Term
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Definition
| Status is gleaned from the off-going nurse's report, and from the chart (paying special attn. to last few days) |
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Term
| before entering room, check for |
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Definition
| SIGNS! Make sure you're aware of their rationale and applicability |
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Term
| First thing a nurse does upon entering a pt room |
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Definition
| GREET THE PATIENT, people care more that you notice them than whether you've gelled in yet. But still, don't forget HAND HYGEINE (these can be done simultaneously) |
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Term
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Definition
level of consciousness
they know who they are, when it is, and where they are (A/O x3) |
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Term
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Definition
1) BP
2) HR
3) RR
4) Temp
5) PAIN |
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Term
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Definition
after medication administration: ~30 min
IV: 15 min
PO: 1 hr |
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Term
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Definition
| nil per os: nothing by mouth (cannot eat or drink anything, all nutrients are IV, etc) |
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Term
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Definition
| is it fitted correctly, is it comfortable, is it actually in? etc. |
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Term
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Definition
machine which exercises the diaphragm/lungs in order to prevent nosocomial pneumonia (bed-ridden pts at high risk); ONLY IF ORDERED
pt exhales, then inhales through machine and holds it--measure pressure QUICKLY--then release |
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Term
| True or False: if gown is thin enough, apical rhythm can be measured through it |
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Definition
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Term
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Definition
| Check Dressings, Braden Risk Assessment: See My Albino Matte? Need Formula: Sensitivity, moisture, activity, mobility (immobile: at risk for break-down), nutrition, and friction/shear |
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Term
| 7 y.o. Johnny is on renal watch, after your initial assessment what would you ask him, and how? |
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Definition
| "Have you peed today?" not urinated, or voided, use his language |
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Term
| Name 7 of Joint Commissions Core Measures |
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Definition
| MI, HF, pneumonia (PN), venous thromboembolism (VTE), stroke (STK), emergency department (ED), substance use (SUB); children's asthma care (CAC), surgical care improvement project (SCIP), hospital outpatient measures (HOP), perinatal care (PC), hospital-based inpatient psychiatric services (HBIPS), immunization (IMM), tobacco treatment (TOB) |
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Term
| Major Abnormalities (Red Flags) |
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Definition
| Always stop assessment and investigate upon unexpected abnormality of any kind |
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Term
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Definition
a nursing communication tool that helps verbalize data (vs. SOAP which helps write data)
Situation
Background
Assessment
Recommendations |
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