Safety/Protection; Professionalism; Research

Airborne, droplet, or contact precautions: measles

airborne

Airborne, droplet, or contact precautions: varicella

airborne

Airborne, droplet, or contact precautions: tuberculosis

airborne

Airborne, droplet, or contact precautions: SARS

airborne

Airborne, droplet, or contact precautions: haemophilus influenzae

droplet

Airborne, droplet, or contact precautions: meningitis

droplet

Airborne, droplet, or contact precautions: pnemonia

droplet

Airborne, droplet, or contact precautions: sepsis

droplet

Airborne, droplet, or contact precautions: neisseria meningitidis

droplet

Airborne, droplet, or contact precautions: pertussis

droplet

Airborne, droplet, or contact precautions: influenza

droplet

Airborne, droplet, or contact precautions: diphtheria

droplet

Airborne, droplet, or contact precautions: mumps

droplet

Airborne, droplet, or contact precautions: rubella

droplet

Airborne, droplet, or contact precautions: streptococcal infections (group A)

droplet

Airborne, droplet, or contact precautions: gastrointestinal

contact

Airborne, droplet, or contact precautions: respiratory

contact

Airborne, droplet, or contact precautions: skin or wound infections

contact

Airborne, droplet, or contact precautions: presence of stool incontinence

contact

Airborne, droplet, or contact precautions: norovirus

contact

Airborne, droplet, or contact precautions: rotavirus

contact

Airborne, droplet, or contact precautions: Clostridium difficile

contact

Airborne, droplet, or contact precautions: enterohemorrhafic escherichia coli

contact

Airborne, droplet, or contact precautions: MRSA

contact

Airborne, droplet, or contact precautions: herpes simplex virus

contact

Airborne, droplet, or contact precautions: scabies

contact

Airborne, droplet, or contact precautions: impetigo

contact

Airborne precautions?

N95 or higher level respirator

Droplet precautions?

Mask

Contact precautions?

gloves + gown

s/s of autonomic dysreflexia (7)

1. hypertension

2. bradycardia

3. profuse sweating above level of lesion

4. headache

5. nausea

6. piloerection

7. red and blotchy skin

What to do when a patient has a chemical burn?

if liquid = water to dilute

if powder = brush it off

What to do when a patient has a thermal burn?

run affected area under cool tap for several minutes

What to do if a patient has an extensive thermal burn?

do NOT run it under cool water —> increases risk for hypothermia

What to do if a patient has an electrical burn?

monitor HR and respiration; monitor for signs of cardiac arrest

What should you do if a patient demonstrates s/s of a concussion?

they should NOT be allowed to return to physical activity until cleared by a medical professional

What to do if a patient has an emergent fx?

assess peripheral pulses and sensation distal to injury - to determine extent of injury to nerves and blood vessels

s/s of heat exhaustion (9)

1. profuse sweating

2. moist and pale skin

3. nausea

4. headache

5. dizziness

6. muscle cramps

7. weakness

8. rapid and shallow breathing

9. weak and rapid pulse

s/s of heat stroke (11)

1. dry skin

2. flushed color

3. nausea

4. headache

5. labored breathing

6. strong and rapid pulse

7. elevated temperature

8. contraction and dilation of the pupils

9. convulsions

10. altered mental status

11. possible LOC

What to do if a patient is experiencing any form of heat illness?

• place pt in shaded or covered area

• monitor vital signs

• remove/loosen any outer clothing layers

• use ice bag or cold compress on pt’s forehead, neck, and/or groin

• water w/electrolytes can be given

What should you NOT give a pt experiencing a heat illness and why?

salt tablets —> can negatively effect electrolyte balance

How to treat hypothermia?

• move pt into warm room, remove any wet clothing

• attempt to warm pt, starting with core of body

• use dry towels/blankets or skin-to-skin contact

When should EMS services be contacted in cases of hypothermia?

When body temp is below 90 degrees F, or LOC

How to treat frostbite?

immerse area in WARM (not hot) water or warm using body heat

Should you massage frostbite?

NO - can increase amount of tissue damage

(hypoglycemia/hyperglycemia) leads to ketoacidosis

hyperglycemia

s/s of hypoglycemia of hyperglycemia: pale and moist skin

hypoglycemia

s/s of hypoglycemia of hyperglycemia: rapid HR

hypoglycemia

s/s of hypoglycemia of hyperglycemia: shallow breathing

hypoglycemia

s/s of hypoglycemia of hyperglycemia: dizziness, headache

hypoglycemia

s/s of hypoglycemia of hyperglycemia: altered vision

hypoglycemia

s/s of hypoglycemia of hyperglycemia: hunger

hypoglycemia

s/s of hypoglycemia of hyperglycemia: excited and agitated behavior

hypoglycemia

s/s of hypoglycemia of hyperglycemia: confusion

hypoglycemia

s/s of hypoglycemia of hyperglycemia: seizure

hypoglycemia

s/s of hypoglycemia of hyperglycemia: thirst

hyperglycemia

s/s of hypoglycemia of hyperglycemia: frequent urination

hyperglycemia

s/s of hypoglycemia of hyperglycemia: glucose in urine

hyperglycemia

s/s of ketoacidosis (4)

