Charting
Where is the appropriate place to chart your pain assessment?
eMAR (inpatient) or vitals/pain assessment tab for ED
If your patient has a pain score of 3, what are some medications that would be appropriate to give?
Acetaminophen, Ibuprofen, Naproxen, etc.
If you give an oral pain medication, when would you need to do a pain reassessment?
Within 1 hour of administration
When is the best time to waste a medication?
Waste on removal, mandatory within 1 hour
Is an order required to use ETCO2 monitoring via Alaris pump?
No
Where's the appropriate place to chart your pain reassessment?
flowsheets (inpatient) or vitals/pain assessment tab for ED
True or False: If your patient rates their pain at a 5, and they do not want the ordered moderate level medication, you may give them the ordered high level medication and chart "per patient request"
False
If you give an IV pain medication, when do you need to do a pain reassessment?
Within 30 minutes
If a coworker asks you to waste with them, but they don't have the medication on hand, what do you do?
Do not waste without observing medication directly, contact charge nurse to resolve discrepancy.
What is the normal range for ETCO2?
35-45
Where do you chart "per patient request"
in the comments box in the eMAR when administering the medication
The patient rates their pain a 10, but they do not want the ordered high level medication. Can you give them the moderate or mild ordered medications instead?
Yes, as long as you chart "per patient request"
What do you do if your patient reports their pain has not decreased on reassessment?
Check your orders, call physician if there are no further appropriate medications ordered.
What are potential behaviors that may signs of diversion?
unusual patterns of medication removal or waste, working extra shifts or unexpected absences, frequent mood swings, lapse in clinical judgement, etc
Is it okay to change parameters on ETCO2 monitor if it is alarming often?
No, this indicates a problem with your patient
What is the best charting practice if you have an order with a range for dose ex: 1-2mg of morphine q4 hours
Ensure dose recorded on MAR matches dose you are giving, not just default dose from scanning bottle.
What steps do you take if your patient rates their pain a 5 and you only have mild and severe pain medications ordered?
Call provider for an order for a moderate pain medication.
True or False: If you cannot complete the reassessment within the scheduled time frame, you should reassess your patient as soon as you can.
True
What's the best practice for waste at time of removal of controlled substance topical patches?
Fold together, dispose in appropriate container. Document in pyxis under "narcotic general waste" with two licensed professionals
What would be the indications of over sedation on you ETCO2 monitor?
Increased CO2, decreased Respiratory rate, patient hard to arouse.