Nursing Skills Final Exam Preparation

Know the proper way to wash hands and apply hand sanitizer, and when to use each one

a. When and how to use soap and water

i. Hands are visibly soiled

ii. Presence of infection

iii. Before and after eating

iv. After using the restroom

v. Wash hands with friction for at least 20 seconds

b. When and how to use hand sanitizer

i. All other situations

ii. Rub hands until completely dry

Know the 4 Bed Safety criteria in safe patient care

a. Bed in LOW position

b. Bed wheels LOCKED

c. Call LIGHT in reach

d. Side RAILS up x2

Know the 8 Critical Elements of Principal-Based Procedures

a. Wash hands before and after care

b. Gather supplies

c. Introduce yourself and others

d. Identify patient with 2 identifiers

e. Explain procedure

f. Provide privacy

g. Use good body mechanics

h. Provide patient safety

Normal range for systolic blood pressure

90-120

Normal range for diastolic blood pressure

60-80

Normal range for pulse

60-100 bpm

normal range for temperature

95.9-99.5 F (35.5-37.5 C)

normal range for respirations

12-20

normal range for oxygen saturation

>95% saturation of peripheral oxygen

why are vital signs checked

i. Monitor body systems

ii. Detect changes in health status

iii. Evaluate effectiveness of interventions

iv. Identify life-threatening warning signs

when are vital signs checked

i. Performed on a regular basis

ii. Frequency determined by:

1. Physician order and/or nursing judgement

2. Client's condition

3. Facility standards

a. Hospitals

i. Stable patient - every 4-8 hours

ii. Postsurgical patient - every 15-60 minutes

iii. Critical/unstable patient - every 5 minutes

b. Home health settings

i. Each visit

c. Clinics

i. Each visit

d. Skilled nursing facilities

i. Weekly to monthly

assessing an apical pulse

left midclavicular line

5th intercostal space

Peripheral pulses

i. Radial pulse - thumb side of inner wrist

ii. Temporal - side of the head at temple

iii. Carotid - side of neck below jaw

iv. Brachial inner side of elbow

v. Femoral - bend of leg at groin

vi. Popliteal - behind knee, inner side

vii. Posterior tibial - below inner ankle

viii. Dorsalis pedis - top of foot

correctly converting from Fahrenheit

i. F Temperature minus 32

ii. Multiply by 5

iii. Divide by 9 = C

correctly converting from Celsius

i. C temperature x 9

ii. Divide by 5

iii. Add 32 = F

physiology of blood pressure

a. Heartbeat forces blood against arterial walls

b. Creates a pressure wave as left ventricle contracts and then relaxes

c. Peak phase (highest) - Systolic pressure

d. Resting phase (lowest) - Diastolic pressure

Define the nursing process

The process nurses use to provide goal-directed, client-centered care

Identify the steps of the nursing process

Assessment

Diagnosis

Planning

Implementation

Evaluation

Apply the nursing process in delivery of patient care

a. Assessment

i. Evaluate the client's condition

b. Diagnosis

i. Identify the client's problems

c. Planning

i. Set goals of care and desired outcomes and identify appropriate nursing actions

d. Implementation

i. Perform the nursing actions identified in planning

e. Evaluation

i. Determine if goals met and outcomes achieved

what is objective data

What you observe and can measure

-vital signs

-Lab tests

what is subjective data

what the patient says

-Nausea

-Pain

what is verbal communication

Spoken communication (get feedback, remember PRIVACY), written communication (legal documentation), and electronic communication (confidentiality)

what is nonverbal communication

Body language (posture, stance, gait, facial expressions, eye contact, touch, and hand gestures), voice inflection (tone, volume, and rate/speed)

Describe the role of the nurse in the four phases of the nurse/patient therapeutic relationship

a. Stage one: pre-interaction phase

i. Gather info. Prior to meeting patient

b. Stage two: orientation phase

i. Meet the patient, introduce yourself, identify patient's needs

c. Stage three: working phase

i. Use therapeutic communication, develop and implement care plan

d. Stage four: termination phase

i. Evaluate outcomes, transition patient to next step

Identify collaborative professional communication and why it is essential for the nurse

