what medications do not come on auto cycle?
Narcotics
PRN
Topicals, Nose spray, eye drops, inhalers
Where should you document all verbal communications with families, guardians, pharmacy, and physicians?
Nursing note
what to do if a resident refuses a shower?
attempt 3x at different times and try other care staff, document refusal on shower sheet, if reoccurring refusal, document on nursing note and notify DOHW
what are wellness checks (rounds) for?
monitoring residents' safety, verifying they are doing well.
Why is it important to document PRN effectiveness after administration
To document whether the medication helped the resident or not.
What should you do if a resident refuses their medication?
Must try at least 3X
if still refuses, document refusal on EMAR and Eldermark, notify DOHW
Where should you document meds that were reordered, or refilled?
Medication refill binder
What do you do if a resident is running low on supplies (briefs, wipes, soap, laundry detergent)
Notfiy family or hospice and request more supplies.
what should always be within reach of the resident to reduce fall risk?
walker/ wheel chair
what are signs a resident needs a PRN?
Agitation, Aggressiveness, Physical aggression, Constipation, high anxiety, high pain, nauseous
What are the 6 rights of medication?
Right resident
right medication
right dose
right time
right route
right documentation
How should you fill out an incident report?
in full detail and all factual information
If a resident repeatedly tries to stand up without assistance, what could this mean?
The resident may need toileting, have pain, repositioning, or another unmet need addressed
what are the main environmental fall risks
Poor lighting in hallways, bathrooms, or staircases
Clutter or loose objects in walkways
Slippery floors
Steep or unsafe stairs without handrails
High beds/mattresses that are hard to get up from
What do you do if a family member asks you to give a medication and its not on the MAR?
Communicate the need for an order for the medication, let them know they can administer medication until we get an order.
what should you do if a medication has not been refilled?
Call the pharmacy/ order on QHP immediately. Write in communication book, document in Eldermark
What are the steps to take for a fall?
Take vitals, do not move resident, (if they hit their head automatically call Ems, especially if they're on blood thinners), print face sheet, med list (IL do not print med list), notify family, PCP, GL group text
what would you do if a resident got a skin tear?
hold pressure for 10 minutes until the bleeding stops. If the resident is on hospice contact hospice. you can put a Band-Aid on, but no creams, wraps or wound care supplies. Notify family and GL group text, Document skin tear on eldermark
Are residents able to to have bed rails?
yes, with an order from a physician
what are 3 main things you want to never do when passing meds?
Give the wrong medication, falsify giving medication you did not give, not watch the resident take the meds
what are the acronyms for these routes administration:
eyes, Mouth, Nose, Skin, ear
eye- ophthalmic-
mouth- Oral- Sublingual
nose- Nasal route-
skin- topical- Transdermal
ear- Otic
What are the steps for a aggressive resident?
Step away, give the resident space, try to redirect the resident away from other residents, attempt to give PRN, document behavior.
what is the difference between palliative care and Hospice?
Palliative care can start at any stage of a serious illness and continues alongside curative treatment, while hospice is for people in the final stage of life who choose comfort care instead of curative treatment
what should be in place after a resident falls?
Q4 checks and document for the next 24 hours
what are the steps of a medication pass?
verify you have all your supplies, login to POC, wash hands, introduce yourself and what you are doing (I'm here to give you your medicine), prep med looking at MAR using 6 rights of medication delegation, verify resident took meds!!