Patient Safety Protocols Flashcards

Which finding in a patient with Guillain-Barré syndrome most strongly suggests the need for intubation?

Answer: Vital capacity under 20 mL/kg

The 20/30/40 rule (VC <20 mL/kg, NIF weaker than -30, PEF <40) signals impending respiratory failure in GBS.

Which statement about the Universal Protocol before a neurosurgical procedure is correct?

Answer: A time-out happens right before the incision with the whole team

Joint Commission's Universal Protocol requires pre-procedure verification, site marking, and a team time-out right before the procedure starts.

A patient on phenytoin shows nystagmus, ataxia, and slurred speech. What is the priority?

Answer: Hold the dose, check a serum level, and use fall precautions

Nystagmus and ataxia are classic signs of phenytoin toxicity, which raises fall risk and requires holding the drug and checking levels.

What is the main safety risk when giving IV phenytoin too fast?

Answer: Hypotension and cardiac arrhythmias

IV phenytoin should not exceed 50 mg/min in adults because faster rates can cause hypotension and arrhythmias.

A patient with a spinal cord injury at T4 suddenly develops a pounding headache, BP 210/110, and flushing above the injury. What is the first action?

Answer: Sit the patient upright and look for the trigger, such as a full bladder

Autonomic dysreflexia is managed by sitting the patient up to lower BP and quickly removing the noxious stimulus, most often bladder distension.

Which patient identification practice meets Joint Commission National Patient Safety Goals?

Answer: Using two identifiers such as name and date of birth

NPSG requires at least two person-specific identifiers, and a room number is never one of them.

For a patient with expressive aphasia, which communication approach best supports safe care?

Answer: Use yes/no questions, picture boards, and allow extra time

Simple closed questions and augmentative tools let aphasic patients report pain, needs, and safety concerns reliably.