a. Important information for the team; communication handoff

i. Situation

ii. Background

iii. Assessment

iv. Recommendation

therapeutic communication techniques

i. patient centered

ii. goal-directed

iii. strengthens the therapeutic relationship

iv. Call patient by proper name

v. Use open ended questions

vi. Actively listen - eye contact

vii. Share observations

viii. Give information

ix. Convey acceptance

x. Offer assistance

xi. Use humor appropriately

xii. Paraphrase patient comments

xiii. Seek clarification

xiv. Validate patient feelings

xv. Summarize conversation

Nontherapeutic Communication Techniques

i. Hurtful communication

ii. Damages relationships

iii. Social conversations

iv. Being self-absorbed

v. Asking "why didn't you..." (condemnation)

vi. Using closed-ended questions (yes/no)

vii. Changing the subject

viii. Giving false assurances

ix. Giving advice

x. Giving stereotyped responses

xi. Showing disapproval or disagreement

xii. Failing to listen

xiii. Excessive self-disclosure

xiv. Comparing patient experiences

xv. Being defensive

xvi. Using personal terms of endearment

Identify ethical, legal, and professional boundary issues with patient communication

a. Legal - confidentiality

i. HIPPA Laws

b. Ethical - Professional boundaries

i. Sharing personal information, inappropriate touch

c. Patient safety

i. 70-80 % of medical errors are due to poor communication

know the importance and purpose of bathing and oral hygiene

bathing

-to keep the patient clean

oral care

-removes bacteria

-reduces risk of tooth decay

-reduces risk of respiratory and cardiac infections

-improves appetite

know the basic guidelines of bathing and oral hygiene

bathing

-wash from distal to proximal to improve venous return

-wash from clean to dirty areas

control temperature of water: allow patient to check water temp.

-change water often

-wash, rinse, and dry before moving to next area

oral care

-provide every 2 hrs if NPO

-provide every 2 hr is unconscious

1. Discuss factors that can influence hygiene, and assisting patients with Activities of Daily Living (ADLs)

a. Physical factors

i. Pain: limits mobility and energy

ii. Mobility deficits: decreased range of motion, weakness, balance

iii. Sensory deficits: safety concerns and decreased independence

iv. Fatigue: exhaustion of strength due to physiologic changes in the body

b. Cognitive impairments

i. Cannot problem-solve ADL processes

ii. Forgets when hygiene was performed

c. Emotional disturbances

i. Profound lack of energy for ADLs

ii. Altered reality does not include hygiene

d. Personal preference

e. Culture and religion

f. Economic status

g. Knowledge level

determine patients' hygiene status and identify nursing interventions to provide hygiene and assistance with ADLs, including recommendations for care involving physical intimate touch

-ask if the patient can do anything themselves

-if they cannot do it themselves

-ask permission

-look for any nonverbal cues

-touch should be firm, but not rough, not hurried, but not lingering

Know proper body mechanics while providing nursing care to patients

a. Keep spine in natural alignment

b. Elevate work surface to center of body

c. Bend from knees, not waist, when lifting

d. Feet apart for wide base, avoid twisting

e. Keep patients or objects close to body

f. Use lifting devices when appropriate

g. Request help when needed

effects of immobility on the pulmonary system

i. Pulmonary edema

ii. Pneumonia

iii. Atelectasis

effects of immobility on the integumentary system

i. Tissue ischemia

ii. Pressure ulcers

effects of immobility on the musculoskeletal system

i. Muscle atrophy

ii. Joint contractures

iii. Foot drop

iv. Bone loss/osteoporosis

effects of immobility on the gastrointestinal system

i. Decreased peristalsis

ii. Constipation

iii. Bowel obstruction/Paralytic ileus

effects of immobility on the genitourinary system

i. Urinary stasis

ii. Urinary tract infection (UTI)

effects of immobility on the nervous system

i. Altered proprioception

ii. Altered balance

effects of immobility on the psychosocial impact

i. Depression/hopelessness

ii. Loneliness/isolation

iii. Altered sleep patterns

iv. Disorientation

Describe nursing interventions that promote safe mobility and activity for patients

a. Obtain appropriate assistive devices

i. Gait belt, walker, wheelchair, crutches, cane

ii. 'Dangle' patient first, raise head of bed, turn patient and lower legs to floor, sit patient on side of bed for several minutes, and have patient move legs before standing

iii. Use transfer board and mechanical lift as necessary

Identify patients who are at risk for activity intolerance and those at risk for immobility

a. Activity intolerance - decreased capacity for exercise and ADLs

i. Heart failure (HF)

ii. Peripheral vascular disease (PVD)

