ACCS Patient Assessment
Advanced Directive
Set of instructions documenting what treatment a patient would want if they were unable to make
decisions.
Changes can be made at any time.
Recorded in the patient chart.
Living Will
Treatment patient wants if the become critically ill ( < 6mos to live).
Does NOT allow patient to appoint someone to make decisions.
Durable Power of Attorney
Legal document naming a healthcare proxy.
Takes effect only when patient is unable to make decisions for themselves.
A properly written respiratory care order should include what four factors?
Type of therapy
Frequency
Medication dosage and dilution
Physician signature
What is the normal range of urine output?
40-80 mL per hour (1-2 L per day)
What findings might indicate that the patient's fluid intake has exceeded his urine output?
Weight gain
Electrolyte imbalance
Increased hemodynamic pressures
Decreased lung compliance
Changes in patient's CVP can indicate?
<2 hypovolemia...fluid challenge
>6 hypervolemia....diuretics
Semicomatose
responds only to painful stimuli
Stuporous
Responds inappropriately
OD
Intoxication
Obtunded
Drowsy
May have decreased cough or gag reflex
Glasgow Coma Scale, above what # is good?
Above 3
When assessing a patient's orientation to time, place, and person, what are four factors that could affect
the patient's ability to cooperate?
Language difficulties
Influence of medications
Hearing loss
Fear, apprehension, depression
Orthopnea
, difficulty breathing when lying down
CHF
Heart problems
General malaise
Associated With
Electrolyte Imbalance
Fix it
Dysphagia
difficulty swallowing
vasovagal syncope
a common physiological response consisting of slow heart rate and low blood pressure that sometimes
occurs in people with blood/illness/injury phobias
orthostatic hypotension
temporary low BP and dizziness when suddenly rising from a sitting or reclining position
carotid sinus
Associated with hypersensitive carotid sinus
Most common in the elderly
Cough (tussive) syncope
transient loss of consciousness following severe coughing
(usually asthma)
Oral temperature
97-99.5 (36.5-37.5)
Rectal temperature
98.6-100.6 F
37.0-38.1 C
tympanic temperature
98.7-100.5 (37.1-38.1)
hemiparesis
Abnormal posturing
Brain injury
peripheral edema
The swelling of tissues, usually in the lower limbs, due to the accumulation of fluids.
CHF
Pulmonary hypertension
Venous insufficiency
Renal failure
Ascites
abnormal accumulation of fluid in the abdomen
Liver failure
Clubbing
bulbous enlargement of distal phalanges of fingers and toes that occurs with chronic cyanotic heart and
lung conditions
Venous distention
Certain veins protrude
JVD
CHF
Obstructive lung disease
Advanced Directive
Set of instructions documenting what treatment a patient would want if they were unable to make
decisions.
Changes can be made at any time.
Recorded in the patient chart.
Living Will
Treatment patient wants if the become critically ill ( < 6mos to live).
Does NOT allow patient to appoint someone to make decisions.
Durable Power of Attorney
Legal document naming a healthcare proxy.
Takes effect only when patient is unable to make decisions for themselves.
A properly written respiratory care order should include what four factors?
Type of therapy
Frequency
Medication dosage and dilution
Physician signature
What is the normal range of urine output?
40-80 mL per hour (1-2 L per day)
What findings might indicate that the patient's fluid intake has exceeded his urine output?
Weight gain
Electrolyte imbalance
Increased hemodynamic pressures
Decreased lung compliance
Changes in patient's CVP can indicate?
<2 hypovolemia...fluid challenge
>6 hypervolemia....diuretics
Semicomatose
responds only to painful stimuli
Stuporous
Responds inappropriately
OD
Intoxication
Obtunded
Drowsy
May have decreased cough or gag reflex
Glasgow Coma Scale, above what # is good?
Above 3
When assessing a patient's orientation to time, place, and person, what are four factors that could affect
the patient's ability to cooperate?
Language difficulties
Influence of medications
Hearing loss
Fear, apprehension, depression
Orthopnea
, difficulty breathing when lying down
CHF
Heart problems
General malaise
Associated With
Electrolyte Imbalance
Fix it
Dysphagia
difficulty swallowing
vasovagal syncope
a common physiological response consisting of slow heart rate and low blood pressure that sometimes
occurs in people with blood/illness/injury phobias
orthostatic hypotension
temporary low BP and dizziness when suddenly rising from a sitting or reclining position
carotid sinus
Associated with hypersensitive carotid sinus
Most common in the elderly
Cough (tussive) syncope
transient loss of consciousness following severe coughing
(usually asthma)
Oral temperature
97-99.5 (36.5-37.5)
Rectal temperature
98.6-100.6 F
37.0-38.1 C
tympanic temperature
98.7-100.5 (37.1-38.1)
hemiparesis
Abnormal posturing
Brain injury
peripheral edema
The swelling of tissues, usually in the lower limbs, due to the accumulation of fluids.
CHF
Pulmonary hypertension
Venous insufficiency
Renal failure
Ascites
abnormal accumulation of fluid in the abdomen
Liver failure
Clubbing
bulbous enlargement of distal phalanges of fingers and toes that occurs with chronic cyanotic heart and
lung conditions
Venous distention
Certain veins protrude
JVD
CHF
Obstructive lung disease
