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RESP 101, Assessment and Caring for a Respiratory Patient > Control Comp #1 (Hand Hygiene, Vital Signs, Pulse Oximetry, Physical Assessment of the Chest, Patient Interview) > Flashcards

Control Comp #1 (Hand Hygiene, Vital Signs, Pulse Oximetry, Physical Assessment of the Chest, Patient Interview) Flashcards

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1
Q

Hand Hygiene (Comp 1)
Procedure Steps Handwashing
(9 Steps)

A
  1. Adjust water flow and temperature; avoids contact with sink
  2. wets forearms and hands thoroughly
  3. applies disinfectant soap liberally
  4. washes hands with appropriate friction for a minimum of 15 seconds
  5. Palms, wrists, between fingers, nails
  6. Avoids hand/finger contact with fixtures
  7. Rinses thoroughly from the fingertips to the forearm.
  8. Dries hands and wrists thoroughly using a separate towel for each, drying from fingertips to wrist
  9. Turns off water avoiding re-contamination
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2
Q

Hand Hygiene
Procedure Steps Handwashing
(Steps 1-5)

A
  1. Adjust water flow and temperature; avoids contact with sink
  2. wets forearms and hands thoroughly
  3. applies disinfectant soap liberally
  4. washes hands with appropriate friction for a minimum of 15 seconds
  5. Palms, wrists, between fingers, nails
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3
Q

Hand Hygiene
Procedure Steps Handwashing
(Steps 6-9)

A
  1. Avoids hand/finger contact with fixtures
  2. Rinses thoroughly from the fingertips to the forearm.
  3. Dries hands and wrists thoroughly using a separate towel for each, drying from fingertips to wrist
  4. Turns off water avoiding re-contamination
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4
Q

Hand Hygiene (Comp 1)
Hand Sanitation
(2 Steps)

A
  1. Fills palms with liquid or foam sanitizer
  2. Rubs into hands, between fingers, into palms and wrists for at least 15 seconds until dry
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5
Q

Vital Signs (Comp 1)
(16 Steps)

A
  1. Gather Equipment
  2. Utilizes and maintains standard precaution as required
  3. Checks Physician Orders
  4. Identifies patient, introduces self and department
  5. Explains purpose of the procedure
  6. Positions patient for accessibility and comfort (sit up)
  7. Palpates appropriate artery (pulse) - counts heart rate, noting force and regularity of beats
  8. Observes respiratory rate, rhythm and depth
  9. Palpates brachial pulse and places arterial pressure cuff
  10. Measures arterial blood pressure
  11. Repositions patient if desired (lays back down)
  12. Reassures patient
  13. Restores patient area, if necessary
  14. Removes gloves, washes hands
  15. Records data in chart or departmental records
  16. Notifies appropriate personnel of results if needed
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6
Q

Vital Signs
Steps 1-6

A
  1. Gather Equipment (Stethoscope, Pulse Ox, Blood Pressure Cuff)
  2. Utilizes and maintains standard precaution as required (Hand Hygiene, Gloves, Mask)
  3. Checks Physician Orders
  4. Identifies patient, introduces self and department (Check Wrist Bands)
  5. Explains purpose of the procedure
  6. Positions patient for accessibility and comfort (sit up)
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7
Q

Vital Signs
Steps 7-10

A
  1. Palpates appropriate artery (pulse) - counts heart rate, noting force and regularity of beats
  2. Observes respiratory rate, rhythm and depth
  3. Palpates brachial pulse and places arterial pressure cuff
  4. Measures arterial blood pressure
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8
Q

Vital Signs
Steps 11-16

A
  1. Repositions patient if desired (lays back down)
  2. Reassures patient
  3. Restores patient area, if necessary
  4. Removes gloves, washes hands
  5. Records data in chart or departmental records
  6. Notifies appropriate personnel of results if needed
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9
Q

Vital Signs (Per Egan) Adult
1. Heart Rate (HR) Pulse Rate
2. Respiratory Rate (RR)
3. Blood Pressure
4. Pulse Ox

A
  1. Heart Rate: 60-100 Beats/Minute
  2. Respiratory Rate: 12-18 Breaths/Minute
  3. Blood Pressure: 90-140 systolic/60-90 diastolic (MMHG)=Millimeters of Mercury
  4. Pulse Ox: >92% (per most hospital policies)
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10
Q

Vital Signs (Per Wilkins) Adult
1. Heart Rate (HR) Pulse Rate
2. Respiratory Rate (RR)
3. Blood Pressure
4. Pulse Ox

