Selected Nursing Skills Chapter 20 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc

Selected Nursing Skills

Chapter 20Chapter 20

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Slide 2Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Standard Steps in Selected SkillsStandard Steps in Selected Skills

• All nursing skills must include basic steps for the safety and well-being of the patient and the nurse.

• Before the Skill Refer to medical record, care plan, or Kardex for

special interventions. Introduce yourself; include your name and title or role. Identify patient by checking arm band and requesting

patient to state his or her name.



• Before the Skill (continued) Explain the procedure and the reason it is to be done

in terms the patient can understand, and give the patient time to ask questions. Advise patient of any unpleasantness that might be experienced.

Assess need for and provide patient teaching during procedure.

Assess patient. Wash hands and don clean gloves according to

agency policy and guidelines from the CDC and OSHA.



• Before the Skill (continued) Assemble equipment and complete necessary

charges. Prepare the patient for intervention.

• Close door/pull privacy curtain.

• Raise bed to comfortable working height; lower side rail on side nearest the nurse.

• Position and drape patient as necessary.



• During the Skill Promote patient involvement as possible. Assess patient’s tolerance, being alert for signs and

symptoms of discomfort and fatigue.

• Completion of Procedure Assist the patient to a position of comfort and place

needed items within easy reach. Be certain patient has a means to call for assistance and knows how to use it.

Raise the side rails and lower the bed to the lowest position.



• Completion of Procedure (continued) Remove gloves and all protective barriers. Store or

remove and dispose of soiled supplies and equipment according to agency policy and guidelines from CDC and OSHA.

Wash hands after patient contact and after removing gloves.

Document patient’s response, expected or unexpected outcomes, and patient teaching.

Report any unexpected outcomes.


Standard Steps: Step 14Standard Steps: Step 14

Removing disposable gloves.

(From Potter, P.A., Perry, A.G. [2003]. Basic nursing: essentials for practice. [5th ed.]. St. Louis: Mosby.)


Skills for Sensory DisordersSkills for Sensory Disorders

• Irrigations Eye irrigations

• Relieve local inflammation of the conjunctiva, apply antiseptic solution, or flush out exudate or caustic solutions.

• Warm saline and small syringe or eyedropper are usually used to instill a few hundred milliliters of solution.

• Irrigation should always be done from the inner canthus to the outer canthus.

• Never allow the syringe tip to touch the eye.



• Irrigations (continued) Eye irrigations (continued)

• At home, eye irrigation can be performed with an eye cup.

• A copious irrigation of the eye may be accomplished with the use of intravenous tubing and bag connected to a Morgan Therapeutic Lens.



• Irrigations (continued) Ear Irrigations

• Using a small syringe and solution at body temperature, the nurse can cleanse a patient’s external auditory canal of excess cerumen or exudate from a lesion or an inflamed area.

• Slow, gentle irrigation works best.

• Irrigation is contraindicated when a vegetable foreign body obstructs the auditory.

• Irrigation is contraindicated if the patient has a cold, a high temperature, an ear infection, or an injured or ruptured tympanic membrane.


Skills for Gastrointestinal DisordersSkills for Gastrointestinal Disorders

• Nasal Irrigation It soothes inflamed mucous membranes and washes

away dried mucus, secretions, and possible foreign matter.

It may be accomplished with the use of a specially designed electronic device or a bulb syringe.

Patients with acute or chronic nasal conditions and patients who inhale allergens and toxins may derive benefits from nasal irrigations.

It is contraindicated with advanced destruction of the sinuses, foreign bodies, and frequent nosebleeds.


Skills for Heat and Cold TherapySkills for Heat and Cold Therapy

• The nurse should Understand the normal responses to local

temperature variations Assess the integrity of the body part Determine patient’s ability to sense temperature

variations Ensure proper operation of equipment



• The body can tolerate wide variations in temperature.

• Normal skin temperature is 93.2° F. • Temperature receptors usually adapt quickly to local

temperatures between 113° and 59° F.• Pain develops when local temperatures exceed

these limits.• Excessive heat causes a burning sensation.• Cold produces a numbing sensation before pain.



• Local Effect of Heat and Cold Effects of heat application

• Heat improves blood flow through vasodilation to an injured part.

