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Interventional Orders 170 > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

Who is the administrative dietitian?

A

the director of the dietary department

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2
Q

what duties are included in the administrative dietitian ?

A
  1. overseeing operation of department
  2. purchasing food
  3. handling admin duties
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3
Q

what does the therapeutic dietitian do? (3)

A
  1. prepares menus for patients
  2. visits patients if requested
  3. provides teaching of special diets to pts and family
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4
Q

When is the cut off time for lunch trays?

A

1000

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5
Q

when is the cut off time for breakfast trays?

A

0600

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6
Q

when is the cut off time for dinner trays?

A

1500

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7
Q

when are evening snacks delivered?

A

2000

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8
Q

if an order is changed BEFORE a mean time cut off we do not have to call down to FNS? T/F

A

true

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9
Q

if a diet order has been changed and its after the meal cut off time we need to call FNS?

A

yes

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10
Q

what are the functions of the FNS department? (3)

A
  1. planning diets for pts and employees
  2. preparing and serving food
  3. preparing diet as per BC diet manual
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11
Q

who are the 5 staff members of the kitchen?

A
  1. dietitian
  2. food service supervisor
  3. food service worker
  4. cooks
  5. dishwasher
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12
Q

what are the hours of of FNS?

A

0600 - 1900

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13
Q

what are the 4 methods of feeding a patient?

A
  1. ingestion - by mouth
  2. NG tube
  3. Gastrotomy tube feeding
  4. TPN
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14
Q

what is a NG tube (nasogastric tube insertion)

A

soft rubber/plastic tube that extends from nose to stomach

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15
Q

why is an NG tube used?

A

to withdraw contents of the stomach for analysis / inserted for tube feeding

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16
Q

who performs a NG tube insertion?

A
  1. doctor

2. nurse

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17
Q

the doctor orders the patients diet to coincide with their condition? T/F

A

true

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18
Q

what are the 2 main categories for diet orders?

A
  1. standrad diet/ DAT

2. therapeutic diets

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19
Q

what is a therapeutic diet?

A

a diet with modifications or restrictions

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20
Q

a nurse/doctor will tell you which texture diet to order? T/F

A

true

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21
Q

the texture of food may be increased as the patient is able to tolerate more food?

A

true

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22
Q

what are examples of diet textures? (4)

A
  1. Normal
  2. digestive light
  3. clear fluids
  4. full fluids
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23
Q

what is a normal texture diet?

A

regular texture

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24
Q

what is a digestive light texture diet?

A

easily digested foods - small portions

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25
Q

what is a clear fluids texture diet?

A

only liquids (coffee, tea, juices, broths)

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26
Q

what is a full fluids texture diet?

A

liquified food at room temp - easily digested

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27
Q

list 5 therapeutic diets

A
  1. calorie count
  2. diabetic calorie count
  3. gluten free
  4. bland diet
  5. digestive soft
  6. tube feeding
  7. heart healthy
  8. pediatric diet
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28
Q

what is a calorie count diet?

A

for patients who can only have a few calories

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29
Q

what is a diabetic calorie count diet?

A

for diabetic patients

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30
Q

what is a gluten free diet?

A

for celiac disease

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31
Q

what is a bland diet?

A

eliminates spicy food

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32
Q

what is a digestive soft diet?

A

restricted to fiber - post op patients

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33
Q

what is a heart healthy diet?

A

cardiac history / low sodium

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34
Q

what is a paediatric diet?

A

for patients 0-6 years

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35
Q

you must always order and diet texture and type? T/F

A

true

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36
Q

name the 5 miscellaneous diets orders

A
  1. hold trays/NPO
  2. fluid restriction
  3. push or force fluids
  4. calorie count
  5. natural laxatives
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37
Q

what is a bag lunch for?

A

patients leaving the hospital for apt. etc

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38
Q

what are the NUAs responsibilities for diet orders?

A
  1. enter into comp
  2. kardex under diet
  3. symbolize EC and K
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39
Q

what are the NUA duties for “hold trays”

A
  1. enter into comp

2. kardex

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40
Q

when a patient is put on a fluid restriction diet, what should we add to the nursing chart?

A

fluid balance record

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41
Q

what does FNS stand for?

A

food and nutrition services

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42
Q

what is TPN used for?

A

pts who can’t or should not get their nutrition through eating

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43
Q

what does NG stand for?

A

nasogastric

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44
Q

when phoning FNS you must have what information? (3)

A
  1. pts name
  2. room number
  3. which ward
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45
Q

all wards stock what types of nourishments? (5)

A
  1. jam
  2. cream
  3. sugar
  4. juice
  5. crackers
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46
Q

who is responsible for stocking the ward with nourishments ?

A

kitchen staff

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47
Q

the NUA is in charge of making all diet changes? T/F

A

true

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48
Q

what are 5 common categories found on admit orders?

