textbook
Page 1: Communication & Chapter 25 Overview
Title: Communication & Chapter 25 TLB Lippincott Skills 2.0 Asepsis and Infection Control
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Page 2: Importance of Communication
Communication is a critical skill in nursing.
It helps to develop relationships with patients and their families.
Comforting patients is a vital aspect of caring.
The quality of the relationship with patients significantly impacts nursing effectiveness.
Page 3: Forms of Communication
Verbal Communication: Language used during interactions.
Nonverbal Communication: Includes body language, such as:
Facial expressions
Posture, gait
Gestures
General physical appearance
Mode of dress and grooming
Sounds and silence
Page 4: Auditory/Spoken Communication Strategies
Control the tone of voice and be knowledgeable about conversation topics.
Flexibility is key; be clear and concise.
Ask patients if they have any questions.
Stay on one subject; avoid medical jargon.
Honesty and avoiding false assurances is essential.
Be open-minded, and utilize listening and silence as effective tools.
Humor can reduce stress and anxiety.
Do not share gossip.
Page 5: Promoting Effective Communication
Be open, honest, respectful, and non-threatening.
Create a warm and friendly environment by offering greetings and smiles.
Show empathy and objectivity when addressing patient feelings and problems.
Remember to treat patients as people, not just diseases.
Build rapport and communicate objectives clearly (e.g. assessing patient condition).
Maintain relaxed and private conversations and respect confidentiality according to HIPAA.
Page 6: Factors Influencing Communication
Developmental Level
Gender
Sociocultural Differences
Educational Level
Roles and Responsibilities
Space and Territoriality
Physical, Mental, and Emotional State
Environment
Page 7: Developing Listening Skills
Sit when communicating with patients for better engagement.
Be alert, relaxed, and take your time during conversations.
Maintain natural conversation flow and appropriate eye contact.
Use facial expressions and gestures effectively.
Think carefully before responding and avoid pretending to listen.
Identify themes in the patient’s comments and employ therapeutic touch appropriately.
Page 8: Types of Questions
Closed-Ended Questions: Limited responses, useful for gathering specific information.
Open-Ended Questions: Encourage narrative responses and free verbalization (e.g., “What are your feelings about…?”).
Page 9: Validating Questions or Comments
Use to confirm understanding of what the patient is conveying.
Example: “You seem to be saying his visits upset you, am I understanding you correctly?”
Page 10: Homework Assignment
Assignment: LOGIN TO THE POINT - Practice and learn the HIPPA assignment.
Task: Identify examples of HIPPA violations from readings.
Page 11: Review for Clinical Sites
Activity: Review 2 CDC PowerPoints before attending clinical sites.
Page 12: Standard Precautions
Apply to all hospitalized patients irrespective of diagnosis or infection status.
Includes blood, all bodily fluids, and certain waste.
New guidelines involve respiratory hygiene, safe injection practices, and mask usage in high-risk procedures.
Page 13: Five Moments for Hand Hygiene (WHO)
Moment 1: Before touching a patient.
Moment 2: Before a clean or aseptic procedure.
Moment 3: After a body fluid exposure risk.
Moment 4: After touching a patient.
Moment 5: After touching patient surroundings.
Page 14: Review Post-CDC PowerPoint Presentation
Discusses infection prevention vs. breaking the infection chain.
Medical Asepsis: Clean technique (e.g., hand hygiene).
Surgical Asepsis: Sterile technique (e.g., inserting IV catheters).
Page 15: Factors for Sterilization & Disinfection
Nature of organisms present.
Number of organisms present.
Type and intended use of equipment.
Available means for sterilization and disinfection.
Timing considerations.
Page 16: Targeted Health Care-Associated Infections (HAIs)
CAUTI: Catheter-associated urinary tract infection.
SSI: Surgical site infection.
CLABSI: Central-line–associated bloodstream infection.
Invasive infections including MRSA and C. difficile.
Page 17: Multidrug-Resistant Organisms
MRSA: Methicillin-resistant Staphylococcus aureus.
VRE: Vancomycin-resistant enterococci.
CRE: Carbapenem-resistant Enterobacteriaceae.
Page 18: Transmission-Based Precautions
Additional measures for patients with infectious agents.
Types include:
Contact, Airborne, Droplet.
Page 19: Contact Precautions
For microorganisms spread via contact.
Private room preferred.
Use PPE and perform hand hygiene consistently.
