PEARL of the Month
All Things Pain
Orders
Picture Time
Miscellaneous
Labs
100
This is where you store "1/2 strength Normal Saline/Hydrogen Peroxide" Irrigation bottles used for OTO patients.
What is the Med Room Refrigerator?
100
She is the pain CNS.
Who is Valerie Gillis?
100
True/False: When an MD pulls a chest tube, you are allowed to discontinue the order.
What is "False", page the residents to dc their order?
100
When assessing your patient's epidural catheter, this represents the 15cm mark
what are the three lines?
100
This is the 4NE mascot.
What is the Honey Badger?
100
This is the number of times a blood tube needs to be inverted after collection.
What is 8?
200
You should contact this person if a patient wants an advanced directive and needs a notary.
What is a social worker?
200
Your patient is having severe abdominal pain, you gave the last dose of 0.1mg at 10/11/24 @ 1301, the time now is 1530, this is the amount of Dilaudid you are able to give.
What is 0.1 now or 0.2 at 1701?
200
This is the standard for frequency of assessments on acute care patients. (i.e. How often can neuro checks be ordered; Q1, Q2, Q4, Q8?)
What is Q4hrs? floor care RNs can monitor more frequently but for only limited amounts of time, i.e. Q2hr sodium labs for a total of 4 hours
200
Restraints shown here go on this limb
What are lower extremities?
Blue locked restraints are for upper extremities
200
This is the dept (or #) to call when you need a bed.
What is EVS, 6181?
200
In multi lumen catheters, this lumen should be dedicated to blood draws.
What is the red lumen?
300
When the Department of Health (DOH) visits name one thing that should be avoided.
1. Multi use scissors: scissors and sharps are one time use. Dispose of them appropriately.
2. No Shared pill splitters: instead, label pill splitter with patient's label and keep in non-refridge
3. No medications in patient rooms
300
This is the color of the sticker on the new CADD pumps.
What is green?
*if you see pink, replace it!*
300
When your patient arrives from PACU, these order sets should be discontinued, and these order sets should be released.
What is Discontinue PACU Order Set, Release Acute Care Order set?
300
You should talk to this person if you receive a Supply Chain order form that says “non-stock item."
Who is Kat, our amazing Op sup :)
300
If you have questions on how to perform a task, you should check here first.
What is the Policy Center?
300
When you are drawing an anti-Xa from a central line, the heparin gtt should be paused for this amount of time before drawing labs.
What is 5 minutes?
400
Deep suctioning a trach is considered this type of technique.
What is sterile technique? you are accessing a patient's airway. Use sterile technique to reduce the risk of microorganism transmission into the trach
400
If you have a .2/6min/6mg PCA and this is your associated clinician bolus order, name what should be modified in this order?
What is the bolus dose should be 0.4mg (aka double the ordered demand dose)?
400
When discontinuing an order set that has an "if then/okay to discontinue" order set. Those orders should be discontinued as "per protocol: _________."
What is per protocol: no cosign required?
400
This numbered port should be attached to suction.
1. "Ortho"
2. "Vacumn"
3. "Patient"
What is number 2- the vacuum?
400
This is the difference between cores paging and secure chat.
CORES paging is appropriate for changes in patient condition, quick response times, and time sensitive information; ie. patient’s LOC has changed, K of 2, or patient fall
Secure chat is good for small things, ie. “please update diet order” or “what is the plan of care for the patient today?”
400
A CVAD should be flushed with this amount of NS AFTER collecting blood.
What is 20cc?
500
To prevent a pressure injury from an NG, you could do this.
1.What is Float the NGT?
2. What is use a bridle?
500
This is when you should reassess after giving your patient PO pain medication.
What is 1 hour post medication?
500
You have a PRN potassium order, your patient’s potassium is within the replacement range, do you give the potassium?
No.
*How should you follow up with the provider about this order? -> page and request order to be discontinued (this is an ICU order)
500
Stage this pressure injury
Stage 3 with full thickness tissue loss.
SQ fat may be visible but bones, tendon, or muscles are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling.
500
This is how often you should you be charting continuous MIVF in the I/O flowsheet.
What is q8 hours (0600, 1400, 2200)?
Epic has a handy little tool that will do the math for you, should be charted with I&Os.
500
You should draw the tacrolimus level at this time if the Tacro dose is scheduled for 0900.
What is 0830 or at least prior to administration of Tacrolimus (you do not need to wait for the lab to result)
-notify team if Tacrolimus was given late, or will be late
- if phlebotomy draws Tacrolimus level after you have administered the medication, notify the provider!
600
When using a purewick with 2 sets of tubing, you should set the suction to this.
What is 60mmHG?
40mmHG for single tubing
600
These things should be included in the pain assessment.
What is Score, Scale, Intensity, Location, Description?
600
You should do this if your NGT air vent is leaking gastric fluid.
what is Flush with 10-20 cc of air to clear vent, if vent is still leaking let team know?
You do not need an order to flush with air.
**Rember! NEVER flush water or air into an esophagectomy patient’s NGT**
600
This part of the GJ tube is used for medications.
What is the "G" portion
600
This is the timeframe in which the admission history should be completed.
What is within 24 hours?
600
Between colors blue, green, and purple, this color tube should be drawn first.
What is blue?
700
You assess your patient's PICC line and it looks like there has been a 4cm change in length. This should be your next step.
What is page the Dr. to order an x-ray to confirm placement?
700
These things should be included in a respiratory assessment when your patient is started on a PCA.
What is O2 sat, rate, depth, regularity, effort and sedation score?
Bonus! what is the frequency of vital signs when a epidural is started or rate is changed? BP and pulse from start of infusion q30 min x2hr, then q2hr x24hrs, then q4hr
700
It is ok NOT to have an "ok to use" order for salem pump NGs when using it for this.
What is low intermittent suction?
700
You are assessing your patient's chest tube that is ordered to be to water seal. Name what is wrong with the chest tube on assessment.
What is there is no fluid in the air leak meter?
700
These wipes should NOT be placed in the wipe warmer.
What are Theraworx?
700
You just receive an order to transfuse 1 unit of RBCs, but first you need to draw a type and screen from their central line. Name the info that should be on the label sent to lab.
What are 2 signatures, time and date of collection?