ATI Chapters 8, 10, 11, 12, 13, 15, 42, 56

Basic Critical Thinking

• A nurse trusts the experts and thinks concretely based on the rules.

• Basic critical thinking results from limited nursing knowledge and experience, as well as inadequate critical thinking experience.

Complex Critical Thinking

• The nurse begins to express autonomy by analyzing and examining data to determine the best alternative.

• Complex critical thinking results from an increase in nursing knowledge, experience, intuition, and flexible attitudes.

Commitment

• The nurse expects to make choices without help from others and fully assumes the responsibility for those choices.

• Commitment results from an expert level of knowledge, experience, developed intuition, and reflective, flexible attitudes.

Competence

Using Nursing Process

Practices that maintain a sterile field issues

• Prolonged exposure to airborne micro-organisms can make sterile items non-sterile.

• Only sterile items can be in a sterile field.

• Microbes can move by gravity from a non-sterile item to a sterile item.

• Any sterile, non-waterproof wrapper that comes in contact with moisture becomes non-sterile

Airborne Infections

• Measles

• Varicella

• SARS-CoV-2

• Pulmonary or laryngeal tuberculosis

Airborne Precautions

• Use an N95 or high-efficiency particulate air (HEPA) respirator for client w/ TB or SARS-CoV-2.

• Negative pressure airflow exchange in the room of at least 6 to 12 exchanges per hour, depending on the age of the structure.

• If splashing or spraying is a possibility, wear full face (eyes, nose, mouth) protection.

• Clients who have an airborne infection should wear a mask while outside of the room/home.

Droplet Infections

• Streptococcal pharyngitis or pneumonia

• Haemophilus influenzae type B

• Scarlet fever

• Rubella

• Pertussis

• Mumps

• Mycoplasma pneumonia

• Meningococcal pneumonia

• Sepsis

• Pneumonic plague

Droplet Precautions

• A private room or a room with other clients who have the same infectious disease. Ensure that clients have their own equipment.

• Masks for providers and visitors.

• Clients who have a droplet infection should wear a mask while outside of the room/home.

Contact Infections

• Respiratory syncytial virus

• Shigella

• Enteric diseases caused by micro-organisms

• Wound infections

• Herpes simplex

• Impetigo

• Scabies

• Multidrug-resistant organisms

Contact Precautions

• A private room or a room with other clients who have the same infection.

• Gloves and gowns worn by the caregivers and visitors.

• Disposal of infectious dressing material into a single, nonporous bag without touching the outside of the bag.

Protective Equipment

• For IMMUNOCOMPROMISED

• Private room.

• Positive airflow 12 or more air exchanges/hr.

• HEPA filtration for incoming air.

• Mask for the client when out of room.

ABCDE Principle

1. Airway/Cervical Spine

2. Breathing (Ventilation)

3. Circulation

4. Disability (Consciousness)

5. Exposure

CAM

Complementary and Alternative Medicine

Whole medical systems

traditional Chinese medicine, ayurveda, homeopathy

Biological and botanical therapies:

diets, vitamins, minerals, herbal preparations, probiotics

Body-based and manipulative methods

massage, touch, chiropractic therapy, acupressure

Mind-body therapies

acupuncture, breath work, biofeedback, art therapy, meditation, guided imagery, yoga, psychotherapy, tai chi

Energy therapies:

reiki, therapeutic touch, magnet therapy

Movement therapies:

Pilates, dance therapy

Homeopathic medicine:

Administering doses of substances (remedies) to ill clients, that would produce manifestations of specific disease states in a well person, to bring about healing

Naturopathic medicine:

Diet, exercise, environment, and herbal remedies to promote natural healing

5 Moments for Hand Hygiene

1. Before touching a patient

2. Before clean/aseptic procedure

3. After touching a patient

4. After body fluid exposure risk

5. After touching patient surroundings