NSE 111 Questions and Answers Already Passed

NSE 111 Questions and Answers Already Passed What is patient centered care? A standard off care that places the patient as the focus of care. Includes the patient as a partner in care and one who participates in their care. Having concern for the dignity, independence, preferences, privacy and safety of patients at all times. Does patient centred care include the patient as a partner in care? Yes, the patient also participants in their care. What does DIPPS stand for? Dignity Independence Preferences Privacy Safety What does DIPPERS stand for? Dignity Independence Preferences Privacy Empathy* Respect* Safety Explain DIPPS Dignity- they must feel worthy of your attention and care being provided/ values respected regardless of differences Independence- encourage and support patients to do what they can themselves (even if it takes longer) Preferences- allow patients to make choices and how they would like to have things done (patient is part of decision making) Privacy- ensure to provide privacy during care (information and physically of their body) you are not allowed to share info to family without permission Safety- patients need to be in environment that will keep them safe from harm (keep call button around or mobility device) What is the nursing process? provides the framework in which nurses use their knowledge and skills to express human caring (a method of thinking + patient focused care) Assists nurses with identifying and treating health related concerns & helps patients to attain health outcomes What are the steps of the nursing process? Assessment- incomes the collection of data or cues important to the patients health care status or situation in order to fully understand the patients priority Diagnosis- involves the analysis of the assessment data in order to determine key issues and make clinical judgements in the form of a nursing diagnostic Also involves the creation of outcomes or goals for the patient and their situation Planning- the creation of a plan that identifies strategies to reach the outcomes or goals Implementation- involves implementing or carrying o or the plan (ex. Care delivery, teaching) Evaluation- involves determining if the implementation of the plan was successful in reaching the outcomes or goals What is layer 3 of the Clinical Judgement Model? Recognize Cues Analyze cues Prioritize hypothesis Generate solution Take action Evaluate outcomes What is the difference between the nursing process and the clinical judgement model? The identification and analysis of cues are not specifically highlighted in the nursing process What is disease? An objective state of ill health What did WHO define HEALTH as? A state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. What are examples of determinants and social determinants of health? 1. Income and social status 2. Social support networks 3. Education and literacy 4. Employment and working conditions 5. Physical environment 6. Biological and genetic endowment 7. Individual health practices and coping skills 8. Healthy child development Why should we examine infection control and prevention measures? 1. To protect a client (who is vulnerable to illnesses as their immune system may be compromised, making them susceptible to illness) 2. To protect the healthcare workers such as yourself from being infected What is the chain of infection? A cycle in which micro organism causes an infection infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host What is infection control based on? Understanding how to break the chain of infection so that infections do not develop What is the infectious agent? Are microorganisms (single cells) ex) bacteria, viruses, fungi and protozoa They live and grow on objects as well as inside and on people (especially on our skin) What is the difference between resident micro organisms and transient micro organisms? Resident- Live permanently on the skin survive and multiply without causing harm not easily removed by handwashing but can be killed with antibacterial ingredients Transient- Carried after contact with a person or object attach to dirt, grease underneath fingernails they can spread between surfaces When does the potential for the micro organism to cause the disease increase? -when they are sufficient in numbers -the micro organism is virulent - can enter and survive in the host -the host is susceptible What is the most common reservoir? human body What is a reservoir? A place where a pathogen can survive that may or may not multiply or cause harm/show symptoms What does it mean when a pathogen is colonizing a site? When a pathogen is present or in the body but does not cause harm What is a carrier? Animals or people who show no symptoms of illness but who have pathogens on or in their bodies that can be transferred to others What factors contribute to the growth of pathogens? Food oxygen to survive water or moisture ideal temperature is 35° (cold temperatures tend to prevent growth) prefer environment with PH 5 to 8 Minimal light What is the Portal of exit? The method which an infectious agent leaves its reservoir Ex) body openings, Breaks in the skin, breaks in the mucous membranes How can the pathogens make it through the portals of exit? Via... Blood Body fluids Excretions Secretions What