PPE/Hand Hygiene
Your patient is on contact and droplet precautions. What PPE is required and in what order do you don your PPE?
wash hands, gown, mask, gloves
What are the elements of the CLABSI bundle?
Scrub the hub
Cap all exposed ports on IV line with green caps
Sterile dressing changes Q 7 days and PRN
CHG impregnated dressings
CHG baths Q 24
Sterile cap (Clear links) changes
Describe the process for wasting narcotics
get a 2nd nurse, review the order, witness the dose being drawn up, ensure waste volume is appropriate, witness the nurse dispose of waste in proper receptacle, document the waste
What do you need in place before starting a blood transfusion?
Type and Cross, Physician Order, Signed Patient Consent, Base Line Vital Signs, Patent IV access
If a patient with Sickle Cell Disease complains of a severe headache, what is your next intervention?
Call the hematologist immediately, activate RRT/Code Stroke if indicated
Your patient is on contact and droplet precautions-- in what order do you remove your PPE?
gloves, gown, mask, wash hands
You removed an indwelling foley cather from your patient at 6am. At 12pm, your patient still has not voided. What intervention comes next on the tiral to void algorithm?
Perform a bladder scan to see if your patient is retaining urine
Describe the process for a hazardous material/medication spill
isolate the spill, obtain the spill kit, don the PPE in the kit to ensure your safety, contain the spill to the best of your ability using the tools in the spill kit. Call 111 Hazardous Material Spill. Environmental to clean area after spill contained
What do we do for suicide precautions
1:1 observation, ensure safety in the room, remove all threats to patient safety,
What does B.E. F.A.S.T. stand for
Balance, Eyes
Face, Arms, Speech, Time
This is a free question because I am sitting here making this up right now
yay
What does the CAUTI bundle consist of?
Daily review of catheter indication, M-Care hygiene, red seal remains intact, utilization of StatLock, no dependent loops or kinks, green clip is utilized, urine collection bag is below the bladder, urine collection bag is emptied prior to transport.
When initiating a PCA medication, how frequently does the RN take the vital signs, pain assessment and RASS?
q15minutes for 1 hour
q30minutes for 1 hour
q1 hour for 4 hours
Describe the technique for measuring a wound
LxWxD
Using a clock face with the head as 12 o'clock
What are the elements of the sepsis bundle?
Notify provider- call sepsis huddle
Vitals Q 15, blood cultures, isotonic fluid bolus 20 mL/kg max of 3 before escalating (30ml/kg for adults)
IV antibiotics
How long do you scrub your hands with soap and water to perform appropriate hand hygiene?
20-30 seconds, 2 happy birthdays
How can we prevent pressure injuries?
What are some common sites for device-related pressure injuries?
Turn & reposition Q2, nutrition consult, moisture management, offload pressure, protective dressings
BiPAP masks, nasal cannula, EEG electrodes, Foleys, NGT, ET tubes
What are the 5 Rights of Medication administration?
Right Medication
Right Dose
Right Route
Right Time
Right Patient
During a blood transfusion, at what point can you stop worrying about a transfusion reaction?
You can't! There can be a delayed reaction even up to 24 hours later! Even days to weeks later!
What triggers Malignant Hyperthermia and what are some of the signs and symptoms?
Anesthesia
Masseter spasm, Generalized muscular rigidity, Tachycardia, Hypercapnia, Hypoxia, Combined metabolic-respiratory acidosis
When should you use alcohol-based hand sanitizer and when should you use soap and water?
to disinfect, in/out of patient rooms, between patients
When visibly soiled
What are risk factors for falls
Medication, rowdy behavior, level of consciousness, lack of parental/staff supervision, potty, reaching for personal items...
You gave a Morphine for 10/10 pain at 1:56pm. When do you reassess their pain?
within 1 hour of administration
How do we define a "Febrile" blood transfusion reaction?
Fever 1 degree change from baseline
If there is a patient with suspected Malignant Hyperthermia (MH) , where can you locate the MH tackle box?
D7
OR
L&D (B7)