Bedside nursing

Shafqat et al. ° previously validated the National Institutes of Health Stroke Scale (NIHSS) assessment as a reliable method of evaluating patients with stroke symptoms at a bandwidth of 384 kbit/s comparing a bedside neurologist to a telemedicine-enabled neurologist teamed with a bedside nurse in patients with ischemic stroke and NIHSS scores ranging from 1 to 24. There was an excellent correlation between bedside and remote scores (inter-rater correlation coefficient... 

Registered dietitian performs initial and follow-up clinical assessments and labOTattny tests, sets goals for nutritional mode and content modified for comorbidities Bedside nursing... 

DIARRHEA. When these dragp are used orally they occasionally result in excessive salivation, abdominal cramping, flatus, and sometimes diarrhea The patient is informed that these reactions will continue until tolerance develops, usually within a few weeks. Until tolerance develops, the nurse ensures that proper facilities, such as a bedside commode, bedpan, or bathroom, are readily available. The patient is encouraged to ambulate to assist the passing of flatus. If needed, a rectal tube may be used to assist in the passing of flatus. The nurse keeps a record of the fluid intake and output and tlie number, consistency, and frequency of stools if diarrhea is present. The primary health care provider is informed if diarrhea is excessive because this may be an indication of toxicity. 

The primary care provider allows the patient to keep pilocarpine eye drops at the bedside and to self-administer the eye drops 4 times daily. The nurse... 

The nurse never leaves hypnotics and sedatives at the patient s bedside to be taken at a later hour hypnotics and sedatives are controlled substances (see Chap. 1). hi addition, the nurse never leaves these dru unattended in the nurses station, hallway, or other areas to which patients, visitors, or hospital personnel have direct access. If these dragp are prepared in advance, it is important to place them in a locked cupboard until the time of administration. 

Antiseptic and germicidal drugp kept at die patient s bedside must be clearly labeled with die name of die product, die strengtii, and when applicable die date of preparation of die solution. The nurse replaces hard-to-read or soiled, stained labels as needed. These solutions... 

The NG route is used most commonly for short-term (less than 1 month) enteral access. Some institutions prefer the OG route because of less damage to the sinuses the OG route is also useful in situations such as facial trauma, where nasopharyngeal damage prevents NG feeding. The major advantage of these routes is that the tubes can be placed quickly and inexpensively by the nurse at the bedside. 

In many laboratory information systems, electronic entry either in the laboratory or at a nursing station of a test order for a uniquely identified patient generates a specimen label bearing a unique laboratory accession number. A record is established that remains incomplete until a result (or set of results) is entered into the computer against the accession number. The unique label is affixed to the specimen collection container when the blood is drawn. Proper alignment of the label on the collection container is critical for subsequent specimen processing when using bar coded labels. Arrival of the specimen in the laboratory is recorded by a manual or computerized log-in procedure. In other systems, the specimen is labeled at the patient s bedside with the patient identification and collection information and enters... 

Upon admission, the cancer patient is asked to complete a survey to assess their current pain situation. A copy of the form is provided in the article. Every 8 hours, a nurse records three pain-intensity values on the bedside flow sheet. After a patient is seen and evaluated, recommendations are conveyed orally to the prescribing physician or documented in the progress notes. Verbal orders are obtained when rapid changes are needed to analgesic orders. An education series is provided every month by the ADS attending physician or pharmacist to cover basic approaches to management of cancer-related... 

Central catheter site of procedure (bedside vs. operating room), radiographic confirmation of placement, supplies used for site care Peripheral line nursing time, supplies used for site care Routine laboratory and clinical measurements, changes in therapy to prevent complications or toxicities, nutrition support clinician time Mechan/ca/ treatment of specific complication Infectious cost of antibiotic therapy or venous access replacement Metabolic increased clinical and laboratory measurements, possible waste of PN solution... 

When using a unit dose system, do not remove die wrapping of the unit dose until the drug reach die bedside of the patient who is to receive it. After administering die drug, die nurse charts immediately on the unit dose drug form. The mediod of administering dni by die unit dose system is widely used. 

The medication is prepared in a quiet place without any interruptions. At the bedside, the nurse follows safety procedures that assure the medication is being administered to the proper patient. The nurse verifies the patient s identity and that the patient knows why the medication is being given. Baseline data (such as vital signs, and labs) is obtained by the nurse. They will be compared to similar data collected after the onset of the medication. 

The nurse is completing A.M. care with a client diagnosed with angina when the client complains of chest pain. The client has a saline lock in the right forearm. Which intervention should the nurse at the bedside implement first ... 

Administering morphine sulfate would be appropriate, but the nurse at the bedside would not have MS at the bedside and it would take time to prepare. 

The nurse would have oxygen at the bedside, and applying it would be the first intervention the nurse could implement at the bedside. 

MEDICATION MEMORY JOGGER When answering test questions or when caring for clients at the bedside, the nurse should remember assessing the client may not be the correct action to take when the client is in distress. The nurse may need to intervene directly to help the client. 

The nurse should prepare the intravenous antibiotie in the medieation room— not at the bedside—and should always flush the tubing so that air will not be injeeted into the elient s vein. 

GoLYTELY is a colonic stimulant that is prescribed to cleanse the bowel prior to bowel surgery therefore, the client should have a bedside commode readily available and the nurse can delegate the UAP to perform this task. 

To monitor serum glucose, the nurse would need to perform an hourly venipuncture. This is painful, is more expensive, and takes a longer time to provide glucose results. Therefore, a capillary (fingerstick) bedside glucometer will be used to monitor the client s blood glucose level every hour. 

The primary nurse is at the bedside and is preparing to administer 3 mL of medication into the deltoid muscle. Which action should the charge nurse take ... 

The charge nurse should not correct the primary nurse at the bedside in front of the client This embarrasses the primary nurse and will make the client lose confidence in the primary nurse. 

The charge nurse is making rounds on the clients and notices that the primary nurse left a medication cup with three tablets at the client s bedside. WTiich action should the charge nurse implement ... 

The nurse should take the medication cup back to the medication room and discuss this situation with the primary nurse. Medications should never be left at the bedside. 

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