iii. Chronic obstructive pulmonary disease (COPD)

iv. Prolonged bedrest - shortness of breath, dyspnea, profound fatigue

b. Immobility - physical impairment

i. Osteoporosis (bone fracture)

ii. Limited joint mobility (arthritis)

iii. Cerebrovascular accident (CVA)

iv. Spinal cord injury

v. Brain injury

vi. Balance/equilibrium problems

Discuss nursing care to reduce the complications of immobility and activity intolerance, including range of motion exercises -- cardiopulmonary care

i. Lung expansion - raise head of bead, turn/cough/deep breath q2H, use incentive spirometer q1H while awake

ii. Prevent blood clots - active and passive ROM, SCD's, anti-embolism stockings, keep hydrated, encourage self-care of ADLs

iii. Prevent orthostatic hypotension - raise head of bed, dangle at side of bed, check vitals

Discuss nursing care to reduce the complications of immobility and activity intolerance, including range of motion exercises -- musculoskeletal and integumentary care

i. Prevent atrophy - active and passive ROM, overhead trapeze bar, footboard

ii. Prevent skin breakdown - turn/reposition every 2 hours or more often if needed, proper alignment in bed, use pillows/wedges/trochanter rolls, keep skin clean and dry

1. Prevent shear by using draw sheet to prevent drag when repositioning

Discuss nursing care to reduce the complications of immobility and activity intolerance, including range of motion exercises -- nutrition and elimination

i. Prevent altered digestion - healthy diet, increase protein and fiber intake, adequate fluids, promote regular toileting

ii. Prevent infection and risk of renal calculi - encourage adequate fluid intake and emptying bladder

Discuss nursing care to reduce the complications of immobility and activity intolerance, including range of motion exercises -- psychosocial care

i. Prevent depression/loneliness

1. Encourage visits from family/friends

2. Include patient in planning care

3. Offer spiritual/chaplain care as needed

4. Prevent sleep disruption

5. Engage in conversation

6. Orient to reality

Identify patient's at risk for falls

i. Over age 65

ii. History of falls and fear of falling

iii. Balance or gait problems

iv. Muscle weakness

v. Visual impairment

vi. Neurological impairment

vii. Cognitive impairment

viii. Bowel or bladder incontinence

ix. Cardiovascular issues

x. Multiple medications

Identify fall precautions

i. Assess every patient for risk of falls

ii. Frequently observe patient - during day Q2H, at night Q1H

iii. Bed safety - 'low, locked, light, lift rails x2'

iv. Answer call light quickly

v. Good lighting in room, nightlight at night

vi. Keep patient's belongings within easy reach

vii. Use gait belt and nonskid socks/shoes

viii. Keep walkways clear, clean, and dry

ix. Use proper fitting clothing

x. Familiarize patient with environment

xi. Patient return-demo call light

xii. Patient to use handrails in bathroom and hallways

xiii. Keep wheelchair wheels locked when stationary

xiv. Communicate and document fall risk to health care team (armband, sign on door)

apply correct terms when discussing legal and ethical issues

autonomy - the patient has a right to make decisions for themselves

accountability - Accept responsibility for own actions and consequences

advocacy - Focus is on the patient as a vulnerable person, Promote and support the patient's needs and voice

beneficence - Do Good (benefit the patient)

confidentiality - Maintains privacy, Legal issue in HIPAA (Health Insurance Portability and Accountability Act)

fidelity - Keep promises, Follow through on what you say you will do

justice - Be impartial, fair, Give equal treatment

nonmaleficence - First, Do No Harm

responsibility - Dependable, reliable

veracity - truthfulness, honesty

identify ethical concepts and applications for decision-making in nursing practice

standards of moral conduct is influenced by:

- values

- social norms

- everyday practice

discuss legal implications in nursing practice

- mandatory reporting - communicable diseases, abuse

- good samaritan laws - texas has a duty to assist

- nurse practice act in each state governs the practice of licensed nurses

- established to protect patients and the public

- defines the scope of nursing practice

- identifies a minimum level of care to be provided

Identify these legal issues in nursing practice, professional boundaries

crossing professional boundaries

- excessive self-disclosure

- keeping secrets with a patient

- spending more time with one patient than others

- personal relationships with patient outside of work

Identify these legal issues in nursing practice, delegation

failure to delegate tasks appropriately to unlicensed staff for patient safety

Identify these legal issues in nursing practice, documentation

failure to document patient care accurately and timely in the legal medical record

