NSG2113 Final Exam VERIFIED
SOLUTIONS, SCORED A+
Top .3 .causes .of .death .in .Canada .- .CORRECT .ANSWER-1. .Cancer
2. .Heart .disease
3. .Patient .safety .incidents
Procedure-related .accidents .- .CORRECT .ANSWER-Hospital .acquired .infections
.(any .tube .that .goes .into .a .patient .poses .a .risk)
Performing .surgery .in .wrong .anatomical .location
Equipment-related .accidents .- .CORRECT .ANSWER-Issues .with .mechanical
.aspect .of .equipment
Patient-inherent .accidents .- .CORRECT .ANSWER-accidents .(other .than .falls) .in
.which .a .patient .is .the .primary .reason .for .the .accident
Number .1 .cause .of .patients .injuries .in .the .hospital .- .CORRECT .ANSWER-Falls .
A .lot .of .acute .care .hospitals .work .with .adults
They .usually .have .multiple .issues .going .on .(ex: .diabetes .and .heart .disease) .→
.putting .them .in .a .new .environment .increases .the .risk .of .falls
Infectious .agents .- .CORRECT .ANSWER-Viruses .that .may .spread .rapidly
.through .the .unit
Over .the .next .30 .years, .it .is .expected .that: .a .patients .safety .incident .(PSI) .will
.occur .in .Canada .nearly .every .minute, .and .a .resulting .a .death .nearly .every
.______ .- .CORRECT .ANSWER-13 .minutes
What .is .the .most .prevalent .patient .safety .incident .in .the .acute .care .system .in
.Canada? .- .CORRECT .ANSWER-Falls .and .infections .are .the .most .common
.causes
Adverse .event .(AE) .- .CORRECT .ANSWER-is .a .type .of .injury .that .most
.frequently .is .due .to .an .error .in .medical .or .surgical .treatment .rather .than .the
.underlying .medical .condition .of .the .patient. .Adverse .events .may .be
.preventable .when .there .is .a .failure .to .follow .accepted .practice .at .a .system .or
.individual .level.
,- .unintended .injury, .prolonged .hospitalization, .or .physical .disability .that .results
.from .medical .or .surgical .patient .management.
- .complications .resulting .from .prolonged .hospitalization .or .by .factors .inherent
.in .the .healthcare .system.
Sentinel .event: .- .CORRECT .ANSWER-When .someone .dies .from .an .unexpected
.outcome
Near .miss: .- .CORRECT .ANSWER-When .person .could .have .had .a .bad .outcome
.but .somehow .avoided .it
Swiss .Cheese .Model .- .CORRECT .ANSWER-- .All .sorts .of .barriers .in .place .(both
.physical .and .not) .so .errors .don't .happen
- .Maybe .there's .some .issues .with .the .barriers .→ ."holes .get .poked .into
.barriers"
EX. .
- .Don't .have .all .the .allergies .of .the .patient
- .Not .enough .supervision/mentors .for .new .nurses
- .Broken .machines
What .happens .when .the .nurse/doctor .makes .a .mistake? .- .CORRECT .ANSWER--
.Focus .is .always .on .prevention
- .Patient-Inherent .accidents
- .Equipment .related .accidents
MEDICATION .ERRORS .- .CORRECT .ANSWER-Labels .- .End .user .does .not
.usually .design .how .the .medications .look.
