SAFETY
Your patient gets an order to go outside. What should you do before you consider letting them leave the floor
1. Question why patient leaving the floor
2. Specify that s/he will have a defined amount time off the floor (30 min)
3. have them sign a release of liability for *each* time they leave the floor.
Name 3 things early mobilization play preventing COMPLICATIONS in the post-operative care of trauma patients
Prevention of atelectasis, pneumonia, DVT. Promote faster recovery.
Per hospital policy, how often should patients receive oral care?
All non-mechanically ventilated patients will receive oral care at a minimum of twice daily/every 12 hours.
In bariatric surgery post-operative care, why is respiratory assessment crucial?
monitor for signs of hypoventilation and atelectasis due to changes in respiratory mechanics.
A patient with a BMI of greater than 30 has orders to go to CT. Pt transport arrived with a gurney. What 3 interventions would help promote safety in the workplace?
1. Sally slide
2. Hover matt
3. Another person to help transfer
What is the primary goal of post-operative care across all surgical specialties: LIST 3 items.
1. ensure patient safety (q4 vitals, q4 I/Os)
2. monitor for complications
3. promote optimal recovery through early mobility
Per Policy, how often should you change feeding tube if it is a closed system
Every 24 hours.
A patient is attempting to elope from the hospital and lacks capacity to leave AMA, should you follow the patient off the floor or into the elevator?
Do NOT physically block the patient or physically prevent the patient from leaving the unit. Do NOT get into an elevator with an eloping patient. Follow the patient at a distance only if it is safe to do so. Do NOT follow the patient outside of the hospital building.
If a patient is experiencing abdominal pain and interventions are not helping, besides calling the team, who else could you call and why?
Call RRT for "failure to respond to treatment"
In the context of post-operative pain management, explain the significance of using a multimodal approach.
Using opioids, non-opioids, and adjuvant medications, to optimize pain relief will minimize side effects and the risk of opioid-related complications.
If a medication is scheduled to be administered 2x/day, per policy how soon or how late can you administer said medication
60 minutes before or 60 minutes after due time.
Heart rate of less than 40 or greater than 130.
SBP <90/ >180
AMS/neuro/stroke/seizures
RR 8 or 28+
U/O less than 50/4 hours
Acute significant bleedingLA 2+/septic
not responding to treatment
Patients who or have a Heparin drip, Telemetry, Epidural, or Nerve Block have what in common?
They all require q 4 vital signs regardless of how the order is written (example: q6 VS).
Why is strict glycemic control important in the post-operative care of patients who have undergone surgery?
to prevent complications like delayed wound healing and infections, especially in patients with diabetes?
What are the EIGHT Rights of Medication Administration?
Eight Rights of Medication Administration: right patient, right medication, right route, right dose, right time, right documentation, right reason, and right response. Administer all medications according to the Eight Rights.
Baseline EKG if not completed in last 30 days to evaluate QTc.
QTc 450‐500 msec: Suggest cardiology consult, dose reduction, eliminate contributing factors, use alternative opioid.
QTc greater than 500 msec: Benefits must outweigh risks.
Explain the nursing considerations regarding post-operative renal function monitoring in a urology patient
Closely assess urine output and serum creatinine levels for early detection and intervention in case of acute kidney injury or electrolyte imbalances.
ETCO2 monitoring is required for all patients receiving PCA therapy EXCEPT (4)
1. End of Life
2. CPAP/BiPAP on + continuous pulse ox (tele box)
3. Patient w/ laryngectomy stoma w/o trach + continous pulse ox (tele box)
4. HFNC w/ + continuous pulse ox (tele box)
Who is our most experienced nurse?
Lourdes Cariaga