Discuss how state and federal regulations affect nursing practice

Assess and document skin integrity of a patient

stage 1 pressure ulcer - skin intact, non-blistered skin, persistent erythema (redness) that will not blanch

assess all areas of skin including:

-temperature

-color

-wounds or scars

-odor

-excessive moisture or dryness

-risk factors

Identify risk factors for pressure ulcers

-nerve impairment - loss of sensation - most serious

-aging skin - less elastic, drier, more prone to injury

-immobility - increased pressure, shearing, friction

-incontinence - urine & stool breakdown skin

-edema - increased fluid in the tissues

-poor circulation - less tissue oxygenation

-chronic diseases - diabetes, heart failure, anemia, renal failure

-malnutrition - less regeneration, poor turgor, longer healing time

-medications - side effects of itching/rashes

-moisture - maceration of skin

-fever - depletes moisture in skin

-infection - slows healing

-lifestyle - tanning, piercings, tattoo

Discuss the nursing care that will decrease the patient risk of developing pressure ulcers

-turn every two hours or more

-post the turning schedule for staff

-document after turning patient

-meticulous skin care

-use moisture barrier creams

-high protein nutrition and hydration

-use pressure relieving mattress

-float heals above mattress w/ pillow under ankles

-if side-lying, elevate head of bed less than 30 degrees to reduce effects of shear

-position pillows between bony areas

-provide adequate oxygenation to prevent hypoxia

-use a mechanical lift to prevent friction and shearing injuries

-provide patient/family teaching and training

Understand the terminology of culture and ethnicity, and discuss the effect on health care

-culture - values, beliefs, and ways of life that are shared from one generation to another

ethnicity- identify with a racial, national, or cultural group; may include biological differences such as skin color

ethnocentrism - belief that your own culture or ethnicity is better than others

stereotype - fixed ideas about a group that are often unfavorable

prejudice - 'thinking' process of devaluing all people within a group

discrimination - 'doing' practices that harm or give different treatment to individuals or members of a group

race - socially grouping people by common descent, heredity, or physical characteristics

socialization - raised within a cultural group and acquiring its characteristics

assimilation - individuals from one cultural group merge or blend into a second group

racism - unfound belief that race determines character or ability, and is superior or inferior to another race

Identify barriers to culturally competent care

-lack of knowledge

-cultural stereotypes

-ethnocentrism

-prejudice

-racism

-sexism

-language barrier

-discrimination

what is the importance of providing nursing care that is culturally competent

-focuses on human 'caring'

-recognizes differences and similarities among beliefs, values, and cultures

-provides meaningful and beneficial health care to the patient and family/caregivers

-Focuses care on individuals with unique experiences, beliefs, values, and language

-Provides quality care for the patient as an 'individual', a 'family member', and 'community'

-Holistic care increases patient satisfaction and improves health teaching compliance

define spirituality

expression of life's meaning and purpose in the innermost self

define religion

organized, structured method of practicing or expressing one's spirituality

describe spiritual practices that patients may engage in

Faith: belief beyond self; based on trust and life experience rather than scientific data.

Hope is the confident expectation of a positive outcome in the face of challenging circumstances.

Prayer: spoken or unspoken communication with a higher power; often influenced by religious or faith belief system.

Reflection: contemplating life experiences, even life-changing experiences, and searching for meaning in those events.

Discuss religious practices that may affect the delivery of nursing care to a patient

same gender caregivers, family involved in decision-making, no pork in diet

kosher diet

Identify individualized nursing interventions for appropriate spiritual care to patients

-Allow time and opportunity for self-disclosure by the patient.

-Be physically present and actively listen when the patient speaks.

-Support meaningful spiritual practices, such as praying, meditating, and listening to music.

-Arrange for privacy and quiet times during clergy visits.

-Monitor and promote supportive social contacts.

