Prioritization and Delegation in Nursing, Exams of Nursing

Download Prioritization and Delegation in Nursing and more Exams Nursing in PDF only on Docsity! Mark Klimek - Prioritization/Delegation 2023 Prioritization questions will always have: -Age -Gender -Diagnosis -Modifying Phrase What is important? - correct answer IGNORE age/gender Most important = modifying phrase Angina Pectoris vs Myocardial Infarction - who is higher priority? - correct answer MI Angina Pectoris with unstable BP vs Myocardial Infarction with stable vital signs - who is higher priority? - correct answer Angina pectoris with unstable BP (modifying phrase more important) *4 rules for prioritization* - correct answer 1. acute > chronic 2. fresh postop (first 12 hrs) > medical or other surgical 3. Unstable > stable Mark Klimek - Prioritization/Delegation 2023 4. More vital the organ, the higher the priority (organ of the modifying phrase) (only use this as a tie-breaker) What is the tie-breaker used for prioritization questions? - correct answer More vital the organ, the higher the priority Vital Organs - order - correct answer Brain Lung Heart Liver Kidney Pancreas Who is the priority? COPD CHF Appendicitis - correct answer Appendicitis (acute) Who is the priority? COPD Mark Klimek - Prioritization/Delegation 2023 -Experiencing the typical expected signs/symptoms with which they were diagnosed Stable or Unstable: Kidney stones with severe colicky pain - correct answer STABLE because expected sign Stable or Unstable: Mild pain while having a chest x-ray - correct answer UNSTABLE because unexpected sign Who is the highest priority patient? 1. 16 yr-old female with meningitis who has had a temp of 103.8 since admission 3 days ago 2. 67 yr-old male with IBS who spiked a temp of 100.3 this afternoon - correct answer 2. 67 yr-old male with IBS who spiked a temp of 100.3 this afternoon BECAUSE...A patient with Meningitis is expected to have a fever. A patient with IBS who recently developed a fever is an unexpected and new symptom. Always high priority (5) - correct answer Hemorrhage Mark Klimek - Prioritization/Delegation 2023 Fever >105 (seizures) Hypoglycemia (<70) Pulseless Breathlessness Black tag (triage) - correct answer Pulselessness Breathlessness Fixed and dilated pupils LPNs can NOT: - correct answer -Starting an IV -Hang or mix IV meds -IV push meds -Administer blood -Central lines (no flushing, dressing changes, etc) -Care plans -Perform or develop teaching -Take care of unstable patients -Cannot do the 1st of anything (1st assessment, 1st post-op dressing, 1st feeding after stroke, etc) -Admission, discharge, transfer, first assessment after a change Mark Klimek - Prioritization/Delegation 2023 LPNs can: - correct answer -Maintain and document IV flow -Reinforce teaching - UAP's can NOT: - correct answer -Chart about the patient -Give meds (except topic OTC barrier creams) -Do assessments or treatments (except enema's) -Be cautious with catheters* UAP's can: - correct answer -Vitals -Accu-checks -Enemas -ADLs (but they should never do the first) UAP's can give what meds? - correct answer Topical, over-the-counter, barrier creams DO NOT delegate what you can EAT! - correct answer E - evaluate A - assess T - teach Mark Klimek - Prioritization/Delegation 2023 -Never mix medications in food without permission -Toddlers = finger food (hot dogs and french fries, even though its not healthy) Pharmacology: -Memorize side effects ***-You know what a drug does but don't know the side effects --> pick a side effect in the same body system that a drug is working*** examples: -GI drug --> pick diarrhea -Heart drug --> pick tachycardia -CNS drug --> pick drowsiness -If it's PO --> pick a GI side effect NEVER tell a child that medicine is - correct answer candy MedSurg - what is the first thing you assess? - correct answer Level of Consciousness OB question - what do you pick when you don't know the answer? - correct answer Check Fetal Heart Rate Mark Klimek - Prioritization/Delegation 2023 What is the first thing you do in a Medsurg situation? - correct answer Establish an airway 3 rules of growth and development questions (always give child more time to grow, dont rush it) - correct answer 1. When in doubt, call it normal 2. When in doubt, pick the older age 3. When in doubt, pick the easier task General guessing skills - correct answer 1. Rule out absolutes 2. If two answers say the same thing, both are wrong 3. If two answers are opposite, one of them is probably right 4. Umbrella --> which answer is more global? An answer that is very broad and covers everything else 5. Always think, what is the WORST that can happen? Post-hip replacement. What is most important to do? -Sips of water -Put side rails up --> Because if you didn't do it, then you could break your hip again, etc -give pain meds -use abductor pillow Mark Klimek - Prioritization/Delegation 2023 ***Sesame street rule: only when NO other way. Right answer tends to be ____ than others. Wrong answers are similar. When something really ____ right it probably is- go with your gut - correct answer Right answers tend to be DIFFERENT than the others. Wrong answers are similar. When something really feels right it probably is. GO WITH YOUR GUT. ***Countertransference - correct answer Refers to the nurse's behavioral and emotional response to the client Transference - correct answer the patient's transfer to the analyst of emotions linked with other relationships The first 10 questions... - correct answer USE COMMON SENSE!!! NEVER have these expectations: - correct answer 1. Don't expect 75 questions 2. Don't expect to know everything 3. Don't expect everything to go right