what does OSHA do?
identifies risks and develops standards to prevent serious injuries and illnesses caused by work related musculoskeletal disorders resulted from repetitious motions
when assessing a pts risk for injury, what should be the viewpoint?
to maintain independence and fostering self esteem while providing a safe and predictable environment
what are some psycho social risk factors that may affect safety?
stress, depression, social isolation,
when looking at the nursing history during a safety assessment, what are some things to look for?
look for history of falls
note assistive devices
history of drug or alcohol abuse
family support systems and home environment (if applicable)
medications ( some can alter LOC or balance)
assess the pts reaction to the environment
During the initial physical examination, what should you be looking for in a risk assessment?
mobility status
ability to communicate
LOC
sensory perception
potential safety hazards
recognize manifestations of domestic violence or neglect
how do home fires start and how do you assess the risk?
smoking in the bed or couch
stoves, candles, electric heaters
assess the knowledge of family members and the presence of functioning smoke detectors
for risk of poisoning, which substances are we most concerned about ?
what are some common agents?
alcohol, tricyclic antidepressants, theophylline
acetominophen hydrocarbons (gas, furniture polish) caustics ( cleaning agents) Iron (vitamins) lead insecticides
what are the most common causes of poisoning in older adults
accidental overdose because of confusion or forgetfullness
poor vision
What are safety risks for fetus’
abnormal growth and development
What are safety risks for neonate
infection, falls, SIDS
What are safety risks for Infants
falls injuries from toys burns suffocation or drowning inhalation or ingestion of foreign objects
What are safety risks for toddlers
falls cuts from sharp objects burns suffocation or drowning inhalation or ingestion of foreign bodies or poisons
What are safety risks for preschooler
falls cuts burns drowning inhalation or ingestions Guns and weapons
What are safety risks for school aged children
burns drowning broken bones concussions inhalation or ingestion guns and weapons substance abuse
What are safety risks for adolescents
drowning
motor vehicle accidents
guns and weapons
inhalation and ingestion
What are safety risks for adults
stress domestic violence motor vechicle accidents industrial accidents drug and alcohol abuse
What are safety risks for older adults
falls motor vehicle accidents elder abuse sensorimotor changes fires
How often should a pt in restraints be assessed?
every 4 hours for adults
every 2 hours for pts 9-17
every hour for children under 9
what documentation is needed for restraints?
date and time
type of restraint
alternatives attempted
notification of family and physician
frequency of assessment, your findings, intervals, and interventions
what are the most common causes of hospital fires?
careless, smoking, faulty electrical equipment, and combustion of anesthetic agents
What is RACE?
Rescue patients
activate the firecode system and notify appropriate person
confine fire
evacuate patients and others to safe area
what is the focus of emergency treatment of poisoning
stabilize body functions
prevent absorption of poison
and encourage excretion of the substance
what are the symptoms presented in chemical choking agents?
dyspnea
couch
pulmonary edema
what are the symptoms presented by blood agents
loss of conciousness
convulsions
respiratory arrest
what are the symptoms of vesicants/blister agents
skin erythema and blisters
eye irritation
progressively severe respiratory symptoms
damage to bone marrow
what are the symptoms of nerve agents
constricted pupils reddened eyes loss of conciousness convulsions respiratory arrest
What are the symptoms of incapacitating agents?
hyperthermia
bizarre behavior
delirium
what are the symptoms of anthrax?
treatments and precautions?
Cutaneous : lesions turning to ulcers with local edema
Gastric: nausea, vomiting, fever, hematemesis
Inhalation: meningitis, septicemia, shock and death
antimicrobials, vaccine
what are the symptoms of plague
severe respiratory infection progressing to pnumonia , sepsis, and death
droplet precautions
streptomycin
What are the symptoms of smallpox
droplet and contact
flue like symptoms with a rash that crusts in 5 days
vaccine available
What are the symptoms of botulism
blurred vision
skeletal muscle paralysis
abrupt respiratory failure
standard precautions
supportive care
What are the symptoms of Tularemia
fever, cough, respiratory failure
streptomycin or gentamicin sulfate
fluid and respiratory support
Viral hemorrhagic fevers symptoms
standard, droplet, and contact, airborn
fever, petechial hemorrhages
conjunctival symptoms
mild hypotension
myalgias