is the mode of transmission? Is the route by which the pathogen travels from the Reservoir to a host List the modes of transmission (know what each means) 1. Direct contact 2. Indirect contact 3. Droplet transmission 4. Airborne transmission 5. Vehicle transmission 6. Vector borne transmission What is the portal of entry? Path through which the pathogen can enter the body- can be the same way as they exited Also any break in the skin- intentional or not- can be a portal of entry Ex) needle piercing skin, catheter, breathing in Someones cough Who is a susceptible host? Patient, health care workers, visitors What can vary susceptibility in individuals? -their immunity (vaccinations our previous illnesses) - Immunocompromise state - general health status - virulence of the micro organism, that is the severity or harmfulness of the disease - Age What are some normal defences against fighting infections? 1. Normal flora- Micro organisms that protect a person from pathogens that live outside and inside the body 2. Inflammatory Response- 3. Body system defences - Several organs have unique defences against infection (ex) respiratory tract, vagina What is a health care associated infection HAI? Nosocomial infection/ iatrogenic infection (originating in the hospital) Is an infection that a client acquired AFTER admission to a healthcare facility that was not present at the time of their admission What type of people are at an increased risk for acquiring a nosocomial infection? Hospitalized patients, especially older people What is Clostridium difficile (C. Diff) and who does is typically effect? A bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon Typically effects older adults inHospitals are in long-term care facilities and typically occurs after use of antibiotic medications How do antibiotics affect C Difícile bacteria? The antibiotics change the normal: bacteria allowing the C Difficile bacteria to grow and produces toxins What is a common healthcare associated infection? Antibiotic resistant organisms because of the overuse of antibiotics, many bacteria organisms develop resistance to certain drugs making it more difficult to treat What is asepsis and the two types? The process for keeping away disease producing micro organisms. Medical asepsis- routine Surgical asepsis -used in and out of the OR What is the focus of medical a sepsis and what does it include doing? Focus is limiting/minimizing the spread of micro organisms includes hand hygiene, using clean disposable gloves to prevent direct contact with any blood or body fluids, and cleaning the environment routinely basic medical is sepsis techniques help to break the infection chain using standard procedures What are the three levels of cleaning equipment? 1. Cleaning- Physical removal of foreign material including micro organisms using water and soap, cleaning products 2. Disinfection- elimination of all pathogens except bacterial spores Includes chemicals or ultraviolet light 3. Sterilization- destruction of all microorganisms including bacterial spores using moist heat (steam), chemicals, gas, and boiling water How can you control or eliminate infectious agents to break the chain of infection? Clean, disinfect and sterilize How can you control or eliminate bacteria at the reservoir stage? Regularly empty drainage bags, replace bags of IV solutions at least daily, discard wound dressings that are soiled, syringes etc. to prevent the opportunity of bacteria growing in a potential reservoir How can you prevent organisms from leaving the body in the portal of exit/entry? Cover your mouth when coughing/sneezing use protective clothing when handling potentially contaminated substances ex) using gloves when providing mouth care to a client or when changing so soiled linen or wearing a mask when necessary How can you break the chain of infection during modes of transmission? Limit ways that the micro organisms can be carried from objects/or people to others NO SHARING HAMS HYGIENE In the chain of infection what are ways to protect a susceptible client or host? Maintain the client skin integrity in order to avoid breaks in the skin thereby introducing a portal of entry supporting good hygiene practises providing adequate fluid and nutrition intake maintaining immunization schedule providing comfort for adequate sleep and reducing stress also promotes healing What does routine practice include appropriate use of? Gowns Gloves Masks Eye wear Etc What is routine practises based on? The same safe standards of practice (hand washing, cleaning, disposal) should be used routinely with all clients/patients/residents to prevent the spread of micro organisms All clients have the potential to transmit infection via blood and body fluids, which can be unknown What precautions must be taken for Tier 2 Contact Infections ? When patient has direct or indirect contact infection nurse would need to wear gloves, gown and perform proper hand hygiene. The client will also be in a private room or a room with similar clients. What precautions must be taken for Tier 2 Droplet Infections ? Nurse would wear eye/mask protection if within 2 m of the client along with proper hand hygiene. The masks to be worn or surgical masks. Clients are to be in a private room or cohort clients What precautions must be taken for Tier 2 