Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

Medical-Surgical Telemetry RN Assessment Content Outline, Exams of Nursing

Medical-Surgical Telemetry RN Assessment Content OutlineMedical-Surgical Telemetry RN Assessment Content OutlineMedical-Surgical Telemetry RN Assessment Content OutlineMedical-Surgical Telemetry RN Assessment Content OutlineMedical-Surgical Telemetry RN Assessment Content Outline

Typology: Exams

2023/2024

Available from 02/17/2024

coursementor
coursementor 🇬🇧

5

(1)

574 documents

1 / 14

Toggle sidebar

Often downloaded together


Related documents


Partial preview of the text

Download Medical-Surgical Telemetry RN Assessment Content Outline and more Exams Nursing in PDF only on Docsity! Page | 1 Medical-Surgical Telemetry RN Assessment Content Outline. Exam Objective To measure the overall clinical knowledge of the Medical-Surgical Telemetry Nurse working in the Acute setting. Knowledge Domains Each question in this assessment is categorized by a cognitive level that the test taker would use to respond. These categories are: Recall: The ability to recall or recognize specific information. Application: The ability to comprehend, relate, or apply knowledge to new or changing situations. Analysis: The ability to analyze and synthesize information, determine solutions, and/or evaluate the usefulness of a solution. Content Outline I. ECG Analysis a. Knowledge of the anatomy and physiology of the cardiovascular system, including but not limited to normal cardiac conduction, SA node, AV node, Purkinje fibers, etc. b. Ability to properly apply, maintain, and troubleshoot ECG monitoring equipment such as electrodes, leads, hardwire monitors, portable monitors, and portable telemetry boxes. Knowledge Domains: Medical- Surgical Telemetry RN ECG Analysis 17% 22% 23% 38% Clinical Assessment and Intervention Critical Thinking and Patient Safety Education and Professional Issues Medical-Surgical Telemetry RN Assessment Content Outline Page | 2 c. Knowledge of the time intervals on a normal ECG paper grid, including but not limited to each small square being 1 mm in length and representing 0.04 seconds, each larger square being 5 mm in length and representing 0.2 seconds. Ability to calculate measurements, time intervals, and heart rates WITH and/or WITHOUT the use of a calculator. d. Knowledge of normal and abnormal heart rates, normal and abnormal components of ECG waveforms, including but not limited to P wave, PR interval, QRS duration, QT interval, and T wave. e. Knowledge of multiple types of cardiac rhythms and ectopy as seen on the ECG, including but not limited to sinus bradycardia, sinus tachycardia, sinus arrhythmia, supraventricular tachycardia (SVT), atrial fibrillation, atrial fibrillation with rapid ventricular response, atrial flutter, premature atrial contractions (PACs), junctional rhythms, first-degree AV block, second- degree AV block type I and type II, third-degree AV block, bundle branch block, premature ventricular contractions (PVCs), idioventricular rhythm, ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, or paced rhythm. f. Ability to recognize lethal and high-risk arrhythmias that require intervention (e.g., atrial fibrillation with rapid ventricular response, supraventricular tachycardia, third-degree heart block, symptomatic bradycardia) and prioritize nursing interventions. II. Clinical Assessment and Intervention a. Knowledge of obtaining information from the medical record to best inform the development of a comprehensive plan of care, including but not limited to patient/family history, current medical complaints/concerns; sensory, mobility, and functional status; diagnoses; surgical history; allergies, vaccinations, home medications (including supplements and OTC meds), and presence of advance directives. b. Ability to perform comprehensive head-to-toe physical assessments and focused assessments when indicated using nursing skills (e.g., observation, interview, inspection, auscultation, palpation, percussion) and necessary equipment (e.g., stethoscope, pulse oximeter, ECG monitoring). c. Knowledge of normal and abnormal physical assessment findings. Knowledge of normal and abnormal vital sign values (e.g., blood pressure, pulse, respirations, temperature) while considering age, medical condition, pharmacology, etc., and interventions to treat abnormalities. Knowledge of common nursing interventions used to treat abnormal assessment findings (e.g., raising the head of bed during periods of dyspnea Medical-Surgical Telemetry RN Assessment Content Outline Page | 5 when indicated per order and assess for complications. k. Knowledge