Ethics
You think one of your nurse friends is diverting narcotics.- What next
Ask to speak privately with manager. Report facts
If your patients ventilator rate is set at 18 breaths per minute. What does you Respiratory rate need to be?
18 breaths/minute or higher
What order should you give these meds to your septic patient?
Morphine 2mg IVP Q4hr prn mod pain (pain 8/10)
Zosyn 3.375 IVPB Q8hr 1st dose now
Protonix 40 mg IVP daily
zosyn
morphone
protonix
Need x-ray confirmation
HOB >30 degrees
check residual and patency
Actions before giving NG/OG meds
What kind PMH would you expect for a patient with a Creatinine of 7.2?
ESRD on dialysis
You find an antibiotic hanging with a full bag that was supposed to be given at 0600 - What next?
tell nurse, call pharmacy to retime, med error report
What does the ventilator mode spontaneous mean?
Patient is initiating all breaths
Prioritize nursing diagnosis:
1.Impaired Electrolyte Imbalance AEB diarrhea and low K+
2.Decreased Cardiac output AEB low blood pressure
3. Ineffective Health Management AEB pt not check blood sugars
2
1
3
Name 5 rights of med administration
Patient
Route
time/date
order
What medication might my patient be on if their INR is 3.2?
Warfarin/Coumadin
Your Doctor comes into your room and begins a procedure on your patient without you. What do you do.
online report, tell charge nurse, send email to manager of incident.
Your patient's ABG is
pH 7.28, CO2 60, P02- 60%, HCO3- 24.
What two ways can you reduce the CO2 to balance the pH
Increase RR
Increase volume of breaths
Prioritize tasks upon receiving this new patient.
stat labs
head to toe assessment
check vital signs
vitals
stat labs
head to toe
Name 3 resources to find accurate medication administration information
Pharmacist
Approved pharm app
Med information in Mar link
What labs are ordered if a MD wants a Pan culture of a paitent?
UA with culture
Blood culture x2 15 min apart (peripheral)
Sputum culture
Your patient confides in you that they want to hurt themselves. Who do you contact?
Charge nurse, MD, place on suicide watch 24/hr sitter, chaplain, social work. Stay in room with patient.
Your patient has distended abdomen, jaundice color, and bleeds easily. What organ is affected?
Liver
What does SBAR stand for?
Situation
Background
Assessment
Recommendations
What 4 things do you want to know before administering a medication you have not given before
Indication
Administration
Adverse Affects
Dosage
Half life
What does CBC stand for?
complete blood count
policy and procedures
Name 3 criteria of a positive sepsis screen
A source, temperature over 100.4, HR over 100,
Prioritize:
1. vented patient 100% fi02/prone/ periodically desats to 83%
2. B/P is 75/42 pt awake and alert but dizzy HR is SVT 175.
3. Confused pt with left sided weakness is trying to get OOB
See pt 2 first, needs nursing intervention
delegate 1 to respiratory
delegate 2 to patient care tech or fellow RN
Epinephrine
Norepinephrine
Vasopressin
Neosynephrine
How many points do you typically see hemoglobin rise with each pint of blood transfused?
1