Medication Management
Do you hold a beta-blocker such as Metoprolol or Labetalol prior to the patient going to the OR?
False -It can help stabilize HR and BP, plus reducing complications during surgery
How should the nurse notify the RMA when a patient is removed from the room, and what specific information must be included?
Call the RMA room and inform them where the patient is going and the expected return time
What does B.E. F.A.S.T. stand for
Balance - Eyes - Face - Arms - Speech - Time
TRUE or FALSE
You can hang a fluid bolus and antibiotics at the same item?
TRUE
(as long as blood cultures have been completed)
What triggers Malignant Hyperthermia?
Administration of Anesthesia
When and where do we properly dispose of narcotic waste?
How many nurses are needed to waste a narcotic?
Waste additional and unneeded narcotic promptly (asap)
Waste narcotic in the incinerator grey bin (located med room)
2 RNs are needed to waste a narcotic
What steps must the nurse take if patient privacy is needed during continuous visual monitoring?
1. Call the RMA room and request for a privacy screen
Name two signs of worsening HF
Increased shortness of Breath, Rales, Peripheral Edema, Sudden Weight Gain, JVD, Coughing and Wheezing
What needs to be completed 15 minutes apart AFTER administering your IV fluids?
Vital Signs
If a patient preferred language is not English, what is the appropriate method to communicate with the patient?
Using the Marti
Why is it important to monitor Vancomycin level?
Because it is nephrotoxic
What medical devices or patient-specific factors should be communicated to the RMA during handoff?
IV access, oxygen, central lines, foley catheters, ostomies, VADs. Patients who at risk for falls, altered mental status, seizure, elopement.
If the patient comes back with a new device or changes in level of care, please update the RMA form and call to update sitter.
Why is it important to monitor daily weights on HF patients?
To assess for major fluctuations in weight which could indicate fluid retention
When does a repeat lactic acid need to be drawn?
1.5 hours after initial lactic acid draw
National Patient Safety Goals: What are the 3 main elements of a time out?
Right Patient, Right Procedure, Right Site
Name a medication you would expect a CHF patient to be on
Diuretic (Lasix)
Inotrope (Milrinone)
What communication and documentation must the nurse complete before RMA staff can begin monitoring a patient on camera?
Complete the tele-sitting initiating in EPIC. Without this form being completed, monitoring cannot begin
Who can mix TNK? Who can administer TNK?
A trained RN can mix TNK, but only a provider can administer
What needs to be done in the first hour of the sepsis bundle?
Draw Lactic Acid, Blood Cultures x2, Fluid Bolus (vasopressors), Broad Spectrum Antibiotics, and Vital Signs
What diagnostic test needs to be performed with possible stroke patients?
CT Scan
When should a trough be drawn on a patient being treated with Vancomycin?
30 min prior to 4th dose
(make sure to follow doctors order)
Why is it important that the nurse does not unplug or disable tele-monitoring device?
All documentation and information can be potentially deleted.
What specific lab value indicates that a person may be in heart failure?
BNP
What is the standard calculation for fluid bolus on a sepsis patient?
30ml/kg
How do we accommodate patients who are visually impaired?
Using the Aira app