283 COMP REVIEW
PRIORITY PATIENTS REQUIRING FOLLOW-UP
- New, developed, becomes
- BP change of 20mmHg
- Glucose < 70
- Post-procedures
o ***VERIFY PATIENT ID WHEN COMING BACK FROM PACU!!!***
- Patient who hasnÕt been to doctor in years
- ***BURN PATIENT WITH LOW O2!!!***
SCOPE OF PRACTICE
- UAP:
o Transport
o I+O collection & documentation
o Feedings
o Ambulation
o Positioning
o Vitals AFTER the RN does first set
o Remind but not reteach or demonstrate
- LPN:
o Reinforce teaching
o Reassessments
o ***OBTAIN PAST MEDICAL HX!!!***
o Accuchecks
o Wound vacs
o Dressing changes
o Trach care
- RN:
o Initial assessments (admission, post-op)
o Initial teaching
o Planning of care
o Discharges
o Anything IV
o Blood Products
o ***RN MUST BE THE FIRST PERSON TO GET THE PATIENT UP
AFTER ANY SEDATION TO ENSURE THEY CAN BEAR WEIGHT!!!***
PALLIATIVE CARE
- Symptom management
- Improving quality of care
HOSPICE CARE
- ***NO ANTIBIOTICS!!!***
,***GRIEF STAGES!!!***
- Bargaining: ÒI just want to see my son graduate.Ó
- Acceptance: ÒIÕve lived a good life.Ó
LEGAL/ETHICS
- Battery: physical harm
- Defamation: damaging someoneÕs reputation
o Slander: spoken defamation
o Libel: written defamation
INCIDENT REPORTS
***DO NOT GO IN PATIENT CHARTS!!!***
- Complete for:
o ***MEDICATION ERRORS!!!***
o Adverse reactions
o Falls/injuries
o Lost/stolen items
INFORMED CONSENT
***MUST BE SIGNED BEFORE GIVING ANY MIND-ALTERING MEDICATIONS!!!***
- Before signing, patient ***MUST BE INFORMED OF:
o Risks vs benefits
o Alternative treatments
o Procedures
o Plan of care in laymanÕs terms
- ***PATIENT CAN CHANGE MIND AT ANY TIME!!!***
- ***DOES NOT MEAN THE PATIENT UNDERSTANDS THE PROCEDURE!!!***
o Gives approval to have body touched by specific individual and to have a
specific procedure performed
ADVANCED DIRECTIVES
- ***ON ADMISSION, THE NURSE MUST ASK ABOUT THE STATUS AND
PLACE A COPY IN THE MEDICAL RECORD!!!***
- Provides guidance on healthcare-related decisions if the patient is unable to do
so for themselves
LIVE VACCINES
- MMR
- Varicella
- Flumist
- Rotavirus
***CONTRAINDICATION: LOW WBCs!!!***
, INTERDISCIPLINARY TEAMS
- ***FOR CHRONIC CONDITIONS!!!***:
o Cystic fibrosis
o ParkinsonÕs
o Hip dysplasia at 6mths
- Respiratory
o Inhaler
o Breathing treatments/nebulizer
o Incentive spirometer
- Physical Therapy
o Improving mobility
o Canes, crutches, walkers
- Occupational Therapy
o Improving ADLs (bathing, dressing, feeding)
- Speech Therapy
o Helps with language, communication, and swallowing disorders
§ ***DYSPHAGIA PATIENTS!!!***
- Chaplin
o Spiritual needs
o Advanced directives
ISOLATION PRECAUTIONS
- Airborne: Private room w/ negative pressure; N95; ***KEEP DOOR CLOSED!!!***
o Measles
o ***TUBERCULOSIS!!!***
o Varicella
- Droplet: Private room OR shared room w/ same organism
o Sepsis/Scarlet Fever/Strep
o Pneumonia/***PERTUSSIS!!!***
o ***INFLUENZA!!!***
o Diphtheria
o Epiglottitis
o Rubella
o Mumps/Meningitis
o AN: Adenovirus
***SURGICAL MASK ON PATIENT DURING TRANSPORT!!!***
- Contact: Private room; Don gown and gloves before entering room
o C. diff
o RSV
o Eye infections
o Wound infections
o Skin infections ***SCABIES/LINEAR RASH NEEDS ISOLATION!!!***
