name: Consider cultural and religious beliefs and values


name: Instruct individual in the prospective identification of the major premenstrual symptoms (e.g., bloating, cramping, irritability), use of a prospective calendar check list or symptom log, and the recording of timing and severity of each symptom


name: Collaborate with individual to prioritize most problematic symptoms


name: Prescribe symptom specific medication, as appropriate to practice level


name: Identify individual needs, concerns, and preferences, foster involvement in decision making, and identify and address barriers to care


name: Discuss importance of participating in prenatal care throughout entire pregnancy and encourage involvement of patient's partner or other family member


name: Monitor for hypertensive disorder (e.g., blood pressure, edematous ankles, hands, and face, and proteinuria)


name: Instruct patient on quickening and importance of monitoring fetal activity


name: Review with patient changes noted on fetal growth and status


name: Discuss nutritional needs and concerns (e.g., balanced diet, folic acid, food safety, and supplements)


name: Instruct patient on effects of exposure to or ingestion of harmful substances (e.g., alcohol, illicit drugs, teratogens, medications, herbs, and tobacco)


name: Discuss activity level with patient (e.g., appropriate exercise, activities to avoid, and importance of rest)


name: Provide genetic counseling and testing if indicated


name: Instruct patient on routine laboratory testing to occur throughout pregnancy (e.g., urinalysis, hemoglobin level, ultrasound, gestational diabetes, and HIV)


name: Instruct patient on nonroutine tests and treatments (e.g., nonstress test, biophysical profile, Rh-immune globulin, and stripping of membranes), if needed


name: Monitor psychosocial status of patient and patient's partner


name: Monitor for risk factors affecting patient or fetal health status (e.g., mental health disorder and intimate partner violence)


name: Offer support and counsel to the patient presenting with an unplanned or unwanted pregnancy


name: Offer anticipatory guidance about physiological and psychological changes and discomforts (e.g., nausea, vomiting, musculoskeletal changes, fears, and breast tenderness)


name: Assist patient in identifying strategies to cope with changes and relieve discomforts associated with pregnancy


name: Review safety precautions to be taken during pregnancy (e.g., seat belt use, avoidance of hot tubs and saunas, and travel restrictions)


name: Provide accurate information pertaining to risks, benefits, contraindications, and side effects of immunizations, if needed


name: Assist patient in preparing for labor and delivery (i.e., discuss pain management options, review labor signs and symptoms, discuss special circumstances requiring medical intervention, and encourage planned involvement of patient's partner or family)


name: Offer anticipatory guidance on infant care and considerations (e.g., circumcision, feeding, and selection of pediatric health care provider)


name: Discuss postpartal concerns and considerations (e.g., family planning and contraception, returning to work or school, and physiological and psychological changes)


name: Provide referral to appropriate service (e.g., supplemental food program, drug dependency treatment, and mental health counseling), if needed


name: Explain procedures in a way that the patient can understand


name: Communicate any concerns (e.g., abnormal laboratory or diagnostic test results, issues related to the patient's understanding of the planned procedure) to the surgeon


name: Involve patient in decisions related to surgery


name: Assure that patient has significant other for postoperative needs, such as transportation home as indicated


name: Link the sensations to their cause when it may not be self-evident


name: Consider the status of the existing chronic health condition


name: Review past medical history, medications, allergies, and past diagnostic testing pertinent to the presenting condition


name: Evaluate the diagnostic utility of the test in addressing the specific clinical question (i.e., understand sensitivity and specificity of the diagnostic test for the presenting condition)


name: Consult with accepted evidence-based practice guidelines, specialists, and other health care professionals, as appropriate


name: Provide the patient or family members with the rationale for the proposed testing, including how the information would benefit clinical decision making or continued monitoring


name: Allow for discussion and questions of the testing


name: Provide alternatives to diagnostic testing, as appropriate


name: Consider the availability and cost of the diagnostic testing and include the patient and family in the discussion


name: Instruct the patient and family on what to expect of the diagnostic test


name: Have a system in place to ensure test results are received when expected


name: Identify a method that ensures accurate communication of test date, time, and location to the patient or caregiver