Illegible .writing
Unapproved .abbreviations .(morph .for .morphine)
Symbols
- .Agencies .will .have .a .set .of .symbols/abbreviations .they .use .so .its .important .to
.stick .to .symbols .used .by .the .agency .you .work .at .in .order .to .not .confuse
.others
Risk .to .Patient .Safety: .FALLS .- .CORRECT .ANSWER-Fall: .is .an .abrupt,
.uncontrolled, .downward .change .in .position, .in .which .the .potential .for .injury
.exists .or .in .which .an .actual .injury .occurs
Near .fall: .- .CORRECT .ANSWER-a .potential .fall .that .is .prevented .through
.purposeful .actions
Repeat .faller: .- .CORRECT .ANSWER-has .had .2 .or .more .falls .within .the .last .3
.months
Interventions .for .falls .- .CORRECT .ANSWER-- .Assess .the .patient's .risk .for .falls
- .Know .the .indicators
,- .Implement .fall .reduction .strategies
- .More .risks .they .have .→ .more .likely .they .are .to .fall
Physiological .Related .Changes .due .to .Aging .(Falls) .- .CORRECT .ANSWER--
.Altered .center .of .gravity
- .Deterioration .in .eyesight .and .hearing
- .Injuries .from .activity .(eg: .used .to .be .a .runner .and .have .a .injury .that .now
.affects .balance .and .motility)
- .Medications .with .side .effects
- .Deconditioning .form .lack .of .activity .(lose .muscle .mass .from .being .sedentary)
- .Certain .diseases .put .people .at .risk .(Parkinsons, .MS)
Where .do .most .falls .happen? .- .CORRECT .ANSWER-Most .falls .happen .at .home
domino .effect .→ .- .CORRECT .ANSWER-more .hesitant .to .engage .in .activities
.because .of .worries .with .falling .again .but .being .sedentary .also .reduced .muscle
.mass .increasing .the .risk .for .falls .(maladaptive)
More .statistics .about .Falls .- .CORRECT .ANSWER-- .Falls .are .the .leading .cause
.of .injury .in .older .adults
- .Falls .cause .90% .of .all .hip .fractures
- .Over .1/3 .of .older .adults .go .to .LTC .after .being .hospitalized .for .a .fall
- .Also .have .chronic .pain, .loss .of .independence, .reduced .mobility .or .death
Why .falls .happen .- .Personal .and .Medical .- .CORRECT .ANSWER-Conditions .like
.Parkinsons .and .MS .that .affect .someone .physical .and .change .their
.motility/balance .→ .increased .fall .risk
Why .falls .happen .- .Behavioural .- .CORRECT .ANSWER-Changes .to .lifestyle
.related .to .the .fear .of .falling
Their .behaviors .have .changed .such .as .sleep .patterns, .engagement .in .activity
.and .substance .use
What .do .they .do .around .the .house? .Eg: .pulling .up .a .chair .to .reach .something
.up .high, .after .a .fall, .might .not .try .this
Why .falls .happen .- .Environmental .- .CORRECT .ANSWER-What .are .the .stairs
.like?
Safe .walkways .during .winter, .ice .can .increase .risk .of .falls
Lighting, .visual .changes .can .put .older .adults .at .risk
Pets .may .also .interfere .with .balance
Why .falls .happen .- .Social .and .economic .- .CORRECT .ANSWER-Lower .income .→
.less .able .to .access .good .nutrition .→ .affects .physical .health .→ .more .risk .of .fall
Fall .prevention .- .Risk .factor .reduction
(BEEEACH .fall .reduction .mode) .- .CORRECT .ANSWER-Behaviour .changes:
, Equipment .→ .using .a .walker .or .cane; .even .though .some .patients .might .not
.want .this .because .it .changes .their .perspective .of .themselves, .it .can .prevent
.falls
Education .→ .educate .them .on .potential .risks .and .solutions
Environment .→ .good .lighting, .type .of .flooring, .physical .obstacles...
Activity .→ .encourage .activity .to .maintain .patients .strength
Clothing/footwear .→ .change .type .of .shoes, .socks .with .grips
Health .management
Patient .Restraints .Minimization .Act .(Bill .85) .- .CORRECT .ANSWER-Essentially
.this .act .asks .nurses .to .look .at .all .alternatives .before .applying .restraints .to .a
.patient .to .ensure .both .patient .and .staff .safety
If .you .see .someone .with .aggressive .behaviour, .don't .automatically .apply
.restaurants, .consider .why .they .are .showing .these .behaviours .and .what .else
.can .be .done .before
What .are .restraints? .- .CORRECT .ANSWER-Restraints .as .defined .by .the .CNO
.are: .physical, .environmental .or .chemical .measures .used .to .control .the .physical
.or .behavioural .activity .of .a .person .or .a .portion .of .his/her .body
Physical .restraints: .- .CORRECT .ANSWER-limit .movement .of .the .clients .whole
.body .or .body .part .(eg: .fixed .table .or .bed .rail)
Environmental .restraint: .- .CORRECT .ANSWER-control .a .client's .mobility .(eg:
.locked .unit)
Chemical .restraint: .- .CORRECT .ANSWER-pharmacological .intervention .to
.control, .inhibitory .or .restrict .a .person's .behaviour .(eg: .psychoactive
.medication .in .long .term .care)
When .using .restraints: .- .CORRECT .ANSWER-always .want .to .use .the .least
.invasive .restraint .possible, .only .if .it .doesn't .work .should .you .move .up .to .a
.higher .restraint
e.g .oven .mitts .to .prevent .patient .from .pulling .out .IV, .but .allows .full .range .of
.motion .for .the .arms
A .side .rail .is .NOT .a .restraint .if: .- .CORRECT .ANSWER-- .The .patient .can .lower .it
.themselves
- .If .it .is .used .as .a .positioning .device .or .mobility .aid .(e.g. .to .help .turning)
- .Is .at .the .request .of .the .patient
- .Following .immediate .administration .of .a .sedative .or .sedating .medication
- .Used .on .a .comatose .patient .that .is .not .functionally .capable .of .voluntary .or
.involuntary .movements
SOLUTIONS, SCORED A+
Top .3 .causes .of .death .in .Canada .- .CORRECT .ANSWER-1. .Cancer
2. .Heart .disease
3. .Patient .safety .incidents
Procedure-related .accidents .- .CORRECT .ANSWER-Hospital .acquired .infections
.(any .tube .that .goes .into .a .patient .poses .a .risk)
Performing .surgery .in .wrong .anatomical .location
Equipment-related .accidents .- .CORRECT .ANSWER-Issues .with .mechanical
.aspect .of .equipment
Patient-inherent .accidents .- .CORRECT .ANSWER-accidents .(other .than .falls) .in
.which .a .patient .is .the .primary .reason .for .the .accident
Number .1 .cause .of .patients .injuries .in .the .hospital .- .CORRECT .ANSWER-Falls .
