Upload
lizsherman
View
230
Download
0
Tags:
Embed Size (px)
DESCRIPTION
s
Citation preview
Copyright 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved. 271
Student _______________________________________________________ Date __________________________
Instructor _____________________________________________________ Date __________________________
PERFORMANCE CHECKLIST SKILL 21-6 USING METERED-DOSE INHALERS
S U NP Comments
ASSESSMENT1. Checked accuracy and completeness of each
MAR against medication order, clarified incom-plete or unclear orders with health care pro-vider. ____ ____ ____ ___________________________
2. Reviewed pertinent information related to medication. ____ ____ ____ ___________________________
3. Assessed patients medical history, history of allergies, and medication history. ____ ____ ____ ___________________________
4. Assessed respiratory pattern, auscultated breath sounds. ____ ____ ____ ___________________________
5. Assessed patients ability to hold, manipulate, and depress canister and inhaler. ____ ____ ____ ___________________________
6. Assessed patients readiness and ability to learn. ____ ____ ____ ___________________________
7. Assessed patients knowledge and understand-ing of disease and purpose and action of medi-cations. ____ ____ ____ ___________________________
PLANNING1. Identified expected outcomes. ____ ____ ____ ___________________________
2. Explained procedure to patient, explained spe-cifics if patient wished to self-administer drug. ____ ____ ____ ___________________________
IMPLEMENTATION1. Prepared medications for inhalation, checked
label of medication against MAR twice, checked expiration date. ____ ____ ____ ___________________________
2. Took medication(s) to patient at correct time, applied the six rights of medication adminis-tration. ____ ____ ____ ___________________________
3. Identified patient using two identifiers. ____ ____ ____ ___________________________
4. Compared MAR with medication labels at patients bedside, asked patient if he or she had allergies. ____ ____ ____ ___________________________
5. Discussed purpose of each medication, action, and possible adverse effects; allowed patient to ask any questions; explained what a metered-dose is and how to administer it, warned about overuse and side effects. ____ ____ ____ ___________________________
Copyright 2014, 2010 by Mosby, an imprint of Elsevier Inc.
272 Copyright 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.
6. Allowed adequate time for patient to manipu-late equipment, explained and demonstrated how canister fits into inhaler. ____ ____ ____ ___________________________
7. Explained steps for administering MDI without spacer:
a. Removed mouthpiece cover from inhaler after inserting MDI canister into holder. ____ ____ ____ ___________________________
b. Shook inhaler well for 2 to 5 seconds. ____ ____ ____ ___________________________
c. Held inhaler in dominant hand. ____ ____ ____ ___________________________
d. Instructed patient to position inhaler prop-erly. ____ ____ ____ ___________________________
e. Had patient take deep breath and exhale completely. ____ ____ ____ ___________________________
f. Had patient hold inhaler in three-point or bilateral hand position when positioned properly. ____ ____ ____ ___________________________
g. Instructed patient to tilt head back and inhale slowly and deeply through mouth for 3 to 5 seconds while depressing canister fully. ____ ____ ____ ___________________________
h. Had patient hold breath for about 10 seconds. ____ ____ ____ ___________________________
i. Removed MDI from mouth before exhaling. ____ ____ ____ ___________________________
8. Explained steps to administer MDI using a spacer.
a. Removed mouthpiece cover from MDI and mouthpiece of spacer device. ____ ____ ____ ___________________________
b. Shook inhaler well for 2 to 5 seconds. ____ ____ ____ ___________________________
c. Inserted MDI into end of spacer device. ____ ____ ____ ___________________________
d. Instructed patient to place spacer mouthpiece in mouth and close lips, avoided covering exhalation slots with lips. ____ ____ ____ ___________________________
e. Had patient breathe normally through mouthpiece. ____ ____ ____ ___________________________
f. Instructed patient to spray one puff into spacer device. ____ ____ ____ ___________________________
g. Had patient breathe in slowly and fully. ____ ____ ____ ___________________________
h. Instructed patient to hold breath for 10 seconds. ____ ____ ____ ___________________________
9. Instructed patient to wait appropriate length between inhalations. ____ ____ ____ ___________________________
S U NP Comments
Copyright 2014, 2010 by Mosby, an imprint of Elsevier Inc.
