Professional Practice 1 Flashcards

Semester 1 Year 1 Revision

What is a healthcare associated infection?

Preventable infections acquired as a direct or indirect result of healthcare

Name the 6 links of the chain of infection.

1. Microorganism (aetiological agent)
2. Reservoir (source)
3. Portal of exit from reservoir
4. Method of transmission
5. Portal of entry into the host
6. Susceptible host

Name the 5 moments of hand hygiene.

1. Before touching a patient
2. Before a procedure
3. After body fluid exposure risks
4. After touching a patient
5. After touching a patient’s surroundings

Name the steps for donning PPE.

1. Hand hygiene
2. Gown/Apron
3. Mask
4. Eyewear
5. Hand Hygiene
6. Gloves

Name the steps for doffing PPE.

1. Gloves
2. Hand hygiene
3. Gown/Apron
4. Hand hygiene
5. Eyewear
6. Hand Hygiene
7. Mask
8. Hand hygiene

What is manual handling?

Any activity involving lifting, pushing, pulling, carrying, throwing or moving objects

Describe High Fowler’s.

Sitting up in bed at a 90 degree angle

Describe Semi Fowler’s.

Sitting up in bed at a 30 degree angle

Describe Fowler’s.

Sitting up in bed at a 45-60 degree angle

Describe lateral position.

Lying on one side (put a pillow in between their knees)

Describe Trendelenburg.

Lying supine with the head of the bed lower than the feet

Describe reverse trendelenburg.

Lying supine with the head of the bed higher than the feet

Describe supine.

Lying on the back

Describe prone.

Lying on the stomach

How can nurses break the chain of infection at the infectious agent link?

Herd immunity or medication (also antimicrobial stewardship - making sure people don’t take antibiotics unnecessarily to avoid bacterial resistance)

How can nurses break the chain of infection at the reservoir link?

Eliminate the possible sources of reservoirs like food, water, animals, people and various environmental surfaces

How can nurses break the chain of infection at the portal of exit link?

Aim to prevent organisms from leaving the reservoir through cough etiquette, managing spills and using PPE when in contact with bodily fluids

How can nurses break the chain of infection at the mode of transmission link?

Staying at home if sick and using standard or transmission based precautions (contact, droplet, airborne, vector)

How can nurses break the chain of infection at the portal of entry link?

Cover any open wounds and broken skin, IV sites, urinary catheters, respiratory tract (masks), and surgical incisions

How can nurses break the chain of infection at the susceptible host link?

Protect the acutely ill, young, frail elderly or other people with low immunity and encourage vaccinations in the community

What are standard precautions?

Basic approaches to infection prevention and control that are applied to everyone, regardless of their infectious status

Name the 8 standard precautions.

1. Hand hygiene
2. Use of PPE when at risk of body fluid exposure
3. Environmental cleaning
4. Aseptic non-touch technique
5. Handling and disposal of sharps
6. Respiratory hygiene and cough etiquette
7. Handling of waste and linen
8. Reprocessing/cleaning of reusable equipment

What are transmission-based precautions?

They are used along with standard precautions for patients with infections that are spread by contact, droplets or through the air (airborne)

What are some extra measures taken with contact, droplet or airborne precautions?

1. Use of additional PPE suitable to the precaution
2. Cohort rooms or single rooms
3. Patient-dedicated equipment
4. Air handling requirements (negative pressure rooms)
5. Enhanced environmental cleaning and disinfection
6. Restricted transfer of patients between facilities/areas

What is fluid balance?

Maintaining a homeostatic balance of fluid within the body. Too much fluid in the body is oedema (swelling) and too much fluid out of the body is dehydration

What is ISBAR used for and what does it stand for?

ISBAR is used for verbal communication (eg. handovers) and it stands for introduction, situation, background, assessment and recommendation

What are the Registered Nurse Standards for Practice?

1. Thinks critically and analyses nursing practice
2. Engages in therapeutic and professional relationships
3. Maintains the capability for practice
4. Comprehensively conducts assessments
5. Develops a plan for nursing practice
6. Provides safe, appropriate and responsive quality nursing practice
7. Evaluates outcomes to inform nursing practice

What are the steps of the Clinical Reasoning Cycle?

1. Consider the patient’s situation
2. Collect cues and information
3. Process information
4. Identify problems and issues
5. Establish goals
6. Take action
7. Evaluate outcomes
8. Reflect on the process and new learning

What is subjective information?

Information that is only apparent to the affected person (eg. their symptoms, feelings, beliefs and perceptions)

What is objective information?

Information that can be measured and tested (eg. vital sign observations and signs of things seen on the patient)

What does the acronym SOLER stand for and what is it used for?

It stands for sitting squarely, open posture, lean forward, eye contact, relaxed posture and it is used for active listening

What does active listening involve?

Questioning (open, closed, probing and clarifying questions)

What are the vital signs and why are they important?

They include respiration rate, oxygen saturation, blood, pressure, heart rate, level of consciousness, temperature and pain and they provide important information about the condition of the patient’s organs

When do we assess vital signs?

1. On admission
2. Changes in health status
3. Following incidents or injuries
4. Before/after any procedure that alters vital signs
5. Before administering some medications

Name the 5 things to look at when assessing respiration rates.

1. Respiration rate
2. Depth (deepness of breaths)
3. Pattern/rhythm (regular or irregular)
4. Equality/sounds
5. Effectiveness

Name the 5 things to look at when assessing pulse.

1. Rate
2. Rhythm (regular or irregular)
3. Strength (strong or weak)
4. Equality (same on both sides)
5. Elasticity

Name the 5 levels of consciousness.