• However, blood flow is reduced by vasoconstriction as the body attempts to control heat loss from the area.

• Periodic removal and reapplication of local heat restores vasodilation.

• Continuous exposure to heat damages epithelial cells.



• Local Effect of Heat and Cold (continued) Effects of cold application

• Exposure of the skin to cold results in vasoconstriction.

• The cell’s ability to receive adequate blood flow and nutrients results in tissue ischemia.

• The skin initially takes on an erythematous appearance, followed by a bluish-purple mottling with numbness and a burning type of pain.

• The skin’s tissue can freeze on exposure to extreme cold.



• Assessment Assess patient’s physical condition for signs of

potential intolerance to heat and cold. Observe the area to be treated for impairment of skin

integrity. Identify conditions that contraindicate heat or cold

therapy.• Warm applications are contraindicated when the patient

has an acute localized inflammation; cardiovascular problems; or active bleeding.

• Cold applications are contraindicated if the site of injury is edematous or the patient has impaired circulation or is shivering.



• Patient Safety Before heat or cold treatment is applied, the patient

should understand its purpose, the symptoms of temperature exposure, and precautions taken to prevent injury.

• Physician's Order A prerequisite to heat or cold application is a

physician’s order, which should include body site and the type, frequency, and duration of application.



• Moist or Dry Applications Heat and cold applications can be administered in dry

or moist forms. The type of injury, the location of the body part, and

the presence of drainage or inflammation are factors to be considered.

• Hot, Moist Compresses For open wounds, sterile, hot, moist compresses

improve circulation, relieve edema, and promote consolidation of purulent exudate.


Skill 20-5: Step 4Skill 20-5: Step 4

Assess condition of exposed skin and wound on which compress is

to be applied.

(From Ignatavicius, D.D., Workman, M.L. [2002]. Medical-surgical nursing across the health care continuum. [4th ed.]. Philadelphia: Saunders.)



• Warm Soaks Immersion of a body part in a warmed solution Promotes circulation Lessens edema Increases muscle relaxation Can provide a means to debride wounds and apply

medicated solution A soak can also be accomplished by wrapping the

body part in dressings and saturating them with warmed solution or by whirlpool treatments.


Figure 20-1Figure 20-1

Whirlpool moist heat therapy.

(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)



• Paraffin Baths Bath consists of a mixture of heated paraffin wax and

mineral oil. Patients with painful arthritis or other joint discomforts

of the hands and feet benefit most from these baths.

• Aquathermia (Water-Flow) Pads This is used to treat muscle sprains and areas of mild

inflammation or edema. This consists of a waterproof plastic or rubber pad

connected by two hoses to an electrical unit that has a heating element and motor.



Aquathermia pad.




• Commercial Hot Packs Commercially prepared, disposable hot packs apply

warm, dry heat to an injured area. Sticking, kneading, or squeezing the pack mixes the

chemicals and releases the heat.

• Electric Heating Pads Pad consists of an electric coil enclosed within a

waterproof pad covered with cotton or flannel cloth. The pad is connected to an electric cord that has a

temperature-regulating unit for a high, medium, or low setting.



• Cold Moist and Dry Compresses Cold compresses should be applied for 20 minutes at

a temperature of 59° F to relieve inflammation and edema.

Commercially prepared cold packs are available for dry application.

The nurse should observe for burning or numbness, mottling of the skin, erythema, extreme paleness, or cyanosis.



Commercial cold pack used for therapy.




• Ice Bags or Collars For a patient who has muscle sprain, localized

hemorrhage, or hematoma or who has undergone dental surgery, an ice bag is ideal to prevent edema formation, control bleeding, and anesthetize the body part.


Skills for Administering Parenteral FluidsSkills for Administering Parenteral Fluids

• The overall goal of fluid IV administration is to correct or prevent fluid and electrolyte imbalances.

• Indications for IV Therapy Poor tissue absorption Inadequate GI tract function Need to maintain medications at optimum levels



• The nurse should observe the following guidelines: Monitor the solution drop rate at the ordered infusion

rate. Infuse the amount of prescribed solution. Maintain the patency of the IV catheter. Monitor site every 1 to 2 hours; IV line should be

assessed every 4 hours. During parenteral therapy, the patient’s I&O should be

recorded.



