Sepsis
How often should you document in the sepsis surveillance intervention?
Every 8 hours or with a change in patient condition.
What is the reference range (normal values) of lactic acid?
0.5-2.2
What must be completed before the patient receives anything PO
Dysphagia screening
What is the most common type of stroke?
Ischemic
What labs need to be completed prior to starting a heparin drip?
CBC and PTT
What lab needs to be drawn prior to administration of antibiotics?
Blood Cultures
If initial lactate was greater than 2, when do you recheck.
Repeat within 3 hours of the initial.
What is the acronym for the warning signs of a stroke
BEFAST- Balance, eyesight, facial weakness, arm weakness, speech problems, time
What are the 5 elements of stroke teaching that must be reviewed with patients prior to discharge?
Signs and symptoms, Call 911, personal risk factors, follow up appts, medications.
What are you looking at with the CBC and why?
Platelet count to monitor for HIT
How frequently are vital signs assessed DURING the fluid bolus?
Every 15 minutes.
What is the time goal to complete weight, LA, blood cultures, antibiotics and IV fluid bolus?
3 hours
If you suspect your patient is having a stroke, what is the first thing that you should do?
Call a rapid response and institute the acute stroke protocol.
What are examples of antithrombotic drugs?
Aspirin, plavix
Which protocol is never bolused?
Neuro
How frequently should you assess vital signs AFTER the fluid bolus?
Minimum of 2 sets every 15 minutes.
What is the inflammatory triad?
Fever, tachycardia and vasodilation.
When is VTE prophylaxis started for stroke patients?
On the day of admission.
What lab needs to be documented as a stroke core measure?
LDL
How often do you check PTTs when your patient is on a heparin drip?
Every 6 hours until the patient has 2 therapeutic levels. then every day
Where do you document when the initiation of the sepsis bundle?
Sepsis bundle intervention. The worksheet is NOT part of the medical record.
How is the fluid bolus calculated?
Pt weight in Kilograms X 30ml
Name 3 risk factors for stroke
HTN, smoking, diabetes, peripheral artery disease, afib, high cholesterol, obesity, physical inactivity
What does NIHSS stand for
National Institute of Health Stroke Scale
What is considered the therapeutic range for Heparin?
50-80