of surgical drains commonly seen in the med/surg unit (e.g., Hemovac®, Wound Vac®, Jackson-Pratt®, penrose) including the ability to assess, manage, apply suction (when indicated), evaluate effectiveness, perform site care, and when to call the provider for abnormal assessment Medical-Surgical Telemetry RN Assessment Content Outline Page | 6 findings. l. Ability to care for various types of wounds (e.g., surgical, pressure, venous/arterial insufficiency), including but not limited to assessment (e.g., size, color, drainage, presence of infection), prevention (e.g., pressure relief, ointments, reduction of friction/moisture), treatment (e.g., debridement, topical products, dressing changes), documentation, and consulting a specialist or the provider when warranted. m. Knowledge of peripheral IV management, including but not limited to proper insertion technique, complications and treatment (e.g., erythema, infiltration, leaking, tenderness, infection), site rotation, maintenance and care, tubing changes, common IV solutions, high-risk or contraindicated peripheral infusions (vesicants, TPN), and resources to verify compatibility. n. Knowledge of various types of central venous catheters (e.g., PICC, temporary, implanted ports, hemodialysis catheters), including indications, characteristics, maintenance (e.g., cleansing, flushing technique and frequency), dressing changes (e.g., technique, frequency), complications (e.g., infection, thrombosis), tubing changes, accessing, discontinuation, and safety (e.g., avoid BP cuffs near a PICC line). o. Ability to assess pain using tools and techniques such as physical assessment (e.g., respiratory status, behavior, blood pressure), interviews (e.g., location, type, onset, radiation, and intensity) and pain scales (e.g., numeric pain scales, Wong-Baker faces scale, PAINAD). Knowledge of behavioral and physical signs and symptoms associated with pain, including grimacing, moaning, groaning, crying, restlessness, agitation, guarding, labored breathing, disrupted sleep patterns, increased respiratory rate, and increased blood pressure. p. Knowledge of common pain medications used in the medical- surgical setting, including indications, contraindications, dosages, routes, expected outcomes, and potential adverse effects. Knowledge of non-pharmacologic modalities for managing pain, including but not limited to heat therapy, repositioning, environmental modifications, and relaxation techniques. q. Ability to perform basic mathematical calculations such as addition, subtraction, multiplication, and division, in order to calculate measurements, time intervals, heart rates, etc. WITH and/or WITHOUT the use of a calculator to ensure correct dosage, IV drip rates, IV flow rates, etc. Knowledge of how to determine timed intervals, including the ability to calculate start and stop times, and the ability to tell standard and military time. r. Knowledge of various medications commonly administered in the medical- surgical setting, including classification, indications and Medical-Surgical Telemetry RN Assessment Content Outline Page | 7 actions, side effects, adverse reactions, and when they are contraindicated. Knowledge of high- risk/high-alert medications (e.g., anticoagulants, insulin, opioids, epidural infusions, look-alike sound-alike drugs, etc.) and how to minimize the risk of error or adverse events (e.g., independent double-checks, addressing clinical warning alerts, dosing charts, etc.). Medical-Surgical Telemetry RN Assessment Content Outline Page | 10 including laboratory (e.g., hematology, chemistry, microbiology, pathology), radiology (e.g., X-ray, CT, MRI, US, nuclear medicine), and cardiovascular diagnostics (e.g., ECG, ECHO, stress tests). c. Ability to identify those at risk for nutritional deficiencies such as patients with tube-feedings, TPN, lipids, altered GI status, or other problems that may warrant the need for consultation with a dietitian, and when to initiate such referrals. d. Ability to formulate an effective and holistic nursing plan of care including but not limited to initiating, maintain, and revising the plan of care, addressing individual patient preferences, physical assessment findings, patient history, input from the patient and family (shared decision-making), and cultural and religious preferences. e. Knowledge of patient identifiers and the type of information used to verify identity prior to each procedure, medication administration, etc., including how to verify in populations who are non-verbal or cognitively impaired. f. Knowledge of actual and potential safety issues and precautions related to patient care, including