Standards of Care
How frequently should a patient be up and ambulating?
3x/day.
What sedation scale is most appropriate for 7 City patient population?
POSS
What are the monitoring guidelines for a patient receiving TPA lysis with or without heparin?
Q6 labs, hourly neurovascular checks and hourly neuro checks for the entire duration of lysis therapy. Hourly site checks
What emergency equipment should be in every room?
Suction set up: canister, short and long tubing, yankhauer, wall suction. Ambu bags in server
No. Order needs to be modified if patient is now taking meds by mouth.
When are weekly weights completed?
Monday night
Patient is admitted wearing a continuous glucose monitor (cgm). Where do we document this device?
LDA flowsheet
You get report from the PACU nurse but he forgets to tell you want time your patient's hourly checks with be complete. Where can you find this information?
Chart review, encounters, anesthesia event, anesthesia end time. The end time is when hourly checks begin.
Name 3 things that are looked for during room audits.
IS (at bedside and/or patient reports instruction and use), SCDs, tubing labels, clutter, labeled drainage cups/canisters, emergency equipment, locked server,
What tubing is used for IV Amiodarone?
0.2 micron filter tubing
When are alarm limits documented for a patient on telemetry?
At the beginning of a shift and also when any change is made to the alarm parameters.
Patient has an IUC. When should pericare be completed and documented?
Once a shift and with every bowel movement
What is the post-op monitoring on a carotid-subclavian bypass?
Hourly neuro checks and upper extremity neurovascular checks, telemetry.
How frequently does an USG IV need to have a dressing change?
Every 7 days
When titrating a vasoactive drip, how soon after titration should you be checking blood pressure and heart rate?
5 minutes after dose change
What are the standard I&Os times?
0600, 14:00, 22:00
How frequently does pain need to be assessed?
What is the post-op monitoring for a fresh EVAR?
Hourly lower extremity peripheral neurovascular checks, puncture site checks and urine output.
How frequently does IV tubing need to be changed
Every 4 days
What insulin do you hold vs no hold in a patient who is NPO?
Lantus?
Prandial?
Sliding Scale?
Lantus - do not hold
Prandial - hold
Sliding Scale - do not hold
When are updated wound pictures and measurements taken?
Sunday night
According to the policy, how frequently are condom caths and purewicks due to be changed?
once a shift
0.5ml per kg of body weight.
Ex: Patient weighs 90kg, urine output should be 45kg to ensure adequate perfusion
How long can a bag of TEN hang once the bag is spiked?
48 hours
Patient is wearing a continuous glucose monitor (cgm). Are we able to use their blood glucose reading for our purposes of monitoring their blood glucose and insulin administration?
No