prioritization/delegation Flashcards
1
Q
question format for priority question
A
age, gender, modifying phrase
- dx and modifying phrase are important but the modifying phrase is more important
2
Q
prioritization
A
- acute > chronic
- 1st 12 hours post op beats medical or other surgical
- unstable > stable
3
Q
stable pt
A
- greater than 12 hours post op
- local or regional anesthesia
- unchanged assessment
- lab abnormalities of A or B level
- admitted longer than 24 hours ago
4
Q
unstable pt
A
- general anesthesia
- changing assessment
- post op less than 12 hours
-lab abnormalities of C or D - admitted less than 24 hours
5
Q
always unstable regardless if its expected or not
A
- hemorrhage
- high fevers (105 +)
- hypoglycemia
- pulselessness or breathless: unless it was unwitnessed because they are dead already and not a priority
6
Q
black tags in an unwitnessed accident
A
- low priority!!!
- pulseless
- breathless
- fixed and dilated pupils (even if still breathing)
7
Q
if still stuck: tie breaker
A
- only use as a tie breaker
- the more vital the organ the higher the priority (the organ in the modifying phrase not dx)
#1 = brain
#2 = lungs
#3 = heart
#4 = liver
#5 = kidney
# 6 = pancreas
8
Q
what to not delegate
A
- what you eat
- Evaluate
- Assess
- Teach
9
Q
LPN do not delegate
A
- starting/hanging/mixing anything IV
- NO IVP meds
- blood administration
- messing with central lines
- plan or create the care plan But they can implement it
- cant perform or develop teaching but they can reinforce it
- unstable pt
- first anything
- admission/dc/transfer/first assessment after a change
10
Q
what you can delegate to a UAP
A
- topical OTC barrier creams
- vitals
- accucheck (glucose)
- enema
- ADLS (not the first one and only one stable pt)
*catheterize if there is nothing else they can do
11
Q
what UAP cant do
A
- chart about the pt (besides what they did)
- give meds
- assess
- treat
-delegate to the family of the patient
12
Q
sitters/caregivers
A
- can only do what you teach them to do and you must make sure you document that you taught them
13
Q
how do you handle inappropriate staff behavior
A
- is the pt in immediate danger: if so, confront and interviene. if no, approach them later
- is what they are doing illegal? if yes, always tell the supervisor
14
Q
if action is harmful or illegal
A
- confront now then tell the supervisor
15
Q
psych questions
A
- great answer is always establish a trusting relationship or the nurse will examine their ow feelings about…
16
Q
nutrition
A
- pick chicken (unless fried)
- pick fish (not shellfish) second
- never pick casseroles for children
- never mix meds in children food
- finger foods for toddlers
17
Q
drugs
A
- if you know what a drug does, pick a side effect in the same body system where the drug is working
- if PO pick GI side effect
- never tell child medicine is candy
18
Q
OB
A
- check fetal HR
19
Q
med surg
A
- LOC over airway on assessments but the first thing you should do is establish an airway
20
Q
pediatric growth and development
A
- always give the child more time dont rush their growth
1. when in doubt call it normal
2. when in doubt pick the older age (if there is two ages it could be pick the older one)
3. when in doubt pick the easier task (roll over is easier than sitting up)
21
Q
generalized absolutes
A
- rule them out
- all, never, always, everyone
22
Q
if two answers are the same
A
- neither of them are right
23
Q
if two answers are opposite
A
- one of them is probably right
24
Q
umbrella strategy
A
- look for an answer that covers all the others without saying it
25
Q
never pick infection when
A
- in the first 72 hours of anything
26
Q
where do you find aortic
A
- 2nd intercostal space @ r sternal boarder
27
Q
pulmonic
A
- 3rd intercostal space @ L sternal boarder
28
Q
tricuspid
A
- 4th intercostal space @ L sternal boarder
29
Q
mitral
A
- 5th intercostal space @ midclavicular
- also called apical or point of maximal impulse
