Code Brown
What does SBAR stands for?
Situation
Background
Assessment
Recommendation
What is the expected flow rate for nasal cannula?
1-6 L/min
This is the most important routine action for preventing the spread of infection.
Hand hygiene
You are calling a physician because your patient's respiratory rate has increased from 18 to 32. Which SBAR section would this information primarily belong to?
Assessment
What is the antidote for Opioids?
Nalaxone
What is the number to call when there is a CODE?
7111
What is the antidote for Warfarin?
Vitamin K
A patient with suspected C. difficile requires these precautions according to FH policy
Contact Plus Precautions Plus, including appropriate PPE and hand hygiene
A nurse calls a physician and says: "I'm calling about Mr. Lee in Room 222. His blood pressure is 82/48 and he is newly confused." Which SBAR component is this?
Situation
What are the 7 medication rights?
Right patient
Right medication (drug)
Right dose
Right route
Right time
Right reason
Right documentation
What is a trough drug level?
A trough drug level is drawn when the drug is at its lowest in the bloodstream right before the next dose is given (usually 30 minutes before the next dose)
What is the flow rate for a non-rebreather mask?
10-15 L/min
Your patient blood glucose reading = 3.1 mmol/L, he/she is able to swallow safely. How much fast-acting carbohydrates should you administer?
Administer 15 g of fast-acting carbohydrates
(e.g. 4 x 4 g Dextrose tabs)
What is the flow rate of simple face mask?
5-10 L/min
You measure from "the tip of the nose" to the "hub of the tube". What does this measure?
Measurement of the external length of small bore nasogastric tube (EN-tube)
What is the antidote for Heparin?
Protamine Sulfate
Your patient blood glucose reading = 2.8 mmol/L, he/she is able to swallow safely. How much fast-acting carbohydrates should you administer?
Administer 20 g of fast-acting carbohydrate
(e.g. 5 x 4 g Dextrose tabs)
A hospitalized patient spends most of the day in bed. This complication can develop even during a relatively short admission.
Hospital-associated deconditioning
What feeding tubes would require tube rotation?
G-tubes and PEG-tubes
For gastrostomy tubes, what is considered a "mature tract"?
> 4 weeks
Mr. Wilson's blood glucose is 2.0 mmol/L. He is now drowsy and unable to safely swallow. He has no IV access. What should the nurse do?
Administer Glucagon powder nasal spray (BAQSIMI) 3 mg (one spray) into single nostril OR administer Glucagon 1 mg SC/IM.
For gastrostomy tubes, what is considered a "immature tract"?
< 4 weeks
What kind of tubes can you do Balloon Volume Check?
Only for mature G-tubes and G-J tubes (only from G-port as J-port is not retained by a balloon) - only for mature tracts
What is the score 2 means on POSS (Pasero Opioid-Induced Sedation Scale)?
Slightly drowsy but easily roused.
For patients requiring opioids: May increase opioid dose if needed; increase sedation and respiratory monitoring while increasing dose.
What color is the PleurX catheter tip?
White
Mrs. Lee has a history of heart failure. She normally maintains SpO2 94-96% on room air. Tonight, her SpO2 is 89%, RR 26, and she has new bilateral crackles. She now requires 4 L oxygen to maintain SpO2 at 93%. What is the best action?
Call RT and MRP immediately to escalate the situation
How much do you prime for a SC catheter for the initial dose of medication?
0.4 mL greater than what is prescribed
Mrs. Smith laboratory results shows K+ = 2.6 mmol/L. She reports feeling weak and says her heart feels like it is "beating funny." What should the nurse do?
Call MRP immediately and report the critical result and symptoms
Mr. Brown's hemoglobin has decreased from 112 g/L to 105 g/L over several days. He is alert, denies dizziness or shortness of breath, BP is 122/70, and HR is 78. You are about to inform MRP about this change, what mode of communication would you communicate this?
Inform MRP using non-urgent communication (Teams)
What color is the ASEPT catheter tip?
Blue
Which Group of Hazardous drugs are considered carcinogenic? (Group 1 vs. Group 2)
Group 1
What is the maximum drainage per session for peritoneal drainage?
2000 mL/session or verify with MRP
How many vial spike would be required for HD1/HD2 medication if you have 5 vials to prepare on hand?
5 vial spikes
How long does the Peel and Place VAC dressing lasts?
7 days
What is the main reason that we need to stay with the patient for the first 5 minutes after initiating blood transfusion?
To monitor anaphylactic reaction and blood transfusion reactions
Why shouldn't we milk/strip a chest tube?
It will cause tension pneumothorax air enters the pleural space and cannot escape. Pressure builds up, compressing the affected lung and shifting mediastinal structures, which reduces venous return to the heart and can cause obstructive shock and cardiac arrest)