COMP 3 REVIEW
From Lab 6/10
1. FIRE: in from ED, fire effecting upper body, worry about AIRWAY, assess for burns in mouth
2. IRON infusion from ample (use filter needle)
a. if IM: change needle b/c of the needle will stain the skin
b. if oral: use a straw so it doesn’t stain teeth
3. Polystyrene (Kayexalate): causes diarrhea to remove K+
(fixes hypokalemia)
4. Oxcarbazepine: prevents seizure
Education: causes drowsiness, regular blood drawn to check levels, soft toothbrush/ extra dental cleaning
3x year
5. To report outsource:
whooping cough, measles/mumps/rubella, std’s
6. Health screenings: what is a priority to follow up on
7. Rapid Response Team: respiratory, ACLS prepared RN (they can transport to ICU),
A. if pulse no back board needed,
B. respirators on wall green=oxygen yellow=100%medical air,
C. run a new strip every 1-2 min or new rhythm,
D. recorder: keep time (vitals, meds given, iv drips, labs drawn, different rhythm, anything physician
shouts out as order, abgs, intubation, staff members present), run rhythm strips,
E. staff members present, disposition, attending sign
8. Biphasic Defib AED: energy level in 2 different ways, more comfortable, stand clear (even from oxygen tubing)
9. Defibrillation = “3” lead
10. Medications on Crash Cart
A. Vasopressin= 0.5-1 (VFIB)
b. Epi: Q3min
c. Amardone: 1st- 300mg, 2nd 150mg, (V-tach)
d. Lidocaine:
e. atropine
11. Medications thru a ET-tube:
a. Narcan
b. Atropine
c. Vasopressin
d. Epi
e. Lidocaine
12. ET tubes conversion:
A. French to US = divide by 4
b. US to French = multiply by 4
, Patricia Benner NOVICE-EXPERT MODEL video (posted June 15,2020)
- novice to expert model, also known as “Benner’s Stages of Clinical Competence”, 5 stages
- applied nursing profession is adapted from the “Dreyfus Model of Skill Acquisition”
1. NOVICE: no background experience, nursing students, beginning in the profession or nurse changing are of
practice
- difficult discerning between relevant and irrelevant aspects of the situation
- apply all rules learned in nursing school to all patients, and are unable to discern individual needs
>Scope of Vision: only feels responsible to follow the rules
>Range of capability: follows specific rules for specific situations, rules are not conditional, “only
capable of following rules”
2. ADVANCED BEGINNER: guided by rules and oriented by task completion
- still requires mentor or experienced nurse to assist w/ defining situations, to set priorities, and to
integrate practical knowledge
>Scope of vision: still does not experience personal responsibility
>Range of capability: begins to create and identify conditional rules, all decisions still follow rules,
“Rules have nuance and become conditional in nature”
3. COMPETENT: after 2-3 years in the same area of nursing
- most pivotal in clinical learning b/c the learner must begin to recognize patterns and determine which
elements of the situation warrant attention an which can be ignored
- devises new rules and reasoning procedures for a plan while applying learned rules for action on the
basis of the relevant facts of that situation
>Scope of vision: sense of responsibility arises from actively making decisions
>Range of capability: learns organizing principals, information sorting by relevance begins, “Higher
order rules shape context and conditions
4. PROFICIENT: after 3-5 years in same area of nursing
- “the nurse possesses a deep understanding of situations as they occur, less conscious planning is
necessary, critical thinking and decision-making skills have developed”
- performer perceives the information as a whole (total picture) rather than in terms of aspects and
performance
-proficient level is a qualitative leap beyond the competent
- nurses at this level demonstrate a new ability to see changing relevance in situation including
recognition and the implementation of skilled responses to the situation as it evolves.
