Medication Math
Doctor’s Order: Hydrocortisone Sodium Succinate 650 mg IV q6h.
Supply: Hydrocortisone Sodium Succinate 1000 mg/ 8mL
Dose = 5.2mL
What position should a patient be in when doing ostomy appliance changes?
Semi Fowlers (not flat)
T/F Suction is required in every patient room.
True. A suction regulator and equipment is required at all patient bedsides
What is the best way to communicate a patient concern with a physician?
SBAR!
How often are care plans documented on?
Once per shift, usually at the end.
Doctor’s Order: DimenHYDrinate 25 mg IV q4h PRN
Supply: DimenHYDrinate 50 mg/mL
What would you do if you change your VAC a day earlier than scheduled?
Contact the wound care specialist to change the order with the new schedule.
What are high falls risk reduction strategies?
proper footwear
signage
bed alarms
education
What must you check before implementing a protocol?
Confirm patient meets any conditional parameter(s) of theactive protocol (and is not disqualified by any identified contraindications)
How are care plans created?
New BPAs will prompt you to add a care plan based on specific assessments and screenings.
Doctor’s Order: Prednisone 7.5 mg PO daily
Supply: Prednisone 5 mg (scored) tablets
Dose = 1.5 tabs
How often does a Tegaderm absorbant for a skin tear need to be changed?
Leave it on until healed or the window is completely obscured.
What is moment 1?
Before contact with patient or environment. This includes the nursing station and medroom.
When to check for signed and held orders?
Nursing staff need to check QShift for any signed and held orders on each patient
Check prior to discharge as orders can linger across the next encounter
T/F: A note is always required when documenting on a care plan?
Documenting a note is not a requirement, but should be done if we ever delineate a goal as ‘not progressing’. Notes also help our interprofessional colleagues see current goals, goal progress etc
Doctor’s Order: Meperidine Hydrochloride 60 mg IM q3h for pain
Supply: Meperidine Hydrochloride 75 mg/1.5 mL
Dose = 1.2mL
What stage of pressure injury would order a therapeutic surface?
Stage three - unless the patient is high risk then order as soon as possible.
T/F: The armband doesn't have to be scanned if you know the patient.
False. There are no exceptions to not scan the patient armband.
EDD should be adjusted when...
there is a change in patient condition OR there is an operational delay
What patients need a care plan?
All of them!
Doctor’s Order: Daletparin Sodium 5000 units subcutaneously
Supply: Dalteparin Sodium 7500 units/0.3mL syringe
Dose = 0.2mL
How often do you reposition a patient on a therapeutic surface?
Every two hours - no change to standard repositioning.
How do you prevent a pressure injury?
frequent repositioning
moisture free
right surface
wound care and/or dietician consults
When can you accept verbal orders or orders through secure chat?
Never. Only telephone orders can be taken and only in an emergency. The physician will still need to verify.
What does a care plan identify?
Care plans identify the goals of care based on documented concerns or problems.