A .lot .of .acute .care .hospitals .work .with .adults
They .usually .have .multiple .issues .going .on .(ex: .diabetes .and .heart .disease) .→
.putting .them .in .a .new .environment .increases .the .risk .of .falls
Infectious .agents .- .CORRECT .ANSWER-Viruses .that .may .spread .rapidly
.through .the .unit
Over .the .next .30 .years, .it .is .expected .that: .a .patients .safety .incident .(PSI) .will
.occur .in .Canada .nearly .every .minute, .and .a .resulting .a .death .nearly .every
.______ .- .CORRECT .ANSWER-13 .minutes
What .is .the .most .prevalent .patient .safety .incident .in .the .acute .care .system .in
.Canada? .- .CORRECT .ANSWER-Falls .and .infections .are .the .most .common
.causes
Adverse .event .(AE) .- .CORRECT .ANSWER-is .a .type .of .injury .that .most
.frequently .is .due .to .an .error .in .medical .or .surgical .treatment .rather .than .the
.underlying .medical .condition .of .the .patient. .Adverse .events .may .be
.preventable .when .there .is .a .failure .to .follow .accepted .practice .at .a .system .or
.individual .level.
,- .unintended .injury, .prolonged .hospitalization, .or .physical .disability .that .results
.from .medical .or .surgical .patient .management.
- .complications .resulting .from .prolonged .hospitalization .or .by .factors .inherent
.in .the .healthcare .system.
Sentinel .event: .- .CORRECT .ANSWER-When .someone .dies .from .an .unexpected
.outcome
Near .miss: .- .CORRECT .ANSWER-When .person .could .have .had .a .bad .outcome
.but .somehow .avoided .it
Swiss .Cheese .Model .- .CORRECT .ANSWER-- .All .sorts .of .barriers .in .place .(both
.physical .and .not) .so .errors .don't .happen
- .Maybe .there's .some .issues .with .the .barriers .→ ."holes .get .poked .into
.barriers"
EX. .
- .Don't .have .all .the .allergies .of .the .patient
- .Not .enough .supervision/mentors .for .new .nurses
- .Broken .machines
What .happens .when .the .nurse/doctor .makes .a .mistake? .- .CORRECT .ANSWER--
.Focus .is .always .on .prevention
- .Patient-Inherent .accidents
- .Equipment .related .accidents
MEDICATION .ERRORS .- .CORRECT .ANSWER-Labels .- .End .user .does .not
.usually .design .how .the .medications .look.
Illegible .writing
Unapproved .abbreviations .(morph .for .morphine)
Symbols
- .Agencies .will .have .a .set .of .symbols/abbreviations .they .use .so .its .important .to
.stick .to .symbols .used .by .the .agency .you .work .at .in .order .to .not .confuse
.others
Risk .to .Patient .Safety: .FALLS .- .CORRECT .ANSWER-Fall: .is .an .abrupt,
.uncontrolled, .downward .change .in .position, .in .which .the .potential .for .injury
.exists .or .in .which .an .actual .injury .occurs
Near .fall: .- .CORRECT .ANSWER-a .potential .fall .that .is .prevented .through
.purposeful .actions
Repeat .faller: .- .CORRECT .ANSWER-has .had .2 .or .more .falls .within .the .last .3
.months
Interventions .for .falls .- .CORRECT .ANSWER-- .Assess .the .patient's .risk .for .falls
- .Know .the .indicators
,- .Implement .fall .reduction .strategies
- .More .risks .they .have .→ .more .likely .they .are .to .fall
Physiological .Related .Changes .due .to .Aging .(Falls) .- .CORRECT .ANSWER--
.Altered .center .of .gravity
- .Deterioration .in .eyesight .and .hearing
- .Injuries .from .activity .(eg: .used .to .be .a .runner .and .have .a .injury .that .now
.affects .balance .and .motility)
- .Medications .with .side .effects
- .Deconditioning .form .lack .of .activity .(lose .muscle .mass .from .being .sedentary)
- .Certain .diseases .put .people .at .risk .(Parkinsons, .MS)
Where .do .most .falls .happen? .- .CORRECT .ANSWER-Most .falls .happen .at .home
domino .effect .→ .- .CORRECT .ANSWER-more .hesitant .to .engage .in .activities
.because .of .worries .with .falling .again .but .being .sedentary .also .reduced .muscle
