Careplans
When should careplans be updated?
At each recertification/with any change
Ordering these medications on admission will better assist in break-through symptom management.
Roxanol and Ativan
What scale is required for all patients with Alzheimer's or dementia related diseases?
FAST Scale
What type of decline do we expect to see with Alzheimer's/Dementia?
Decreased cognition, increased confusion, increased agitation/behaviors, weight loss, muscle wasting
What should be left for the facility prior to leaving?
Facility progress note
This careplan is required for all patients.
Pain
Patient's with continued pain issues should have what two type of medication?
Short term pain control and long term pain control
All facility admissions require this.
Written admit orders
What type of decline do we expect to see with End stage liver?
fluid retention/ascites, increased confusion/agitation, increased pain
Who do we touch base with before leaving the facility.
Facility DON/administrator
This careplan is required for all patients with an active opioid in chart.
Gastro-Intestinal (Bowel Management)
What is most beneficial for increased dyspnea in patients with COPD/pulmonary fibrosis?
Opioids (Roxanol)
This should be obtained at every recertification and admission visit if patient has a PPS of 40% or greater.
Weight
What type of decline do we expect to see with COPD?
Increased dyspnea, weight loss, muscle wasting
This careplan must be included in all Facility patients.
Patient evacuation plan
You can't perform this task without this careplan intervention.
Monitor sp02 intervention under respiratory careplan
Used to treat increased confusion for end stage liver patients and constipation.
Lactulose
When should you update the verbal certification careplan?
At IDG
What should be assessed and documented at every nursing visit?
Pain
Must be provided to the facility with each medication change.
Written orders
This careplan should be active and updated with each fall.
Musculoskeletal
What symptoms are considered "GIP" symptoms and when do we consider the patient GIP appropriate?
Uncontrolled pain, uncontrolled/terminal restlessness, Uncontrolled dyspnea, uncontrolled n/v.
Patient is "GIP appropriate" once the home team RN has attempted at least two tried and failed interventions.
If patient's recertification date is 6/1/24, when is the first day you can complete RN recertification visit.
5/2/24 (30 days prior)
Patient can be transferred to wheelchair with maximum assistance. Patient is dependent in 6/6 ADLs. Patient has a reduced diet and sleeps most of the day. What is their approximate PPS scale?
30%
If your patient has been transferred to a local hospital for symptom management. What three options does the patient/family have at this time?
Go back to their home, send to HCC if GIP appropriate, revocate hospice services