• Intravenous Therapy/Venipuncture Before the procedure, assemble and make ready the

equipment. Assess the patient’s veins. Select and clean a puncture site. Perform venipuncture. Begin infusion. Teach the patient about the signs and symptoms of

problems and ways to perform activities while on IV therapy.

Follow strict aseptic principles.



Common intravenous sites. A, Dorsal surface of the hand. B, Inner arm.

(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)


Figure 20-5, AFigure 20-5, A

A, Apply tourniquet.



Figure 20-5, BFigure 20-5, B

B, Select intravenous site.



Figure 20-5, CFigure 20-5, C

C, Cleanse site for venipuncture.



Figure 20-5, DFigure 20-5, D

D, Pull skin taut as catheter is inserted.




A, Close valve.




B, Remove insertion port cover.



Figure 20-6, CFigure 20-6, C

C, Insert spike.




• Intravenous Therapy/Venipuncture (continued) Tubing is selected based on the patient and type of

infusion to be initiated. The valve is closed. The tubing spike is inserted into the insertion port on

the correct fluid bag. The fluid bag is held upright, and the tubing drip

chamber is gently squeezed to partially fill it with fluid. The valve is slowly opened to permit the flow of fluid

down the tubing.



• Intravenous Therapy/Venipuncture (continued) The venipuncture needle and catheter should be

selected according to the solution to be infused and the size and condition of the patient’s veins.

Plastic IV catheters are flexible and have blunt tips that reduce infiltration and allow the patient to move.



• Intravenous Therapy/Venipuncture (continued) Intravenous monitoring

• Patency A condition of being opened and unblocked

• Flow rate is ordered by the physician.

• Assess tubing for kinks or obstructions.

• Inspect and palpate the site for edema, erythema, induration, heat, and discomfort.

• Assess for signs and symptoms of fluid overload.



• Changing the Tubing This is most easily accomplished when a new

container of solution is added. Connect and prime the new solution container and

tubing. Carefully remove the tape, securing the old tubing to

the IV catheter hub while gently stabilizing the catheter and site.

Working carefully but quickly, turn off the flow valve of the old tubing, remove the old tubing from the catheter hub, insert the new tubing into the catheter hub, and open the flow valve. Secure with tape.



• Discontinuing Intravenous Therapy Intravenous infusions are discontinued when

• The prescribed amount of solution has infused

• There are signs of infiltration

• The patient has developed phlebitis or other complications



• Discontinuing Intravenous Therapy (continued) Steps for discontinuing an IV infusion:

• Assemble supplies.

• Wash hands.

• Explain procedure to the patient.

• Don gloves.

• Turn IV flow regulator to the “off” position.

• Gently remove tape and dressing from site while carefully stabilizing the needle or catheter.



• Discontinuing Intravenous Therapy (continued) Steps for discontinuing an IV infusion (continued):

• Place dry gauze pad over needle insertion site.

• Swiftly withdraw needle or catheter from the site while applying gentle pressure over the site.

• Hold site above heart level while continuing to apply direct pressure for about 45 seconds to 1 minute.

• Assess for bleeding from the site.

• Apply a bandage or sterile dressing according to agency policy.



• Discontinuing Intravenous Therapy (continued) Steps for discontinuing an IV infusion (continued):

• Gather soiled supplies, remove gloves, and discard in appropriate containers.

• Wash hands.

• Document promptly and accurately.

• Reevaluate site every 10 to 15 minutes.

• Instruct patient to report any redness, pain, drainage, or swelling.



• Intravenous Therapy/Venipuncture (continued) Infiltration

• Edema that does not subside generally indicates that the catheter is out of the vein.

• Discomfort and dysfunction may also indicate that the solution has infiltrated.

• An infiltrated arm will feel cool, and the skin may have a blanched appearance.

• The solution is discontinued and another site is used to continue therapy, preferably in the opposite extremity.



• Intravenous Therapy/Venipuncture (continued) Phlebitis

• This results from mechanical irritation (the needle moving in the vein), the low pH of some IV solutions, and highly concentrated additives.

• Classic signs Erythema, warmth, edema, and discomfort

• Applying warm compresses to the inflamed area lessens discomfort.



• Intravenous Therapy/Venipuncture (continued) Septicemia

• A systemic infection occurs from pathogens introduced into the circulating bloodstream.