Limit patient movement and avoid sharing equipment.
Page 20: Airborne Precautions
For infections transmitted through the air.
Use private rooms with monitored negative air pressure.
Wear N-95 respirators when entering the room.
Page 21: Droplet Precautions
For infectious agents spread through large droplets.
Utilize private rooms; maintain appropriate PPE.
Keep visitors at least 3 feet from patients.
Page 22: Personal Protective Equipment (PPE)
Include gloves, gowns, masks (surgical/N95), face shields, and eyewear.
Page 23: Using the N95 Mask
Guidelines on how to properly wear and fit an N95 respirator (CDC guidance).
Page 24: Effective Use of PPE
Wear PPE before patient contact.
Minimize touches with PPE to reduce contamination risk.
Page 25: Practice Sessions
Clinical groups practice hand washing and donning/doffing PPE.
Page 26: Break Time
Reminder for students to take a break.
Page 27: Chapter 26 Overview
Title: Vital Signs - Lippincott Skills 2.0.
Page 28: Definition of Vital Signs
Vital Signs include:
Temperature (T)
Pulse (P)
Respiration (R)
Blood pressure (BP)
Pain as often an additional sign
Pulse oximetry.
Page 29: When to Assess Vital Signs
Upon admission or change in patient condition.
Before and after surgical procedures or medications affecting vital signs.
Page 30: Normal Ranges for Vital Signs
Temperature: 35.8–37.5°C; Pulse: 60-100 (average 80); Respiration: 12-20 breaths/min; BP: <120/80.
Page 31: Equipment for Measuring Temperature
Electronic thermometers measure in under 50 seconds.
Color codes for oral (blue) and rectal (red).
Use of disposable probe covers.
Page 32: Rectal Temperature Consideration
Most accurate but contraindicated in certain conditions (e.g., rectal surgery).
Page 33: Sources of Heat Loss
Skin as primary source, evaporation, breathing, and elimination process impact temperature regulation.
Page 34: Factors Affecting Body Temperature
Circadian rhythms, age, gender, physical activity, health state, and environmental temperature.
Page 35: Fever Definitions
Afebrile: without fever.
Pyrexia: with fever.
Page 36: Equipment for Temperature Assessment
Types include electronic, tympanic, disposable, and automated monitoring devices.
Page 37: Temperature Assessment Techniques
Visual aids showing thermometer types for various assessments.
Page 38: Normal Temperature Ranges for Adults
Oral: 35.9–37.5°C; Rectal: 36.3–38.1°C; Axillary: 35.4–36.9°C; Tympanic: 36.8–38.3°C; Forehead: 36.3–38.1°C.
Page 39: Essential Elements for Vital Signs Assessment
Detailed steps for assessing temperature, pulse, respiration, and blood pressure including hand hygiene and patient identification.
Page 40: Oral Temperature Considerations
Must be appropriate for the patient’s ability (contraindications) and waiting period after food/drink.
Page 41: Rectal Temperature Procedure
Steps including hand hygiene, patient positioning, and proper thermometer insertion techniques.
Page 42: Tympanic Temperature Procedure
Hand hygiene, probe cover use, and contraindicated conditions are highlighted.
Page 43: Axillary Temperature Procedure
Required waiting period for accurate assessment following recent washing of the axilla.
Page 44: Pulse Regulation
Regulated by autonomic nervous system; differentiation in response to sympathetic vs. parasympathetic stimulation.
Page 45: Characteristics of Pulse
Pulse Rate: measured in beats/min, normal range 60 to 100.
Amplitude: indicates fullness and strength of pulse.
Rhythm: measures evenness of heartbeats.
Page 46: Common Pulse Sites
Temporal, carotid, brachial, radial, femoral, popliteal, posterior tibial, dorsalis pedis.
Page 47: Pulse Strength Assessment
Strength categorized from absent to bounding, depending on palpation findings.
Page 48: Pulse Rhythm Assessment
Regular vs. irregular rhythms, and terminology like dysrhythmia, tachycardia, bradycardia.
Page 49: Assessment of Radial Pulse
Methodology for proper palpation and counting techniques during assessment.
Page 50: Measuring Apical Pulse
Steps to correctly measure the apical pulse using a stethoscope.
Page 51: Essential Elements for Apical Pulse Assessment
Detailed procedural steps outlined for measurement, with focus on hand hygiene and documentation.