.mass .increasing .the .risk .for .falls .(maladaptive)
More .statistics .about .Falls .- .CORRECT .ANSWER-- .Falls .are .the .leading .cause
.of .injury .in .older .adults
- .Falls .cause .90% .of .all .hip .fractures
- .Over .1/3 .of .older .adults .go .to .LTC .after .being .hospitalized .for .a .fall
- .Also .have .chronic .pain, .loss .of .independence, .reduced .mobility .or .death
Why .falls .happen .- .Personal .and .Medical .- .CORRECT .ANSWER-Conditions .like
.Parkinsons .and .MS .that .affect .someone .physical .and .change .their
.motility/balance .→ .increased .fall .risk
Why .falls .happen .- .Behavioural .- .CORRECT .ANSWER-Changes .to .lifestyle
.related .to .the .fear .of .falling
Their .behaviors .have .changed .such .as .sleep .patterns, .engagement .in .activity
.and .substance .use
What .do .they .do .around .the .house? .Eg: .pulling .up .a .chair .to .reach .something
.up .high, .after .a .fall, .might .not .try .this
Why .falls .happen .- .Environmental .- .CORRECT .ANSWER-What .are .the .stairs
.like?
Safe .walkways .during .winter, .ice .can .increase .risk .of .falls
Lighting, .visual .changes .can .put .older .adults .at .risk
Pets .may .also .interfere .with .balance
Why .falls .happen .- .Social .and .economic .- .CORRECT .ANSWER-Lower .income .→
.less .able .to .access .good .nutrition .→ .affects .physical .health .→ .more .risk .of .fall
Fall .prevention .- .Risk .factor .reduction
(BEEEACH .fall .reduction .mode) .- .CORRECT .ANSWER-Behaviour .changes:
, Equipment .→ .using .a .walker .or .cane; .even .though .some .patients .might .not
.want .this .because .it .changes .their .perspective .of .themselves, .it .can .prevent
.falls
Education .→ .educate .them .on .potential .risks .and .solutions
Environment .→ .good .lighting, .type .of .flooring, .physical .obstacles...
Activity .→ .encourage .activity .to .maintain .patients .strength
Clothing/footwear .→ .change .type .of .shoes, .socks .with .grips
Health .management
Patient .Restraints .Minimization .Act .(Bill .85) .- .CORRECT .ANSWER-Essentially
.this .act .asks .nurses .to .look .at .all .alternatives .before .applying .restraints .to .a
.patient .to .ensure .both .patient .and .staff .safety
If .you .see .someone .with .aggressive .behaviour, .don't .automatically .apply
.restaurants, .consider .why .they .are .showing .these .behaviours .and .what .else
.can .be .done .before
What .are .restraints? .- .CORRECT .ANSWER-Restraints .as .defined .by .the .CNO
.are: .physical, .environmental .or .chemical .measures .used .to .control .the .physical
.or .behavioural .activity .of .a .person .or .a .portion .of .his/her .body
Physical .restraints: .- .CORRECT .ANSWER-limit .movement .of .the .clients .whole
.body .or .body .part .(eg: .fixed .table .or .bed .rail)
Environmental .restraint: .- .CORRECT .ANSWER-control .a .client's .mobility .(eg:
.locked .unit)
Chemical .restraint: .- .CORRECT .ANSWER-pharmacological .intervention .to
.control, .inhibitory .or .restrict .a .person's .behaviour .(eg: .psychoactive
.medication .in .long .term .care)
When .using .restraints: .- .CORRECT .ANSWER-always .want .to .use .the .least
.invasive .restraint .possible, .only .if .it .doesn't .work .should .you .move .up .to .a
.higher .restraint
e.g .oven .mitts .to .prevent .patient .from .pulling .out .IV, .but .allows .full .range .of
.motion .for .the .arms
A .side .rail .is .NOT .a .restraint .if: .- .CORRECT .ANSWER-- .The .patient .can .lower .it
.themselves
- .If .it .is .used .as .a .positioning .device .or .mobility .aid .(e.g. .to .help .turning)
- .Is .at .the .request .of .the .patient
- .Following .immediate .administration .of .a .sedative .or .sedating .medication
- .Used .on .a .comatose .patient .that .is .not .functionally .capable .of .voluntary .or
.involuntary .movements
