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Unit Profile - 8C Nurse Manager Supervisor Clinical Nurse Specialist Educational Nurse Coordinator Brief Description of the Unit Deborah Eastman, M.S., R.N. Robin Russell, R.N. 936-6201 / Pager 34638 615-2694 / Pager 78316 Deb Spilak, B.S.N., R.N. 936-6202 / Pager 78340 Christina Reames M.S., R.N. 232-6415 / Pager 35405 8C is a 32-bed adult medicine and surgical unit. Nursing activities focus on the post-operative patient, which includes care of wound and incisions, ostomies, surgical drains, enteral tube feedings, fluid/electrolyte balance, and airway and pain management. The patient care team also includes respiratory therapy, physical therapy and dieticians. Primary Services 1. Urology (SUA) 2. General Surgery Endocrine (GSE) 3. Surgery Oncology (SON) 4. University Family Medicine (UFM) 5. Dermatology (MFH) 6. Gynecology – Surgery (GY1, GY2) 7. Anesthesia – Pain (ANS) Patient Demographics Patients on 8C range from young adults to the elderly and are from diverse racial, cultural and religious backgrounds. Patients experience a variety of nursing needs related to mobility, pain, nutrition, elimination, airway disruption, psychological support, oncological issues, body image, and complex family/other psychosocial situations. Common Medication (Categories of Drugs) Common Procedures 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. • • • • • • • • • • • • • Pain medications: Hydrocodone, Dilaudid, Oxycodone, Fentanyl patch, Morphine, Toradol Antiemetics: Zofran, Compazine, Phenergan Antibiotics: Ampicillin, Vancomycin, Clindamycin, Piperacillin, Cefazolin Anticoagulants: Heparin, Lovenox, Coumadin Bowel function: Colace, Senna, Miralax GI tract: Protonix, Zantac, Reglan Cardiac & blood pressure: Norvasc, Cardura, Imdur, Labetalol, Hydralazine, Atenolol Insulin Potassium Magnesium Blood products Foleys Nasogastric tube Dobhoffs Jackson-Pratts Ostomies Epidurals PCA pumps Sequential compression devices (SCDs) Various orthotics, traction Bladder scanning Point-of-care testing (e.g. capillary blood glucose, hem occult blood) CT Scans X-rays of the abdomen and chest Specialty areas of patient care on 8C include: • IV insulin and heparin therapy • Insulin therapy based on nutritional needs • Blood product transfusion (e.g. PRBC, platelets, fresh frozen plasma) • PCA’s • Safety interventions as required by patient condition (e.g. alcohol withdrawal, delirium, dementia) • Comfort measures, pain relief • Nutritional therapy • Radical cystectomy with ileal conduit or neobladder • DeLancey Protocol • Laparoscopic partial nephrectomy Common Medical Diagnoses 1. Prevalent medical/surgical diagnoses are many including: colo-rectal and multiple endocrine disorders requiring surgical intervention – thyroidectomies, parathyroidectomies, adrenalectomies, pancreatectomies. 2. Common Urology diagnoses include : bladder cancer, renal neoplasm, open partial nephrectomy, neurogenic bladder, Chronic dermatology patients have diagnoses of psoriasis, cutaneous T-cell lymphoma and other chronic skin diseases that are both benign and malignant. Family Medicine is a general medicine service with a wide range of medical diagnoses including pneumonia, CHF, GI bleeding, COPD, DVT, urosepsis, etc. Other diagnoses : cellulitis, gastritis, ulcerative colitis, diverticulitis, total abdominal hysterectomy, colon resection, colovesical fistula, gastric adenocarcinoma and alcohol withdrawal 3. 4. 5. Common Precautions and Safety Measures • Intermittent straight cath • Continuous bladder irrigation 1. Falls precautions 2. All isolation precautions – VRE, MRSA, C- diff, respiratory, droplet, neutropenic 3. Spine precautions 4. Chemotherapy 5. Suicide 6. Seizure 7. Pandemic 8. Elopement precautions