Concepts
You are assessing the pt's JP drain and see that the drainage is bright red-bloody color. What would you document for the color of the drainage?
Sanguineous.
Name one lab value (be specific, don't say CBC or CMP) and one non-blood work testing to check when the pt is admitted for pneumonia.
WBC (or blood cx)
Chest x-ray, sputum cx, nasal swab (resp. panel)
What is one nursing intervention that can be done for pts wearing NC for supplemental O2 for their dry nares?
Sterile water for humidification.
When the pt's admitting diagnosis/priority problem is COPD exacerbation, is this an acute or chronic issue?
Acute - exacerbation means an acute worsening of the pt's chronic condition that requires more elevated level of care and tx.
According to Ms. Kim, the student is recommended to start by reading this on Epic when trying to learn about the assigned pt? In other words, what gives a comprehensive summary of the pt's background and reason for current admission?
H&P (History and Physical)
You receive report that the pt is on seizure precautions. Besides the standard precautions, what are two items you make sure that are in use for the pt?
suction set up, all 4 bed rails padded (and up)
What do we have to watch out for when the pt's sodium is LOW? Name 3 cues.
AMS, seizures, lethargy, tachycardia, N/V, headache
Name 3 nursing interventions for pts with impaired tissue integrity related to sacral pressure injuries.
Repositioning, appropriate dressing change based on orders, hydration/nutrition, reduce friction, skin care, wound consult
Give examples of admitting diagnosis and S/S the pt presented with.
GI bleed - bloody, black tarry stools; bloody emesis
COPD exacerbation - cough, hypoxia
Which tab on Epic do you go to view images of the pt's wounds?
Chart Review > Media
Why do some pts with COPD like to sleep in recliners/chairs instead of beds?
They often experience orthopnea due to damaged lung tissues.
Name 3 cues that indicate an acute inflammation
CRP, elevated WBC, and elevated temp.
What is a teach-back method and provide an example of how nurses can utilize it.
Name 4 assessment findings that may indicate the adult pt is in a fluid deficit volume.
dark urine, poor skin turgor, weight loss, orthostatic hypotension, low UO, dry mucous membranes.
You forgot to chart your daily cares that were done at 1037. What do you click to chart under this specific time?
Insert Column and enter the time.
Name three nursing actions/interventions that can be taken if you are unable to palpate the pt's pedal pulses.
Use a Doppler US, palpate for popliteal pulse, check for cyanosis or the pallor.
Name 4 cues that could indicate fluid volume overload in your pts.
edema, weight gain, crackles, dyspnea, ascites, maybe HTN
It promotes deep breathing, expands your lungs, and improves your ventilation. This can help prevent further infection in your lungs (pneumonia) by clearing mucus and other secretions from the lungs.
Which is the more reliable indicator of kidney function: Cr vs. BUN and why?
BUN can also be caused by dehydration or high level of muscle breakdown.
Cr tells us how well the kidney (glomerulus) is filtering the blood.
What does "Hover to Discover" mean?
hover (don't click) over the items on your left column on Epic - can access most recent lab/diagnostic testing results, VS, pregnancy hx, diet, etc.
Your pt has a hx of end-stage renal disease and asks you about renal diet. How do you explain this to the pt? Include 3 foods to avoid. Avoid using medical jargon.
It is a diet that is least stressful for your kidneys. It is low in sodium, potassium, and phosphorus, as your kidneys have difficulty getting rid of them from your body properly. If too much of them build up in your body, they can cause more damage to your kidneys.
ex. orange juice, bananas, greens, processed meat (sausage, bacon, hot dogs, etc.).
Your pt is at a risk for aspiration. Name 4 cues that support this nursing diagnosis.
dysphagia, crackles in lungs, diminished cough or gag reflex, inability to clear secretions, pocketing food in the mouth, drooling, AMS
Your pt on fluid restriction for fluid volume overload is asking for more water. Name two nursing interventions for this pt.
Explain the fluid restriction to decrease stress on the heart and swelling, offer ice chips or oral care instead.
A bedridden pt complains of having to wear TED hose/SCD pumps and to take anticoagulants. How would you educate the pt about the necessity of these interventions? Don't just say prevent blood clots. This is 500 points for PATHO. Avoid using medical jargon.
How do you know other specialties have been consulted?
These can be good cues for your priority problems.