Rapid assessment

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Author:
xiongav
ID:
282448
Filename:
Rapid assessment
Updated:
2014-09-10 22:02:45
Tags:
rapid
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Description:
NURS 1150
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  1. Rapid assmnt enables the nurse to? (5)
    • 1. Establish a baseline.
    • 2. Prioritize Pt care.
    • 3. Recognize changes in Pt status
    • 4. Evaluate Pt progress.
    • 5. Modify nursing care.
  2. What are the 5 nursing knowledge base for Rapid Assmnt?
    • 1. Hollistic assmnt.
    • 2. Maslow
    • 3. Erickson
    • 4. Human anatomy
    • 5. Anatomical landmarks for auscultation of heart, lung, and bowel sounds.
  3. What are the nursing skills rq'd to PERFORM a rapid assmnt? (6)
    • 1. Communication
    • 2. Inspection
    • 3. Auscultation
    • 4. Palpation
    • 5. Body mechanics
    • 6. Physical & psychological safety
  4. How do you assess ABCDEs of the RA?

    What should the Pt be able to tell you?
    If Pt talks to you w/o difficulty, it may indicate no problems with breathing however there still may be a potential problem)

    • Pt should be able to:
    • -State name
    • -Place
    • -DOB
    • -Time
  5. What should you do before entering the Pt's room for a RA?
    Wash your hands & gather equipment: steth, penlight, document form, hand sanitizer.
  6. What does "D" and "E" stand for and how should you assess for them?
    D: discomfort. Ask about pain, nausea, SOB, discomfort.

    • E: environment
    • Check tubes: Is IV solution hanging? Pump set correctly? IV site w/o redness, swelling? 

    *Include siderails,bed up/down, call light, drapes, gown, etc.)

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