• Signs and symptoms Fever, chills, prostration, pain, headache, nausea, and

vomiting

• Antibiotic therapy is vigorously initiated if blood cultures verify a septicemic condition.



• Blood Transfusion Therapy This is most commonly used to replace blood loss. Individuals may store their own blood before

anticipated surgery for infusion during hospitalization. The fear of HIV infection has led some patients to

refuse blood products. Plasma expanders (Plasmanate, Dextran) can be

used for patients who refuse blood transfusions because of personal or religious beliefs.



• Blood Transfusion Therapy (continued) Autologous blood transfusion

• A process of collecting a patient’s lost blood during surgery or after a traumatic injury and infusing it intravenously into the patient.

• It is used in cardiac thoracic surgery or after traumatic chest injury.

• Suction drainage device collects blood in a special bag.

• The blood should be administered immediately or not more than 6 hours after initial collection.



• Blood Transfusion Therapy (continued) Initiating a blood transfusion

• Nurse is responsible for assessing and monitoring the patient before, during, and after transfusion.

• Obtain informed consent.

• An infusion of 0.9% or 0.45% normal saline is initiated.

• Follow established protocol for obtaining the blood, double-checking the compatibility of the blood with the patient’s blood, and identifying the patient.



A, Opened blood administration set and tubing primed with normal saline 0.9%.




B, Attached blood product to the normal saline 0.9%.




• Blood Transfusion Therapy (continued) Initiating a blood transfusion (continued)

• Baseline vital signs are taken and recorded.

• Prime the special blood filter administration tubing and piggyback it into the primary infusion line.

• Remain with the patient while slowly infusing the first 50 ml of blood.

• Assess the patient’s response and monitor vital signs.

• The nurse must know the symptoms of blood transfusion reaction and interventions to initiate for them.



• Blood Transfusion Therapy (continued) Blood transfusion reactions

• If the infused blood is not compatible with the patient’s blood type, a reaction will occur.

• A transfusion reaction is an emergency.

• Signs and symptoms Statement of “not feeling right” Chills, fever, low back pain, pruritis, hypotension, nausea

and vomiting, decreased urine output, chest pain, dyspnea



• Blood Transfusion Therapy (continued) Blood transfusion reactions (continued)

• If a transfusion reaction is suspected Stop the infusion. Keep the vein open with 0.9% or 0.45% sodium chloride

solution. Notify the physician and the blood bank. Monitor vital signs and urine output every 15 minutes. Reassure and support the patient. Send remaining blood to the blood bank for analysis.



• Maintaining an Intravenous Site Change catheter dressings when loose, wet, or soiled. Gauze dressings should be changed every 48 hours. Fluid containers may be changed frequently

depending on the rate of infusion and the volume of the container.

Change infusion tubing according to facility policy. Infusion tubing should not be disconnected to change

a gown or clothing.


Skills for Respiratory DisordersSkills for Respiratory Disorders

• Oxygen Therapy Goal of oxygen therapy is to prevent or relieve

hypoxia. Any patient with impaired tissue oxygenation can

benefit from controlled oxygen administration. Oxygen is not a substitute for other treatments and

should be used only when indicated. Oxygen should be treated as a drug. Oxygen is expensive and can have dangerous side

effects. The dosage or concentration of oxygen should be

ordered and continuously monitored.



• Oxygen Therapy (continued) Oxygen is a colorless, odorless, and tasteless gas

that will not burn or explode. If combined with other factors, such as an electrical

spark or fire, it will support combustion and ignite. Oxygen therapy is frequently initiated by a respiratory

therapist, who is a health care professional licensed to deliver treatment that will improve a patient’s ventilation and oxygenation needs.

The signs and symptoms manifested by patients who might require oxygen will vary according to the degree of oxygen deficiency.



• Oxygen Therapy (continued) Transtracheal oxygen delivery

• A newer method of oxygen delivery is the transtracheal catheter, which is inserted directly into the trachea between the second and third tracheal cartilages.

• Delivery does not interfere with drinking, eating, or talking.

• Oxygen is delivered throughout the respiratory cycle.

• It is recommended for patients with heart failure or chronic obstructive pulmonary disease.