1. fruity smelling breath

2. deep, labored breathing

3. nausea and vomiting

4. dry tongue

What to do in cases of hypglycemia? What if pt is unconsious?

administer sugar; if unconscious intravenous glucose injection

difference b/w arterial bleeding and venous bleeding?

arterial = spurting blood that is bright red

venous = flowing blood that is more purple in appearance

When to intervene if a pt has an obstructive airway?

if pt can speak, cough, or breath = do NOT intervene

if pt cannot speak, cough, or breath = INTERVENE

hand placement for Heimlich?

above umblilicus and below diaphram

hand placement for back blows for infant that is choking?

interscapular regionWh

When to call EMS when a patient has a laceration?

• cut is bleeding severely

• blood is spurting out

  • bleeding does not stop after 10min of steady pressure

s/s of PE (12)

1. SOB*

2. cough (sometimes w/bloody sputum)*

3. chest pain that worsens with deep breathing*

4. lightheadedness/dizziness

5. tachypnea

6. rapid and irregular HR

7. fever

8. diaphoresis

9. anxious behavior

10. cyanosis

11. clammy skin

12. leg pain and swelling

What causes shock?

Loss of perfusion to organs

s/s of shock (13)

1. pale, moist, and cool skin

2. diaphoresis

3. shallow and irregular breathing

4. weak and rapid pulse

5. hypotension

6. low body temperature

7. weakness

8. dizziness

9. nausea and vomiting

10. dilated pupils

11. anxiety

12. altered mental status

13. syncope

What is important to track if a pt is experiencing a stroke?

time - tx is dependent on the amount of time that has elapsed!

Asepsis definition

elimination of the microorganisms that cause infection and the creation of a sterile field

Medical Asepsis definition

technique that attempt to contain pathofens to a specific area, object, or person

primary goal = reduce the spread of pathogens

Nasocomial Infection definition

an infection that is acquired during a hospitalization

primary factor in prevention = hand hygiene

Surgical Asepsis definition

state in which an area or object is w/o any microorganisms

When positioning pt’s the most __ part of the extremity should be __ than the heart to prevent __

distal; higher; dependent edema

Flaccid extremities (should/should not) be placed in gravity-dependent positions.

should NOT

Describe positioning in supine.

• pillow under head (and under upper thorax if needed for comfort)

• pillow/support under each arm

• pillow/support lengthwise under calves (avoid pressure on heels)

Describe positioning in prone.

• turn pt head to one side w/ or w/o pillow

• pillow under abdomen as needed to maintain neutral lumbar alignment

• pillow under lower legs to keep pressure of the shins and toes

Describe positioning in semi-prone (1/4 turn from prone).

• pillow under head (turned to one side)

• pillow under uppermost part of arm at pt’s side or slightly behind pt

• both legs flexed (uppermost leg more flexed)

• pillow b/w legs

Describe positioning in semi-supine (1/4 from supine).

• pillow under head

• pillow under uppermost arm

• pillow under uppermost leg

• pillow wedged lengthwise at back to assist in comfort and alignment

Describe positioning in sidelying.

• pillow under head (but not under lowermost shoulder)

• pillow under uppermost arm

• pillow b/w legs

• pillow(s) wedged lengthwise at the back to assist in comfort and alignment

• pillow/towel roll under lowermost extremity, just above lateral malleolus

Describe Fowlers position.

• pt supine

• head of bed elevated b/w 45-50 degrees

• knees supported in flexion or straight depending on amount of lumbar curve

Describe Semi-Fowler’s position.

• pt supine

• head of bed elevated b/w 30-45 degrees

• knees supported in flexion or straight to maintain a neutral lumbar spine

For which populations is the Fowler’s position and its variations used for?

• cardiac conditions

• respiratory conditions

• pts w/breathing difficulties

• pts w/nasogastric tube

Describe Trendelenburg positioning.

• pt supine

  • foot of bed elevated higher than head of bedWh

What pt populations if Trendelenburg positioning used for and why?

• postural drainage, hypotension, certan medical emergencies

• promotes venous return

Positioning of UE w/hemiplegia should focus on varying amounts of:

• shoulder abduction and ER

• elbow extension

• wrist extension

• thumb abduction and extension

• finger extension w/lumbrical grip

Positioning of LE w/hemiplegia should focus on varying amounts of:

• hip and knee extension

• hip abduction and IR

• ankle DF and eversion

Positioning for split-thickness burns and grafted areas of burns?

AVOID positions of comfort

encourage gentle AROM

Positioning post TKA and THA?

TKA = knee extension w/neutral positioning at hip

THA = abduction wedge pillows