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What type of focused assessment does a BMH patient need?
Psychosocial assessment
Your female patient is 12 years old and has an abdominal xray ordered. You need this before marking them ready for imaging
Negative pregnancy test or signed pregnancy waiver
Your patient in 21 is being discharged! During their stay they received IV fluids, deep suction, and labs. What do you need to remove from the room with discharge?
IV pole, suction canister, and patient stickers!!
The doctor has ordered 1475mg of IV Rocephin for your patient. The concentration for the prefilled syringes of Rocephin in the med Omnicell is 1000mg/25mL. How many syringes will you need and how many mL’s will you administer?
2 syringes, 36.88mL
There is an LPN in your zone. You ask if she can triage your patient in room 12. She says "no". Why?
It is not in the LPN scope of practice to triage! Or initiate CIPs
You need these items completed to get your Initial Assessment Check mark on the track board
Initial assessment, vital signs, home med rec, and learning needs
Your BMH patient is on a 1013 and being admitted, who needs to go with the patient as they travel upstairs?
Security (also probably the sitter)
You just gave your patient IV morphine for pain. Within what time do you need to reassess their pain?
Within 60 minutes
2 y/o female weighting 11.36kg seen in ED for excessive vomiting and diarrhea x2 days. The doctor has ordered a IVF bolus. Based on the patient’s weight, what ml/hr normal saline bolus should you expect?
227.27mL (20ml/kg)
Your patient wants to PO, but you need to ask the Doctor. What method should you use to ask the doctor? Text, call, face to face
Text
A EMS patient is being sent to your room, EMS states the patient had a seizure at home. What do you need to set up in your room?
NRB, oxygen-inflating (anesthesia) bag, appropriately sized mask, suction
Your female patient has a pelvic US ordered, what do they need to have before going to US?
A full bladder
*BONUS: What ways do we do this? Name 3
You take over a zone and the off going nurse mentions she gave room 35 ibuprofen PO for pain at 1200, by what time do you need to reassess your pain?
Within 90 minutes, 1330
10 y/o patient weighing 38.6kg comes to the ED for abscess. Upon Initial Assessment their temperature 39.1 orally. The doctor hasn’t signed up for the patient. What can you protocol?
* BONUS: How many mg would you give this patient?
Ibuprofen
BONUS: 386mg
A Paramedic is covering you zone for lunch. These are your outstanding orders: give morphine, chart a sedation, start insulin, discharge a patient. What 2 order can they NOT complete?
Start insulin and discharge a patient
Your patient arrives with a splint placed by the school nurse. They are crying in pain and triaged a 3. What is the first thing you should do?
Remove the splint!
BONUS: You remove the splint and notice a small puncture like wound to the under arm. What should you do?
You attempted to call report but the nurse was unavailable to take report. You attempt 5 minutes later and she is unavailable. How long do you wait before sending the patient up without giving report?
After 20 minutes since first report attempt you can send the patient upstairs without report. Even if there is not a bed in the room we can leave them on our stretcher!
Your patient arrived to your room with wheezing and a history of asthma. Our goal is to give Decadron within what time of their arrive?
Door to steroid time is 60 minutes
You patient is 12 months old and weighs 10.2kg the doctor orders Tylenol for their fever. What would be the appropriate dose with this patients weight?
*BONUS: The Tylenol concentration is 160mg/5mL, how many ML will you administer to the patient?
153mg (10.2kg X15mg/kg =153)
BONUS:4.78mL
You have the following orders, what can you not delegate to your tech: 24 day old catheter, 6 month old bulb suction, fingerstick POC glucose, forearm splint
24 day old catheter
Your patient is 11kg, what is the maximum volume of blood that can be draw in a 24 hour period? What is the formula?
*BONUS: What is their optimal total blood culture volume
Weight in kg X2, so 22mL
BONUS:8 mL
You patient is going to MRI, what needs to be completed before they go? And who needs to complete it?
MRI screening form. Need 1 for patient, parent going with them, and RN if they are staying with patient
A patient is coming to your room with Sickle Cell Fever. Your preceptor tells you we need to get the antibiotics in time to meet our goal! What is our goal time?
Door to antibiotics is 60 minutes
You patient weighting 60kg just received a 20ml/kg normal saline bolus and now the doctor is ordering maintenance fluids! What do you expect the matience rate to be? Hint: use the 421 rule
100mL/hr
4*10 = 40mL
2*10 = 20mL
1*40 = 40mL
100mL/hr x 24hrs
Your 4 year old patient tests positive for step. Instead of antibiotics the parents ordered a Bicillin Injection. What is the only approved site to administer this for infants/small children?
Ventroglueteal