompt intervention because ongoing vein irritation can worsen tissue injury.

Infiltration

Leakage of a non-vesicant solution into surrounding tissue.

- Stopping the infusion prevents further tissue damage.

Extravasation

Leakage of a vesicant solution into surrounding tissue.

- Can cause severe tissue injury, blistering, and necrosis, requiring immediate treatment.

Vesicant

A medication capable of causing tissue damage if it escapes from the vein.

- Often requires administration through central venous access to minimize harm.

Non-Vesicant

A medication or fluid that generally does not cause tissue damage when it infiltrates.

- Although less harmful, infiltration still requires assessment and intervention.

Catheter Embolism

A catheter fragment breaks off and travels through the bloodstream.

- Can become life-threatening if the fragment lodges in the heart, lungs, or blood vessels.

CLABSI

Central Line Associated Bloodstream Infection.

- A major preventable complication associated with central lines.

Intradermal (ID)

Injection into the dermis beneath the epidermis, usually

Subcutaneous (SC)

Injection into adipose tissue between dermis and muscle.

- Provides slower absorption than intramuscular injections.

Intramuscular (IM)

Injection directly into muscle tissue.

- Allows faster absorption due to greater blood supply.

Intravenous (IV) Injection

Medication administered directly into the bloodstream.

- Produces an immediate effect and requires careful monitoring because it cannot be reversed once administered.

Intrapersonal Communication

Communication that occurs within oneself; self-talk.

- Positive self-talk improves self-awareness, confidence, stress management, and decision-making.

Interpersonal Communication

Communication between two or more individuals.

- Essential in nursing because nurses constantly communicate with patients, families, and healthcare team members.

Public Communication

Communication directed toward large groups of people.

- Allows nurses to educate communities and promote public health.

Small Group Communication

Communication among several individuals working toward a common goal.

- Promotes teamwork and collaboration in healthcare settings.

Credibility

The trustworthiness and reliability of the communicator.

- Patients are more likely to trust healthcare recommendations and disclose important information.

Denotation

The dictionary definition of a word.

- Shared understanding prevents communication errors.

Connotation

The emotional or cultural meaning associated with a word.

- Different interpretations can lead to misunderstandings.

Therapeutic Communication

Purposeful communication used to build helping relationships with clients and families.

- Improves trust, patient satisfaction, and health outcomes.

Active Listening

Giving full attention to the speaker through verbal and nonverbal behaviors.

- Helps patients feel heard and encourages open communication.

Empathy

Understanding another person's feelings while maintaining objectivity.

- Helps establish rapport and therapeutic relationships.

Open-Ended Question

A question requiring more than a yes/no response.

- Encourages patients to share detailed information.

Incivility

Rude comments or behaviors such as eye-rolling or sarcasm.

- Disrupts teamwork and patient care.

Bullying

Repeated intimidation or threatening behaviors.

- Creates a hostile work environment and negatively impacts safety.

Lateral Violence

Hostile actions among peers, such as gossiping, exclusion, or verbal abuse.

- Decreases teamwork and quality patient care.

Fecal Incontinence

Loss of voluntary control over fecal elimination.

- Can lead to skin breakdown, embarrassment, and decreased quality of life.

Diarrhea

Frequent passage of loose or liquid stool.

- Can cause dehydration, electrolyte imbalances, and skin breakdown.

Clostridioides difficile (C. diff)

A bacterial infection causing colon inflammation and severe diarrhea.

- Often occurs after antibiotic use and can become life-threatening if untreated.

Constipation

Passage of hard, dry stools or infrequent bowel movements.

- May cause discomfort and increase risk of fecal impaction.

Fecal Impaction

Hard stool lodged in the rectum or colon.

- Can obstruct bowel elimination and require enemas or digital removal.

Laxative

Medication that softens stool and eases defecation.

- Helps relieve constipation.

Cathartic

A stronger medication that stimulates bowel evacuation.

- Produces rapid emptying of the colon.

Bulk-Forming Laxative

Increases stool bulk by absorbing water (e.g., Metamucil).

- Stimulates normal bowel movement through increased stool volume.

Osmotic Laxative

Draws water into the intestine to soften stool (e.g., MiraLAX).

- Makes stool easier to pass.

Stimulant Laxative

Increases intestinal motility and secretions (e.g., Dulcolax).

- Promotes bowel evacuation.

Enema

Instillation of fluid into the rectum and colon to stimulate defecation.

- Relieves constipation and prepares patients for procedures.

Cleansing Enema

Enema used to remove stool from the colon.

- Helps relieve constipation and prepare for diagnostic procedures.

Retention Enema

Enema retained in the bowel for an extended period to soften stool.

- Softens stool and lubricates the bowel.

Rectal Suppository

Medication inserted into the rectum that melts at body temperature.

- Stimulates bowel movements or administers medication.

Colostomy

Surgical creation of an opening from the colon to the abdominal surface.

- Allows stool elimination when normal bowel function is impaired.