Nursing Interventions

MONONGALIA GENERAL HOSPITAL 1200 J.D. ANDERSON DRIVE MORGANTOWN, WV 26505 EMERGENCY DEPARTMENT NURSING INTERVENTION SHEET Nursing Interventions Triage Includes Initial VS and WTs (on peds) 1. Adult 2. Peds 3. Pulse Oximetry 4. Pulse oximeter continuous 5. Cardiac Monitors 6. Visual Acuity 1. Reassess pt 2. Retake vital signs 3. Discharge Instruction- a. Simple b. Discharge InstructionComplex

Oxygen Admin per hr x___ 1. Nasal Cannula 2. Simple Mask 3. Non re-breathing –venti- mask

Pts

Nursing Interventions

Pts

Nursing Interventions

Pts

25 30 30 40 30 40

1. Sub Q/IM/event 2. Rectal- X _____ 1. Eye/ear installation each 2. IV push/piggyback 3. IV Cont. infusion- no med x ______ hrs 4. IV cont. inf. W meds x ______ hrs

50 50 50 50

NG Tube Insertion NG Lavage/15 min x _____

100 100

Restraints/30 minutes Pts who require 1:1 or who are confused/combative, pyschotic/15 min X ______ Peds<6 (no adult) Abuse exam, peds/adult Asst with: 1. Peds exam 2. Gyn Exam (no specimen) 3. Gyn Exam (specimen) 4. Suture setup 5. Suture assist 6. Rape Examination 7. Lumbar Puncture 8. Chest tube insertion 9. Needle decompression

100

10. 11. 12. 13.

80 80 60 75

45 35 30 45

40 30 35

Wound Care: 1. Irrigation <15 min 2. Irrigation >15 min <30 min 3. Irrigation >30 min

30 70 100

1. 2. 3. 4.

30 45 75 35

Dressing-simple Dressing- wet/dry Dressing- complex Suture Removal

1. Splint application- wrist 2. Splint application- ankle 3. Splint application- knee 4. Dislocations

50 60 100 40

1. 1.

50

Crutch (adjust/teach) Sling, ACE wrap, etc. (apply/teach)

Medications: 1. Oral- per trip x ______ IV Start- each attempt 1. Adult X ____ 2. Peds x _____ 3. DC IV Site Administer blood x ______ unit

40 45 100

Venipuncture: (Specimen Collection) 1. Adult x ________ 2. Peds X _________ 3. AG Sugar x _____ 4. Dip Urine

1. ED Staff to lab x _______ 2. Arrange Outpt. Testing 3. D/C pt via W/c to POV 4. Assist pt to ED via W/C 5. ED staff with pt for tests per 15 min x ______ 6. Pt transfer with ED staff to another hosp Admission Pt transport by ED Staff 1. To Xray 2. To Floor Other tests Arrange: Transfers (nsrg home,home) Taxi/Bus Transfer to another hosp Perform: 1. Ear irrigation 2. Eye irrigations 3. Fill foley cath 4. Enema X _____ 5. Foley Cath- Insert adult 6. Cath Peds 7. Peds apply U-Bag 8. Irrigate Cath 9. Oral suctioning x _____ 10. Tracheal suctioning x _____

50 75 50 75 40 40

50 55 45 45 45 300 45 65 50 75 65 100 80 70 60 100 80 50 45 40 50 50

125 45 150

99281( 0-50) 99282 (51-100) 99283 (101-150) 200) 99285 (201-300) 99291 (301-400)

99284 (151-

Prepared by:

Date:

1. 2. 3. 4.

Thoracentesis Paracentesis Nasal Packing Rectal Exam

Fetal Heart tones Newborn Care Prepare pt for OR Bed linen change X ______

100 100 150 100 75 100 35 65 250 90 200 80

50 100 200 40

1. Cardiac Arrest <15 min 2. Cardiac arrest each addl. 15 min x ______ 3. Ventilator pt x ______ hrs

200

1. Cardioversion/event 2. Intubation 3. External Pacer 4. Defib/time Conscious Sedation Thrombolytic Administration Critically Ill pt observation x ____ ½ hr Committal of patient for drug/alcohol rehab

300 200 250 150 300 350

150 100

150 300