• The transtracheal opening should be inspected and cleaned regularly.



A transtracheal catheter may be inserted into the trachea between 2nd and 3rd tracheal cartilages.



• Oxygen Therapy (continued) Care of the tracheostomy

• A tracheostomy is an artificial opening made by a surgical incision into the trachea.

• It is performed to provide the patient with a patent airway.

• After the surgical procedure is performed, the physician inserts a tracheostomy tube and secures it in place with cotton tape around the patient’s neck.

• Sterile gauze is placed around the opening under the flange of the outer tube for skin protection.



• Oxygen Therapy (continued) Care of the tracheostomy (continued)

• It is essential that nursing interventions be consistently implemented that

Minimize infection risk Minimize sensory deprivation



• Oxygen Therapy (continued) Care of the patient with a tracheostomy collar and T-

piece/tube• This requires constant humidification to the airway.

• The T-piece/tube is a T-shaped device with a 15 mm connection with large-lumen tubing.

• A tracheostomy collar is a curved device with an adjustable strap that fits around the patient’s neck; an exhalation port remains open at all times and another connects to large-bore tubing.



A, Trach tube (fenestrated) with inner cannula removed and cap in place to allow speech.




B, Trach tube with obturator for insertion and syringe for inflation of

cuff.




T-piece/tube.



Tracheostomy collar.


• Types of Catheters Coudé catheter

• Selected for ease of insertion when enlargement of the prostate gland is suspected

Foley catheter• Designed with a balloon near the tip so that the balloon

may be inflated after insertion, holding the catheter in the urinary bladder for continuous drainage

Skills for Urinary or Reproductive Tract DisordersSkills for Urinary or Reproductive Tract Disorders


• Types of Catheters (continued) Malecot, Pezzer, and Mushroom catheters

• Used to drain urine from the renal pelvis of the kidney Robinson catheter

• Has multiple openings in its tip to facilitate intermittent drainage

Ureteral catheter• Are long and slender to pass into the ureter




Different types of commonly used catheters.

(From Lewis, S.M., Heitkemper, M.M., Dirksen, S.R. [2004]. Medical-surgical nursing: assessment and management of clinical problems. [6th ed.]. St. Louis: Mosby.)


• Types of Catheters (continued) Whistle-tip catheter

• Has a slanted, larger orifice at its tip to be used if there is blood in the urine

Cystostomy, vesicostomy, or suprapubic catheters• Introduced through the abdominal wall above the

symphysis pubis

• Used to divert urine flow from the urethra to treat injury to the bony pelvis, urinary tract, or surrounding organs; strictures; or obstructions

• Inserted via a surgical incision or puncture of the abdomen and bladder walls with a trocar



• Types of Catheters (continued) Condom catheters

• This device is not a catheter but a drainage system connected to the external male genitalia.

• It is used for the incontinent male to minimize skin irritation from urine.




A, Condom catheter. B, Condom catheter attached to leg bag.




Drainage system must be below the level of the bladder.

(From Potter, P.A., Perry, A.G. [2003]. Basic nursing: essentials for practice. [5th ed.]. St. Louis: Mosby.)


• Self-Catheterization This is used for the patient who experiences spinal

cord injuries or other neurological disorders that interfere with urinary elimination.

Intermittent self-catheterization promotes independent function for the patient.



• Routine Catheter Care Perineal care and the cleansing of the first 2 inches of

the catheter every 8 hours are expected at minimum. The use of powders or lotions on the perineum is

contraindicated. Assess the urethral meatus and surrounding tissues

for inflammation, swelling, and discharge. Note amount, color, odor, and consistency of discharge.



• Routine Catheter Care (continued) The urinary tubing and collection bag should be

changed only if there are signs of leakage, odor, or sediment buildup.

Check the drainage tubing and bag to ensure that no tubing loops hang below the level of the bladder, that the tube is coiled and secured onto the bed linen, and that the tube is not kinked or clamped.




Empty and record urine output from Foley catheter into clean graduated container.



• Bladder Training Involves developing the use of the muscles of the

perineum to improve voluntary control over voiding; may be modified for different problems.

In preparation for the removal of a urethral catheter, the physician may order a clamp/unclamp routine to improve bladder tone.

For the patient with stress incontinence, instruct to perform Kegel exercises.

