General Nursing
How often should patients be turned?
Q2 Hours
If you have to call out due to being sick, what time do you have to call out by?
Before 10 the shift before
What symptom do most SAH patients present with in ED
WHOL
What is your blood pressure goal for this patient population?
<160
What are the two most common treatments for ischemic strokes?
TNK, thrombectomy
When should you order a specialty mattress?
Within 24 hours of the patient's admission for any patient with a Braden score less than 18
If you have a question that isn't an emergency and you need to contact a Manager or Scheduler, what is the best method of contact?
EMAIL!
What is the most common cause of SAH in our patient population?
Aneurysm Rupture
What is the most common cause of ICH?
HTN
What does it mean to be a comprehensive stroke center?
Nursing staff trained in neurocritical care/stroke
24 hour neurosurgery and IR
How often are you required to change out your IV tubing? How about if you disconnect it for more than an hour? How about if it is lipid-based?
All tubing should be labeled with date/time + Med
Tubing is good for 7 days
If disconnected more than an hour it has to be changed within 24 hours
Lipid-based meds tubing needs to be changed every 12 hours
What time is considered late?
0700 or 1900
If there is no blood flow to the aneurysm, no longer at risk for bleeding
Clipping, coiling, stent
IR or OR
What surgical intervention might you do for this patient population?
Clot evac
What is common complication post TNK?
Hemorrhagic conversion
If your patient requires intermittent straight catheterization, how often are you doing it?
Depends on Urine output....If you don't know check policy stat. DO NOT NEED TO BLADDER SCAN
What is the weekend callout policy?
If you call out 2x in 6 month period (this includes one whole weekend), then you have to make up a weekend that is short RNs.
What is the main complication of SAH? How do we treat this complication?
Vasospasm
Push blood pressures to higher limit
Interventional radiology--DSA with Verapamil/Milrinone
At what ICP would you notify your provider? What nursing interventions would you do to lower your ICP?
>20
Elevate HOB, Ensure head midline
What is a TICI Score? What is the best and worst score?
Thrombolysis in Cerebral Infarction--used to assess the degree of blood flow restoration in brain artery after thrombectomy. 0 = no reperfusion 3=complete reperfusion
How often should patients be getting up to the chair? How long can they stay in the chair? What are the only contraindications to not being in the chair?
EVERY DAY!!!
If they cannot move themselves, then they can only be in the chair for 2 hours.
There are very little contraindications. High ICPs, Hemodynamically unstable
What NPI is Brisk and what is sluggish? With pupillometry which results would you want to notify a provider for?
What NPI is Brisk and what is sluggish?
Pupils non reactive, sluggish, different in size from each other, different in size from what they have been
What is the only medication that we have to prevent vasospasm? What is the dose? Why would we spread out the dosing? Should we every not give it?
Nimodipine
30 Q2
60 Q4
Hypotension
NEVER DONT GIVE
How do you know if your EVD is still working properly? What would you do to troubleshoot if you are having issues?
Good waveform
Tidals
change filter if waveform is bad, rezero/Level EVD
Contact neurosurgery after
What are we checking for post thrombectomy and where do you find the sheet to document?