BAT Flashcards
I - SAFETY
(MUST complete ALL items to pass)
a. Knock on the patient’s door, greet patient. Perform hand hygiene. Introduce yourself. Don gloves.
b. Verify patient’s identity: name, DOB, MRN. Check with wrist band and chart. – Verbalize findings: do they match or are there discrepancies?
c. Verify allergies: medication, food, latex, tape & environmental. Check with wrist band and chart. – Verbalize findings: do they match or are there discrepancies?
II - VITAL SIGNS
(MUST complete ALL items to pass)
a. VS provided in chart. Review with patient. State “All vital signs are within desired ranges”.
b. Ask patient if they have pain. If they do, you must OLDCARTS the complaint:
Onset: When did your pain start?
Location: Where is your pain located?
Duration: How long have you had pain?
Characteristics: What does the pain feel like?
Aggravating: What makes the pain worse?
Relieving: What makes the pain better?
Treatments: What treatments have you tried?
Severity: On a scale of 0-10, how severe is your pain?
- III - LEVEL OF CONSCIOUSNESS
(Verbalize ALL findings)
Can you tell me your full name?
Do you know where you are?
What time of day is it?
Patient is not showing any signs of distress. Body is symmetrical. Patient is alert and oriented X3.
IIII - EQUIPMENT
(Verbalize ALL findings)
a. Oxygen:
“I’m going to check your nasal cannula/mask. I do not see any skin breakdown on your nose, ears, or under the chin. I’m going to following the tubing to make sure there are no kinks or leaks. I don’t see any at this time. The flow rate matches your provider’s orders.”
b. IV lines:
“I’m going to check your IV. Does this feel okay? No erythema or edema present. I’m going to following the line to make sure there are no kinks or leaks. I don’t see any at this time. The IV solution and flow matches your orders.”
c. Urinary catheter:
“I do not see a urinary catheter, however if I did I would assess the catheter accordingly.”
V - HAIR / SKIN / NAILS
(Verbalize ALL findings)
a. Inspect: hair, scalp, nails, skin.
“I’m going to check your hair and scalp. There is even distribution. No lesions, rash, or breakdown present.”
b. Assess: wounds? I do not see any wounds present on the patient’s skin. If I did I would check the dressings, drains, and drainage.
c. Palpate: skin turgor, temperature. Any edema in the extremities?
Check temp. with back of hands on each arm. “Patient is warm and dry bilaterally. Skin appropriate for ethnicity. I am going to check for any signs of edema. No pitting present (check both arms and legs). I am going to check skin turgor. No tenting present (check skin tugor on hand).
d. Palpate: Check capillary refill (1 finger per hand, 1 toe per foot). “Cap refill is less than three seconds in all areas.”
VI - HEENT
(Verbalize ALL findings)
a. Inspect: external ears
Check both ears. “I’m going to look at your ears. No rashes, lesions, or drainage present.”
b. Inspect: eyes – PERRLA, conjunctiva color, sclera.
With pen light check eyes for direct and consensual light reflect. Check accommodation- look at shoulder and then at pen, back at shoulder, and pen again.
“Eyes are PERRLA. Pupils are equal, round, and reactive to light and accommodation. “
Check conjunctiva and sclera. “Conjunctiva is pink and moist. Sclera is white.”
c. Inspect: nares – color, any drainage?
Check nose. “Nares appear moist. No drainage.”
d. Inspect: mouth, tongue, oropharynx (color, any lesions?)
Have patient open mouth, stick out tongue, say Ahhhh. “Uvula and soft palate rises to the midline. Mouth is pink and moist. No lesions present.”
e. Assess: smile.
Ask patient to smile, check for facial symmetry. “No apparent facial weakness or drooping. Patient’s face is symmetrical.”
VII - 7. RESPIRATORY
For check off purposes, examine POSTERIORLY only, sitting up.
a. Inspect: accessory muscle use, work of breathing. – Verbalize findings.
No signs of distress. No accessory muscle use observed. AP:T ratio is 1:2.”
b. Auscultate: breath sounds using Greek Key pattern from apex to base (MUST be completed on skin, auscultation over gown NOT acceptable)
Ask patient to move to side of bed opposite of BAT grader. “I am going to check your breath sounds using the Greek Key pattern. Each time you feel my stethoscope touch your skin, please take a deep breath. If you feel lightheaded or dizzy at all, please let me know. No adventitious breath sounds heard.”
c. Verbalize – “I do not see an incentive spirometer, but if I did I would teach patient how to use it.”
VIII - CARDIAC
Examine patient ANTERIORLY, leaning forward slightly
a. Palpate: carotid – one side at a time. Thrills? – Verbalize findings. “Regular rate and rhythm. No thrills present.”
b. Palpate: pulses (radial and dorsalis pedis) – Verbalize findings. “Regular rate and rhythm. No thrills present.”
c. Palpate: PMI. Lifts? Heaves? – For check off purposes, you may verbalize: “I would palpate the PMI at the 5th ICS MCL, no lifts or heaves noted.”
d. Auscultate: carotid – one side at a time. Bruits? – Verbalize findings. “Regular rate and rhythm. No bruits present.”
e. Auscultate: heart sounds in all areas with diaphragm and bell. – All locations and positions must be verbalized: aortic /RSB 2nd ICS, pulmonic/LSB 2nd ICS, erbs point/LSB 3rd ICS, tricuspid/LSB 4th ICS, mitral/5th ICS MCL. (MUST be completed on skin, auscultation over gown NOT acceptable. For check off purposes, ONLY mitral area can be verbalized instead of auscultation: “I would auscultate the mitral area over the 5th ICS MCL”. All other areas should be auscultated)
f. Verbalize: rate, rhythm, any extra sounds? “Regular rate and rhythm. S1 and S2 heard. No extra sounds heard. S3 and S4 not present”.
VIIII - GI
Examine with patient laying supine
a. Ask patient: “Have you had any nausea, vomiting or diarrhea? Do you have any dietary restrictions? When was your last BM? Was it normal or abnormal?”
b. Inspect: shape, symmetry, any pulsations?
c. Auscultate: bowel sounds in all 4 quadrants with diaphragm.
d. Verbalize: “I would listen for 5 minutes in each quadrant if no sounds were auscultated”
e. Auscultate: aorta with bell – any bruits?
f. Palpate: all 4 quadrants lightly (1 hand approach) and then deeply (2 hand approach) – Any tenderness? Guarding? Masses?
X - GU
a. Ask patient: “Have you been urinating more frequently than your usual? How often do you urinate a day on average? When did you last urinate? Was it normal or abnormal?”
b. Verbalize: “I would monitor intake/output for the patient”
XI - MS/EXTREMITIES
a. Ask patient: “Are you experiencing any swelling or numbness or tingling in any of your extremities?”
b. Perform: hand grip test & foot pumps against resistance for strength – Verbalize findings. “Muscle strength 5/5 bilaterally, in all areas.”
XII - FINAL CHECKS
Verbalize all areas
a. Call light within reach? Verify patient knows how to use call button
b. Bed in down position? Side rails down/up?
c. Verbalize – “is there anything else I can do for you?”
d. Perform hand hygiene. Leave room.