-Maximize patient's comfort and relief from pain

-Collaborate with the dietary department

-Respect the patient's religious items and clothing

-Explore the patient's possible meanings for 'healing', 'cure' and 'miracle'

Calculate calories for proteins

4 cal / gram

Calculate calories for carbohydrates

4 cal / gram

Calculate calories for fats

9 cal / gram

Identify factors that affect nutrition

-development or stage of life

from infants to elders

pregnancy and lactation

-literacy or education

reading ability

knowledge of nutrition

-socioeconomic level

poverty

lack of access to nutritional food

-lifestyle choices

dietary patterns

vegetarianism

dieting

religious practices

-other factors

ethnicity/culture

disease processes

functional limitations

food allergies

Discuss nursing interventions for patients with impaired nutrition of 'less than' and 'more than' body requirements

Patient/family teaching related to:

•Vitamin and mineral supplements

•Obtaining nutritious foods on a limited budget

•Assisting patients with feeding

•In-patient: may delegate feeding to CNA or family

•Home care: refer to social services agency for help obtaining food, Meals-on-Wheels

Identify and discuss therapeutic diets commonly used in health care

-clear liquids - clear juices without pulp; examples: apple or cranberry juice, jello, clear broth, popsicles, carbonated drinks, coffee, tea

-full liquids - foods that become liquid at room or body temperature; examples: juices with pulp, milk, ice cream, yogurt, cream soups, liquid dietary supplements, pudding/custard

-pureed - foods put in a blender for a liquid-like texture

-thickened liquids - thickening agent added to liquids to improve swallowing and reduce aspiration

-NPO - nothing per os (mouth), may be needed prior to surgery, after GI surgery, or with an intestinal blockage, do oral care every 2 hours

Apply correct feeding techniques for patients who require assistance with eating

•Determine how much assistance is needed

•Encourage independence, may need partial help

•Gather equipment

•Correct diet, utensils, small towel, adaptive equip.

•Prepare patient and environment

•Wash patient's hands, check and position tray

•Position patient - High Fowlers, if tolerated

If unable to tolerate upright - position lateral

•Open packages, prepare food, monitor temp

•Assist as needed, allow time to chew/swallow, offer fluids, monitor for dysphagia

•At completion of meal - make patient comfortable, keep semi-upright position, wash hands and face, remove tray

•Document food and fluid intake, adverse symptoms, assistance required

•Meals (solid food) documented as percentage eaten - example: 25% breakfast, 50% lunch, 75% dinner

•Report if client does not eat sufficiently

Identify nursing interventions for patients who have issues with impaired swallowing

•Warm or cold foods

•Flavorful foods

•Thickened liquids

•Sauces and gravies

•Moist pasta

•Casseroles

•Egg dishes

•Blenderized soups

Correctly calculate and document Intake and Output (I&O)

•Use appropriate measuring device for output - urinal, emesis basin, graduated cylinder, hat in toilet

•Include drainage from tubes, drains, or suction

•For accuracy, keep toilet paper out of urine

Convert common container measurements to metric measurements

- 1 oz = 30 mls

- 1 cup = 8 oz = 240 mls

- 1 cup ice = 1/2 cup = 4 oz = 120 mls

Correctly assess and document daily weight with conversion from pounds to kilograms

lbs / 2.2 = kg

1 kg = 2.2 lbs

Discuss fluid imbalances of volume deficit and volume excess

volume deficit - they will be dehydrates, they have lost more volume than they are taking in

volume excess - they will be overhydrated, they will have taken more liquid than they are expelling

Discuss the importance of electrolytes in the body and know normal ranges of key elements

sodium - 135-145 mEq/L

potassium - 3.5-5.0 mEq/L

calcium - 8.5-10.5 mg/dL

Discuss nursing assessments and interventions for patients who have dehydration and over-hydration

dehydration - dry skin, not enough urine, non-elastic skin turgor, flat veins, bp low, heart rate is up, weight is down, high temp.

overhydrated - cool/pale skin, edema, weight is up, crackles in lungs, shallow respirations, bp is up, distended veins

Know the chain of infection

First link - infectious agent

Second link - Reservoir

Third link - portal of exit

Fourth link - Mode of transmission

Fifth link - portal of entry

sixth link - susceptible host

Discuss standard precautions, and transmission-based precautions: contact, droplet and airborne

standard precautions

- put on gloves

- wash hands

contact - MRSA, D. diff.

