How many days does the prevena usually last before it shuts off automatically?
7 days
What should you do if the consent form is expired?
Obtain an extension from the coordinator.
How often are central/PICC line dressings expected to be changed?
Every 7 days
What is the best exercise for patients who just finished a hip/knee surgery?
Walking!
Patients can begin walking as soon as they can, starting with short distances.
Which medications should not be given at the same time if Toradol is scheduled?
a) aspirin
b) celebrex
c) dialudid
d) gabapentin
b) celebrex
True or False:
The patient can have a pillow underneath their knee
FALSE
What happens when there is no blood return in a chamber study?
Do not disturb the patient. Skip the scheduled blood draw and try again for the next draw.
How often should patients get chlorhexidine baths?
Every 24 hours
At what point should the patient begin to bend down to sit on a bed, chair, or toilet?
Until the patient feels the front of the bed/chair/toilet on the back of their legs.
How often should you draw the vancomycin trough?
Every 3-4 doses (based on order).
What should you do when the prevena is making a noise?
Check for leakage or kinks. Cover up the foam dressing with a tegaderm where the leak is. If still not solved, notify physician (prevena may need to be changed).
How often do you need to renew your CT certifications?
How often should patients get chlorhexidine baths?
Who performs chlorhexidine baths?
Nurses or Nurse aids
What is not a correct way for a patient to get out of bed with their walker?
How often do you need to draw the aptt when initiating/changing the dose until it's therapeutic?
Every 6 hours until it is therapeutic.
What are the signs and symptoms to look for in compartment syndrome?
Pain
Pallor
Paralysis
Paresthesia
Pulselessness
Poikilothermia
Where is the research pharmacy located?
Milstein basement
For nurse driven heparin protocol, in what circumstances would the aptt need to be drawn?
1. When orders are initiated
2. When there is a rate/dose change
3. Q6H until therapeutic
What is the correct way to get out of bed after a hip surgery?
Get out of bed on the side opposite of the surgery and lead with the good leg.
Proper administration of an ordered narcotic
1. can lead to addiction.
2. should be done promptly to prevent increased pain and the need for larger doses.
3. would include holding the drug as long as possible until the patient really needs it.
4. should rely on the patient’s request for medication.
Answer: 2
The nurse is caring for clients on an orthopedic floor. Which client should be assessed first?
1. The client diagnosed with back pain who is complaining of a “4” on a 1-to-10 scale.
2. The client who has undergone a myelogram who is complaining of a slight headache.
3. The client two (2) days post–disk fusion who has T 100.4, P 96, R 24, and BP 138/78.
4. The client diagnosed with back pain who is being discharged and whose ride is here.
Answer: 3
This client is postoperative and now has a fever. This client should be assessed and the health-care provider should be notified.
For Dr. Cook's clamp study, how many total stopcocks are required per protocol?
4 stopcocks
2 on each IV line
Katie a 13 yo female has a PCA of morphine with a demand dose 0.4mg (lockout of 10 minutes) and a clinician bolus of 0.6mg every 20 minutes, as needed, to a maximum of 1.8mg in 4 hours OR 3 boluses in 4 hours. Katie is complaining of pain 10/10 at 1:30PM. She has been dosing herself regularly using her demand dose and is awake and alert. You determine that she would benefit from a Clinician/Nurse bolus. Upon checking the Controlled Substances Flowsheet, you see that Katie had boluses at 7:00AM, 7:20AM, 8:15AM and 10:00AM. It is now 1:30PM. Can Katie receive a bolus now?
Four-hour window: 9:30 AM – 1:30 PM (4 hours BACK from 1:30P is 9:30AM) Number of Clinician/Nurse bolus doses during that four-hour window: 1 bolus which = 0.6 mg Four hours maximum for clinician bolus: 3 boluses. Therefore, Katie may receive another clinician bolus at 1:30 PM
What is the correct way of walking up and down the stairs with a patient who had a hip or knee surgery?
Walking up the stairs: lead with the good leg, then the operated leg
Walking down the stairs: lead with operated leg, then good leg
Patient is a 87 y.o. female with hx of HTN, OA, chronic pain, and DM2. Patient is schedule for OR today and was NPO since midnight. Patient is complaining currently complaining of 10/10 pain. Her AM BP was 125/83 and HR of 95. Which of the following medications should not be given? SELECT ALL THAT APPLY.
a) Metformin
b) Oxycodone
c) Meloxicam
d) Metoprolol
e) Aspirin
a, c, e