Would You Chart It?
Temp: 98.4 F
BP:124/76
Pulse: 82
RR: 16
O2: 97%
Chart it or Recheck It?
Chart it!
A resident blood sugar is 68 before breakfast. They are awake, alert, and say "I feel a little shaky."
What do you do?
Read the directions in PCC
(usually 4oz of juice, a glucose tablet, etc.)
A resident has redness in the groin folds after sitting outside on a hot day. Skin is intact.
What are you going to do monitor or call triage?
Monitor
I would like to pick up day next week. Do you have anything open?
Can it wait?
Yes it can wait.
There is a medication due @7pm and I cant find it?
Who should you call?
Pharmacy
Temp: 93.2 F
BP: 118/74
Pulse: 76
RR: 16
O2: 98%
Chart it or Recheck it
Recheck it
A blood sugar below __ is considered hypoglycemia?
70
A resident has vomited 4 times today and cannot keep fluids down.
What are you going to do call triage or monitor?
Call triage
"Im missing a time punch and I need you to sign a kronos."
Can it wait?
Yes
A resident toilet is overflowing.
Who should you notify?
Maintenance
Temp: 98.8 F
BP: 68/42
Pulse: 74
RR: 16
O2: 98%
Chart it or Recheck it
Recheck it
A resident blood sugar is 48. They are sweating, confused, and having trouble answering questions.
What should you do?
Treat immediately according to PCC orders and call EMS
A resident reports pain 10/10 in their lower back. They have already recieved their PRN Tylenol an hour ago with no relief. They are grimacing , unable to get comfortable, and now refuse to eat and get out of bed because of the pain.
What are you going to do call triage or monitor?
Call triage
There are two medications popping up but are two different dosages. Was this a mistake?
Can it wait?
No contact HWD/HWD
A resident has been found in the parking lot.
Who should you notify?
HWD, HWC, ED
Temp: 98.3 F
BP: 130/78
Pulse: 81
RR: 18
O2: 83%
Chart it or Recheck it
Recheck it
A residents blood sugar is 415 before lunch. The resident is asymptomatic.
The sliding scale says:
350-400= 8 units
-Notify provider is > 400
What should you do?
Give the 8 units and Telehealth/Notify provider
A resident rates their chronic arthritis pain a 6/10 which is their usual level. The are walking, eating, and says "This is how it always feel."
What are you going to do call triage or monitor?
Monitor
A resident tells you "I dont feel right". No other information haas been gathered.
What should you do before calling or texting the Nurse?
Assess 1st!
-what symptms are they having?
-Vital signs?
-When did it start?
-Are they alert and oriented?
-Pain level
-Any medication changes
A resident has developed a rash.
Who should I call?
Teletriage
Temp: 93.6 F
BP: 72/44
Pulse: 108
RR: 19
O2: 89%
The resident is dining room in the playing bingo, laughing with friends, and is having a great day. Would you chart it or recheck it? Why?
Recheck them!
The resident appearance is completely inconsistent with vital signs. Before documenting, repeat every vital sign! Critical thinking means making sure the numbers fit the clinical picture. Dont be a "number recorder" Be an observer who ask "does this makes sense?"
Resident blood sugar is 44 and is unconscious. The orders says for hypoglycemia to give orange juice and recheck in 30 minutes.
What should you do?
Call EMS
DO NOT GIVE ANYTHING BY MOUTH WHEN SMEONE IS UNCONCIOUS!
A resident has:
-fever of 102 F
-Productive cough
-Oxygen 89%
-RR of 28
-Complains of shortness of breath
What should you do?
This resident is in respiratory distress. This is an emergent situation not a wait for telehealth.
A resident refuses all meds (which includes bp and seizure medication).
Can it wait?
No notify HWD/HWC
A resident had a fall and has no injuries.
Who should you notify?
Provider, Family, and HWD/HWC