Exam (elaborations)
N450 declining patient (1)
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- N450 - Ch. 3 - Principles Of Geriatrics
N450 declining patient (1)
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N450 declining patientcauses of deterioration - ANS-acute change in condition
comorbidities
meds/interactions
age
nutritional status
vital signs - ANS-know normal range and patient baseline
evaluate trends
do VS match assessment?
MEWS/PEWS - ANS-early warning system
ID patients at risk for deterioration
SBP, HR, RR, temp, and LOC
high score = high risk
increased RR - ANS-pain, anxiety, stress
sit up and apply O2
increased BP/HR - ANS-pain, fluid overload, not taking BP meds, MI
decreased BP, increased HR - ANS-HYPOVOLEMIC SHOCK, dehydration (v/d, maintenance
IVs, I/Os)
increased HR/RR/temp - ANS-infection, shock
intake/output - ANS-last 24 hours, during shift, any major changes, standard = 30 ml/hour
Na CHANGE = LOC CHANGE
dehydration - ANS-low UO, decreased skin turgor, dry mucous membranes, sunken eyes,
increased HR, decreased BP, crave fluids, INCREASED Na
overload - ANS-JVD, crackles in lungs, increased BP, bounding pulse, peripheral edema,
DECREASED Na
labs - ANS-major changes and why
blood gases - ANS-pH: 7.35-7.45
PCO2: 35-45
HCO3: 22-26
PaO2: 80-100
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