A
  1. Heart Rate: 60-100 Beats/Minute
  2. Respiratory Rate: 12-20 Breaths/Minute
  3. Blood Pressure: 120 systolic/80 diastolic (MMHG)=Millimeters of Mercury (Median)
  4. Pulse Ox: >92% (per most hospital policies)
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11
Q

Pulse Oximetry
(Steps 14-17)

A
  1. Assures patient comfort and safety
  2. Disposes of PPE, Washes/gels hands
  3. Records data in chart and departmental records
  4. Communicates with appropriate staff
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12
Q

Physical Assessment of the Chest (Comp 1)
(25 Steps)

A
  1. Utilizes and maintains standard precautions required
  2. Identifies patient, introduces self, department; explains purpose
    3-12. Assessment by inspection: (what is seen)
    -Overall appearance, age, sex, and weight
    -Patient positioning (tripod, high Fowler’s, etc)
    -General shape and appearance, A-P diameter, sternal deformities, surgical or other scars, and symmetrical expansion
    -Normal or abnormal spinal curvatures
    -Retractions, pursed-lip breathing, nasal flaring, and abdominal paradox
    -Presence of chest tubes
    -Cyanosis, pallor, mottling, diaphoresis, swelling, pitting edema, turgor, dryness, bruises, erythema, or petechiae, masses, lesions, or nodules
    -Respiratory: depth, pattern, regularity, and accessory muscle use
    -Paradoxical or unequal expansion
    -Assesses capillary refill
    13-17. Assessment by palpation
    -Palpates pulse
    -Position of trachea
    -Presence of subcutaneous emphysema
    -Bilateral chest expansion
    -Tactile fremitus using “ninety-nine”
  3. Assessment by percussion-performs diagnostic chest percussion
    19-20. Assessment by auscultation
    -Auscultates chest for normal, abnormal, and adventitious breath sounds
    -Listens for egophony, bronchophony, and whispered pectrilloquy
    FOLLOW-UP
  4. Ensures patient’s comfort, safety, and needs
  5. Thanks patient
  6. Disposes of PPE; washes/gel hands
  7. Documents
  8. notifies appropriate personal and makes recommendations based on assessment
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13
Q

Physical Assessment of the Chest
(Steps 1-2)

A
  1. Utilizes and maintains standard precautions required (Hand Hygiene, Glove, Mask)
  2. Identifies patient, introduces self, department; explains purpose (Check Wristband)
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14
Q

Physical Assessment of the Chest
(Steps 3-12)

A

3-12. Assessment by inspection: (what is seen)

  1. Overall appearance, age, sex, and weight
  2. Patient positioning (tripod, high Fowler’s, etc)
  3. General shape and appearance, Anterior/Posterior diameter, sternal deformities, surgical or other scars, and symmetrical expansion
  4. Normal or abnormal spinal curvatures (Scoliosis)
  5. Retractions, pursed-lip breathing, nasal flaring, and abdominal paradox
  6. Presence of chest tubes
  7. Cyanosis, pallor, mottling, diaphoresis, swelling, pitting edema, turgor, dryness, bruises, erythema, or petechiae, masses, lesions, or nodules
  8. Respiratory: depth, pattern, regularity, and accessory muscle use
  9. Paradoxical or unequal expansion
  10. Assesses capillary refill (Pressure on Nail bed) (2-3 sec refill = Normal)
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15
Q

Physical Assessment of the Chest
(Steps 13-17)

A

13-17. Assessment by palpation

  1. Palpates pulse
  2. Position of trachea (midline)
  3. Presence of subcutaneous emphysema (air beneath skin)
  4. Bilateral chest expansion
  5. Tactile fremitus using “ninety-nine” (fluid in lungs)
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16
Q

Physical Assessment of the Chest
(Steps 18-20)

A
  1. Assessment by percussion-performs diagnostic chest percussion

19-20. Assessment by auscultation

  1. Auscultates chest for normal, abnormal, and adventitious breath sounds
  2. Listens for egophony, bronchophony, and whispered pectrilloquy
17
Q

Physical Assessment of the Chest
(Steps 21-25)

A

FOLLOW-UP

  1. Ensures patient’s comfort, safety, and needs
  2. Thanks patient
  3. Disposes of PPE; washes/gel hands
  4. Documents
  5. notifies appropriate personal and makes recommendations based on assessment
18
Q

Pulse Oximetry (Comp 1)
(17 Steps)

