Quiz 1 Concepts Flashcards
6 interventions for HC Improvement
1) deploy rapid response teams
2) improve care of pts with AMI
3) prevent ADE through med reconciliation
4) prevent central line infections
5) prevent surgical site infections
6) prevent ventilator associated pneumonia
joint commission 2016 national pt safety goals
1) identify pts correctly
2) improve staff communication
3) use medications safely
4) prevent infection
5) identify pt safety risks
6) prevent mistakes in surgery
7) use alarms safely
who is on the rapid response team
critical care nurse, respiratory therapist, critical care physician as back up
what is the role of the rapid response team
- intervene quickly in emergency situations
- follow up on high risk pts
- educate the staff
who is critical to the RRT
bedside nurses because they initiate the call
who can initiate the RRT call
any staff can initiate call if pt exhibits criteria
what is the highest priority of the RRT
BP and O2 status
RRT will initiate what
- ABGs
- initiate pulse ox
- O2 at appropriate level
- ECG
- basic labs
- IV fluids NSS
what is the rapid response criteria
- heart rate > 140 bpm or <40 bpm
- RR >28 or <8
- systolic BP >180 or <90
- O2 sat <90 % with supplementation
- acute change in mental status
- urine output of <50 cc in 4 hrs
- staff member has significant concern
- chest pain unrelieved by nitro
- threatened airway
- seizure
- uncontrolled pain
how long does a typical RR last
30-40 min
what is the most common time that RR are called
nights and at shift change
what units are RR most commonly called on
CV, PCU, surgical and units with new staff
most common reasons for RR
- altered mental state
- SOB
- tachycardia
- staff worried about pt
- hypoxemia
- hypotension
what are the two most common reasons RR are called
rapid deterioration of pt and too much care for the floor setting
what to tell physician about pt
- diagnosis (medical and surgical)
- most recent labs
- meds
what is the most common treatment for RR pt
- IV fluid bolus
- medications changed
- supplemental O2
what diagnostic measures are typically done for RR
-ABG/pulse Ox, cardiac monitor, CBG, EKG, CXR
why are RR called for surgical pts most often
- hypoxia
- decreased BP d/t dehydration
what are the 5 Hs
- hypovolemia (decreased BP, give fluids)
- hypoxemia (O2 stat, give oxygen)
- hyper/hypokalemia
- hypo/hyperglycemia
- hypothermia
what does high and low K cause on the EKG
high K= high T wave
low K= PVCs
what are the 5 Ts
- tables, overdose, sedation, med induced
- tamponade, cardiac
- tension, pneumothorax
- thrombosis, myocardial infarction
- thrombosis, pulmonary
what does SBAR stand for
Situation, Background, Assessment, Recommendation
describe tampondade cardiac
- after open heart surgery
- blood fills up space and stops the heart
- caused by increased pressure in the intrathoracic cavity
how to treat tamponade, cardiac
remove blood from space with needle
describe tension pneumothrorax
air in the lung/ increased pressure in lungs causes lungs to collapse
how to treat tension pneumothorax
chest tube to allow air to escape lungs
what is the key in BOTH tension pneumothorax and tampondade cardiac
relieve pressure
