CNA2 OSBN Curriculum

 Temp > 38 degrees C or F  SBP > 170 or < 90 ◦ Retake manually if done with machine  DBP > 90 or < 50 ◦ Retake manually is done with machine  Respirations > 24 or < 12  HR >110 or < 50 flvplayer/movie.php?movie= medcomrn.com/flv/cna515r_sec02_30 0k.flv&title=&detectflash=false

 Intake ◦ Decreased due to N/V  Output ◦ UOP  <30 ml/hr or 240ml/8hr  Appearance of Blood ◦ Emesis ◦ Sputum ◦ Urine ◦ Stool

 ADL’s  Movement

 Blood Glucose ◦ If 400 ◦ NOTIFY NURSE IMMEDIATELY!!!

 SOB  Dyspnea  Cough  Sputum ◦ Note Color ◦ Note Changes

 N/V  Poor Appetite  Difficulty Swallowing/Eating  Urine ◦ Sediment ◦ Foul Odor ◦ Pink Colored ◦ Dark Tea Colored  Stool ◦ Melena ◦ Frank Blood

 Excessive Drowsiness  LOC  New Onset ◦ Confusion ◦ Weakness ◦ Agitation  New ◦ Inability to Communicate ◦ Drooling while Awake ◦ Facial Droop

 Location  Intensity  Onset  Duration  Chest Pain  Sudden Change in Pain Level

 Cyanosis  Pallor  Chills  Diaphoresis  Edema  Any Drainage  Rashes/Bumps/Sores

 Dislodgment of any Tubes/Drains  Physical Signs of Abuse  Verbalization of Abuse  Pt. Expressing Concerns ◦ Code Status