knowledge of how to implement nursing interventions related to each issue (e.g., fall precautions/prevention, bleeding precautions, aspiration precautions, seizure precautions, medication administration, suicide precautions, elopement precautions, hospital-acquired conditions [e.g., pressure injury, C-diff, CAUTI, CLABSI, SSI]). g. Knowledge of proper ergonomic principles and equipment use when providing care and when to use additional clinicians and/or devices to assist in patient mobility such as gait belts, mechanical lifts, transfer sheets, walkers, etc. h. Knowledge of principles and implementation of infection control to decrease the risk of spread of infection and communicable diseases, including hand hygiene, isolation precautions (e.g., standard, droplet, contact, airborne), proper use of personal protective equipment, etc. Knowledge of hazardous materials, including how to handle and properly dispose of hazardous materials such as blood, body fluids, and soiled linens. i. Knowledge of how to safely and effectively operate, troubleshoot, and locate resources for equipment common in the medical- surgical setting (e.g., IV pumps, PCA pumps, suction equipment, oxygen devices and tanks, pulse oximeters, incentive spirometers, feeding pumps, sequential compression devices [SCDs], drainage systems, glucometers, urinary catheters, ostomy equipment, dressing change materials, bladder scanners, non-invasive blood pressure cuffs, remote cardiac monitors, specialty beds, patient transfer devices). Knowledge of alarm systems used with medical equipment, such as programming, significance, when to respond, Medical-Surgical Telemetry RN Assessment Content Outline Page | 11 and how to address or resolve them (e.g., IV pump alarms, wound vac alarms, SCD alarms). j. Knowledge of physical restraint devices including indications, order requirements (i.e., violent vs. non-violent, initial, renewal, timeframe), appropriate device selection based on patient need (e.g., mittens, wrist, lap Medical-Surgical Telemetry RN Assessment Content Outline Page | 12 belt, etc.), correct application, required assessment and interventions when in use, and necessary documentation per hospital policy/procedure. k. Knowledge of pre-op checklists and patient preparation for procedures and/or diagnostic tests (e.g., educating the patient, obstructive sleep apnea risk screening, anti-microbial bath, diet/NPO status, confirmation of allergies, IV gauge size and location, bowel prep, hair removal, medications to be given/held, prophylactic VTE equipment, MRI screening form). Knowledge of Universal Protocol requirements (i.e., 'time-out': Correct patient, site, procedure) and documentation. Knowledge of the informed consent process, including the provider’s and nurse’s roles, information to be covered, and how and when to obtain. IV. Education and Professional Issues a. Knowledge of techniques for assessing educational needs of the patient and family to achieve goals in the plan of care and provide patient- and family- centered care. b. Ability to provide education to the patient and family on various topics including but not limited to disease processes, medications, therapies, procedures, safety and preventive measures, nutrition, lifestyle, healthy coping mechanisms, and comfort options. c. Knowledge of evidence-based techniques for planning and delivering education based on patient learning styles (e.g., written materials, demonstration, auditory), preferences (e.g., language, time of day/week, presence of family members or caregivers), and needs (e.g., avoiding use of medical language and jargon, hearing and vision assistive devices, moderating educational level). d. Knowledge of teach-back techniques to deliver and assess patient and family understanding of information provided on various health-related topics. Ability to use written and verbal information that is appropriate to the patient’s literacy level and knowledge of where to obtain educational material. e. Knowledge of the roles of other disciplines on the healthcare team and when to communicate with them, including but not limited to physicians, case managers, pharmacists, pain specialist, RT, PT, OT, SLP, wound care clinicians, social workers, dietitians, and spiritual counselors or ministers. This includes identifying information to report to ensure continuity across disciplines and provide coordinated care to maximize patient outcomes and satisfaction. f. Knowledge of components of effective patient handoffs of care and best practices for performing written and verbal handoffs across the continuum of care (e.g., next shift, critical care, OR, radiology,