Page 52: Apical-Radial Pulse Assessment
Requires two nurses for accuracy, useful for irregular radial pulses.
Page 53: Respiratory Rates and Definitions
Eupnea, tachypnea, bradypnea, apnea, dyspnea, orthopnea defined.
Page 54: Blood Pressure Overview
Measurement specifics concerning systolic and diastolic pressures.
Page 55: Factors Affecting Blood Pressure
Demographic factors like age and sex, along with physiological activity and emotional states.
Page 56: Decreased Blood Pressure Definitions
Hypotension defined; orthostatic hypotension noted as a clinical consideration.
Page 57: Equipment for Assessing Blood Pressure
Equipment including sphygmomanometer, stethoscope, electronic devices outlined.
Page 58: Sphygmomanometer Overview
Components of a sphygmomanometer introduced, alongside different cuff sizes.
Page 59: AHA Blood Pressure Categories
Classification of blood pressure ranges from normal to hypertensive crisis.
Page 60: Blood Pressure Assessment Techniques
Use of Korotkoff sounds to determine systolic and diastolic pressures.
Page 61: Practice and Learn Activity for Vital Signs
Encouragement to practice vital signs and assessment techniques in clinical settings.
Page 62: Essential Elements for Apical Pulse Assessment
Step-by-step guide included for thorough understanding of apical pulse measurement.
Page 63: Essential Elements for Vital Signs Assessment
Comprehensive review sheet for temperature, pulse, respiration, and blood pressure assessments outlining necessary steps.
Page 64: Chapter 34 Overview
Title: Activity for Week 3 Lab
Page 65: Factors Affecting Mobility
Key determinants of mobility include developmental considerations, health status, lifestyle, and environmental impacts.
Page 66: Role of the Skeletal System
Functions of the skeletal system including support, protection, and blood cell production.
Page 67: Skeletal Muscles and Bones Relationship
Diagram showcasing skeletal muscle attachment through tendons and functional movements.
Page 68: Classification of Bones by Shape
Categories of bones: long, short, flat, irregular based on shape and function.
Page 69: Joint Movements Practice
Directions on abduction, adduction, flexion, extension, hyperextension, and other movements for hands-on understanding.
Page 70: Advanced Joint Movements
Further movements such as rotation, supination, and eversion detailed.
Page 71: Movement Question Example
Scenario question regarding circumduction and differentiation among bodily movements.
Page 72: Answer Explanation for Movement Question
Explanation of circumduction and its distinction from other movement categories.
Page 73: Types of Exercise
Descriptions of isotonic, isometric, and isokinetic exercises.
Page 74: Effects of Immobility
Comprehensive list of negative physiological changes due to immobility, including increased risk of complications.
Page 75: Physical Assessment for Mobility
Components to observe during mobility assessments and aspects to evaluate in patients.
Page 76: Safe Patient Handling and Mobility (SPHM)
Definition of ergonomics and its relevance to patient handling in healthcare.
Page 77: Proper Object Lifting Techniques
Visual demonstration to showcase safe techniques for lifting.
Page 78: Back Injury Contributing Factors
Identification of significant variables leading to injury in healthcare providers during patient handling.
Page 79: Patient Mobility Practices
Guidelines for turning and transferring patients safely and effectively.
Page 80: Equipment for Patient Movement
Overview of various tools and methods available for aiding patient mobility.
Page 81: Assistive Devices for Patient Handling
Visual aids and descriptions of lateral-assist devices and their applications in healthcare settings.
Page 82: Importance of Regular Position Changes
Explanation of how timely position changes prevent pressure ulcers and maintain skin health.
Page 83: Patient Positioning Strategies
Defined patient positions including high Fowler’s, supine, and lateral.
Page 84: Patient Positioning Aids
Equipment and techniques used in aiding efficient patient positioning and care.
Page 85: Overview of Assistive Devices
Listing various equipment designed to support patient mobility and safety.
Page 86: Hand Roll Usage
Purpose and application of a hand roll in maintaining functional positions.
Page 87: Trochanter Roll Purpose
Device usage describes preventing hip rotation risks, especially in the elderly.
Page 88: Stand Assist Devices for Elderly
Devices designed to aid recovery and prevent risks for frail clients during rehabilitation.
Page 89: Assistive Devices Overview
Description of mechanical aids used for supporting walking activities.
Page 90: Overview of Mechanical Aids
Listing various aids from walkers to braces that assist patient movement.
