Basics of Nursing Ch 20

• Environmental factors that need to be controlled are

  1.) Temperature

  2.) Ventilation

  3.) lighting

  4.) Odor control

  5.) Noise

  6.) humidity
• Room Temperatures should be between 68 and 74 degrees F
• Infants and older adults need warmer rooms
• No opening of hospital windows
• fans are highly discouraged because of infection control concerns
• Comfortable humidity is 30-50%. If humidity is too little it will dry respiratory passages
• Perfumes and scented cosmetics or lotions should not be worn in patient areas
• empty and rinse bedside pans, bedside commodes and urinals promptly
• Avoid long conversations in the hallway, speak in lowered voices
• Avoid jokes and laughter at the nurses station
• Answer alarms promptly
• Keep the over-the-bed table clear of unnecessary clutter or equipment
• Always knock and identify yourself before entering patients room
• Close the curtain for privacy in a multi patient room
• if performing tasks such as bathing or using a bedpan post a sign on the door to inform others
• Always lock the wheels on a bed and leave it in the lowest position when not performing a procedure
• An occupied bed is made only if the patient absolutely cannot be out of bed
• Bed linens should be free of wrinkles
• An unoccupied bed is made when the patient is out of bed in the chair or out of the room for a procedure
• The six elements of enviornment are described by Florence Nightingale
• Soiled linens should not be placed on the floor when making a bed
• Safety prevents accidents and possible injuries to patients, visitors and health care personnel
• Common patient accidents

  • Falls
  • burns
  • cuts and bruises
  • Fights with others
  • loss of possessions
  • choking
  • electrical shock
• Falls can occur because of impaired mobility, altered mental status and sensory/motor deficits
• A leg or bed alarm is used for fall risk patients
• When burned you must:

  • flush the burn with cool running water for several minutes
  • call 911 if severe
  • apply burn ointment or spray
  • take ibuprofen or acetaminophen for pain if needed
• Burns can occur by hot or cold materials
• Those at risk for burns:

  • diabetic patients
  • paralyzed patients
  • altered mental awareness
• Check the temp of liquids before giving to patient
• Inspect electrical cords for frayed or broken areas as this can cause a fire and burn the patient
• patients who are sedated, confused or irrational must be supervised if wanting to smoke
• Smoking is NEVER allowed when oxygen is in use
• steps for a fire:

  • rescue patients in immidiate danger
  • activate fire alarm
  • contain the fire (close doors and windows)
  • extinguish flames
• Evaluate patients meds that might increase fall risk
• Tell the patient when you will next check in
• Night lights are provided for going to the bathroom
• High risk patients should be placed in rooms closest to the nursing station
• nurses should provide diversionary(distraction) activities for confused patients
• For safety In the home:

  • Place a nonskid bath mat in the tub
  • use nightlights
  • grab bars
  • install door buzzers or bed alarms
  • remove extension cords
  • caution the patient of toys and animals
• Biologic agent, chemical or conditions that can be harmful to a person is considered biohazard