Airborne Infections ? An N95 mask would be worn Clients must be in a private room with the door closed and negative pressure airflow What is the difference between a negative pressure room and a positive pressure room? Negative pressure room- when the air flows INTO the isolation room but does not escape the room. When opening the door the airflow/current will be into the room so that no airborne particles escape the room. Positive Pressure Room- when air will flow OUT of the room instead of in, so that any airborne micro organisms that may infect the patient are kept away Patients whose immune system's are compromised may be put into a positive pressure room to keep potential airborne micro organisms away from them. What is a pathogen? A microorganism that is capable of causing disease What is infection? An infection is a disease state resulting from the entry and multiplication of a pathogen in the tissues of a host, causing the body to manifest clinical signs and symptoms. What does virulence mean? ability to produce disease What is the most important and most basic technique in preventing the transmission of infections? Hand hygiene What is the prime cause of infection? Contaminated hands See the distance of why soap and water is more or less efficient than alcohol based waterless antiseptic When are the 4 moments of hand hygiene? 1. BEFORE initial patient or patient environment contact to protect the patient/patients environment from harmful germs carried on your hands 2. BEFORE any antiseptic procedures in order to protect the patient against any harmful germs from entering his/her body 3. AFTER any exposure to bodily fluids to protect yourself and the healthcare environment from harmful germs 4. AFTER patient/ patient environment contact in order to protect yourself and the healthcare environment from harmful patient germs List situations where hand hygiene must occur Before and after direct contact with all clients before donning gloves and after dolphin gloves before and after performing invasive procedures after contact with bodily fluids or excretions, mucous membranes, non-intact skin, or wound dressing (if visibly soiled, must use soap and water) after personal body functions, such as using the toilet or blowing ones noes when moving from a contaminated body site to a clean body site during patient care after contact with inanimate objects including medical equipment in the immediate vicinity of the patient before and after preparing handling serving or eating food before and after feeding the client What are examples of PPE Personal protective equipment? Gown, gloves, mask and protective eyewear When are caps or shoe covers required,? For sterile surgical procedures only What is the primary reason to wear a gown? To prevent contamination of clothes during contact with the client to protect healthcare workers and visitors from coming in contact with infected material, blood, or body fluids may also be required for contact precautions What should the gown be made of when used for barrier protection? Fluid resistant material and should be changed immediately if damaged or heavily soiled Is there a special technique for putting on a gown? No, as long as they are fastened appropriately however when taking off careful attention must be taken to minimize the contamination of hands in uniform Is wearing gloves a substitute for hand hygiene? No What are gloves used for? To prevent transmission of pathogens by direct and indirect contact When should gloves be worn? When there's a risk of hand contact with blood, body fluids, secretions, excretions, non-intact skin, mucous membranes or contaminated surfaces or objects When should gloves be changed? Between tasks and procedures on same client after contact with material with high concentration of micro organisms Why should hand hygiene be performed after glove removal? Because gloves may not be completely free of leaks and hands may become contaminated when removing gloves Why would you verify information with the glove manufacturer? Because gloves may be adversely affected by petroleum based hand lotions or creams so you have to see what the gloves are compatible with in regards to products to use in the healthcare setting When should you not wear gloves? - bathing a patient with intact skin except for doing pericare - taking vital signs on a patient - Delivering dietary trays - applying lotion and provide comfort care to a patient with intact skin - pushing stretchers/carts - handling intact laundry bags - answering telephones What is the criteria for selecting a mask? 1. Mask should securely cover the nose and mouth 2. Mask should be substantial enough to prevent droplet penetration 3. Mask should be able to perform for the duration of the activity for which the mask is indicated (eg. surgery) When are masks used? In addition to eye protection, when it is anticipated that activity will generate splashes or sprays of blood, body fluids, secretions or excretions or within two m of a coughing patient Why are masks worn? To protect the mucous membrane of the nose and mouth What is the order of Donning PPE? Donning: 1. Hand Hygiene 2. Gown - tie properly 3. Mask 4. Eye protection 5. Gloves What is the order of removing PPE? 1. Gloves 2. Gown 3. Hand Hygiene 4. Eye protection 5. Mask 6. Hand Hygiene