Page 91: Cane Usage Guidelines
Rules for using a cane effectively, emphasizing the COAL principle.
Page 92: Examples of Physical Conditioning Exercises
Suggested exercises for improving strength and mobility.
Page 93: Range of Motion (ROM) Exercises
Definition and differences between active and passive ROM exercises clarified.
Page 94: ROM Exercise Support Measures
Guidelines for safely conducting ROM exercises without risking patient injury.
Page 95: Questions Section
Invitation to inquire about the material covered and for clarification.
Page 96: Safety, Security, and Emergency Preparedness Overview
Chapter 28 overview and fundamental principles in safety.
Page 97: Factors Impacting Safety
Overview of considerations affecting safety like developmental factors and functional ability.
Page 98: Developmental Considerations for Safety #1
Assessing safety for neonates, infants, toddlers, and preschoolers.
Page 99: Developmental Considerations for Safety #2
Identifying issues pertinent to school-age children and adolescents regarding safety risks.
Page 100: Indicators of Concussion
Signs to watch for pertaining to potential concussion cases in patients.
Page 101: Developmental Considerations for Safety #3
Identifying risks specific to adults and older adults in relation to safety.
Page 102: Safety Considerations for Adults
Counseling adults on stress effects and evaluating workplace safety.
Page 103: Domestic Abuse Safety Plans
Recommendations for safety planning when faced with domestic abuse situations.
Page 104: Safety Considerations for Older Adults
Strategies to ensure the safety and security of the elderly population.
Page 105: Safety Question Example
Test question to assess understanding of safety risks for older adults.
Page 106: Safety Question Answer Explanation
Correct answer rationalization regarding safety fatalities among older adults.
Page 107: Patient Environments and Safety
Evaluating various environments affecting patient safety outcomes.
Page 108: Functional Ability & Health Assessment
Identifying functional capabilities that relate to health outcomes in patients.
Page 109: Assessing Fall Risks in Older Adults
Key indicators to identify risks that older adults may face concerning falls.
Page 110: Factors Contributing to Falls
List of common factors leading to falls in various patient environments.
Page 111: Liability Question Example
Scenario questioning potential liability issues for nurses in fall situations.
Page 112: Liability Question Answer Explanation
Correct answer justification regarding liability and reasonable nursing actions.
Page 113: Safety Improvement Strategies
Web of strategies targeted to curtail falls and enhance patient safety.
Page 114: Fall Risk Screening Guidelines
Steps to assess and intervene for patients based on fall risks.
Page 115: Morse Fall Scale Overview
Tool description for assessing fall risk through various parameters.
Page 116: Nursing Fall Prevention Strategies
Interventions that nursing staff can employ to mitigate fall risks.
Page 117: Patient Outcomes for Safety Improvement
Target objectives for safety that should be evaluated during patient care.
Page 118: General Patient Safety Principles
Key principles to ensure effective and safe patient interactions.
Page 119: Restraint-Related Physiological Hazards
Potential hazards resulting from the misuse of restraints in patient care.
Page 120: Restraint Question Example
Test on understanding the conditions under which side rails are considered restraints.
Page 121: Restraint Question Answer Explanation
Clarification of when side rails are not deemed restraints based on patient requests.
Page 122: Restraint Types for Adults and Children
Various restraint types used in healthcare settings described.
Page 123: Facility Safety Considerations
Overview of general safety strategies for healthcare environments.
Page 124: RACE Fire Safety Protocol
Overview of the RACE method during fire emergencies in healthcare.
Page 125: Fire Safety Priority Question
Test question assessing knowledge around addressing fires in healthcare.
Page 126: Fire Safety Priority Answer Explanation
Clear reasoning behind the prioritization of patient evacuation in fire emergencies.
Page 127: Procedure-Related Accidents Overview
Situations where procedure-related accidents may occur and need management.
Page 128: Safety Event Report Guidelines
Requirements and purpose of documenting safety incidents in health care.
Page 129: Health Teaching in Schools
Strategies for promoting health safety in educational settings for children.
Page 130: Maintaining Emergency Preparedness
Overview of the various preparedness strategies for potential emergencies.
Page 131: Chemicals of Mass Destruction Overview
Listing different types of chemical agents that can impact public safety and emergency responses.
Page 132: Chemicals of Mass Destruction #2
Further delineation of chemical hazards to be aware of in potential emergency scenarios.