Client Safety
Priority nursing actions to prevent falls:
Assess fall risk, bed in lowest position, nonskid footwear, call light within reach, hourly rounding, assist with ambulation.
Fire safety procedures (RACE & PASS):
RACE: Rescue, Alarm, Contain, Extinguish/Evacuate
PASS: Pull, Aim, Squeeze, Sweep
Stages of grief (Kubler-Ross):
Denial → Anger → Bargaining → Depression → Acceptance (not linear).
Priority goal of palliative care:
Improve quality of life through symptom management.
Nonpharmacologic pain interventions:
Heat/cold, repositioning, relaxation, imagery, massage.
Risk factors that increase injury:
Impaired mobility, sensory deficits, cognitive impairment, medications (sedatives, antihypertensives), and unfamiliar environment.
Medication safety practices:
Follow 6 rights, check allergies, use two identifiers, double-check high-alert meds, do not leave meds unattended.
Difference between grief and mourning:
Grief = internal response; Mourning = outward expression of loss.
Signs of complicated grief:
Prolonged depression, inability to function, denial of death long-term.
Opioid nursing considerations:
Monitor respiratory rate, sedation, constipation, nausea.
Signs of opioid overdose:
Respiratory depression, decreased LOC, pinpoint pupils.
Use of restraints – legal and safety principles:
Used only as last resort
Requires provider prescription (except emergencies)
Time-limited order
Least restrictive method
Frequent monitoring (skin, circulation, ROM)
Injury risks by age:
Infants: suffocation
Toddlers: poisoning
School-age: accidents
Adolescents: risk-taking behaviors
Older adults: falls
What is anticipatory grief?
Grief experienced before an actual loss occurs.
Nursing care at end of life:
Pain control, comfort measures, emotional support, respect cultural/spiritual wishes.
When should pain medication be given?
Before pain becomes severe; around-the-clock for chronic pain.
Nursing responsibilities for restraint use:
Assess need first, obtain order, explain to patient/family, pad bony prominences, remove regularly, document behavior and alternatives tried.
Home safety teaching:
Remove throw rugs, install grab bars, adequate lighting, store chemicals safely.
Nursing interventions for a grieving client:
Active listening, presence, allow expression of feelings, avoid clichés.
Difference between acute and chronic pain:
Acute: sudden, short-term
Chronic: lasts >3–6 months, ongoing.
Adjuvant pain medications:
Antidepressants, anticonvulsants (for neuropathic pain).
Seizure safety precautions:
Pad side rails, suction and oxygen available, bed in low position, do not restrain or place objects in mouth during seizure.
Aspiration prevention:
Elevate HOB, assess swallowing, thickened liquids if ordered, suction PRN.
Difference between palliative care and hospice:
Palliative: comfort at any stage of illness
Hospice: end-of-life care, typically <6 months
Best way to assess pain:
Patient self-report (pain scale).
Patient teaching about pain management:
Pain control improves healing; addiction is rare when opioids are used correctly for pain.