PRIORITY PATIENTS REQUIRING FOLLOW-UP
- New, developed, becomes
- BP change of 20mmHg
- Glucose < 70
- Post-procedures
o ***VERIFY PATIENT ID WHEN COMING BACK FROM PACU!!!***
- Patient who hasnÕt been to doctor in years
- ***BURN PATIENT WITH LOW O2!!!***
SCOPE OF PRACTICE
- UAP:
o Transport
o I+O collection & documentation
o Feedings
o Ambulation
o Positioning
o Vitals AFTER the RN does first set
o Remind but not reteach or demonstrate
- LPN:
o Reinforce teaching
o Reassessments
o ***OBTAIN PAST MEDICAL HX!!!***
o Accuchecks
o Wound vacs
o Dressing changes
o Trach care
- RN:
o Initial assessments (admission, post-op)
o Initial teaching
o Planning of care
o Discharges
o Anything IV
o Blood Products
o ***RN MUST BE THE FIRST PERSON TO GET THE PATIENT UP
AFTER ANY SEDATION TO ENSURE THEY CAN BEAR WEIGHT!!!***
PALLIATIVE CARE
- Symptom management
- Improving quality of care
HOSPICE CARE
- ***NO ANTIBIOTICS!!!***
,***GRIEF STAGES!!!***
- Bargaining: ÒI just want to see my son graduate.Ó
- Acceptance: ÒIÕve lived a good life.Ó
LEGAL/ETHICS
- Battery: physical harm
- Defamation: damaging someoneÕs reputation
o Slander: spoken defamation
o Libel: written defamation
INCIDENT REPORTS
***DO NOT GO IN PATIENT CHARTS!!!***
- Complete for:
o ***MEDICATION ERRORS!!!***
o Adverse reactions
o Falls/injuries
o Lost/stolen items
INFORMED CONSENT
***MUST BE SIGNED BEFORE GIVING ANY MIND-ALTERING MEDICATIONS!!!***
- Before signing, patient ***MUST BE INFORMED OF:
o Risks vs benefits
o Alternative treatments
o Procedures
o Plan of care in laymanÕs terms
- ***PATIENT CAN CHANGE MIND AT ANY TIME!!!***
- ***DOES NOT MEAN THE PATIENT UNDERSTANDS THE PROCEDURE!!!***
o Gives approval to have body touched by specific individual and to have a
specific procedure performed
ADVANCED DIRECTIVES
- ***ON ADMISSION, THE NURSE MUST ASK ABOUT THE STATUS AND
PLACE A COPY IN THE MEDICAL RECORD!!!***
- Provides guidance on healthcare-related decisions if the patient is unable to do
so for themselves
LIVE VACCINES
- MMR
- Varicella
- Flumist
- Rotavirus
***CONTRAINDICATION: LOW WBCs!!!***
, INTERDISCIPLINARY TEAMS
- ***FOR CHRONIC CONDITIONS!!!***:
o Cystic fibrosis
o ParkinsonÕs
o Hip dysplasia at 6mths
- Respiratory
o Inhaler
o Breathing treatments/nebulizer
o Incentive spirometer
- Physical Therapy
o Improving mobility
o Canes, crutches, walkers
- Occupational Therapy
o Improving ADLs (bathing, dressing, feeding)
- Speech Therapy
o Helps with language, communication, and swallowing disorders
§ ***DYSPHAGIA PATIENTS!!!***
- Chaplin
o Spiritual needs
o Advanced directives
ISOLATION PRECAUTIONS
- Airborne: Private room w/ negative pressure; N95; ***KEEP DOOR CLOSED!!!***
o Measles
o ***TUBERCULOSIS!!!***
o Varicella
- Droplet: Private room OR shared room w/ same organism
o Sepsis/Scarlet Fever/Strep
o Pneumonia/***PERTUSSIS!!!***
o ***INFLUENZA!!!***
o Diphtheria
o Epiglottitis
o Rubella
o Mumps/Meningitis
o AN: Adenovirus
***SURGICAL MASK ON PATIENT DURING TRANSPORT!!!***
- Contact: Private room; Don gown and gloves before entering room
o C. diff
o RSV
o Eye infections
o Wound infections
o Skin infections ***SCABIES/LINEAR RASH NEEDS ISOLATION!!!***