A
  1. diet
  2. activity
  3. diagnosis
  4. vital signs
  5. medications
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49
Q

what are the 10 unit clerk responsibilities for surgical admission

A
  1. greet patient
  2. follow regular admit routine
  3. if pt. already admitted check if they have had all pre-op tests
  4. put chart together
  5. put pre-op check list onto chart for nurse
  6. leave MAR in front of chart & have labels
  7. have old chart
  8. OR will call for patient when ready
  9. OR will call porter to get patient
  10. double check chart to make sure its ready
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50
Q

the patients activity order is ordered by who?

A

doctor

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51
Q

what does BRP stand for?

A

bed rest w/ bathroom privileges

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52
Q

name the 8 types of activity orders

A
  1. CBR
  2. BW w/ commode
  3. BR w. BRP
  4. Dangle
  5. Up in chair
  6. Walk w/ resistance
  7. ambulate
  8. AAT
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53
Q

define dangle

A

pt sits at edge of bed and dangles over the side

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54
Q

define AAT

A

patient has no restrictions

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55
Q

define BR with commode

A

patient may use the commode at the bed side

56
Q

what are the 4 advancing stages of ambulation?

A
  1. dangle
  2. up in chair
  3. walk with assistance
  4. AAT
57
Q

where do you record the activity orders?

A

under mobility on kardex

58
Q

NUAs duties for Activity orders?

A
  1. enter into comp (enter physio referral if specified)
  2. kardex
  3. symbolize
59
Q

define walk w resistance

A

physio/nurse will assist the patient with walking

60
Q

define up in chair

A

pt sits beside their bed for a certain amount of time

61
Q

define BR w BRP

A

bed rest with bathroom privileges

62
Q

define CBR

A

patient remains in bed at all times

63
Q

why does a doctor order vital signs?

A

to help diagnose patients disease and determine progress

64
Q

what do vital signs consist of?

A
  1. temperature
  2. pulse
  3. respiration rate
  4. blood pressure
65
Q

what is the normal range of human body temperature?

A

97F to 99F

66
Q

where can the pulse be taken from?

A
  1. radial artery
  2. carotoid artery
  3. femoral artery
  4. perdal artery
  5. apex
67
Q

define apex

A

taken over the heart with a stethoscope

68
Q

how is respiration rate taken?

A

watching patients chest rise and fall or listening by stethoscope

69
Q

define systole

A

top number and it records the heart at work or contracting

70
Q

define diastole

A

bottom number and it records the heart at rest

71
Q

name examples of how vital signs may be ordered

A
  1. VSR
  2. VS TID
  3. Check BP q15 min x 2h
  4. Temp qH, notify MD if T>38.5C
72
Q

NUA duties for Vital Signs

A
  1. Kardex in Vital signs section
  2. Symbolize
  3. if order changes, erase off kardex and replace with new order
73
Q

what does an adults heart rate/pulse range from?

A

70 - 82 BPM

74
Q

what does a childs heart rate/pulse range from?

A

80 - 150 BPM

75
Q

what does a adults respiration rate range from?

A

15-20 RPM

76
Q

what does a childs respiration rate range from?

A

12 - 60 RPM

77
Q

what is the usual blood pressure of an adult?

A

120/80

78
Q

what is a child’s blood pressure?

A

8o + 2x = systolic and 6o - 8o is the diastolic

79
Q

define systole

A

top number, records the heart at work or contracting

80
Q

define diastole

A

bottom number, records the heart at rest

81
Q

NVS are commonly ordered as?

A

NVS q2h, q4h, etc

82
Q

NUA duties with NVS orders

A
  1. kardex
  2. symbolize
  3. if changed/cancelled we erase off kardex and update newest order
83
Q

what are common pre-op orders?

A
  1. diet
  2. meds
  3. lab orders
  4. IV therapy
  5. skin prep
  6. bowel prep
  7. urinary cath
84
Q

a consent form must be what?(4)

A
  1. witnessed
  2. signed
  3. dated
  4. time
85
Q

unit clerks are allowed to witness consent forms. T/F

A

false

86
Q

if patient is unable to sign consent, who can sign?

A
  1. parents
  2. siblings
  3. son, daughter
87
Q

what happens in an emergency situation with consent forms

A

doctor will sign “need for emergency surgery or procedures” form

88
Q

who orders pre-op meds?

A

anesthetist

89
Q

when does the anesthetist see the patient, and what for?

A

before surgery to determine type of anesthetic needed

90
Q

the anesthetist will routinely order the following types of drugs: (3)

A
  1. anti-anxiety
  2. antic nausea
  3. antibiotics
91
Q

does the NUA mar pre-op orders?

A

yes, and any specifics

92
Q

what type of test is done prior to surgery? (blood replacement)

A

type and crossmatch test

93
Q

why is a type and crossmatch test preformed before surgery?

A

incase there is blood loss during surgery

94
Q

why is skin prep done before surgery?

A

prevent contamination

95
Q

who performs skin prep?

A

nurse

96
Q

if a doctor write an order for skin prep what does the NUA do?

A

kardex and symbolize

97
Q

why is bowel prep ordered?

