By Mills, Elizabeth Jacqueline

The newly revised Fourth variation of this renowned and known reference is a start-to-finish advisor for almost four hundred simple and complicated nursing strategies. It offers step by step directions for every strategy, explains tips on how to use and troubleshoot apparatus, and offers key info on rationales, cautions, problems, sufferer educating, and documentation. The effortless structure contains checklists, quick-scanning tables, trademarks that flag crucial info, and greater than seven hundred illustrations and images of kit and strategies. This version contains a brand-new bankruptcy on psychiatric nursing systems and new entries on companies positioning, surgical web site verification, ST section tracking, swallowing and aspiration precautions, and bispectral index tracking (BIS).

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Bed and dialysis scales, with platforms that are placed under the castors of the bed, are useful if frequent weights are needed or the patient is too critically ill to move. Documentation Record the patient's height and weight on the nursing assessment form and other medical records, as required by your facility. ASSESSMENT TECHNIQUES To perform physical assessment, a nurse uses four basic techniques: inspection, palpation, percussion, and auscultation. Performing these techniques correctly helps elicit valuable information about the patient's condition.

Then insert the earpieces into your ears. Count the beats for 60 seconds (or count for 30 seconds and multiply by 2) and note their rhythm, volume, and intensity (loudness). • Remove the stethoscope and make the patient comfortable. Taking an apical-radial pulse • Two nurses work together to obtain the apical-radial pulse; one palpates the radial pulse while the other auscultates the apical pulse with a stethoscope. Both must use the same watch when counting beats. • • • Help the patient to a supine position and drape him if necessary.

Release the pressure completely, but maintain fingertip contact with the skin. IDENTIFYING PERCUSSION SOUNDS Percussion produces sounds that vary according to the tissue being percussed. This chart lists important percussion sounds along with their characteristics and typical sources. SOUND INTENSITY PITCH DURATION QUALITY SOURCE Resonance Moderate to loud Low Long Hollow Normal lung Tympany Loud High Moderate Drumlike Gastric air bubble, intestinal air Dullness Soft to moderate High Moderate Thudlike Liver, full bladder, pregnant uterus Hyperresonance Very loud Very low Long Booming Hyperinflated lung (as in emphysema) Flatness Soft High Short Flat Muscle Inspection • • Focus on areas related to the patient's chief complaint.

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