A - H Assessemnt Flashcards
1
Q
A
A
AIRWAY
- C-Spine
- Airway patency - Cough,Sputum, Vomit
- Inspiratory or expiratory noises (stridor)
- Risks ie. loose denture, burns
2
Q
B
A
BREATHING
R - Respiratiry Rates
A - Auscultation
T - Tracheal position
E- Effort
- Assessing for signs of distress WOB
- Talking full or short sentences
- Sp02
3
Q
C
A
CIRCULATION
- Haemorrhage control
- Pulse (manual Rate + rhythm)
- BP (manual if outside normal)
- Cap refill (central + peripheries)
- ECG Cardiac monitoring
- Colour (pale, mottled)
- Skin temperature (cool / clammy / warm)
- lVC / CVAD
- Neurovascular observations
4
Q
D
A
DISABILITY/DISCOMFORT/DRUGS
- GCS
- AVPU
- Cognitive State
- Delirium
- Amnesia score
- Pain - PQRST
- Alcohol, Tobacco, or Other Drugs- withdrawal scale/ intervention
- Medication/changes
- BGL
5
Q
E
A
EXPOSURE
- Temperature
- IVC (L/R, day, appearance)
- Head to toe & back
- Skin integrity
- Pressure areas
- Skin appearance (rash, swelling, colour)
- Wounds & dressings
6
Q
F
A
FOOD/FLUIDS
- Fluid balance
- IV fluids
- Diet type & intake / NBM
- Bowel / Urine output
- Insensible / other loss
- Weight
7
Q
G
A
GLUCOSE + Gadgets
- BGL (pre/post meal, random) > Intervention
- IVC / CVAD / IDC / SPC / Drains / NGT / Arterial Line - site,appearance,position
- Diagnostics
8
Q
H
A
HOLISTIC Person Centred
- ADLs
- Mobility
- Risk assessments
- Mental Health
- Emotional/spiritual Wellbeing
- Behaviour
- Multidisciplinary team?
- Pressure area care
- Patient / family / carer requests / concerns?
- Visitors
- Patient education
