CPAP machine

[akaur212]

Answer this for me please:

In a large acute care hospital a client tells you he uses CPAP machine every night but he left his machine at home.he is concerned about sleeping without it .what is most appropriate action to take ?

A. Ask the supervisor for direction

B. Reassure the client he won't need the machine at night

C. Ask the respiratory therapist to order a CPAP machine

D. Call the admitting physician to request an order for CPAP machine

[dishes, BSN, RN]

Which answer do you think is correct and why?

[Meeshie]

E. Depends on the protocols and standing orders of the hospital and/or floor.

I don't need to call anyone because a patient that answers 'yes' to OSA during the PHH generates a set of orders including respiratory to come set up CPAP at night for the patient if the patient does not have a home machine (or for MIS/Respiratory to clear their personal machine to be set up for use if they did bring one from home). So I'd call RT to let them know about my patient, especially since he actually wants to use a CPAP (more often than not my OSA patients are non-complaint even after being educated) but...................... there is an order in place that is sent to the MD to be co-signed based on my actions. I just don't need to call.

But since I'm assuming this is homework.... what does your textbook say? Or your professor?

[akaur212]

I don't know the answer

[akaur212]

Tell me an answer form these 4 options .what is appropriate ?i know the answer E already .what if this is on NCLEX ?what should be the best response

[offlabel]

.....D

[Meriwhen, ASN, BSN, MSN, RN]

E. Depends on the protocols and standing orders of the hospital and/or floor.

I don't need to call anyone because a patient that answers 'yes' to OSA during the PHH generates a set of orders including respiratory to come set up CPAP at night for the patient if the patient does not have a home machine (or for MIS/Respiratory to clear their personal machine to be set up for use if they did bring one from home). So I'd call RT to let them know about my patient, especially since he actually wants to use a CPAP (more often than not my OSA patients are non-complaint even after being educated) but...................... there is an order in place that is sent to the MD to be co-signed based on my actions. I just don't need to call.

And in my unit, I have to call the MD for orders...because it's a psych unit and you know, CPAPs can be used as tools to harm either oneself or someone else. I'd also have to get them transferred to the psych-medical unit where we're better equipped for medical equipment. Then RT would be the ones to bring the machine over every night (unless patient has his/her own), hook the patient up, tweak settings during the night if needed, then come and take it away (or pack it back up) in the AM. Then call RT again the next night...or even if the patient wants to take a nap. That's an awful lot of work for someone with sleep apnea...but in psych, we just can't leave the machine in the room 24/7.

OP: technically, there's good arguments for answers C (call RT as that presumes arranging for a CPAP without MD orders would be allowed under the ivory tower nursing standardized procedure) and D (as MDs in ivory tower nursing should be consulted on and/or order everything). If I was under the gun and told to choose, I'd go with D: notify the MD about the patient's history, and then he/she can order a referral to RT and/or a CPAP.

B is an automatic no-go answer. You wouldn't tell a diabetic that they won't need their insulin pump in the hospital, would you?

A could be correct but is also not the best answer. The supervisor is either going to tell you to refer to the standardized order set or call the MD.

[akaur212]

I am working as a LPN at the unit ,so don't you think I should get direction from supervisor ?can I directly contact the doctor and RT ?

[CelticGoddess, BSN, RN]

I am working as a LPN at the unit ,so don't you think I should get direction from supervisor ?can I directly contact the doctor and RT ?

Why wouldn't you be able to contact the MD directly?

[~Mi Vida Loca~RN, ASN, RN]

I am working as a LPN at the unit ,so don't you think I should get direction from supervisor ?can I directly contact the doctor and RT ?

Is this a real question in your real workplace or a scenario question?? Because if this is a real question this will be specific for your facility.

No you wouldn't go to your supervisor, why would you need to? You only would if you didn't know what your facilities policy and protocols are for this, and even then I would ask the charge first. Actually I would try to find the answer myself first, if I couldn't then I would ask my charge if they knew.

If this is for a NCLEX or school question the answer would be D. If there were standing orders like in a PP to bypass the doc, there is still an order and a testing bank isn't going to have you assume there are standing orders (without telling you) because with standing orders the key factor is there is still an order. But not all facilities have that so you should assume you will need to get an order for it placed.

[dishes, BSN, RN]

A. Calling a supervisor for direction is never the correct answer on a NCLEX exam, as it does not reflect critical thinking or clinical judgement

B. As meriwhen said NO

C. Respiratory therapists are not authorized to order tests or treatments

D. The only correct answer

[Meriwhen, ASN, BSN, MSN, RN]

I am working as a LPN at the unit ,so don't you think I should get direction from supervisor ?can I directly contact the doctor and RT ?

You could contact the MD directly. Now whether you could take a verbal/telephone order as a LPN depends on both your state's scope of nursing practice AND your facility's policy. For example, your BON may say that LPNs can take verbal orders, but your facility P&P may permit only RNs to take TO/VO orders.