Renal
Urology/I&O
Hem/Onc
General Surgery
Hodge Podge
100
2 ideas to get your school aged renal patient to reach his fluid goal of 1.5L a day.
What is flavoring water, different choices, race with nurse, goal on white board, etc?
100
Describe daily catheter cares.
What is assessing q8 hours, washing with soap and water (or bag bath), assessing integrity of system, assessing urine charateristics, etc?
100
Explain the 3-2-1 initiative.
What is walk/exercise 3 times, oral cares 2 times, and 1 bath/CHG?
100
Your patient had an appy done late afternoon yesterday with dermabond at his incision sites. The appropriate response to if he can take a shower this AM.
What is no? May shower 24hr after but no soaking for 2 weeks.
100
Pain control measures for a baby getting heel stick labs.
What is sucrose, swaddling, distraction toys, pacifier, breastfeeding?
200
The difference between PD and HD.
What is HD has a large catheter usually in neck to dialyze the patient with a dialysis machine that filters out the products necessary where as PD is in patient's belly and the dialysate solution dwells and drains for X amount of cycles to filter out via peritoneal fluid? Both can be done outpatient or inpatient.
200
The amount of urine you should expect to see in foley bag 8hr after a 26kg child had a reimplant procedure done.
What is 8hr x26kg= 208mL MINIMUM?
200
Calculate 2x maintenance IVF rate for your 68kg teenage patient receiving Cytoxan.
What is 205mL/hr?
200
Interventions to prevent blood clots.
What is ted hose, SCDs, ambulate 4x's/day, lovenox if at great risk, etc?
200
DAILY DOUBLE!!!! Emergency drug equipment needed at the head of bed and safety checks supposed to be done at hand off.
What is bag masks of all sizes, yankeur suction, suction tubing, smaller suction chatheters, ambu bags x2, emergency drug list at HOB, and suction and oxygen working?
300
True or false: You hold both tacrolimus and vancomycin doses until the level comes back if you are ordered to draw a trough for these medications.
What is False? Tacro you do NOT hold and will make changes to PM dose if low/high. Vanco you DO hold until level comes back to save kidneys if level is high- make adjustments or level low- increase to therapeutic level.
300
Interventions if your patient doesn't have at least 1mL/kg/hr of UOP when you empty the foley at 1400.
What is assess for kinks, leaking, flush with saline, reposition patient, have patient walk? If none work, call MD for possible increase of fluids or fluid bolus.
300
Interventions if your patient last voided at 1000 and was due to void at 1200 but they only voided 100mL. (Call HO for UOP <130mL q2)
What is let staff RN/me know, increase IVF, and give another 2hr max to meet parameters again? If not, usually give Lasix or mannitol.
300
Substitutes if patient not at age to understanding using incentive spirometer (IS).
What is blowing bubbles, blowing out imaginary birthday candles, cough/deep breath, etc?
300
The onset of action for LMX numbing cream vs EMLA numbing cream.
What is 30 minutes vs 60 minutes?
400
4 foods high in potassium (aka greater than 250 mg of potassium per serving).
What is beans, dark leafy greens, potatoes, squash, yogurt, fish, avocados, mushrooms, and bananas, etc? http://www.uptodate.com/contents/image?imageKey=PI%2F67156&topicKey=PI%2F4427&source=see_link&utdPopup=true
400
DAILY DOUBLE!!!! Describe a 'double diaper.' (aka if you see foley to DD)
What is one diaper with foley to straight drain into and one diaper for stool?
400
The 4 things we test on a routine urine dipstick at the beside and reason why.
What is glucose, protein, pH, and blood?
400
PCA documentation requirements.
What is POSS q4, clear attempts/demands q4, clear volume q4, cont. pulse ox (for first 48hr at least)?
400
Interventions to try if unable to get VS the first time for babies vs toddlers vs school age vs teenager.
What is?: Babies- try while feeding, swaddle, sleeping (leave cuff on then come back), do less invasive first Toddlers- sing a song, parents hold, leave cuff on, try leg, any distraction, do on animal/baby, do less invasive first School age & teenager- explain, say will come back in 30 min, give choice, give expectation of when will do it
500
Interventions if you have call for SBP>125 or DBP >90 and the nursing assistant reports an AM BP of 130/84.
What is check manually recheck, make sure pt is calm/quiet/still, check for PRN meds to give, and if still high, call HO and ask if ok to give? If gave, recheck in 30 min if IV and 1hr if PO.
500
Normal saline bolus dose for pediatrics.
What is 10-20mL/kg?
500
Normal transfusion levels for oncology patients (for Hgb and Platelets).
What is Hgb <7 and Plt <10?
500
Meds that require POSS pre/post assessments: IV Morphine, Tylenol, Morphine IR, MS Contin, Toradol, Oxybutnin, Dilaudid PCA, Ativan, Benadryl, and Percocet?
What is What is IV morphine, Morphine IR, MS Contin, Dilaudid PCA, and Percocet?
500
Flush/heparin volumes for PICC vs Hickman vs Port.
What is 1ml, 3ml, and 5ml?
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