You're in the Zone
You need these items completed to get your Initial Assessment Check mark on the track board
Initial assessment, vital signs, home med rec, learning needs
Your female patient is 12 years old and has an abdominal xray ordered. You need this before marking them ready for imaging
Negative pregnancy test or pregnancy waiver
What type of assessment does a BMH patient need?
Psychosocial Assessment
In what type of patients do we typically give smaller boluses because we are worried about fluid overload?
Cardiac Patients!
Your doctor says they are ordering a Raskins on your patient. What medications are you expecting them to order?
Compazine, Benadryl, Toradol, NS bolus
A EMS patient is being sent to your room, EMS states the patient had a seizure at home. What do you need to set up in your room?
NRB (Bag, mask), suction
You patient is going to MRI what needs to be completed before they go?
BONUS: who all needs to complete the form?
MRI screening form
MRI screening form
BONUS: patient, parent going with them, and RN if they are staying with patient
Your patient arrives with a splint placed by the school nurse. They are crying in pain and triaged a 3. What is the first thing you should do?
BONUS: you remove the splint and notice a small puncture like wound to the under arm. What should you do?
Remove the splint!
BONUS: Upgrade to 2 acuity, notify MD, if no MD order open fx protocol
The doctor has ordered 1475mg of IV Rocephin for your patient. The concentration for the prefilled syringes of Rocephin in the med Omnicell is 1000mg/25mL. How many syringes will you need and how many mL’s will you administer?
2 syringes, 36.88mL
Your BMH patient is on a 1013 and being admitted, who needs to go with the patient as they travel upstairs?
Security (also probably the sitter)
Your patient in room 21 is being discharged! During their stay they received IV fluids, deep suction, and labs. What do you need to remove from the room with discharge?
IV pole, suction canister, and patient stickers!!
You attempted to call report but the nurse was unavailable to take report. You attempt 5 minutes later and she is unavailable. How long do you wait before sending the patient up without giving report?
After 20 minutes since first report attempt you can send the patient upstairs without report
Out of these medications which will always require a dual sign? Morphine, Racemic Epi, Insulin, Magnesium Sulfate? Multiple answers!
Morphine, insulin, magnesium sulfate
2 y/o female weighting 11.36kg seen in ED for excessive vomiting and diarrhea x2 days. The doctor has ordered a IVF bolus. Based on the patient’s weight, what normal saline bolus should you expect?
227.27mL (20ml/kg)
Your female patient has a pelvic US ordered, what do they need to have before going to US?
BONUS: What ways do we do this?
A full bladder
BONUS: fill up with Bolus, foley connected to fluids, or Lasix infusion
A patient is coming to your room with Sickle Cell Fever. Your preceptor tells you we need to get the antibiotics in time to meet our goal! What is our goal time?
Door to antibiotics is 60 minutes
10 y/o patient weighing 38.6kg comes to the ED for abscess. Upon Initial Assessment their temperature 39.1 orally. The doctor hasn’t signed up for the patient. What can you protocol?
BONUS: How many mg of ibuprofen would you give this patient?
Ibuprofen using the fever protocol
BONUS:386mg
You just gave your patient IV morphine for pain. Within what time do you need to reassess their pain?
60 minutes
Your patient is 12 months old and weighs 10.2kg the doctor orders Tylenol for their fever. What would be the appropriate dose with this patient's weight?
BONUS: the Tylenol concentration is 160mg/5mL, how many ML will you administer to the patient?
153mg (10.2kg X15mg/kg =153mg)
BONUS:4.78mL
You have the following orders, what can you NOT delegate to your tech: 24 day old catheter, bulb suction, fingerstick POC glucose, forearm splint
24 day old catheter
Your patient is 12kg, what is the maximum volume of blood that can be draw in a 24 hour period? What is the formula?
BONUS: Where can you find their blood culture volume max and min?
Weight in kg X2, so 24mL
BONUS: in the orders or look up the policy
Your patient arrived to your room with wheezing and a history of asthma. Our goal is to give Decadron within what time of their arrive?
Door to steroid time is 60 minutes
You take over your zone and the off going nurse mentions she gave room 35 ibuprofen for pain at 1200, by what time do you need to reassess your pain?
Within 90 minutes, 1330
You patient weighing 60kg just received a 20ml/kg normal saline bolus and now the doctor is ordering maintenance fluids! What do you expect the maintenance rate to be? Hint: use the 421 rule
100mL/hr
Your patient weighing 32kg just received a 20ml/kg bolus and now the doctor is ordering maintenance fluids. What do you expect the maintenance rate to be? Hint use the 421 rule
72ml/hr