Lab #3 assessment in acute care Flashcards
What is the normal range for SpO2
95-100%
What is normal blood pressure
135/85
what is considered hypotension
usually less than 90/60 is considered hypotensive but they have to be symptomatic before starting treatment
what is normal temperature
36-38 degrees
what is considered a fever
anything over 38.5
where is Erbs point
3rd intercostal space left of the sternum
where would you best hear the aortic valve
2nd intercostal space right of the sternum
where would you best hear the pulmonic valve
2nd intercostal space left of the sternum
Where would you best hear the tricuspid valve
fourth intercostal space left side
where would you best hear the mitral valve
fifth intercostal space left side mid clavicular (so more over in the middle of the chest)
when is a QPA normally performed
usually done after report at the start of shift
what is step one of a QPA
Very brief
-Staff introduction
-make sure there are no patients in distress
-make sure no patients dead in bed
What is step two of a QPA
Nurses go to their specific patient and preform a ABCDE and make sure that they have their
-name band on
-allergy band on
-blood band on
what is step 3 of a QPA
document or chart any abnormal findings and any action taken on those findings
what is step 4 of a QPA
nursing team re group and determine next plan of action
