How to manage a patient who is a fall risk: identification
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Factors that Contribute to Falls
1. Age greater than 65
2. History of Falls
3. Lower body weakness
4. Poor vision
5. Gait and/or balance issues
6. Postural Dizziness
7. Problems with feet and/or shoes
, 8. Use of psychoactive medications
9. Hazards in home or community
Assessments and planning before moving patients
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1. Assessing:
See what can a patient handle, daily exercise levels
Nursing history:
Daily activity level
Endurance
Exercise and fitness goals
Mobility problems
Physical or mental health alterations that affect mobility
2. Physical Assessment:
General ease of movement and gait
Alignment
Joint structure and function
Muscle mass, tone, and strength
Endurance
Planning:
Patient will:
· Identify personal benefits of regular exercise
· Demonstrate full range of joint motion ( joint mobility)
· Demonstrate adequate muscle mass, tone and strength to perform
functional ADLs
· Be free from alterations in skin integrity
Show signs of adequate venous return
· Be free from contractures
how as a nurse you can break chain of infection
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HAND HYGIENE
· Infectious agent to Reservoir
o Hand hygiene, sterilization, antibiotics/antimicrobials
· Reservoir to Portal of Exit
o Transmission-based precautions, sterilization or use of disposable
supplies
· Portal of Exit to Mode of Transmission
o Dry intact dressing, hand hygiene, wear gloves if contact with body fluids,
cover nose and mouth when sneezing
· Mode of Transmission to Portals of Entry
o Hand hygiene, use of pesticides to eliminate vectors, adequate
refrigeration
· Portals of Entry to Susceptible Host
o Hand hygiene, wear gloves, use masks and appropriate protective gear,
proper disposal of needles/sharps
· Susceptible Host to Infectious Agent
o Immunizations, screen health care staff
Names used to describe medications -recognize the differences
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1. Chemical Name: identifies drug's atomic and molecular structure
2. Generic Name: identifies the drug's active ingredient
Usually derived from the chemical name which described the drug's
chemical composition
There is only ONE generic name universally used
3. Trade name: "brand name"
A drug can have several trade names based on different manufacturers
, Ex:
Generic Name: Ibuprofen
Trade/Brand Name: Advil, Motrin
oral care
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· Poor oral hygiene leads to colonization of oropharyngeal secretions by
respiratory pathogens
· Poor oral hygiene can lead to aspiration pneumonia
Care of dentures
· Daily cleaning by soaking in and brushing with an abrasive denture
cleaner
· Store in cold water when not in patients mouth
· Leaving dentures dry can cause warping
· Label denture holder with patient name
ORAL MEDS: BUCCAL, SUBLINGUAL
Give this one a try later!
Give this one a try later!
Factors that Contribute to Falls
1. Age greater than 65
2. History of Falls
3. Lower body weakness
4. Poor vision
5. Gait and/or balance issues
6. Postural Dizziness
7. Problems with feet and/or shoes
, 8. Use of psychoactive medications
9. Hazards in home or community
Assessments and planning before moving patients
Give this one a try later!
1. Assessing:
See what can a patient handle, daily exercise levels
Nursing history:
Daily activity level
Endurance
Exercise and fitness goals
Mobility problems
Physical or mental health alterations that affect mobility
2. Physical Assessment:
General ease of movement and gait
Alignment
Joint structure and function
Muscle mass, tone, and strength
Endurance
Planning:
Patient will:
· Identify personal benefits of regular exercise
· Demonstrate full range of joint motion ( joint mobility)
· Demonstrate adequate muscle mass, tone and strength to perform
functional ADLs
· Be free from alterations in skin integrity
Show signs of adequate venous return
· Be free from contractures
how as a nurse you can break chain of infection
,Give this one a try later!
HAND HYGIENE
· Infectious agent to Reservoir
o Hand hygiene, sterilization, antibiotics/antimicrobials
· Reservoir to Portal of Exit
o Transmission-based precautions, sterilization or use of disposable
supplies
· Portal of Exit to Mode of Transmission
o Dry intact dressing, hand hygiene, wear gloves if contact with body fluids,
cover nose and mouth when sneezing
· Mode of Transmission to Portals of Entry
o Hand hygiene, use of pesticides to eliminate vectors, adequate
refrigeration
· Portals of Entry to Susceptible Host
o Hand hygiene, wear gloves, use masks and appropriate protective gear,
proper disposal of needles/sharps
· Susceptible Host to Infectious Agent
o Immunizations, screen health care staff
Names used to describe medications -recognize the differences
Give this one a try later!
1. Chemical Name: identifies drug's atomic and molecular structure
2. Generic Name: identifies the drug's active ingredient
Usually derived from the chemical name which described the drug's
chemical composition
There is only ONE generic name universally used
3. Trade name: "brand name"
A drug can have several trade names based on different manufacturers
, Ex:
Generic Name: Ibuprofen
Trade/Brand Name: Advil, Motrin
oral care
Give this one a try later!
· Poor oral hygiene leads to colonization of oropharyngeal secretions by
respiratory pathogens
· Poor oral hygiene can lead to aspiration pneumonia
Care of dentures
· Daily cleaning by soaking in and brushing with an abrasive denture
cleaner
· Store in cold water when not in patients mouth
· Leaving dentures dry can cause warping
· Label denture holder with patient name
ORAL MEDS: BUCCAL, SUBLINGUAL
Give this one a try later!
