Show me the SBAR!
As field nurses, we are prohibited from accepting verbal orders from what types of clinicians?
What are Physician Assistants and Nurse Practitioners?
On the BAYADA MARS in each client's home chart, the medications are first listed as standing orders followed by _____ order.
What is PRN?
You are running late for your shift. Who you gonna call?
The Office!
This is the minimum frequency that a nurse must document care within thee narrative of their nursing note
What is Q2hr?
It is optional to write a note or document on a MAR in blue pen if that is what you have on hand?
Blue does not photo copy well, black is best.
Your doctor gives you a verbal order for the following medication:
Ciprofloxacin 500mg BID x 7 days, first dose to be administered this evening.
What's missing from this verbal order?
What is the route?
If a medication scheduled to be administered during the nurse's shift was not, that nurse should still initial next to the medication name in the corresponding day/time slot, circle their initials, and then do what?
Explain why the medication was not given within the body of their nursing narrative in their shift note.
Your client is down to his last foley catheter and will need more soon! Who you gonna call?
What is the DME vendor?
PCG, often notated within a 485, stands for what?
What is patient caregiver?
You complete the Narcotic Record Sheet in the home at the beginning of your shift and have not given any narcotics at the end of your shift therefore your narcotics documentation is considered complete. True or False?
What is False? The nurse is required to sign out on the Narcotic record whether they administered a medication or not, as well as notate that the narcotics were counted at the start and end of their shift within their nursing note.
You call the doctor to report some changes in client's urine. The doctor gives you and order for antibiotic, what document do you check to see if client is any allergies?
Look at the 485.
This form provides the nurse with medication information such as intended action, side effects, and contraindications, and is utilized when transcribing a new medication order onto the MPTRs.
What is the drug classification guide?
You escort your client to a doctor's appointment, and the doctor provides a script for a new medication order. You leave with the script, your client's family member picks up the medication from the pharmacy, and brings it back to the house in time for you to administer it. Who you gonna call?
What is your Clinical Manager?
When documenting on the nursing shift note, the "Progress Towards Goals/Outcomes" section at the bottom of your note should contain goals that you have created for your client on your own. True or False?
What is False?!!!!!! Your goals should mirror the established goals on the 485 but in present tense, as you are addressing them in the current moment.
Which is inappropriate to document:
a. When received client he was in his electric chair...
b. Climate in client's room was approx. 78 degrees and I was sweating...
c. Fed cat a cup of dry food...
d. All of the above
What is D...all of the above
What piece of clinical data is important to have prior to calling the doctor to report a suspected infection?
What is a set of vital signs? (assuming there is an order on the 485 for such)
When DC'ng a medication from the MARs, what three items MUST be listed in the "Key" Column?
What is "D/C", the date, and the nurse's initials
Your client's MARs are not in the home for the upcoming month and it is already the 31st of the preceding month. Who you gonna call?
What is the Office?
When caring for a client intellectual disabilities, you the nurse are required to read what piece of info created by the supports coordinator?
What is the ISP.
You make an error while writing an addendum. You cross it out, write ______ above or next to it, and then continue with the remainder of the order.
You notify the doctor that your client is having pain and ask to receive a pain medication order. The doctor provides a verbal order for Ibuprofen 200mg q6hr PRN pain via GT. What additional piece of information would make this order more specific in regards to pain?
What is a severity scale for the pain i.e. mild, moderate, and/or severe?
True or False: the field nurse is permitted to write information to the left of the "Key" column.
What is False? Only the prescribing physician or your Clinical Manager is permitted to write to the left of that line.
If you see an inappropriate interaction between your client and family member, who are you going to call?
Make a call to your clinical manager.
When the nurse completes a task, removes her/his gloves, washes her/his hands, dries her hands with clean paper towel, turns of the faucet with a clean paper towel then returns to client, correct?
Last step to complete hand hygiene is to cleanse hand with hand sanitizer.
Identify the incorrect sentence in this paragraph:
1-Client slightly moaning after repositioning this afternoon. 2-SN checked the MARS and Dilaudid (q2hr) was just given 30 minutes ago, prior to SN arrival. 3-Mom entered client's room and suggested that the client receives an additional dose of Dilaudid, that the doctor told mom she could give it if need be, and SN agrees with mom therefore gave an additional dose of Dilaudid. 4-Client appears to be more comfortable.
What is sentence #3?