Heparin
Can you bolus Heparin from the bag?
No!
After obtaining an order for blood, what is the first step to transfusing a blood product?
What is obtaining informed consent
*if the provider has not signed, please complete the nursing documentation section
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.
How often and how do you verify the placement of a dubhoff tubes
verify the correct CM placement at each change of shift.
List 3 reasons you should call RRT?
change in LOC, unstable v/s, acute bleed, CVA, CP, seizures, change LOC, worries, concerned arrhythmias,
1. Which lab used to monitor Heparin level
2. What 4 labs do you collect before you start a Heparin drip?
Extra card: Where in EPIC can you place a task or reminder to collect the APTT when due?
1. APTT
2. CBC with diff, PT/INR, aPTT
3. the brain
prior to start
1015
1100
1200
1300
Ture or false:
Pt labels on all pages, FULL name of the physician, surgery/procedure name spelled out, DNA analysis consent signatures, date/time, full names with signature, use of primary language form and interpreter
True!
**if LAP is signing, please provide reason why.
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, what do you do?
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.
What is the tubing needed to transfuse a blood product?
Plum pump blood tubing primed with blood.
*Do not prime with tubing
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, check residual. Replace gastric contents below 500 mL 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
1. How often do you complete neuro checks when you start a heparin drip?
2. Why do we do this?
1. 2 hours after starting the drip and then every 4 hours.
2. worried about bleeding the brain
Tell us more about the Blood transfusion rider
Random question:
It is your responsibility to give your preceptor the Oreination Progress tool on a regular basis.
True
please follow the directions from your educator
What can you do if your patient has pills and a dubhoff tube?
Call the pharmacy to see if the meds are available in liquid.
**ER, SR, IR, EC-DO NOT CRUSH!!**
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
What are the time considerations (min and max) you need to remember when giving PRBCs?
minimum transfusion: 2 hours
maximum transfusion: 4 hours
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 30mL of sterile water before first and after the last medication
Flush in-between each medication with 15mL of sterile water
Elixir medications should be used when appropriate. Crushed medications should only be used when no other option is available.
What happens if you do not complete mandatory CBLS?