Heparin
Can you bolus Heparin from the bag?
No!
What is the first step to transfusing a blood product?
What is obtaining informed consent
What is required for informed consent?
Informed consent is given by the patient or LAP after a general description of a procedure or intervention is given by a Physician or credentialed provider.
Inserted nasally and is post pyloric.
Dobhoff
110-2000
Rapid Responses Phone Number
Anticoagulation lab used to monitor Heparin level.
APTT
Name the different types of blood products.
Platelets, packed red blood cells, fibrinogen and cryoprecipitate.
First and Last name of the Physican
What is required for a proper consent.
*Remember no abbreviations
What angle should the head of bed (HOB) be at if a patient is on tube feeds?
30 Degrees
If the patient is unconscious and you are not able to obtain a BP or the patient’s respirations are agonal, call a _______?
Code Blue
How often do you draw an APTT when a patient is on Heparin?
Prior to initiation, Q6h after initiation or dose change and after 2 consecutive therapeutic results, change to daily.
Plum pump blood tubing primed with blood.
What is the tubing needed to transfuse a blood product.
*Do not prime with Normal Saline
Where do you document the use of the interpreter?
Interpreter services flowsheet
Patient shows s/s of feeding intolerance (i.e., nausea, abdominal distension, cramping)
What is hold feeds for 1 hour, if s/s subside, resume feeds. If no resolution, continue holding and contact MD.
Fill in the blank:
When collecting a blood culture off a _______, do not flush the line or waste any blood.
Central Line
Dedicated pump and primary tubing
What is required to start a Heparin drip.
*Nothing should go secondary or be Y-sited to Heparin
How often do you do vital signs when transfusing a blood product?
At initiation of the transfusion
After the first 15 minutes
Every hour
Post transfusion
Cefazolin
Antibiotic given 1 hour prior to cut time.
How often is gastric residual checked?
Aspirate large bore feeding tube q8h or prn
If greater than 250cc, return to stomach and continue feed, recheck in 1 hour
If still greater than 250cc, return to stomach, hold tube feed and notify physician
Fever greater than 100.4F
WBC less than 4,000 or greater than 12,000
HR greater than 90 beats per min
RR greater than 20 breaths per min
Early Signs of Sepsis
Do you change the Units/Kg/Hr or the mL/hr?
ALWAYS verify that the UNITS/KG/HR is what is being changed on the pump NOT mL/hr
The minimum time red blood cells can run over and the maximum time a blood product can run over.
What 5 forms are needed to send a patient to a procedure?
surgical consents
blood consents
Transport criteria screening tool
The pink preop checklists
The online preop checklists in the patient's chart
Explain how to give meds through a G/J tube
Administer medications CRUSHED one at a time through gastric tubes only
Flush with 30cc of sterile water before first and after last medication
Flush in-between each medication with 15cc of sterile water
Elixir medications should be used when appropriate. Crushed medications should only be used when no other option is available.
What is part of the sepsis bundle?
Measure lactic level
Obtain blood cultures
Administer broad spectrum antibiotics (only after cultures are drawn)
Fluids