Safety Checks/Charting
What am I checking for during safety checks?
Ambu Bag
Oxygen source
Monitor parameters
tracing lines
What counts as a bath?
Soap & water
purple wipes
hibiclens
Where can I draw a Co-ox from?
Uppper body line (arm PICC/PA line/IJ etc)
Who do we check Pre & post-ductal sats on?
Coarc, IAA, TGA, other ductal dependent lesions
When would we use Nitroglycerin? why?
Glenn line, post ASO, coronary concerns
How Often do I chart an SBS for my sedated/intubated baby?
Q1 Hr, before & after PRN's
When must a pre-op be completed by?
After 5pm day prior too surgery
If my PIV infiltrates, where do I obtain "Y" measurements to see severity?
Axilla to tip of middle finger
Difference between a BTT shunt and Sano Shunt?
BTT: subclavian artery to branch PA
Sano: RV to Main PA
What is the half-life of adenosine? Where should I give this med?
1-10 seconds; upper body line (left side if possible)
How Often do I chart an SBS for my sedated/intubated & paralyzed baby?
never
How do you CORRECTLY use HibiClens?
Apply to wet cloth, wipe on pt and then wipe clean with warm/wet cloth.
What does an RA pressure tell us?
Pre-load, RV function
Surgery that creates total cavopulmonary connection so that systemic venous blood bypasses the heart and goes directly to the lungs.
Fontan
What 2 symptoms does Prostaglandin E cause?
fever/flushing and apnea/respiratory depression
How often do we chart on PCA pumps? When do we clear them?
Q4, at AM shift change or when discontinuing.
Who needs daily CHG treatment?
Anyone >36 weeks with a central line
Where does a Glenn Line sit?
SVC at the Pulmonary artery (aka PA line)
What is the Transpulmonary Gradient in a Glenn Pt?
Glenn pressure minus left/common atrial pressure; transpulmonary gradient indicates high pulmonary vascular resistance (PVR) and need to be addressed by avoiding hypoxia/acidosis or using nitric oxide.
What drug should you push for polymorphic ventricular tachycardia?
Mag
When do we chart CAP-D? what is it telling us?
1200/0000; delirium
where do I chart CHG bath pre-op?
Flowsheets--> Procedural checklist
What med runs through a Glenn line? Why?
Nitroglycerin; vasodilation of the PA at anastomosis site
What categorizes a patient as "Single Ventricle Physiology?"
Sats in PA = Sats in Aorta
Which drip improves cardiac contractility (inotropy), cardiac relaxation (lusitropy), and induces vasodilation and has the overall effect of increased cardiac output?
Milrinone