Mark K Lecture #12

you are determining what?

what patient is the sickest/healthiest

when you prioritize

get rid of age/gender

most important part of a priority question

modifying phrase

4 rules for priority questions

1. acute beats chronic

2. fresh post-op beats medical/any other surgical

3. unstable beats stable

4. the more vital organ is priority (tie breaking)

stable words in an answer

the word stable

chronic illness

post op > 12 hours

local/regional anthesia

lab abnormalities level A/B

ready to be discharged

admitted > 24 hours ago

unchanged assessments

typical signs/symptoms

unstable words in an answer

the word unstable

acute illness

post op < 12 hours

general anthesia

lab abnormalities level C/D

newly admitted/diagnosed

not ready to be discharged

admitted < 24 hours ago

changed assessment

unexpected signs/symptoms

4 things that are always unstable

1. high fever (105)

2. hemorrhage

3. pulselessness/breathlessness

4. hypogylcemic

organ importance

1. brain

2. lungs

3. heart

4. liver

5. kidney

6. pancreas

do not delegate to an LPN

starting an IV

mix/hanging IV meds

pushing IV meds

administer blood

mess with central line

plan care

perform/develop teaching

take care of unstable PT

do the first of anything

following assessments after

-transfer

-admission

-discharge

-1st after a change

do not delegate to a UAP

charting (about a pt)

give meds (except topical OTC barrier cream)

assessments (except vitals/acu checks)

treatments (except enemas)

you can delegate to UAP

ADL's just not the first time

do not delegate safety responsibilities to family members

they can do what you teach them to do

document the teaching

how do you intervene inappropriate behavior between staff?

1. tell supervisor

2. confront it/take over

3. @ a later date, talk to them

4. ignore it > never the answer

is it illegal?

tell supervisor

is someone being harmed/in danger?

confront them, take over

is it simply inappropriate?

@ at later date, talk to them