For habit training, a voiding schedule is established.



• Managing Incontinence Urinary incontinence occurs because pressure in the

bladder is too great or because the sphincters are too weak.

Kegel exercises Bladder training Credé’s method Disposable adult undergarments or underpads



• Discontinuing an Indwelling Catheter An indwelling catheter must be removed or changed

after a certain period of time. It may be removed and replaced by a new catheter or

removed and the patient allowed to excrete urine via the normal route.




• Inserting and Maintaining Nasogastric Tubes Nasogastric tube is a pliable tube that is inserted

through the patient’s nasopharynx into the stomach. The tube allows for removal of gastric contents and

introduction of liquids into the stomach. The primary purpose is decompression or removal of

flatus and fluids from the stomach. Nursing challenges: patient comfort and maintaining

patency of the tube



A, Small-bore feeding tube. B, Salem sump tube.




• Bowel Elimination Elimination of bowel waste (defecation) is a basic

human need and is essential for normal body function. Normal bowel elimination depends on several factors:

a balanced diet, including high-fiber foods; a daily fluid intake of 2000 to 3000 mL; and activity to promote muscle tone and peristalsis.

Normal stool (feces) is described for documentation as moderate in amount, brown, and soft in consistency and is expelled every 1 to 3 days.



• Care of the Patient with Hemorrhoids The patient with hemorrhoids has pain when

hemorrhoidal tissues are directly irritated from the passage of hard stool.

The primary goal for the patient with hemorrhoids is soft, formed stools.

Proper diet, fluids, and regular exercise improve the likelihood of soft stools.

Local heat provides temporary relief to swollen hemorrhoids; sitz bath is the most effective means of heat application.



• Flatulence This is the presence of air or gas in the intestinal tract. It may occur when a person consumes gas-producing

liquids and foods, such as carbonated beverages, cabbage, or beans; swallows excessive amounts of air; or has constipation.

In hospitalized patients, flatulence is often caused by decreased peristalsis, abdominal surgery, some narcotic medications, and decreased physical activity.



• Flatulence (continued) May cause distention of the stomach and abdomen

and mild to moderate abdominal cramping and pain One of the most effective measures to promote

peristalsis and passage of flatus is walking Rectal tube may be used



• Administering an Enema This involves the instillation of a solution into the

rectum and sigmoid colon. Primary reason for an enema is promotion of

defecation. The volume and type of fluid instilled can lubricate or

break up the fecal mass, stretch the rectal wall, and initiate the defecation reflex.

Patients should not rely on enemas to maintain bowel regularity because enemas do not treat the cause.

Frequent enemas disrupt normal defecation reflexes, resulting in dependency on enemas for elimination.



• Fecal Incontinence The first step in care of the patient with fecal

incontinence is to assess whether fecal impaction is the cause.

An impaction involves the presence of a fecal mass too large or hard to be passed voluntarily.

Either constipation or diarrhea can suggest the presence of an impaction.

An oil retention enema lubricates the rectum and colon, softens the feces, and facilitates defecation.

It can be used alone or with manual removal of a fecal impaction.



• Ostomies Colostomy

• A surgical creation of an artificial anus on the abdominal wall formed by incising the colon and bringing it out to form a stoma on the abdominal surface

• Performed for patients with cancer of the colon, intestinal obstructions, intestinal trauma, or inflammatory diseases of the colon

• May be permanent or temporary until intestinal healing occurs



• Ostomies (continued) Ileostomy

• A surgical formation of an opening of the ileum onto the surface of the abdomen through which fecal matter is emptied

• Performed for patients with inflammatory bowel conditions and cancer of the large intestine

• Stoma looks like a colostomy, but it is smaller and located lower on the abdomen

• Patient wears a pouch to collect the semiliquid fecal matter



Ostomy pouches and skin barriers.



Laboratory Values

Laboratory Values

• Identify laboratory values for ABGs (pH, PO2, PCO2, SaO2, HCO3), BUN, cholesterol (total), glucose, hematocrit, hemoglobin, glycosylated hemoglobin (HgbA1C), platelets, potassium, sodium, WBC, creatinine, PT, PTT & APTT, INR

Need to know Lab Values:

Documents

Selected Nursing Skills Chapter 20 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc