Fy16 Primary care LPN Annual Policy Review

It is the policy at the Medical Center and selected CBOCs where Primary Care, Women’s Health and/or Mental Health services are provided, access to clinically-appropriate services that extend beyond regular business at least once on weekdays (Wednesday) and once every weekend (Saturday), at times and venues that match Veteran demand and expectations will be made available

• True

• False

Primary Care nursing staff will document annual foot screening for patients at risk of lower limb loss or history of amputation that includes: 1) visual inspection of skin surfaces, 2) assessment of pedal pulses, 3) monofilament testing for loss of protective sensation, and 4) patient education at the patient's level of understanding.

• True

• False

Verification of patient identity is important to ensure patient's receive proper care and health information. At RHJ VAMC, the proper method of verifying a patient's identity is using which of the following?

• Last 4 of SSN

• FULL Name and Room #

• FULL Name and FULL SSN

• Mother's maiden name

Prior to each primary care visit, a medication list will be printed for each scheduled clinic visit and given to the patient at the time of check in. The ________ will be asked to review and make notations/changes/corrections on this document for discussion with the provider during the visit.

After recognizing the signs and symptoms of Acute Ischemic Stroke (AIS), the appropriate nursing action would be to call 911 to have the patient transported immediately to the nearest AIS facility.

• True

• False

Care that is provided to a patient under the "Hypoglycemia - Outpatient Clinic Protocol" is to include documentation of VS, FSBS, and neurological status every 15 minutes on the:

• Hypoglycemia-Hyperglycemia Protocol Note in CPRS

• Clinic Nurse Note in CPRS

• RN Triage Note in CPRS

• Interfacility Transfer Note

<span style="color: black; font-family:;" new="" roman";"="" "times="" ar-sa;="" en-us;="" roman";="" 10.0pt;="" 12pt;="" arial","sans-serif";="">Requests for mammography studies will be processed by local Non-VA Care Coordination (NVCC) Team in coordination with the Women Veterans Program Manager

• True

• False

Care that is provided to Veterans with symptomatic hypoglycemic episodes is documented:

• On the hard copy note that is placed in the patient's Interfacility Transfer packet

• In CPRS, under the Clinic Nurse Note

• In CPRS, under the template titled "Hypoglycemia/Hyperglycemia Protocol Note"

• In CPRS, under the RN Clinic Triage note

Links to Material Safety Data Sheets (MSDS) for approved non-critical reusable medical equipment cleaning agents can be found at the end of the policy on the T:drive.

• True

• False

Signs and symptoms of an adverse blood transfusion reaction include all of the following EXCEPT:

• Tachycardia and sudden change in BP

• Constipation and/or impaction

• Hives or rash to the patient's trunk and back

• Fever with or without chills

• Wheezing and/or dyspnea

You call a Veteran from the waiting room and notice that the patient is showing signs and symptoms of a stroke. You know that the following are signs and symptoms of Acute Ischemic Stroke (select all that apply):

• Slurred speech

• Facial drooping

• Pain in jaw and shoulder

• Weakness on one side of the body

The organ procurement agency for RHJ VAMC is:

• Death Point

• Life Star

• Life Point

• DHEC

Nursing personnel will take the following action with any Veteran exhibiting suicidal or homicidal ideations except:

• Send the Veteran down the hall to meet with the Mental Health Intensive Case Manager

• The Veteran will be placed on one to one observation pending a mental health provider’s determination that suicidal precautions are necessary or until such time as these orders are rescinded

• Ensure the Veteran remains in full view of the staff member assigned to monitor them at all times

• Patient is restricted to clinical area. Staff will escort patient to restroom, medical procedures or evaluations remaining in one to one observation at all times

Which of the following are considered to be "High Alert Medications"? (select all that apply):

• Heparin for therapeutic anticoagulation

• Chemotherapy IV drugs

• Hypertensive drugs

• Insulin

• Fentanyl patches