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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.
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.
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
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
What should you do before entering the Pt's room for a RA?
Wash your hands & gather equipment: steth, penlight, document form, hand sanitizer.
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.)