A

prevent contamination and prevent blocking the surgeons view of the abdominal organs

98
Q

if a doctor orders bowel prep what does he NUA do?

A

MAR the order and symbolize

99
Q

what is a catheter ?

A

tube inserted into a body cavity/vessel

100
Q

what do catheters allow?

A

drainage of fluids

101
Q

what are 3 common catheter orders?

A
  1. foley cath to straight drainage
  2. CBI until clear
  3. foley prn
102
Q

if the doctor orders a catheter the NUA does what?

A

kardex and symbolize

103
Q

what is an OR slate?

A

schedule of all the surgeries being done the next day

104
Q

what does the NUA do with OR slate?

A

highlight the patients scheduled for surgery on their unit

105
Q

Additional NUA duties for Pre-op patients

A
  1. have chart prepared and pre-op orders are complete
  2. on day of surgery check chart for completion
  3. morning of surgery check any new reports have been filed
  4. OR will call when sending for pt. inform RN asap
106
Q

after surgery where is the pt transferred?

A

to PAR (post anesthetic recovery room)

107
Q

how long will the pt spend in PAR?

A

approx. 1-3 hours

108
Q

in PAR the pt is assigned to a nurse, what will that nurse do after seeing the pt.

A

call the unit and ask when the best time to send them is

109
Q

NUAs duties for post-op orders

A
  1. return old chart and thinned
  2. file forms and papers from PAR
  3. record date, time, surgery on kardex (if not already done)
  4. process post-op orders (if not already done)
110
Q

what are examples of some forms we may find once pt is back from PAR? (6)

A
  1. consent
  2. OR checklist
  3. OR record
  4. PAR record
  5. Record of surgical anesthesia
  6. surgical procedures performed
111
Q

All pre-op orders that were written prior to surgery are automatically discontinued and replaced by post-op orders. T/F?

A

true

112
Q

what is PCA (patient controlled analgesia)

A

drug delivery system that gives a preset dose of analgesia when the patient pushes the button. (pain relief system where a pts. pushes a button)

113
Q

what are the 2 types of PCA?

A
  1. intravenous PCA

2. Epidural PCA

114
Q

what is intravenous PCA?

A

small tube in your arm - pain meds are delivered to your body via your veins

115
Q

what us epidural PCA

A

small tube in your back - pain meds are delivered near the nerves in your back

116
Q

there are 2 functions of the PCA pump to ensure you don’t over medicate yourself. what are they?

A
  1. safety timer called a lockout

2. limit to how much pain meds you cab receive in 48 hours

117
Q

what are PCA pumps used for?

A

when a pt can’t take meds orally

118
Q

the anesthetist will write an order when to stop PCA? T/F

A

true

119
Q

what is the NUA duties when the anesthetist write a order to stop PCA?

A
  1. enter into comp

2. MAR

120
Q

who orders “monitor I&O” ?

A

doctor

121
Q

what does “monitor I&O” mean?

A

the pts fluid intake and output are to be estimated and recorded throughout the nurses shift

122
Q

dressing are used to?

A

protect surgical incisions/wounds

123
Q

dressings are applied by?

A
  1. doctor

2. nurse and examined by the nurse regularly

124
Q

for an ostomy nurse to see a patient the doctor must do what?

A

write an order - and the NUA enters it into medi-tech

125
Q

what are examples of wound/skin treatment orders (3)

A
  1. remove staples
  2. change dressing
  3. saline soaked dressings to leg ulcer q6h while awake
126
Q

a telephone consent can be accepted in an emergency situation if what? (2)

A
  1. heard by 2 people

2. both people sign consent

127
Q

Mr. Green is on the OR slate for surgery today, what are our duties?

A
  1. file any diagnostic reports
  2. get old/thinned chart
  3. have chart and MAR ready
  4. double check chart
  5. OR porter will come get pt
128
Q

when the OR calls to tell us they are calling for a patient, what do we need to do?

A
  1. inform nurse

2. have chart and MAR ready

129
Q

when the OR slate prints, what do we do with it?

A

highlight pts on our unit

130
Q

how do we indicate in medi-tech that a pt wants extra gravy with their meals?

A

under clinical data in diet info

131
Q

it is 1600 and Mr. green’s surgery has been cancelled, the nurse asks us to ensure he gets a dinner tray, what do we do?

A

call FNS and ask them to bring us a tray

132
Q

list the activity orders from most confined to least restrained

A
  1. CBR
  2. BR w commode
  3. BR w BRP
  4. Dangle
  5. Up in chair
  6. Walk w assistance
  7. Ambulate
  8. AAT
133
Q

dr. asks you to print off the pts last urinalysis, how do you do this? (3)

A
  1. click lab
  2. click which report
  3. print
134
Q

how do you print a census report from Medi-Tech? (5)

A
  1. click reports
  2. inpatient
  3. nursing unit bed roster
  4. select location
  5. print
135
Q

define afebrile

A

no fever

136
Q

define febrile

A

fever

Interventional Orders 170 (6 decks)

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