Nurse Driven Protocols
Patients with high risk of developing a thrombus and in the absence of chemical intervention, the nurse can place an order for this.
What are SCD's?
Most commonly seen in patients after treatment of lymphomas and leukemias, when there is high tumor cell death.
What is tumor lysis syndrome?
This chemo can cause neurotoxicity that is exacerbated by cold temperatures.
What is Oxaliplatin?
This is done within 4 hours when level is >2.
What is a repeat lactate?
You have 30 mins to document MD notification of this in cerner, including an action.
What is a critical callback?
This is done because patients are in close proximity to each other in a clinical care environment, including nursing home, SNF, long term care, or a hospital.
What is a MRSA screen?
When a tumor puts pressure on vertebrae causing paralysis.
What is spinal cord compression?
Typical pre-med for abdominal cramping and diarrhea related to chemo.
What is atropine?
This is when blood cultures and antibiotics must be documented in cerner.
What is 1 hour of time zero?
This must be documented in the admission database as well as a paper form upon admission.
What is patient belongings?
The nurse can order this when a patient comes in with acute diarrhea, in the absence of stool softeners.
What is a C-diff stool sample?
More common in lung cancer, non-hodgkin lymphoma, or cancers that spread into the chest.
What is SVC Syndrome?
Chemo that is given directly into the csf via LP or Omaya Reservoir.
What is Intrathecal chemo?
A patient presents from a nursing home, with tachycardia and a fever.
What are 2 SIRS and a suspected infection?
This must be documented every shift, if the patient refuses these, a notification to the MD must be documented every shift.
What are SCD's?
The nurse places this order into cerner when a patient has a history of an infectious disease.
What is contact isolation?
A life threatening condition that requires acute attention and intervention when the patient has an ANC < 500.
What is neutropenic fever?
Chemo with a maximum cumulative lifetime dose is between 400 and 550 mg/m2, use caution and monitor cardiac function
What is Daunorubicin?
Isolyte, NSS, LR, Normosol, Plasmalyte, given based on 30ml/kg.
What are approved IVF in the sepsis pathway?
When this is checked on the admission database, the patient does not need a pneumonia vaccine.
What is vaccinated at age 65 or older?
A patient is 66 years old with a history of diabetes, this order should be placed in cerner by the nurse if indicated.
What is a pneumonia vaccine?
A state of hypercoagulation that occurs in patients with cancer, this emergency causes multiple micro clots to form in various organs, this condition eventually results in massive hemorrhage and death.
What is DIC (disseminated intravascular coagulation)?
Used in refractory AML, CML, or MDS in patients unable to receive typical chemotherapy.
What is Vidaza?
A patient @ 0800 had a temp of 102.2, A suspected infection documented @1530, a HR of 110 @1600, a WBC count 15,000 @1630. Time zero is....
What is 1630?
The person that reviews the nurses' sepsis worksheet.
Who is Carla?