Quick Nursing Reference Sheet



  1. Insulin generally lowers potassium and so does albuterol treatment
  2. Accurate I/O means literally just that
  3. Anuric is general < 100 cc a day & Oliguria <500 cc day
  4. Measurement: 30 ml (cc) = 1 oz.
  5. A typical hospital patient pitcher is usually 800-1000 cc
  6. If patient gets SOA and is on IV fluids- stop IV fluids and call on call provider
  7. COPD tend to have higher C02 levels
  8. Chronic kidney disease patient are often (almost always) anemic because of the lack of production of erythropoietin (hormone that stimulates RBC production) from kidney.
  9. Sodium bicarbonate helps to neutralize the body when it has become acidotic
  10. Renal patients taking calcium carbonate (tums) near meals- this is actually to help decrease the phosphorus as it attaches to phosphorus containing food. Phosphorus does not dialyze off
  11. If a renal patient has a fistula or AV graft– always assess the bruit (auscultation) & thrill (feel) to make sure working. This is their lifeline to remove toxins from their body!
  12. Steroids (solumedrol, prednisone, methyprednisolone) can cause insomnia, agitation, weight gain, lower extremity swelling, increased hunger
  13. Alcoholics often have low magnesium and low platelets
  14. If giving Vancomycin & patient suddenly gets flushed – stop infusion call on call provider. It is likely that Redman syndrome is happening and that the infusion needs to be slowed
  15. Head of bed should always be at least 30 degrees if patient has peg tube feeding
  16. If patient has diarrhea or suddenly has diarrhea- they really should be tested for C-diff
  17. No sticks, IV insertion, draws, blood pressures on arm of dialysis access (AV graft, fistula)
  18. Don’t go outside of a contact precautions room with the protective gear on. You must take it off before going out of the room
  19. If patient nose dries out from nasal cannula do not put Vaseline (can potentially cause a flame) in their nose instead get a bubbler to humidify the air
  20. Consents: The provider needs to be the one to explain the procedure
  21. Do not wipe finger with alcohol pad right before taking a glucose (at least allow it to dry) as this may falsely elevate glucose due to the ETOH. Wiping finger with water is best
  22. Best place for absorption of insulin is in abdomen
  23. Make sure to rotate sites with injections
  24. Normal ejection fraction 55-60%
  25. It is ideal that a patient is NPO for an abdomen ultrasound
  26. Metformin needs to be held if contrast is given (for 48 hrs after)
  27. Fluoroquinolones (levofloxacin, ciprofloxacin,) are antibiotics often given in hospital. It is important to watch for muscle pain ache as this may be a sign of the black box warning of tendon rupture. This adverse reaction is more common in patients >55 years old
  28. Do not be afraid to clarify an order
  29. Stress tests: patient should not smoke the day of the test. The patient should not have any caffeine 24 hrs before the test. Patients should also not take beta blockers, nitroglycerin, and some other heart medications on day of the test (nurse should always clarify with cardiology if any questions on this)
  30. If you did not witness a fall you should not technically chart that the patient fell. You must chart what you actually witnessed and notify on call provider immediately
  31. Blood should be transfused within 4 hours (no longer). In general PRBC transfused is transfused under 2 hours. Exception include CHF & ESRD
  32. Sickle cell crisis pain is REAL and can be SEVERE!
  33. If a patient begins to have confusion, in addition to a neurological exam a glucose should also be checked
  34. Often the better report you receive, the better shift you will have (not always but more likely). So the point is, ask questions, get details, clarify
  35. LPN’s generally do not do: IV pushes, administer blood products, admission assessment, IV insertion (allow I have heard of certification to do this). These are general and may possibly change so if anyone has any update on this info is always welcome!
  36. Chest pain: If an MI is suspected general orders include EKG, cardiac enzymes, EKG, CBC, BMP, Morphine, oxygen administration, nitroglycerin, aspirin
  37. Blood cultures should ideally be drawn before antibiotic administration
  38. If a patient suddenly develops severe headache or abdomen pain let on call provider know this!! Don’t just give pain medication available. Imaging may be needed. If it is truly severe, we need to know what is causing these severe symptoms
  39. Many hospitals require a second nurse to verify insulin dosage before being administered
  40. CHF and Renal patients need to have accurate intake and output along with daily weights
  41. Consider asking for a catheter if risk for skin breakdown likely, need accurate I/O but unable to obtain, and/or comfort measures
  42. If suspect urine retention- bladder scan before calling on call provider

 

 

NOTE: The above is not intended as medical advice for patients. This is simply for educational purposes for medical professionals only. All patient should ALWAYS check with their primary care provider with any questions that they may have. This informational sheet does not serve as medical advice. As always, medical professionals should always call the on call provider if any clarifications are needed. State and hospital protocols should always be followed accordingly

 

-Med Made Ez-

Updated 4/21/16

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