>Scope of Vision: sense of responsibility increases with experience
>Range of capability: uses pattern recognition to assess what to do. Uses rules to determine how
to do it, “intuition aides in identifying the situation; that actions are governed by the principals”
5. EXPERT: after 5 years or < same area: forms deep understanding of the total situation
- expert performer no longer relies on an analytic principle (rule, guideline, maxim) to connect her/his
understanding of the situation to an appropriate action
- expert nurse, with an enormous background of experience, now as an intuitive grasp of each situation
and zeroes in on the accurate region of the problem without wasteful consideration of a large range of unfruitful,
alternative diagnoses and solutions
>Scope of Vision: responsibility extends to others and the environment
>Range of capability: no analysis or planning, pattern recognition extends to plan as well as
actions, “Just does what works”
From Lab 6/10
1. FIRE: in from ED, fire effecting upper body, worry about AIRWAY, assess for burns in mouth
2. IRON infusion from ample (use filter needle)
a. if IM: change needle b/c of the needle will stain the skin
b. if oral: use a straw so it doesn’t stain teeth
3. Polystyrene (Kayexalate): causes diarrhea to remove K+
(fixes hypokalemia)
4. Oxcarbazepine: prevents seizure
Education: causes drowsiness, regular blood drawn to check levels, soft toothbrush/ extra dental cleaning
3x year
5. To report outsource:
whooping cough, measles/mumps/rubella, std’s
6. Health screenings: what is a priority to follow up on
7. Rapid Response Team: respiratory, ACLS prepared RN (they can transport to ICU),
A. if pulse no back board needed,
B. respirators on wall green=oxygen yellow=100%medical air,
C. run a new strip every 1-2 min or new rhythm,
D. recorder: keep time (vitals, meds given, iv drips, labs drawn, different rhythm, anything physician
shouts out as order, abgs, intubation, staff members present), run rhythm strips,
E. staff members present, disposition, attending sign
8. Biphasic Defib AED: energy level in 2 different ways, more comfortable, stand clear (even from oxygen tubing)
9. Defibrillation = “3” lead
10. Medications on Crash Cart
A. Vasopressin= 0.5-1 (VFIB)
b. Epi: Q3min
c. Amardone: 1st- 300mg, 2nd 150mg, (V-tach)
d. Lidocaine:
e. atropine
11. Medications thru a ET-tube:
a. Narcan
b. Atropine
c. Vasopressin
d. Epi
e. Lidocaine
12. ET tubes conversion:
A. French to US = divide by 4
b. US to French = multiply by 4
, Patricia Benner NOVICE-EXPERT MODEL video (posted June 15,2020)
- novice to expert model, also known as “Benner’s Stages of Clinical Competence”, 5 stages
- applied nursing profession is adapted from the “Dreyfus Model of Skill Acquisition”
1. NOVICE: no background experience, nursing students, beginning in the profession or nurse changing are of
practice
- difficult discerning between relevant and irrelevant aspects of the situation
- apply all rules learned in nursing school to all patients, and are unable to discern individual needs
>Scope of Vision: only feels responsible to follow the rules
>Range of capability: follows specific rules for specific situations, rules are not conditional, “only
capable of following rules”
2. ADVANCED BEGINNER: guided by rules and oriented by task completion
- still requires mentor or experienced nurse to assist w/ defining situations, to set priorities, and to
integrate practical knowledge
>Scope of vision: still does not experience personal responsibility
>Range of capability: begins to create and identify conditional rules, all decisions still follow rules,
“Rules have nuance and become conditional in nature”
3. COMPETENT: after 2-3 years in the same area of nursing
- most pivotal in clinical learning b/c the learner must begin to recognize patterns and determine which
elements of the situation warrant attention an which can be ignored
- devises new rules and reasoning procedures for a plan while applying learned rules for action on the
basis of the relevant facts of that situation
>Scope of vision: sense of responsibility arises from actively making decisions
>Range of capability: learns organizing principals, information sorting by relevance begins, “Higher
order rules shape context and conditions
4. PROFICIENT: after 3-5 years in same area of nursing
- “the nurse possesses a deep understanding of situations as they occur, less conscious planning is
necessary, critical thinking and decision-making skills have developed”
- performer perceives the information as a whole (total picture) rather than in terms of aspects and
performance
-proficient level is a qualitative leap beyond the competent
- nurses at this level demonstrate a new ability to see changing relevance in situation including
recognition and the implementation of skilled responses to the situation as it evolves.
>Scope of Vision: sense of responsibility increases with experience
>Range of capability: uses pattern recognition to assess what to do. Uses rules to determine how
to do it, “intuition aides in identifying the situation; that actions are governed by the principals”
5. EXPERT: after 5 years or < same area: forms deep understanding of the total situation
- expert performer no longer relies on an analytic principle (rule, guideline, maxim) to connect her/his
understanding of the situation to an appropriate action
- expert nurse, with an enormous background of experience, now as an intuitive grasp of each situation
and zeroes in on the accurate region of the problem without wasteful consideration of a large range of unfruitful,
alternative diagnoses and solutions
>Scope of Vision: responsibility extends to others and the environment
>Range of capability: no analysis or planning, pattern recognition extends to plan as well as
actions, “Just does what works”
