Breathe Easy
When should you use a humidifyer with a nasal canula?
At 4 LPM or more
What is the most common modifiable risk factor for ischemic and hemorrhagic stroke?
Hypertension aka Uncontrolled blood pressure
The Confusion Assessment Method (CAM) is an evidence-based tool that assists in the identification and recognition of delirium quickly and accurately. How often should the CAM be completed?
At least once per shift
(And as a patient's neurological condition changes)
Name at least two symptoms of left sided heart failure.
Restlessness
Confusion
Tachycardia
Fatigue
Cyanosis
Orthopenia
Exertional Dyspnea
Pulmonary congestion
Paroxysmal or nocturnal dyspnea
Cough or crakles
After IV fluids are administered for a sepsis patient with initial hypotension, how frequently should the blood pressure be checked?
2x within 1 hour of IV fluid bolus completion time
What is at least 1 emergency equipment should be at the bedside for a patient with a trach?
Two extra trach tubes (one current size, one smaller)
An obturator of the current size
Suctioning device and catheters
Bag valve mask
True or False...
All Stroke/TIA patients are NPO until they pass a bedside swallow screen. If they fail the bedside swallow screen they are kept NPO until cleared for oral intake by a Speech Therapy Consult.
TRUE!
Swallow screening is critical to prevent post-stroke complications such as aspiration pneumonia. Aspiration pneumonia post stroke can increase length of stay, prolong patient recovery, and increase post-stroke mortality.
Name at least 1 treatable cause of delirium
•Toxic situations: CHF, shock, dehydration, deliriogenic medications, new onset organ failure (e.g. kidney and liver)
•Hypoxemia
•Infection/sepsis, inflammation, immobilization, or new nosocomial infection
•Non-pharmacologic interventions: early mobility, sensory aids (e.g. hearing aids, glasses), reorientation, sleep hygiene, music, control noise
•K+ or any other electrolyte imbalance
Name at least two signs and symptoms of Right sided heart failure:
Fatigue
Increase peripheral venous pressure
Ascites
Enlarged liver and spleen
Secondary to chronic pulmonary problems
Distended jugular veins
Anorexia or GI distress
Weight gain
Dependent edema
Why do you need to check the BP x2 within 1 hour of the fluid bolus completion time?
To check for Persistent Hypotension
What is one patient indications for suctioning?
Gurgling sounds during respirations
Adventitious sounds when the chest is being auscultated
Rhonchi or coarse crackles
Name 2 diagnostics that are required prior to the administration of tPA.
1. Glucose
2. Non-Contrast Head CT
Note: INR also required if taking Warfarin
•Promoting patient's sleep/wake cycle
•Ambulation and mobility (e.g., in chair for meals, active or passive range of motion)
•Provide sensory stimulation (e.g., glasses/hearing aids, activity blanket)
•Medications such as Haloperidol (Haldol)
Btype natriuretic peptide (BNP) is a biomarker released by the ventricle when there is an excessive pressure due to heart failure.
A. True
B. False
True
Patients receiving beta blockers are not likely to exhibit this indication of SIRS
Tachycardia