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PERITONEAL DIALYSIS

Name: Section: Clinical Instructor: PERFORMANCE POINTS I KNOWLEDGE 1 Explain the purposes of dialysis 2 Enumerate the indications of peritoneal dialysis 3 Explain the rationale of each action 4 Enumerate the materials used II SKILLS 1 Warm dialysate solution to body temperature. 2 Apply mask, then prepare dialysis administration set. Have client wear mask during connection & disconnection of administration set. 3 Place drainage bag below client. 4 Connect outflow tubing to drainage bag 5 Connect dialysis infusion lines to the bag/bottles of dialysate, and hang at clients bedside. 6 Place client in supine position when equipment & solution are ready. 7 Prime infusion tubing by allowing solution to fill tube Keeping clamp closed, connect one infusion line to the abdominal catheter 8 Check patency of catheter: 9 Open the clamps on the infusion lines, and infuse the prescribed amount of dialysate over 5 go 10 min allow solution to dwell for prescribed interval Remove and discard gloves, and perform hand hygiene. 10 When dwell time is completed, open the outflow and allow the solution to drain into the collection bag. Client may need to change position, roll from side to side. 11 Repeat the cycles of infusion-dwell-drainage until the prescribed amount of dialysate & the prescribed number of cycle have been achieved. 12 When dialysis treatment is complete, disconnect the inflow line from the catheter, place a sterile cap over the catheter end, the discard gloves. Group: Score Date

III ATTITUDE 1 Answers questions politely 2 Shows effort to improve performance 3 Works harmoniously with clinical instrucor and groupmates 4 Reports in clean uniform, well roomed & neat GRADING COMPUTATION CLINICAL INSTRUCTORS SIGNATURE Toatal score x 75+25= 100

Score

REMARKS

x 75+25=

ASSESSMENT OF THE HEART


Name: Section: Clinical Instructor: PERFORMANCE POINTS I KNOWLEDGE 1 Explain the purposes of cardiovascular asssesment 2 Enumerate the indications for heart assessment 3 Explain the rationale of each action 4 Enumerate the materials used II SKILLS 1 Assess for distention of the right Internal Jugular vein Positioned 45, and the filling level of the jugular vein determined when looking for the pulsation jugular vein should be less than 3 centimetres 2 Palpate for the PMI for ventricular enlargement Thrill- vibratory sensation produced by turbulent blood flow that is usually secondary to valvular abnormalities 3 Palpate for the carotid artery a Gently tilt the head to relax the sternomastoid muscle. b Palpate the carotid artery by placing your fingers near the upper neck between the sternomastoid and the trachea roughly at the level of cricoid cartilage 4 Auscultate for heart sounds a Murmurs of Aortic Stenosis Place stethoscope on the right 2nd ICS listen for abnormal murmurs as evidenced during expiration b Aortic Regurgitation Place stethoscope on the right 3-5th ICS listen for abnormal murmurs as evidenced during expiration c Murmurs of Mitral Stenosis Place stethoscope on the left 4-5th ICS listen for abnormal murmurs as evidenced during left lateral recumbent postion or murmurs can be heard throughout the left axillary area d Mitral Regurgitation Place stethoscope on the left 4-5th ICS listen for abnormal murmurs as evidenced while the patient is sitting or standing up aggrevated after exercise Group: Score Date

f Tricuspid Stenosis Place stethoscope on the left 3-5th ICS listen for abnormal murmurs as evidenced while the patient is in inspiration g Tricuspid regurgitation Place stethoscope on the left 3-5th ICS listen for abnormal murmurs as evidenced while the patient is in inspiration III ATTITUDE 1 Answers questions politely 2 Shows effort to improve performance 3 Works harmoniously with clinical instrucor and groupmates 4 Reports in clean uniform, well roomed & neat GRADING COMPUTATION CLINICAL INSTRUCTORS SIGNATURE Toatal score x 75+25= 100

Score

REMARKS

x 75+25=

ASSESSMENT OF THE LUNGS


Name: Section: Clinical Instructor: PERFORMANCE POINTS I KNOWLEDGE 1 Explain the purposes of pulmonary assessment 2 Enumerate the indications of lung assessment 3 Explain the rationale of each action 4 Enumerate the materials used II SKILLS 1 Assess for comfort & breathing pattern 2 Asessess for the use of accessory muscles of breathing for respiratory difficulty 3 Observe for cyanosis & pulmonary distress a Check for cyanosis of the lips b Check for cyanosis of the nailbeds c Check for clubbing of the nailbeds 4 Observe for obvious chest or spine deformities a Pectus excavatum: Congenital posterior displacement of lower aspect of sternum b Barrel chest: Associated with emphysema and lung hyperinflation c Kyphosis demonstrates extreme curvature of the spine. d Scoliosis Condition where the spine is curved to either the left or right. 6 Palpate for respiratory excursion Lower thoracic excursion measurements were taken at the level of the 10th thoracic spinous process and the xiphoid process. 7 Percuss for signs of lung consolidation & pleural fluids a Dull or thudlike sounds are normally heard over dense areas such as the heart or liver Dullness replaces resonance when fluid or solid tissue replaces air-containing lung tissues, such as occurs with pneumonia, pleural effusions, or tumors. b Hyperresonant sounds that are louder and lower pitched than resonant sounds are normally heard such as may occur in patients with COPD, or patients having an acute asthmatic attack Group: Score Date

c Tympanic sounds are hollow, high, drumlike sounds heard over the chest indicate excessive air in the chest, such as may occur with pneumothorax. 8 Ascultate the lungs for abnoramal breath sounds a wheezes when air is forced through airways narrowed b Rales scratchy sounds Very distinct, diffuse c Rhonchi secretions in larger airway d Auscultation over a pleural effusion e Auscultation of patients with severe emphysema f Egophony III ATTITUDE 1 Answers questions politely 2 Shows effort to improve performance 3 Works harmoniously with clinical instrucor and groupmates 4 Reports in clean uniform, well roomed & neat GRADING COMPUTATION CLINICAL INSTRUCTORS SIGNATURE Toatal score x 75+25= 165

Score

REMARKS

x 75+25=

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