Alert, new confusion, verbal, pain, unresponsive

Name the 2 core temperatures.

Ear (tympanic membrane) and rectum

Name the 3 surface temperatures.

The mouth (oral), axilla and skin

What does PQRST stand for and when is it used?

It is used to complete a comprehensive pain assessment and it stands for provoking factors, quality, region/radiation, severity and time

What is the normal range for heart rate?

60-100 beats per minute

What is the normal range for respiration rate?

12-20 breaths per minute

What is the normal range for oxygen saturation?

95-100%

What is the normal range for blood glucose?

4-8 mmols/L

What is the normal range for temperature?

36-37.5 degrees C

What is blood pressure?

The pressure that is put into the artery walls when the heart pumps blood through the arteries

What is systolic blood pressure?

The maximum pressure of blood against the artery wall during left ventricular contraction

What is diastolic blood pressure?

The minimum pressure of blood against the artery wall during left ventricular relaxation

What is the normal range for blood pressure?

Hypertensive - Systolic above 140/ diastolic above 90 mmHg

Hypotensive - Systolic below 90 mmHg

What are some signs and symptoms of hypertension?

Usually asymptomatic but patients can experience headaches, visual disturbances, dizziness, shortness of breath and nausea

What are some nursing interventions for hypertension?

* Accurately measure BP (take it manually)
* Monitor, document and report the reading
* Support the patient with changing any high risk lifestyle factors (SNAP risk factors)
* Manage pain and anxiety
* Ensure they get medication education

What are the 4 SNAP risk factors?

Smoking, poor nutrition, increased alcohol intake and lack of physical activity

What are some signs and symptoms of hypotension?

Dizziness, lightheadedness, pallor, cold clammy skin and syncope

What are some nursing interventions for hypotension?

* Sit, Stand, Step (keep progressing if no symptoms appear)
* Reposition the patient
* Hydration
* Measure orthostatic hypotension (lying and standing)
* Monitor, document and report
* Review their medications

What are the 3 criteria for orthostatic hypotension?

1. A drop in systolic BP of 20mmHg or more (with/without symptoms)
2. A drop to below 90mmHg on standing, even if it is less than a 20mmHg drop
3. A drop in diastolic BP of 10mmHg with symptoms

What is good nutrition?

Intake of a well balanced diet with regular physical activity

What does poor nutrition lead to?

* Reduced immunity
* Increased susceptibility to disease
* Impaired physical and mental development
* Reduced productivity

What are the 4 phases of swallowing?

Preparation, swallowing, pharyngeal and oesophageal swallowing

How to we help patients with dysphagia?

1. Sit them in High Fowler’s position until at least 15 minutes after meals
2. Check they have the correct diet (eg. thickened fluid)
3. Face them during feeding
4. Tilt head forward and tuck chin
5. Direct food to the unaffected side (eg. stroke)
6. Feed them slowly with small mouthfuls and check chewing and swallowing occurs every time
7. Watch for signs of fatigue
8. Stop if choking, coughing or gurgling occurs
9. Sweep mouth to check for food pocketing
10. Note food consistencies that are difficult for them

What is enteral nutrition?

Nutrition support or replacement delivered as a liquid formula directly into the stomach or small intestine by a narrow tube

What is parenteral nutrition?

Nutrition that occurs intravenously, bypassing the usual process of eating and digestion

Where are the 3 locations for nasal or oral feeding tubes?

1. Stomach (nasogastric)
2. Duodenum (nasoduodenal)
3. Jejunum (Nasojejunal)

What does a percutaneous endoscopic gastrostomy tube (PEG) mean?

It means through the skin, inserted with a camera into the stomach through an artificially created opening

What does a percutaneous endoscopic jejunostomy tube (PEJ) mean?

It means through the skin, inserted with a camera into the jejunum through an artificially created opening

What is diabetes mellitus?

A deficiency of insulin or a cellular resistance to the action of insulin due to a disorder of the endocrine pancreas

Describe Type 1 diabetes.

Often diagnosed in childhood, where the pancreas has been attacked so the cells that produce insulin don’t work at all

Describe Type 2 diabetes.

Usually lifestyle related, due to the body not producing enough/low quality insulin

Describe gestational diabetes.

Occurs in women during pregnancy, where the placenta releases hormones that have similar resistance to insulin as Type 2 diabetes. In some cases it can be managed through diet but sometimes requires regular injections of insulin

What is a normal urine output?

0\.5-1ml per kilogram per hour

When are handovers conducted?

* When escalating deteriorating patients
* Shift change over
* Multidisciplinary team handover
* Patient discharge or transfer
* to another unit or facility
* for a test, procedure or appointment
* to or from community setting
* involving paramedics or patient transport

What are all the things you must include when you sign off on progress notes?

* Signature
* Full name
* Student nurse
* University name
* RN co-sign

What is SOAPIER and when is it used?

Subjective, objective, assessment, plan, interventions, evaluation and revision which is used for written documentation

What does the A-G assessment stand for?

Airway, breathing, circulation, disability (ACVPU), exposure (temperature), fluids and glucose

What are the steps of the Gibbs Reflective Cycle?

1. Description
2. Feelings
3. Evaluation
4. Analysis
5. Conclusion
6. Action plan (improvements)

Why is reflection important?

It improves quality of care, closes the gap between theory and practice, stimulates personal and professional growth and promotes self-directed learning and improvement as well

What are SMART goals?

Specific, measurable, actionable, realistic and time-bound goals that aim to encourage goal achievement