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CPNE Critical elements in plain english#11. Write a Care Plan that has two problem labels that comes from the list of overriding, required andselected areas of care that are marked on your Assignment card. One of them has to be a real problemand not a risk for problem.List an outcome that you can measure for each problem or diagnosis.List 2 things that you will do to try and help the patient reach the outcome you wrote down. So thereshould be 4 things you do total and they should be things you can do during the PCS.2. Write down the flow rate in drops per minute on the Care plan if there is a gravity flow IV in thepatient. Make sure that you write down the right flow rate!#2

Clinical Decision Making

CDM means that your try to solve problems by making choices during your patient care. It means usinggood judgement and you knowledge of Nursing and keeping the patients best interest in mind.If your going to not do or change a critical element, you have to tell the CE what your doing and why atthe time your doing it. Don't wait to tell the CE. If the CE decides that you are not using good judgement in problem solving, you'll fail.

OVERRIDING AREAS OF CARE

Asepsis

1. Wash your hands in front of the CE before you start taking care of the patient.2. Protect yourself, others, and the rooms your in from contamination3. Protect the patient for contamination4. Make a sterile area when you need to#4

Caring

1. Don't ignore your patient. Be real and introduce yourself to the patient. Treat your patient the wayyou want to be treated.After the introduction ID the patient by checking at least 2 of these:1) the patients name2) when the patient was born3) the patients Medical record numberThen explain what your doing there. If your patient is a child or adult that doesn't talk use touch if it'sOK culturally. Figure that out by asking relatives of the assigned nurse if your don't know whats OK

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culturally. Don't ignore your patient or act as if they don't matter just because they don't talk.#5

Caring Cont.

2. Talk to your patient and their significant others in a way that they can understand.Also encourage the patient to let you know what they need.Respond when your patient talks to you.Respond to the patients body language, for example when your patients winces in pain, ask about it.To help when your taking care of the patientexplain what your about to doask about how your patient feels about the care your givingask if your patient is comfortabletalk about things that are important to your patientask your patient what order they would want they're care tasks done in3. Don't be patronizing, demeaning or rag on your patient in any way, verbally or physically. If youtreat people bad, nursing is not for you.4. Be respectful, treat your patient with dignity and respect their culture.#6

Emotional Jeopardy

Anything you do or don't do that threatens your patients or their friends and relatives emotional wellbeing will end the PCS and you'll fail.#7

Mobility

1. Check the patientfor the way they get around or can't get aroundthe way they use canes, walkers or other things they use to get aroundif they have balance problems2. Move your patient or change their position bysupporting weak or injured parts of their bodysupport your patients head, shoulders, and pelvisturning, lifting, or moving your patient to a different positionuse your patients body parts or helpful devices to keep your patient in the position you want them inuse positioning and/or helpful devices to reduce pressure on sensitive skin areasdo what you have to to prevent cutting your patients skin#8

Mobility cont.

3. Help your patient move or walk bysteadying equipmentdo what you have to to in order to help your patient keep their balance

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4. Write downyour patients ability to move and get aroundwhat things your patient uses to help get aroundany problems your patient has with balanceIf you positioned, transferred, or walked your patient during the PCSHow your patient reacted to the positioning, transferring and/or walking.#9

Physical Jeopardy

Anything you do or don't do that threatens your patients physical well being. Your responsible for yourpatients physical safety for the entire PCS. If you don't report a deterioration in your patients conditionor are about to do something that might hurt your patient, the PCS will be stopped and you'll fail.

REQUIRED AREAS OF CARE

#10

Fluid Management

1. Check the fluid status of your patient in one of these wayscheck the skin turgor(elasticity)look at the inside of your patients mouthfeel the anterior fontanel(top of the head in the front. the soft spot) of a child less than 1 year old2. for intestinal feedings by mouth or tubedetermine the kind of fluid your patient is going to take inGive or restrict fluids as ordered3. for fluids given by IV

It's important that you do the following in the first 20 minutes of beginning your patients care

Check that the flow rate is correct bycounting the drops per minute that are flowing right now orwrite down the flow rate of the pump that's running is set at the exact number for the right amountof fluid to be delivered. Make sure you write on the PCS form.#11

Fluid Management

cont.Check the area where the line goes into your patient. It might be a central, on arms or legs, orimplanted in the vein type of device. Look for problems such as dislocation, infiltration(fluid going intothe tissue instead of the vein) or other problems byfeeling the skin around the IV for changes in temperature. It might be cooler or warming than therest of the surrounding skinor feeling the area for edemaIf the flow rate is not right change it byadjusting the flow to plus or minus 5 drops per minute of the rate you calculated. It's the samefor microdrops.if it's on a pump, adjust the pump to the exact number required to deliver the prescribed volumeWrite the prescribed fluid that's going into your patient on the PCS form