NG/G tubes
How do I measure for an NG tube placement
From the patients nose, to earlobe, to between xyphoid and umbilicus
True or False
When I am giving a med through a central line I need to scrub the hub of the med line with CHG before attaching the syringe.
True!
Always scrub the hub of the med line before attaching medications or flushes
What needs to be charted in real time
Vitals, PEWS, I/Os and anything abnormal
True or False
When transferring IV medications between syringes I can first squirt the medication into a med cup to draw up my dose
FALSE.
When transferring medications between syringes use a syringe transfer device (green connector)
How long is the minimum for a Car Seat Test?
90 mins
or as long as the families car ride home is
What do I do if I cant get a pH on an NG tube
Turn the patient on their Left Side and try again in a few minutes
Can I draw blood from both lumens of a Double Lumen PICC line?
No!
White Lumens don't draw blood in PICC lines smaller than 2.6 Fr
I need to chart flush volumes
TRUE!
What is Foley Care?
Washing around the Foley Catheter with soap and water. MUST happen q Shift
Where can ID bands be?
ONLY on the patients wrist or ankles
How often do I preform GT care
GT care is done q Shift or more frequent if excess drainage is present
How many units of Heparin do you use to HL a PORT?
50 units for a Port!
(30 units for a PICC and Broviac)
What are WATS and how often are they charted?
WATs- withdrawal assessment tool
Charted q4 for patients on sedation weans
True or False:
If I send a GI PCR or a Resp PCR I have to put my patient on isolation until the test results
True!
What categories of medications are a 2 RN check?
All Narcotics/Opioids, Electrolyte Boluses, High Risk Infusions, All other high risk meds (i.e. Digoxin)
+
Any medication that we dont use that often on HKU
(More info in Infusion Confusion Book)
When do pH or flush syringes expire? What syringe size do you use to flush or pH test?
12 hrs
10mL for pH
5mL or 3mL syringe for flush
DAILY DOUBLE!
Who is allowed to access an HD line
HD nurses
HKU Shift Coordinators
HKU RNs after a kidney transplant (w/ a comm order!)
What do I do at the end of a blood product transfusion
Grab vitals, Note the volume transfused, END transfusion in BRDIGE, document volume in I/Os
How many CHG baths do patients get Pre-Op Cardiac Surgery
2!
Night before surgery: Full bath + CHG + Linen Change
within 6 hrs of OR time: CHG wipes
How/When do you rack urine
Post Kidney Biopsy
Take a small sample of every void and place in specimen cup with time and date.
We change our feed bags q4 - q8 based on the formula expiration. How often should parents change the bag at home?
Parents only go home with 1 bag a day through insurance! Part of teaching a parent going home with tube feeds is teaching them how to rinse out a bag between feeds.
My Tubing is good for:
1. Med lines:
2. Primary Tubing
3. Secondary Tubing
Q24: Med lines + Secondary Tubing
Q 4 days: Primary Tubing
ALWAYS change your lines when you change your caps!! (new caps, new lines)
If your patient is in restraints, how often do you need to do/document an assessment
Q15 mins!
Your patient has been on TPN/IL for a few days and they spike a fever. The night shift RN cultured them and did a cap change at 0700. Do you do a Cap Change when you hang your TPN/IL in the evening?
No.
The nightshift RN erroneously did a cap change too early. You shouldnt cap change. The cap can be changed with tomorrows TPN/lipids instead
What are your steps when your chest tube is bubbling?
Trace your lines
Clamp tubing at all intervals to to assess where leak is coming from
LAST: change system