Labs
What does the abbreviation CMP stand for?
Complete metabolic panel
It is unintentionally coming to rest on the ground, floor, or other lower level, but not as a result of an overwhelming external force.
Fall
It is a major decline or improvement in the resident’s status that does not normally resolve itself without intervention.
Significant change in condition
Who evaluates medication usage in order to prevent and detect adverse consequences and medication-related problems such ADRs and side effects?
Interdisciplinary team
Give 5 systems/areas that you can assess for changes in condition.
•Vital signs
•Neurological status
•Current level of pain and any recent changes in pain level
•Level of consciousness
•Cognitive and emotional status
•Respiratory
•Cardiovascular
•Gastrointestinal
•Genitourinary
•Skin
What does an elevated BNP indicate?
Congestive heart failure (CHF)
Give 3 examples of consequences from a fall.
Major injury such as fractures, lacerations.
Minor injury such as skin tears, abrasions, bruises.
Increased risk of death associated with hospitalization and complications.
Loss of independence and decreased ability to function.
Loss of self-confidence and fear of falling
Reduced quality of life.
Increased need for care.
Give 3 examples of change in condition that requires MD notification.
•Accident or incident involving the resident
•Discovery of injuries of an unknown source
•Adverse reaction to medication
•Significant change in the resident’s physical/emotional/mental condition
•Need to alter the resident’s medical treatment significantly
•Refusal of treatment or medications 2 or more consecutive times
•Need to transfer the resident to a hospital/treatment center.
•Discharge without proper medical authority
•Specific instruction to notify the Physician of COCs.
It is defined as an unpleasant symptom or event that is due to or associated with a medication such as a decline in an individual's mental condition.
Adverse consequence
What is the nursing/care process?
•Assessment
•Diagnoses
•Care planning
•Interventions
•Monitoring and follow up evaluation
What are included in the Lipid Panel?
1.Total Cholesterol
2.Low-density lipoprotein (LDL)
3.High-density lipoprotein (HDL)
4.Triglycerides
Give 5 examples of fall interventions.
Fall risk assessment
Medical evaluation
Medication review
PT and OT treatment; Gait and balance training
Keep bed in lowest position
Landing mats at bedside
Provide safe or non-skid foot wear
Assist with toileting needs or Toileting program
Behavioral strategies
Remove clutter from room and bathroom
Promote safety during transfer
Use of blood pressure precautions when needed
Keep frequently use items within reach
Pain assessment and management
Keep call light within reach and encourage its use.
Dycem mat on wheelchair
What is the communication form used for changes in condition?
Interact SBAR Communication form
It is defined as the preparation or administration of drugs or biological which is not in accordance with physician's orders, manufacturer's specifications or accepted professional standards and principles of the professional providing services.
Medication error
Give 5 things which are included in the respiratory assessment.
•Respiratory rate, rhythm and depth
•Breath sounds
•Use of accessory muscles
•Cough and/or sputum production
•Respiratory effort - Shortness of breath,
difficulty/labored breathing, Tachypnea
•Skin, nail beds or lips – color
•Oxygen use
•Pulse oximetry
•Symmetry and shape of chest
Give 3 situations that warrants immediate notification of MD/NP.
•Physician requested to be notified as soon as result is received.
•Result is something that should be conveyed to a physician regardless of other circumstances.
•Resident’s clinical status is worsening.
•High or toxic drug levels.
What are the nursing documentation needed after a fall incident?
Fall Event
Fall risk observation
Paper Incident Report
Fall care plan
Give 3 examples on when to notify family or RP regarding COC.
•Any accident or incident of the resident that results in an injury including injuries from an unknown source.
•Significant change in resident’s physical, mental or psychosocial status.
•Need to change resident’s room assignment.
•Decision made to discharge the resident from the facility.
•It is necessary to transfer the resident to a hospital/treatment center.
Give 5 examples of medication error.
Omission
Unauthorized drug
Wrong dose
Wrong route of administration
Wrong dosage form
Wrong drug
Wrong time
Failure to follow manufacturer's instruction and/or accepted professional standards.
Give 5 things which are included in the neurological assessment.
•Mental status
•Motor function
•Sensory exam
•Reflexes
•Evaluation of the 12 cranial nerves
•Coordination exam
•Pupillary assessment
•Extremity strength
•Pain
•Glasgow coma scale
Enumerate 10 lab results that you can obtain from a CMP.
1.Albumin
2.Alanine aminotransferase (ALT)
3.Alkanine Phosphatase
4.Aspartate aminotransferase (AST)
5.Blood urea nitrogen (BUN)
6.Calcium
7.Carbon dioxide (Bicarbonate)
8.Chloride
9.Creatinine with estimated GFR
10.Glucose
11.Potassium
12.Sodium
13.Total Bilirubin
14.Total protein
Give 4 intrinsic fall risk factors.
Effects of normal aging
Acute and Chronic diseases
Side Effects of medications
Drug interaction and/or Polypharmacy
What are the things you need to do for a COC?
•Make a detailed observation and gather relevant and pertinent information prior to notifying the MD.
•Use the Interact SBAR Communication form
•Perform nursing assessments
•Identify root causes and potential risk factors
•Notify MD of COC and carry out physician’s orders as ordered.
•Notify family or responsible party
•Complete all necessary documentation
What are considered significant medication-related error or adverse consequences? Give 4 examples.
Requiring medication discontinuation or dose modification.
Requiring hospitalization or extending a hospitalization.
Resulting in disability
Requiring treatment with a prescription medication.
Resulting in cognitive deterioration or impairment
Life threatening
Resulting in death
Give 5 things which are included in the cardiovascular assessment.
•Heart rate and rhythm
•Apical and peripheral pulse
•Edema
•Heart sounds
•Neck vein
•Capillary refill
•Chest, jaw or arm pain
•Circulatory status and hydration status of upper
and lower extremities
•Color (central and peripheral): pink, flushed, pale,
mottled, cyanosed, clubbing