Reassessment Flashcards
What are the goals of reassessment
- Continues on initial steps of assessment
- Identifies changes and trends
- Changes (subtle and profound) • Trends
- Deterioration
- Improvement
Things to think about when interacting with the patient
- Explain process
* Consider patient’s feelings, such as anxiety or embarrassment
First Step in Reassessment
- Recheck for life-threatening problems
- Reassess mental status
- Maintain open airway
- Monitor breathing (rate and quality)
- Reassess pulse (rate and quality)
- Monitor skin color and temperature
- Re-establish patient priorities
What are you thinking about when Reassessing Vital Signs
- Compare results with baseline measurements
- Re-evaluate oxygen
- Document findings to record and identify trends
• Think of an example of a problem that might develop into a life threat to the patient on the way to the hospital.
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What are you doing when repeating a focused assessment
• Chief complaint may change, especially
with regard to severity
• Ask about changes in symptoms, especially ones anticipated because of treatments administered
• Repeat physical exam to identify changes from baseline
• Check any interventions
If you have intervened what are you thinking about
- Ensure adequacy of oxygen delivery and artificial ventilation
- Ensure management of bleeding
- Ensure adequacy of other interventions
• Describe an example of an intervention that might need to be reevaluated and discuss your process for examining it.
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How would you establish trends
- Repeat reassessment steps frequently
- Establish and document trends
- Trending: observing patterns that have emerged among vital signs
- Trends may indicate new treatments or adjustments to ongoing treatments.
Reassessment for Stable and Unstable Patients
- Patient condition, as well as length of time with patient, will determine how often you reassess
- The more serious patient’s condition, the more often you reassess
- Every 15 minutes for stable patient
- Every 5 minutes for unstable or potentially unstable patient
- If you believe there may have been a change in patient’s condition, repeat at least primary assessment
Reassessment of the Stable Medical Patient
- Repeat primary assessment
- Repeat and record vital signs
- Repeat pertinent parts of history and physical exam
- Check interventions you performed
- Repeat all steps every 15 minutes
Reassessment: Unstable Trauma Patient
- Repeat primary assessment to check for life-threatening problems
- Repeat and record vital signs
- Repeat trauma assessment
- Check interventions you performed
- Repeat all steps every 5 minutes
Chapter Review
• Reassessment is the last step in your
assessment of a patient.
• You should reassess a stable patient at least every 15 minutes and an unstable patient at least every 5 minutes.
• Elements of reassessment include the primary assessment, vital signs, pertinent parts of the history and physical exam, and checking the interventions you performed for the patient.
• Interventions you need to check include oxygen, bleeding, spine immobilization, and splints.
Remember
- Assess if the patient’s condition changed in any way, indicating the need for new interventions. Is the airway clear? Is breathing adequate? Is circulation intact?
- Check the interventions you performed. Are they functioning as they should?
- Adjust interventions if necessary.
Consider
• Name the four steps of reassessment and list what assessments you will make during each step.
