Patient Safety Protocols Flashcards

How often must an adult in violent or self-destructive behavior restraints be reassessed and have the order renewed under CMS rules?

Answer: Every 4 hours

CMS limits violent/self-destructive restraint orders for adults to 4 hours, after which they must be renewed.

Which is the best way to position a patient with increased intracranial pressure?

Answer: HOB 30 degrees with the head midline

Raising the head of bed to 30 degrees with the head midline helps venous drainage and lowers ICP.

Before an MRI for a neuro patient, which item is the greatest safety concern?

Answer: A cochlear implant or older pacemaker

Implanted electronic or ferromagnetic devices can move, heat up, or malfunction in the MRI field and must be cleared before scanning.

A patient with Parkinson's disease is admitted NPO for surgery. What is the main medication safety risk?

Answer: Abrupt levodopa withdrawal causing rigidity or parkinsonism-hyperpyrexia syndrome

Missed or delayed levodopa doses can cause severe rigidity, aspiration, and a neuroleptic malignant-like syndrome, so time-critical dosing must continue.

Which antiemetic should be avoided in a patient with Parkinson's disease?

Answer: Metoclopramide

Metoclopramide blocks central dopamine receptors and can worsen parkinsonism.

Which tool is commonly used to measure fall risk in hospitalized neuro patients?

Answer: Morse Fall Scale

The Morse Fall Scale scores fall history, secondary diagnosis, ambulatory aid, IV access, gait, and mental status.

A patient with myasthenia gravis is prescribed a fluoroquinolone. What is the safety concern?

Answer: It can cause a myasthenic exacerbation

Fluoroquinolones carry an FDA boxed warning for worsening myasthenia gravis weakness, including respiratory failure.