Stroke/STEMI
Name the two types of strokes?
-Ischemic (87% of strokes)
-Hemorrhagic (13% of strokes)
What are the TWO treatment choices for a BG less than 40, pt is not alert and oriented, and is NPO
Glucagon and D50
Where are Policies kept?
Policy Tech
When should pain reassessments occur?
Within 60 min of intervention
Name 4 universal fall precautions that are to be utilized on ALL patients at all times
Familiarize with environment
Bed in low position
Brakes locked
Floor surfaces clean/dry
Patient areas clutter free
Follow SPH practices
Educate pt and family on fall precautions
Mercy Hospital Washington is a Level____Stroke Center by Missouri DHSS since 2105
Level III
POC glucose must be checked np greater than _____prior to insulin administration?
No greater than 30 minutes
Where are procedures kept at Mercy?
Dynamic Health by EBSCO
What are the 3 lines of pain medication (categories) for administration?
First Line (initial)
Anticipatory or breakthrough
severe, unrelenting pain (rescue dose)
Name 2 items that may be considered dangerous and must be removed from patients' room when on suicidal precautions
Objects with glass
Sharp or pointed objects (nail files, clippers, razors)
Aerosal, beverage or aluminum cans
Loose medications
Curling irons, blow dryers, electrical devices
Plastic bags
Wire hangers
Cigarette lighters
Dental floss, belts or shoelaces
Name 2 early signs of a heart attack?
Chest discomfort
Discomfort in other areas of the upper body
SOB
other signs (cold sweat, nausea, lightheadedness)
If patient is NPO, which insulin is to be held?
Prandial Insulin (given with meals)
How often are Protocols reviewed?
Every year
When charting pain, what must be documented on for ALL new admissions per JCAHO
Acceptable Comfort Level
How often are safety assessments performed when patient is on suicide precautions?
Who is the STEMI coordinator for Mercy Washington?
Ella Farrar
ella.farrar@mercy.net
Ext: 8637
How often is a patient's blood glucose to be monitored if they are NPO status?
Check blood glucose every 4 hours
This document contains standing orders that have been preapproved by the Medical Executive Committee (MEC) in conjunction with pharmacy and nursing leadership
Protocols
Which pain scale is used in patients with Dementia?
PAINAD (Pain Assessment in Advanced Dementia Scale)
Name 5 alcohol withdrawal symptoms
tremors, nausea, vomiting, loss of appetite, confusion, irritability, mood swings, fever, headaches, heart palpitations, seizures, anxiety, restlessness, confusion, sweating
Assess the patient having a stroke by using B.E.F.A.S.T. What does each letter mean in this assessment?
Balance (loss of balance or coordination)
Eyes (blurred/double vision, loss of vision)
Face (Ask to smile, facial droop noted)
Arms (raise bopth arms, drfiting, weak/numb)
Speech (slurred/garbled speech)
Time (when did symptoms begin, call 911)
According to Hypoglycemia Protocol, 15 gm of carbohydrate is to be given if patient is alert, and BG is less than 70. Give an example of a 15-gm carb choice (per Hypoglycemia Protocol)
4 oz apple juice
6 oz regular white soda
1/2 c regular Jello
A document that outlines a process/practice and serves as a guide for hospital staff
Policies
List the 5 components of a pain assessment
Pain
Intensity
Location
Duration
Aggravating Factors
Name at least 3 steps that must be completed when your patient expresses suicidal ideations.
Initiate safe environment
Call charge RN/supervisor
Contact BH intake department for an assessment
Maintain 1:1 observation with every 15 min "observations" documentation in "BH Safety Rounding" flowsheet