All too often, administrators continue to fail to see the impact on patient safety (32 per cent linked disruptive behavior to an adverse event) – or cost (over $11,000 per nurse per year) – if they did, they would move swiftly to end these behaviors with the urgency of calling a code. Nursing leadership has firmly supported such reforms. a. The nurse subsequently reviewed all birth records for the previous year and found that the incidence of children born with this defect in her facility was significantly greater than the national rate: 30 cases per 10,000 births versus 10 cases per 10,000 births, respectively. Role play b. Even the smallest of condescending mannerisms has a profound impact on the team. On the basis of this research, the nurses might have developed plans for educating the community on disease prevention and health promotion related to the primary source of the problem: well water contamination with chemicals used to fertilize crops. a. will need expansion to include communication with entire communities and the general public if they are to fill an essential niche in environmental health. c. Swelling and coolness are observed at the IV site. And so they tolerate the behavior. A nurse is teaching a client about dietary management of hypercholesterolemia. A Protective Environment does not include the use of barrier precautions beyond those indicated for Standard and Transmission-Based Precautions. Examine personal values about the issue. a. Purulent exudate b. d. Complete an incident report. Diagnoses, planning, and interventions may be altered at any stage based upon new information from the patient or any other source. This role is particularly important when advocacy. Such resources may include nurse experts; professionals from other disciplines; written materials; and local, state, and federal public health and environmental protection agencies. The family member providing the feedings reports that the client has begun to have diarrhea. You will be subject to the destination website's privacy policy when you follow the link. Which of the following responses should the nurse provide? The pediatric nurse practitioner examination content outline dedicated a section to environmental issues, and the general nursing practice test content outline noted the influence of "environmental and occupational factors" in consideration of health promotion, disease prevention, and control. However, research shows that raising awareness of horizontal hostility and teaching a set of skills to help new nurses deal with the non-verbal assaults allows them to depersonalize the attack and continue to learn (Griffin). Critical pathway b. Compelling data have been compiled that demonstrate the potential to increase accessibility of care and decrease cost, without a loss of quality of care (Boex et al., 1993). A nurse is caring for a client who is postoperative and refuses to use an incentive spirometer following major abdominal surgery. Regulate oxygen via nasal cannula at a flow rate of no more than 6 L/min. See the 2006 HICPAC/CDC MDRO guideline 927 for discussion of possible criteria to discontinue Contact Precautions for patients colonized or infected with MDROs. Which of the following actions should the nurse take to prevent skin breakdown? In 1990, that agency recommended the establishment of 35 state plans to define and track sentinel environmental diseases (DHHS, 1990). The HICPAC/CDC Guidelines also include recommendations for creating a Protective Environment for allogeneic HSCT patients. Which of the following actions should the nurse take to prevent the spread of infection? If this is not possible, then a mask should be worn while providing patient care. A nurse working in the emergency department is witnessing the signing of informed consent forms for the treatment of multiple clients during her shift. I’ll never do that again.”. Patients on Droplet Precautions who must be transported outside of the room should wear a mask if tolerated and follow Respiratory Hygiene/Cough Etiquette. abdominal cramping, weakness, headache and nausea, Where should a nurse listen for a pt with a heart murmur, second intercostal space at the left sternal border and apex, A nurse is educating a client who has a terminal illness about her request to decline resuscitation in her living will. Protocol for Excellence in Public Health (NACHO, 1991) and ATSDR's Public Health Assessment process (Lybarger et at., 1993) involve identifying risk factors and exposures that affect the health of the community. Which of the following actions should the nurse plan to take first? For some interactions (e.g., performing venipuncture), only gloves may be needed; during other interactions (e.g., intubation), use of gloves, gown, and face shield or mask and goggles is necessary. The nurse should wear a mask when providing care or when within 1 m (3 ft) of the client who has a disorder requiring this precaution. After giving several speeches in Canada over the last two years, nurses began writing to me with their stories of incivility: “After I told the younger nurse that I couldn’t pick up extra days to cover her vacation, my hair was pulled three times during the shift.” The first step in creating healthy work place relationships is to point out the behaviors that are unacceptable. Hospital News is Canada's health care newspaper since 1987. Which of the following actions should the nurse take? A nurse is caring for a client who asks about the purpose of advanced directives. lack of education and redeployment strategies to ensure a supply of appropriately prepared RNs for the demands of the future. Facilitate interaction with other disciplines both within and external to the practice setting through clearly stated job expectations with the appropriate allocation of time and resources. A) Make sure the client's room has at least 6 air exchanges per hour B) Make sure the client wears a mask when outside the room if there is construction in the area. Because schools of nursing use data on the passing rate for NCLEX as an educational outcome indicator, the influence of NCLEX items and the content of this examination on curricular decisions for nursing education cannot be underestimated (see Chapter 4). The application of Standard Precautions during patient care is determined by the nature of the HCW-patient interaction and the extent of anticipated blood, body fluid, or pathogen exposure. A nurse is caring for a client who is reporting difficulty falling asleep. a. BUN 15 mg/dL b. Creatinine 0.8 mg/dL c. Sodium 143 mEq/L d. Potassium 5.4 mEq/L. However, none of the clinicians wore a face mask, giving rise to the speculation that droplet transmission of oralpharyngeal flora was the most likely explanation for these infections. d. Wear a surgical mask when providing client care. Which of the following actions should the nurse identify as an indication of correct use? a. Promote interdisciplinary approaches to environmental health issues in nursing practice, education, and research with funding support from private and public agencies and through recommendations from nursing professional associations, including American Association of Colleges of Nursing (AACN) and International Council of Nursing (ICN). 1 quart of water c. 8 oz of ice chips d. 6 oz of tea. A nurse is admitting a client who has an abdominal wound with a large amount of purulent drainage. A charge nurse is discussing the responsibility of nurses caring for clients who have a C. diff infection Which of the following information should the nurse include in the teaching? a. Effective interventions for environmentally related illness require collaborative efforts from many disciplines due to the complex nature of environmental health issues, the rapidly advancing science base in environmental health, and the need for primary prevention strategies that often must involve professionals from fields other than nursing. The process is compatible with the framework of investigator, educator, and advocate, established by the California Public Health Foundation (1992) to address nursing roles and responsibilities particular to environmental health issues.
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