Patient assessment

1.Ventilation: moving air in and out of the lungs.

2.Oxygenation: getting oxygen in to the blood.

3.Circulation: moving the blood through the body.

4.Perfusion: getting oxygen into the tissues

• RR (12-20bpm)
• Tidal volume
• Chest movement
• Breath sound
• Paco2
• Etco2

• HR
• color
• Sensorium
• Pao2
• Spo2

• HR and strength
• CO

• BP
• sensorium
• Temp
• Urine Output
• HEMODYNAMICS

• admitting dx
• history of present illness
• chief complain
• past medical history
• current medication

• a. Pack Years: # of packs/day X # of years smoked.
• b. type of tobacco use: pipe, cigar, chewing, etc.
• c. Always recommend Nicotine replacement therapy

• admission notes
• s/s
• occupation, employment hx, hobbies
• allergies
• surgical hx, illness or injury
• Physical examination

• type of tx
• frequency
• medication dosage and route of administration
• physician signature

• 1. Normal Urine output is 40 ml/ hr
• 2. Sensible water loss- urine, vomiting
• 3. Insensible water loss- lungs and skin.
• 4. if intake exceeds output this could result in:
•    a. weight gain
•    b. electrolyte imbalance
•    c. increased hemodynamic pressure
•    d. decrease lung compliance

• Normal CVP: 2-6 mm HG
• Decreased CVP: hypovolemia= Fluid Therapy
• Increased CVP: hypervolemia= Diuretics

Normal

may be due to sleep apnea or excessive 0s therapy in patient with COPD.

• Responds inappropriately, may be due to:
• drug overdose
• intoxication

responds only to painful stimuli

• Drowsy state
• MAY HAVE A DECREASED COUGH OR GAG REFLEX

Does not respond to a painful stimuli.