Fundamentals~SAFETY

MED SURG~Diagnostics

Nursing Interventions for Diagnostics 

MRI: Ensure there is no metal present such as jewelry, IV pole, portable oxygen tanks, pacemakers or in the body with knee replacement for example, ensure the pt. is not claustrophobic, there will be loud noises during the procedure

Bone Marrow Aspiration: Position is lateral or prone, maintain sterile technique, observe for bleeding, signs of infection, bed rest for 1 hour after the procedure and administer PRN analgesics 

Lumbar Puncture: Assist to sid-lying position with knees to the chest, maintain sterile field, lie flat for 48 hrs, perform neurologic assessment, assess the site for drainage, administer PRN analgesics

Paracentesis: Weigh pt., measure abdomen girth before, assist to fowlers position, limit amount of fluid drained to 1000 mL, assess for signs of shock (hypotension, tachycardia, change in mental status), assess for hemorrhage and abdominal pain, monitor strict I &O 

Thoracentesis: Sitting position leaning forward, limit amount of fluid drained to 1000 mL, position to unaffected side after procedure, monitor vitals, assess puncture site, assess respiratory status and arrange for chest x-ray if ordered

Bronchoscopy: Keep NPO until gag reflex have returned, monitor respiratory status, encourage liquid diet for first 6 hours after procedure, instruct to report abdominal pain 

Cystoscopy: Monitor voiding patterns, inspect for blood clots, frequent dysuria and pink to light red after the procedure is common 

DOSAGE CALCULATION~PARENTAL MEDICATIONS (RECONSTITUTE)

The PCP ordered Methylprednisolone 100 mg IV q8h for 2 doses. 

The label reads...

How much would you give to the pt.? How many vials of medication will you need for one dose? What size syringe will you use? 

⬇

100mg/40mg × 1ml = 2.5 mL (You will need 3 vials of medication to draw up 2.5mL of medication) You will use a 2.5 or 3 mL hypodermic 

The amt. ordered is more than the strength available. You will need more than 1 mL to administer the required dosage. You will need 3 vials of medication to obtain the indicated dose. The total volume per vial is 1.2 mL which contains 40 mg. 

 C., G. M. (2017). CALCULATE WITH CONFIDENCE (Vol. 6th). S.l.: MOSBY.

DOSAGE CALCULATIONS~PARENTAL MEDS

The PCP ordered 0.2 mg of Naloxone IM stat. You have 400mcg/mL available in the medication cart. How much will you give? 

⬇

0.2 mg = 200 mcg 
200 mcg/400 mcg × 1 mL= 0.5 mL 


 C., G. M. (2017). CALCULATE WITH CONFIDENCE (Vol. 6th). S.l.: MOSBY.

DELEGATION NOTES

Your Preceptor has a duty to report you?

According to the Nursing Practice Acts it is mandatory that...

A nurse shall report to the Board in the manner prescribed under Subsection (d) if the nurse has reasonable cause to suspect that

:

(2) the ability of a nursing student to perform the services of the nursing profession would be,or would reasonably be expected to be, impaired by chemical dependency. 

The Steps of Evidence Based Practice.

Step 1: Formulating the question. The researcher converts the need for information about a regulatory problem into an answer- able question. For example, educators might wish to know why they cannot substitute 100% of students’ clinical experiences with simulation. Thus, the researcher might develop the following answerable question: In prelicensure programs, are clinical experiences with actual patients essential for public protection?

Step 2: Identifying and collecting evidence. The researcher search- es and retrieves published results of studies. This step requires a comprehensive review of databases and websites to ensure that all relevant primary studies have been collected.

Step 3: Appraising quality of the evidence. The researcher critically appraises the evidence for its validity and impact, or effect size, and for relevance to the question.

Step 4: Processing data. The researcher extracts and synthesizes the data, integrating them with regulatory expertise and the values of public protection.

Step 5: Disseminating findings. Results are reported to a wider policy community, and best practices are identified.

Step 6: Evaluating effectiveness and efficiency. Continuous quality improvement is conducted in an effort to seek ways to improve steps 1 through 5. 

ncsbn.org