Pressure Injury Stages
Interventions
Patient & Family Education
100

This pressure injury has bone, muscle and tendons exposed. 

What is:

A stage 4 PI

100

2 nursing interventions to implement for an at risk patient with a Braden Score < 18. 

What is:
Boots, turn schedule, wedges, allevyn
  

100

What teaching method should we always include when educating patients and family?

What is:
Teach Back Method

200

A dressing that can be applied to a partial thickness skin tear to prevent sticking. 

What is: adaptic or xeroform

200

What you do if you're waiting for additional help to arrive and one of your other patients requests pain medication.  

What is:
Ask another nurse for help
Do not leave stroke patient alone

200

A list that's important to reconcile and review with the patient and family prior to discharge

What is:
The medication list

300

The stroke symptom I assess for when asking the patient to smile

What is:
Facial droop
Change in facial symmetry

300

Three nursing interventions to perform when your patient is having a stroke

What is:
Vital signs
Complete comprehensive neuro assessment
Make patient NPO
Suction PRN
Place patient on cardiac monitor (Zoll)
Establish large bore IV (18g if possible)
Obtain accurate weight if none in past 24hrs
Maintain O2 SATs >94%
Telestroke if appropriate for your area
Consider notifying family

300

An acronym to teach the patient and family prior to discharge so they can recognize something is wrong

What is:
BEFAST (Balance, Eyes, Face, Arms, Speech, Time)

M
e
n
u