Copyright 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved. 273
10. Instructed patient to not repeat inhalation before next scheduled. ____ ____ ____ ___________________________
11. Warned patient they may feel gagging sensa-tion. ____ ____ ____ ___________________________
12. Instructed patient to rinse and spit with warm water 2 minutes after dose. ____ ____ ____ ___________________________
13. Instructed patient in daily cleaning of inhaler. ____ ____ ____ ___________________________
14. Asked if patient had any questions. ____ ____ ____ ___________________________
15. Assisted patient to comfortable position, per-formed hand hygiene. ____ ____ ____ ___________________________
EVALUATION1. Had patient explain and demonstrate steps in
use and cleaning of inhaler. ____ ____ ____ ___________________________
2. Asked patient to explain drug schedule and dose or medication. ____ ____ ____ ___________________________
3. Asked patient to describe side effects of medica-tion and criteria for calling health care provider. ____ ____ ____ ___________________________
4. Assessed patients respirations, breath sounds, and peak flow measures after medication administration if ordered. ____ ____ ____ ___________________________
5. Identified unexpected outcomes. ____ ____ ____ ___________________________
RECORDING AND REPORTING1. Recorded drug, dose, route, number of inhala-
tions, and time on MAR; included initials or signature; recorded patient teaching and valida-tion of understanding in nurses notes. ____ ____ ____ _________________________
2. Recorded patients response to MDI, side effects, and patients ability to use MDI. ____ ____ ____ _________________________
3. Reported adverse effects/patient response/withheld drugs to nurse in charge or health care provider. ____ ____ ____ _________________________
S U NP Comments
Copyright 2014, 2010 by Mosby, an imprint of Elsevier Inc.
Student: SDate: Instructor: IDate: Check Box2: Check Box3: Check Box_44: comment1: Check Box4: Check Box5: Check Box6: comment2: Check Box7: Check Box8: Check Box9: comment3: Check Box10: Check Box11: Check Box12: comment4: Check Box13: Check Box14: Check Box15: comment5: Check Box16: Check Box17: Check Box18: comment6: Check Box19: Check Box20: Check Box21: comment7: Check Box22: Check Box23: Check Box24: comment8: Check Box25: Check Box26: Check Box27: comment9: Check Box28: Check Box29: Check Box30: comment_99: Check Box31: Check Box32: Check Box33: comment10: Check Box34: Check Box35: Check Box36: comment11: Check Box37: Check Box38: Check Box39: comment12: Check Box40: Check Box41: Check Box42: comment13: Check Box44: Check Box45: Check Box43: Check Box49: Check Box50: Check Box51: comment14: comment15: comment16: Check Box52: Check Box53: Check Box54: comment17: Check Box55: Check Box56: Check Box57: comment18: Check Box58: Check Box59: Check Box60: comment19: Check Box61: Check Box62: Check Box63: comment20: Check Box64: Check Box65: Check Box66: comment21: Check Box67: Check Box68: Check Box69: comment22: Check Box70: Check Box71: Check Box72: comment23: Check Box73: Check Box74: Check Box75: comment24: Check Box76: Check Box77: Check Box78: comment25: Check Box79: Check Box80: Check Box81: comment26: Check Box82: Check Box83: Check Box84: comment27: Check Box85: Check Box86: Check Box87: comment28: Check Box88: Check Box89: Check Box90: comment29: Check Box91: Check Box92: Check Box93: comment30: Check Box94: Check Box95: Check Box96: comment31: Check Box98: Check Box99: Check Box97: comment32: Check Box100: Check Box102: Check Box101: comment33: Check Box103: Check Box104: Check Box105: comment34: Check Box106: Check Box107: Check Box108: comment35: Check Box109: Check Box110: Check Box111: comment36: Check Box112: Check Box113: Check Box114: comment37: Check Box46:
Check Box47:
Check Box48:
comment38: Check Box115: Check Box116: Check Box117: comment39: Check Box118: Check Box119: Check Box120: comment40: Check Box121: Check Box122: Check Box123: comment41: Check Box124: Check Box125: Check Box126: comment42: Check Box127: Check Box128: Check Box129: comment43: Check Box130: Check Box131: Check Box132: comment44: Check Box133: Check Box134: Check Box135: comment45: Check Box136: Check Box137: Check Box138: comment46: