What is a pre-dialysis evaluation?
1) Review of the patient's health.
2) Compares current health status to previous evaluations.
Why is
... [Show More] pre-dialysis evaluations needed?
1) To determine if the patient is stable to receive treatment.
2) Determine if there has been a change in health status.
3) Provides a baseline date to plan for a safe treatment.
Describe Universal precautions
Steps we take with all patient contact to decrease the risk of spreading infection to protect our patient and ourselves.
What are the 3 C's?
1) Condition (objective)
2) Complaints (subjective)
3) Changes (objective)
What should you look for with:
Ambulation
Gait changes, use of assistive devices, ROM, energy level.
What should you look for with:
Mental status and mood
A&O x 3, any changes in usual mood
(Alert and orientation)
Person, place, time (situation) A&Ox4
What should you look for with:
Skin
Color, integrity, temperature, edema
What should you look for with:
Vital signs
Weight, BP, HR, respiration's, temperature
What is EDW?
Estimated Dry weight
A patient's wt with excess fluid removed
When is a RN required to assess a pre-treatment wt?
If the patient pre-treatment wt is >4 kg above EDW.
What does a blood pressure measure?
Measurement of the pressure of force of blood against the walls of the arteries.
When do you report a blood pressure to the RN?
SBP <100 or > 180
DBP> 100
When do you report a heart rate to a RN?
New onset of HR <60 or >100
or a irregular beat
When do you report a respiratory rate to the Rn?
A respiratory rate of > 24 breaths per minute
True or False
Does a dialysis patient maintain an average temperature?
False!
When do you report a temperature to the RN?
Temperature < 96 & > or = to 100 degrees
Name some important complaints you need to report to the RN?
(10)
1) Dizziness
2) Chest pain
3) SOB (shortness of breath)
4) Any new complaints
5) A visit to the ER or a hospital stay
6) Weakness
7) Numbness or tinglinng
8) Fever or chills
9) Depression/sadness
10) Pain
What changes do you report to the RN?
New medications or visit to ER or hospital stay.
What are the ABC's of the patients assessment?
A) Access
B) Breathing
C) Cardiac
What to look for with:
Access
Bruises, redness, drainage, swelling, bruit, thrill, pain, bleeding
What to look for with:
Breathing
Rate, rhythm, quality, SOB, breath sounds
What to look for with:
Cardiac
Skin color and turgor, heart sounds, pulse rate, rhythm & quality, edema, pain, SOB
Why do patients expreience crackles (rales) breath sounds?
Indicates fluid or congestion in lungs
Name some reasons for an abnormal heart rate?
Can indicate chemical imbalances or adverse effects from medications.
Names some places fluid can get trapped?
(Edema)
Abdomen, lungs, feet, legs, hands,and face
What are the ranges for pitting edema?
1-4 cm
What do you do when you have a red light as a complaint?
Do not start the treatment until the RN has done a full assessment on the patient. [Show Less]