Sepsis
Name 3 symptoms of sepsis
Tachycardia, tachypnea, fever, hypotension, confusion, lethargy, increased liver enzymes, low temp, decreased urination and many more
How do we document wounds present upon admission (pictures)?
Media Manager App
Do all floors in the hospital have code blue buttons on the wall?
NO, the entire second floor does not have buttons on the wall, you have to call the code line from your iMobile phone. All other floors have buttons.
NG stands for?
OG stands for?
Nasogastric
Orogastric
What is the goal MAP for a patient?
65 or higher
Where do you document a SPOT alert?
Safety, risk, regulatory
Assess sepsis
We have 24 hours to document wounds upon admission, otherwise, we OWN the wound as a hospital acquired wound.
Someone performing chest compressions starts to slow down and get tired, how do you address this in a code?
Say something! It's nothing personal; it is for the benefit of the patient. High-quality chest compressions save lives.
When we insert NG/OG tubes do we check for placement with an air bolus? What is the Gold Standard for placement confirmation?
Yes, you can air bolus
XRAY is the gold standard
Why do dialysis nurses give the patient Albumin during their dialysis treatment?
Rapid fluid removal can reduce blood volume, causing hypotension. Albumin can help by drawing fluid back into the vascular space, stabilizing blood pressure.
T- 101
P- 100
BP- 90/43
SPOT alert is called, after filing out the sepsis assessment, it is positive, what do you do next?
How many times are the wound care nurses required to assess your patient per week?
Once
They assess the patient/wound and write orders for treatment; we carry out the treatment per the orders.
The patient goes into VTACH during a pulse check and we shock the patient, then the patient goes into asystole. What do we do next?
Bonus for the medication we give to alleviate the VTACH*
Resume CPR
Amiodarone IV push
What is a dobhoff? How is it different from an NG/OG?
A Dobhoff tube is a small‑bore, flexible, post‑pyloric feeding tube designed for long‑term enteral nutrition, while an NG tube is a larger, stiffer gastric tube used for short‑term feeding, suction, and decompression. Dobhoff tubes (8–12 Fr) typically advance into the small intestine and require X‑ray confirmation, whereas NG tubes (14–18 Fr) remain in the stomach and can be used for gastric lavage, tube feeding and decompression.
What does ATN stand for?
Acute tubular necrosis
What does SPOT stand for?
Sepsis
Prediction and
Optimization of
Therapy
Can you order a wound care consult as a nursing measure? (Z order)
Yes!
After giving one round of Epi and high-quality CPR, we get a pulse back with a HR of 30. What medication do we give next?
Atropine
Night shift RN states she increased the tube feed to 50ml/hr. at 0200, you are to increase it to 60ml/hr. (goal) at 0800. Patient is anxious, aphasic from a previous stroke, moving around in bed, wide eyes, and wrenching. What is your ursing intervention?
Check residuals! The patient had over 1 liter in the stomach and was uncomfortable and unable to communicate that due to the aphasia. Suck the contents of the stomach out with either the syringe or place it to suction to prevent aspiration pneumonia. Do not increase the rate of tube feed, the patient was not tolerating it.
A patient with a chest tube is now SOB, they were fine a minute ago when they went to the bathroom. Now they are back in bed, SOB, tachy, sweating, and tripoding. What is your first nursing intervention?
Check the chest tube! The insertion site to ensure it did not get pulled out. Follow the tube down to the canister on the floor. Is it to -20 suction? What is the VISUAL clue the suction is on?
What is septic shock?
Sepsis with persistent hypotension despite adequate fluid resuscitation.
What stage does a wound have to be to qualify for a foley catheter (wound healing)?
Stage 3
Where do you place the pads on the patient's chest during a code blue? What if they have a pacemaker?
Upper right chest, left lateral phlebostatic axis
Do not place pads over pacemaker site (usually on the left upper chest)
You walk in the room to see the patient has slid down int he bed with the HOB flat, tube feedings at 50ml/hr., he has a wet voice and is coughing. What do you do?
Stop the tube feed, reposition the patient in bed, elevate HOB, assess the NG tube for placement, obtain chest XRAY, this patient probably aspirated. Call a rapid if the patient becomes unstable or decompensates.
During a code blue, RT cannot intubate the patient due to an esophageal mass. The ICU doctor cannot intubate the patient either. What will happen next?
Call a code dart (difficult airway response team)
Beside Percutaneous Tracheostomy
Bedside Cricothyroidotomy