1.These 4 are always

1.These 4 are always UNSTABLE, as these can all

lead to brain death:

Hypoglycemia

HEMORRHAGE

High fever over 105 F Pulseless or breathless 2.Do not delegate these to the family

Safety responsibilities: the

family can only do what you teach them to do • Document your teachings!!!!!!!

3.Examples of prioritization questions are ones that start with All four call lights are on, who to see first • Disaster/mass casualty, who to discharge • RN/LPN/AP tasks • New graduate nurse 4.How do you intervene with inappropriate behavior of the staff? 4 options Tell supervisor Confront them and take over Counsel them later on Ignore it is ALWAYS

WRONG!!!!!!

5.In what situation will the ABC's not apply in prioritization?Acute beats chronic 6.Is this behavior legal, harmless, but still inappropriate?If so, counsel them later 7.Is what they are doing illegal?If so, tell the supervisor. If not, next question 8.Is what they are doing physically or psychologically dangerous to staff or pt?If so, confront and take over, if not, next question 9.PrioritizationDecide which patient is the sickest or the healthiest 10.rule #1 for prioritization? Acute beats chronic 11.Rule #2 prioritization FRESH POST OP (12 hours or less) beats medical or other surgical 12.Rule #3 prioritization UNSTABLE beats Stable 13.Rule #4-Tie breaker for stable vs unstable the more vital the organ, the higher the priority

• Most vital is the brain
• Next is the lungs
• Heart
• Liver
• Kidneys
• Pancreas

Remember: Black Lipstick Has Left Kisses

Passionately 14.Should you prioritize by symptom severity alone No 15.Things that make a pt

STABLE

Use of the word STABLE A CHRONIC illness Post-op MORE than 12 hours old Local or regional anesthesia Unchanged assessment Lab abnormalaties of an A or B (see "lab values" notes) ready for/to be discharge, or admitted longer than 24 hrs ago.

16.Things that make a pt

UNSTABLE

Use of the word UNSTABLE ACUTE illness Post-op LESS than 12 hours old General anesthesia (for the 1st 12 hours) A changed or changing assessment Use of the phrase "newly or just admitted" or "newly diagnosed" Lab values of a C or D (see "lab values" notes) 17.What can you not delegate to an aid (AP, UAP, etc) Charting Assessments (except for VS and accuchecks) Give meds Treatments (except for SSE - soap suds enema) Nurse may delegate ADLs, Beds, Bath, and the 2nd feeding onward 18.what do stable pts experience Stable pts are experiencing the typical expected signs and symptoms of the disease with witch they were diagnosed. and for which they are receiving treatment

- REGARDLESS OF THAT SIGN'S SEVERITY

19.what do unstable pts experience Unstable pts are experiencing unexpected signs and symptoms, complications.Mark Klimek Prioritization, Delegation Study online at quizlet.com/_23r8ge

20.What should you not delegate to an LPN Starting an IV Hanging or mixing IV meds Evaluating ANYTHING!!!Giving IV piggyback meds Giving a blood transfusion Performing an admission, discharge, or transfer assessment Develop a plan of care Take or transcribe orders from an MD Care for an unstable pt Do the first of anything (dressing change, tube feed, vitals, ambulation, etc) 21.what variable do you ignore in prioritization? Diagnosis 22.What variable is very important in prioritization?Modifying phrase 23.When do you prioritize forPrioritize for the "right now" as opposed to the "5 minutes from now"