Medication Management
Do you hold a beta-blocker such as Metoprolol or Labetalol prior to the patient going to the OR?
False -It can help stabilize HR and BP, plus reducing complications during surgery
What is the acronym we use for stroke?
B.E. F.A.S.T.
What type of diet is expected for this patient?
2g Sodium Diet
TRUE or FALSE
You can hang a fluid bolus and antibiotics at the same item?
TRUE
(as long as blood cultures have been completed)
What triggers Malignant Hyperthermia?
Administration of Anesthesia
When and where do we properly dispose of narcotic waste?
How many nurses are needed to waste a narcotic?
Waste additional and unneeded narcotic promptly (asap)
Waste narcotic in the incinerator grey bin (located med room)
2 RNs are needed to waste a narcotic
Who can mix TNK? Who can administer TNK?
A trained RN can mix TNK, but only a provider can administer
Name two signs of worsening HF
Increased shortness of Breath, Rales, Peripheral Edema, Sudden Weight Gain, JVD, Coughing and Wheezing
What needs to be completed 15 minutes apart AFTER administering your IV fluids?
Vital Signs
If a patient preferred language is not English, what is the appropriate method to communicate with the patient?
Using the Marti
Why is it important to monitor Vancomycin level?
Because it is nephrotoxic
A patient goes to sleep normal condition at 9pm, wakes up at 3am and shows signs of stroke. What time is considered onset of symptoms?
Cannot be determined
Why is it important to monitor daily weights on HF patients?
To assess for major fluctuations in weight which could indicate fluid retention
When does a repeat lactic acid need to be drawn?
1.5 hours after initial lactic acid draw
National Patient Safety Goals: What are the 3 main elements of a time out?
Right Patient, Right Procedure, Right Site
Why is it important to understand what Antimicrobial Stewardship is?
1. Optimize antibiotics to effectively treat infections
2. Decrease length of stay, reduce healthcare cost
3. Protect patients from treatment failures, side effects, opportunistic secondary infections and antibiotic resistance
What does B.E. F.A.S.T. stand for
Balance, Eyes
Face, Arms, Speech, Time
Name a medication you would expect a CHF patient to be on
Diuretic (Lasix)
Inotrope (Milrinone)
What needs to be done in the first hour of the sepsis bundle?
Draw Lactic Acid, Blood Cultures x2, Fluid Bolus (vasopressors), Broad Spectrum Antibiotics, and Vital Signs
Name three early warning signs of Malignant Hyperthermia?
Masseter spasm, Generalized muscular rigidity, Tachycardia, Hypercapnia, Hypoxia, Combined metabolic-respiratory acidosis
When should a trough be drawn on a patient being treated with Vancomycin?
30 min prior to 4th dose
(make sure to follow doctors order)
What diagnostic test needs to be performed with possible stroke patients?
CT Scan
What specific lab value indicates that a person may be in heart failure?
BNP
What is the standard calculation for fluid bolus on a sepsis patient?
30ml/kg
How do we accommodate patients who are visually impaired?
Using the Aira app