7.9 Spotlight Application

Allison is a new graduate nurse who is recently transitioned from her orientation period to her scheduled night shift work on a medical telemetry unit. She has a patient care assignment of six patients. Her patient, Mr. Daniels, was admitted from the ER at 2200 shortly before her shift began. He was transferred to the floor with a diagnosis of Heart Failure exacerbation. The patient was prescribed IV push furosemide for diuresis. It is now 0500 and the patient’s morning potassium level is reported from the lab to be 2.9 mmol/L. Allison understands that this level needs to be reported to the admitting physician. Utilizing an ISBARR format, what information should Allison be prepared to phone the physician?

Allison should be prepared to tell the physician her role on the unit and that she is calling to relate information on a critical lab value. She should describe information about the patient, including Mr. Daniel’s name, position on the unit, and a reminder of when the patient was admitted. She should provide a brief synopsis of the stability of the patient. If there is relevant information regarding allergies, this should be related at this time as well. The concern related to the lab value and any accompanying symptoms should also be described. Allison should provide insight into the current intake and output status, weight, cardiac rhythm, signs of edema, respiratory status, etc. Allison should outline her request related to orders for potassium replacement. When these orders are received from the provider, she must be sure to repeat back the order to confirm accuracy.