- gown and gloves

droplet - flu, pertussis

- gown, gloves, eye shield and mask

airborne - tuberculosis

- gown, gloves, N95 mask, negative pressure room, foot covers, eye shield, hair shield

Identify when infection is present

local - occurs in a limited region in the body (eg. urinary tract infection)

swelling, redness, pain, heat

systemic - spread via blood or lymph, affects many regions (septicemia)

fever

acute - rapid onset of short duration (common cold)

chronic - slow development, long duration (osteomyelitis)

latent - infection present with no discernible symptoms (HIV/AIDS)

signs and symptoms of infection

fever, increased heart rate, increased respiratory rate, increase BP, chills, fatigue, altered mental status, headache, pain, swelling, redness, heat, increased WBC count

Identify nursing interventions to prevent the spread of infection

medical asepsis - a state of cleanliness that decreases the potential for the spread of infections

maintained by: a clean environment, hand hygiene, respiratory etiquette

Correctly apply and remove personal protective equipment (PPE), including appropriate gloving technique for unsterile gloves

putting on

-gown

-mask

-gloves

taking off

-pull gown off (pull from front and break the ties)

-gloves off

-mask off (neck first, then ears)

What does asepsis mean?

clean technique

Identify the normal adult ranges for: hemoglobin, hematocrit, WBCs, and platelets

hemoglobin

male - 13-18

female - 12-16

hematocrit

male - 42-52%

female - 37-48%

white blood cells

males - 5,000-10,000

females - 5,000 - 10,000

platelets

males - 150,000-400,000

females - 150,000-400,000

Discuss risk factors for anemia

-low RBCs

-low Hgb

-low Hct

-cannot carry enough oxygen for body

-hypoxia-decreased oxygen in the blood

Identify assessment findings which indicate anemia and infection

anemia

- cool skin

-tachycardia

-short of breath

infection

-warmth

-redness

- swelling

- pain

- loss of function

Select nursing interventions to care for patients who have anemia or infections

anemia

- take v/s every 4 hours

- assess for worsening s/s

- increased pulse and respirations

- decreased BP and O2 sat

- monitor fatigue and increase supportive services

- monitor for orthostatic hypotension

- assess for fall risk

- encourage fluids

- encourage high protein diet

- provide comfort measures

infection

- Take temperature every 2 - 4 hours

- Medicate following Dr.'s orders - typically when temp. is over 100.5 F.

- Encourage fluids and good diet

- Check I&O for dehydration

- Assist patient to turn, cough and deep breath

- Provide comfort measures if chilled - warm blankets

- If fever over 101º, remove blankets, use fan to cool air

Identify general safety issues in the health care setting

- falls

- infections

- restraints

Properly apply restraints and safely care for the patient in restraints

- you must try alternatives before using restraints

- use least invasive method

- must have Dr.'s order, except in emergency

- must notify patient's family

only reasons to use restraints

- prevent harm to self and/or others

- assess patient safely

- provide medical care safely

what are the requirements for restraints

- must have Dr.'s orders every 24 hours

- must assess patient every 30 min

- must release restraints every 2 hours to assess skin, circulation, ROM, toileting

- mist document patient care every 2 hours

Implement basic nursing interventions to prevent deep vein thrombosis (DVT) and pulmonary emboli (PE) in patients

- Ambulate; Leg Exercises; Deep Breathe; Cough

- Apply compression hose - correct size, smooth

- Apply Sequential Compression Device (SCD)

- Must have Dr's order for

compression hose and SCD

Implement basic nursing interventions to prevent atelectasis and pneumonia in patients

- Assess respirations - rate, effort, O2 sat.

- Position for best lung expansion - high or semi-Fowler position

- Have patient cough/deep breathe hourly

- Use incentive spirometer

- Good hydration to thin secretions

- Assess for risk of aspiration/choking

- Oxygen therapy - cannula/mask

Understand and teach oxygen safety to patients and caregivers

- Flammable!

- No petroleum products on face/lips/nose

- May use lanolin products

- Teach family/caregivers about O2 safety

- NO SMOKING when oxygen is in use

- Correct assembly of oxygen equipment

- Test for oxygen delivery through tubing - bubble nasal cannula in glass of water

- Oxygen placement in home 5 ft. from gas outlet/open flame/electrical appliances

- Transport oxygen tank behind front seat - never in trunk!

- Notify Fire Dept. and Electric Co. that home oxygen is in use

Recognize the need for, and begin cardiopulmonary resuscitation (CPR)

single most important action to take when breathing and/or pulse have stopped

A = airway

B = breathing

C = circulation

- Assess patient for breathing and pulse

- Call CODE if no breathing/pulse: (emergency button in room, call 911)

- Start CPR - better outcomes when started quickly

- Chest compressions at 100/minute until emergency team arrives

- NO CPR if patient is 'No Code' or 'DNR' Do Not Resuscitate - must have Dr's order