A
  1. Gathers appropriate equipment and leans finger probe
  2. Checks physician’s orders
  3. Identifies patient, introduces self and department
  4. Washes hands and dons gloves
  5. Explains purpose of the procedure
  6. Positions patient for accessibility and comfort
  7. Performs function check on oximetry
  8. positions probe on an appropriate site
  9. Palpates and measures pulse on the opposite wrist pulse for at least 15 seconds, if irregular measures for 1 full minute
  10. obtains initial reading and correlates with a manual pulse
  11. Switches fingers and obtains a second reading when indicated (or positions probe for continuous reading)
  12. Concludes procedure and explains to the patient if it is a continuous or spot check
  13. Cleans probe, stores and/or removes equipment
  14. Assures patient comfort and safety
  15. Disposes of PPE, Washes/gels hands
  16. Records data in chart and departmental records
  17. Communicates with appropriate staff
19
Q

Pulse Oximetry
(Steps 1-6)

A
  1. Gathers appropriate equipment and leans finger probe
  2. Checks physician’s orders
  3. Identifies patient, introduces self and department
  4. Washes hands and dons gloves
  5. Explains purpose of the procedure
  6. Positions patient for accessibility and comfort
20
Q

Pulse Oximetry
(Steps 7-13)

A
  1. Performs function check on oximetry (turn on)
  2. positions probe on an appropriate site
  3. Palpates and measures pulse on the opposite wrist pulse for at least 15 seconds, if irregular measures for 1 full minute
  4. obtains initial reading and correlates with a manual pulse (w/in 2%)
  5. Switches fingers and obtains a second reading when indicated (or positions probe for continuous reading)
  6. Concludes procedure and explains to the patient if it is a continuous or spot check
  7. Cleans probe, stores and/or removes equipment
21
Q

Patient Interview/History (Comp 1)
(17 Steps)

A
  1. Utilizes standard precautions
  2. Identifies patient, introduces self and department
  3. Explains objective of interview
    4-6. Uses therapeutic communications skills to determine:
    -Level of consciousness & sensorium a/o x3
    -Ability to follow commands & level of cooperation
    -Emotional status, nutritional status, level of dyspnea, tolerance of activities of daily living
    7-11. Interview patient with questions to verify information obtained from chart:
    -Demographics
    -Chief complaint: onset, duration, frequency, severity, character, location, radiation, aggravating factors, associated manifestations
    -History of present illness
    -Past medical history
    -Psychosocial assessment: Birthplace, race, religion, culture, highest education level, alcohol intake, drug, occupational history, allergies, current meds, smoking history
    12-14. Interviews patient to determine specific pulmonary information
    -Dyspnea on exertion or at rest; orthopnea, platypnea
    -Cough, sputum production amount, color, consistency, presence of any blood
    -Chest pain-quality, location, radiation, aggravating factors, alleviating factors, associated manifestations
  4. assesses patient’s comfort level, safety, and needs; thanks patient
  5. Disposes of PPE; washes/gels hands
  6. Documents
22
Q

Patient Interview/History
(Steps 1-3)

A
  1. Utilizes standard precautions
  2. Identifies patient, introduces self and department
  3. Explains objective of interview
23
Q

Patient Interview/History
(Steps 4-6)

A

4-6. Uses therapeutic communications skills to determine:

  1. Level of consciousness & sensorium a/o x3
  2. Ability to follow commands & level of cooperation
  3. Emotional status, nutritional status, level of dyspnea, tolerance of activities of daily living
24
Q

Patient Interview/History
(Steps 7-11)

A

7-11. Interview patient with questions to verify information obtained from chart:

  1. Demographics
  2. Chief complaint:
    onset, duration, frequency,
    severity, character, location,
    radiation, aggravating factors, associated manifestations
  3. History of present illness
  4. Past medical history
  5. Psychosocial assessment:
    Birthplace, race, religion, culture,
    highest education level, alcohol intake, drug, occupational history, allergies, current meds, smoking history
25
Q

Patient Interview/History
(Steps 12-14)

A

12-14. Interviews patient to determine specific pulmonary information

  1. Dyspnea on exertion or at rest; orthopnea, platypnea
  2. Cough, sputum production amount, color, consistency, presence of any blood
  3. Chest pain-quality, location, radiation, aggravating factors, alleviating factors, associated manifestations
26
Q

Patient Interview/History
(Steps 15-17)

A
  1. assesses patient’s comfort level, safety, and needs; thanks patient
  2. Disposes of PPE; washes/gels hands
  3. Documents

RESP 101, Assessment and Caring for a Respiratory Patient (11 decks)

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