Wednesday, March 7, 2012

CPNE Mnemonics

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The only way in my mind to even come close to remembering all of your "critical elements" for each area of care assigned and THEN remember to document the appropriate elements is to use mnemonics. I have pretty much a photographic memory and even I wouldn't have chanced the idea of forgetting one little thing either in implementation or documentation. You would want to rip your own head off if you got to the end and left off one tiny thing and failed the whole shabang...

There are 23 Areas of Care- 19 of which, in my opinion, you should have mnemonics for.
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I got all of my mnemonics from Sheri Taylor's workshop (if you are wondering who this lady is that I keep referring to, head over here). I sat down one afternoon with my set of EC flashcards and her studyguide with mnemonics and I went through each critical element with each mnemonic making sure that the one I picked included ALL of the critical elements not only for doing the AOC but also for documenting it. I tweaked them here and there and re-did some to fit my brain better.

Enter Room
EWIIG
Enter
Wash hands
Introduce self
ID patient
Gloves


Vital Signs(you don't necessarily need a mnemonic for this since they are listed on your PCS recording form but I decided to do it anyway just incase)
GT PRB WOPR (Get PRegnant Belly a Whopper, lol, it worked for me ok)
Gloves (for oral temp)
Temp
Pulse (apical/radial)
Resps
BP
Weight (if assign)
02 sats (if assign)
Pain (what scale)
Record


Fluid Management (20 Min Check)
HIPPICOW
Hydration status turgor/muc membranes
IV type/rate/amt
Palpate site temp/edema
Pump settings
Inspect tubing air
Check enteral feeds
Oral intake- explain
Write it down


Mobility
MOBIL
Mobility status
Observe devices
Balance abnormalities?
Implement activity/increase support
Log patient response


Medications
M3 IASAS
MAR (get the mar)
Meds (check meds)
Measure/calc
ID patient
Allergies?
Special assessments?
Administer meds
Sign MAR


Abdominal Assessment
4P's LLF RR

Privacy
Pain any?
Pee need to?
Position flat
Look distention
Listen x4
Feel tender/rigid
Reposition patient
Record

Neurological Assessment
LOGICSS

Level of consciousness x3
Observe pupils
Grasps- hands
Inspect fontanel- child
Check dorsi/plantar flex
Stimulii noxious- unresponsive
Symmetry of movement- child

Peripheral Vascular Assessment
C-PERIPH
Compare bilaterally
Pulses distal
Edema?
Refill cap
Inspect sensation eyes closed
Pale/Pink color
Hot/cold temp

Respiratory Assessment
PI BREATHE

Position upright
Instruct to breathe normal
Breathing abnormalities?
Resp rate/rhythm
Equipment clean
Auscultate x4
Tell patient breathe slow/deep
Hear x4
Evaluate 02 if assign

Skin Assessment
TWICE RED
Temp hot/cold
Wet/dry
Integrity intact?
Color red/pink
Edema?
Reposition off area
Evaluate for pain
Do 2 areas

Comfort Management
A 3RD CHANCER

Assess level of comfort (ask)
3 things
Reposition (I usually stopped writing after this point because I knew a bunch of things I could offer for comfort by heart, so I'd just rattle them off if I needed to)
Dental hygiene
Change linens
Hygiene activities
Nsaids/meds
Comfort rub
Environmental controls- lights
Record patient response

Musculoskeletal Management
MAD PARTER
Mobility status

Abnormalities
Devices
Pain
Apply heat/cold if ordered
Range of motion
Traction
Evaluate tolerance
Response

Oxygen Management
BREATHE sAFER
Best position
Resp rate/rhythm
Ears nares
Assess tolerance to activity
Triggers to combustion
Humidity
Evaluate 02 if assign
Assess cap refill/color/clubbing
Finally
Evaluate &
Record

Pain Management
PAID MGMTTRR

Pain level
Assess location
Intensity sharp/dull
Duration
Massage
Guided imagery
Meds
Temp hot/cold pack
Turn/reposition
Reassess after 20 mins
Response & record

Respiratory Management
PBRAE PRRP
(said peebray purp, no clue... but it worked for me)
Position upright
Breathing abnormalities?
Resp rate/rhythm
Auscultate x4
Explain resp activity
Provide receptacle
Repeat as ordered (x10)
Reassess lungs x4
Patient response

Wound Management
WOUNDED

Wound location
Observe drainage type/amount
Unique irrigation supplies
Need clean or sterile field
Dressing change or pack
Evaluate pain/tolerance
Document

Drainage & Specimen Collection
Drain ACT, Spec OCLC (said ock-lock)
Drainage
  Assess color and amount
  Clean area if assign
  Tube replace as found
Specimen
  Obtain specimen
  Correct container
  Label date/time
  Correct location (to lab)

Enteral Feeding
FLOW STOMACH RR
Feeding type
Low fowlers
Orient patient
Warm (room temp)
Select device
Total amount
On time +- 30
Measure/calc gtts
Aspirate AND air
Check residual & reinstill
Have baby burp
Response
Record

Irrigation
STOP A FLOW

Select solution
Temp (room)
Obtain special equip
Position for drainage
Aspirate AND air (NG's)
Flow rate slow gentle
Look at return solution
Observe patient response
Write it down

Patient Teaching
LEARN

Learning readiness
Evaluate prior knowledge
Activity of learning
Reassess understanding
Need to document





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