name: Instruct the patient and family on the test date, time, location, and how to expect test results to be reported


name: Employ a system that provides for the timely return of diagnostic test results and assurance that missing or delayed reports are noted and pursued


name: Monitor for adverse effects of the diagnostic test


name: Maintain knowledge of diagnostic testing used in practice (e.g., sensitivity or specificity, rationale, alternatives, standards of care, evidence based practice, side effects, monitoring and state regulations or policy issues)


name: Determine signs and symptoms of current health problem


name: Review past and current therapeutic treatments tried for the health problem, including the reasons for stopping treatment


name: Document the effects of other treatments on the health problem


name: Identify nonpharmacological treatments (e.g., exercise, diet, physical therapy, occupational therapy, heat and cold treatment) that are indicated for current health problems


name: Consider the availability and cost of the recommended treatment and include the patient and family in the discussion


name: Provide the patient and family members with the rationale for the proposed treatment, expected outcome, and duration of the treatment


name: Allow for questions and discussion related to the diagnosis and treatment and provide alternatives to the treatment


name: Monitor for adverse effects of the treatment


name: Ensure for follow up to assess response to treatment


name: Maintain knowledge of treatments commonly used in practice, including rationale, alternatives, standards of care, evidence based practice, side effects, monitoring, and state regulations or policy issues


name: Touch patient to express concern, as appropriate


name: Offer to remain with patient during initial interactions with others on the unit


name: Help patient to realize that you are available but do not reinforce dependent behaviors


name: Offer to contact other support persons (e.g., priest/rabbi), as appropriate


name: Describe characteristics of the ulcer at regular intervals, including size (length × width × depth), stage (I-IV), location, exudate, granulation or necrotic tissue, and epithelization


name: Use a 19 gauge needle and a 35 cc syringe to clean deep ulcers


name: Utilize methods of measuring skin temperature to determine pressure ulcer risk, as per agency protocol


name: Avoid "donut" type devices to sacral area


name: Ensure the presence of a person dedicated to provide support to the infant


name: Evaluate the need for painful procedures


name: Separate the number and grouping of laboratory and diagnostic procedures according to infant's tolerance


name: Avoid painful procedures at the same time as nonemergency routine care


name: Use minimal amounts of tape or adhesives


name: Use noninvasive monitoring devices whenever possible


name: Instruct parents about signs and symptoms of pain and the comfort that they can provide


name: Reduce light and noise whenever possible during painful procedures


name: Use facilitated tucking (i.e., hand swaddle to hold extremities flexed and contained close to the trunk)


name: Use blanket swaddling after a painful procedure


name: Use nonnutritive sucking with a pacifier


name: Use sucrose solution with pacifier before and throughout painful procedures


name: Facilitate breastfeeding or feed breast milk during painful procedures


name: Facilitate kangaroo care (i.e., skin-to-skin contact) with parent during painful procedures, when possible


name: Facilitate holding by parent, when possible


name: Assemble a multidisciplinary product selection and evaluation team if change will affect other providers


name: Gather information on use of the existing product that is being replaced


name: Establish criteria for product selection


name: Decide on a disposable versus a reusable product


name: Strive for standardization of inventory when within and across facilities, when possible


name: Select a product that has an uncomplicated user interface


name: Solicit input from other health care providers (e.g., biomedical engineers, pharmacists, physicians, other agencies), as needed


name: Determine whether a higher cost product achieves better patient outcomes


name: Report significant medical device adverse events to the FDA (Food and Drug Administration) as well as to the manufacturer


name: Explain the purpose and process of the technique to the patient


name: Instruct patient to wear comfortable, unrestricted clothing


name: Screen for neck or back orthopedic injuries to which hyperextension of the upper spine would add discomfort and complications


name: Screen for increased intracranial pressure, capillary fragility, bleeding tendencies, severe acute cardiac difficulties with hypertension, or other conditions in which tensing muscles might produce greater physiological injury and modify the technique, as appropriate


name: Ask patient to loosen any tight clothing


name: Instruct the patient to sit in a reclining chair or lie down on a comfortable surface


name: Instruct the patient to assume a passive attitude by focusing on achieving relaxation in specific body muscles and refrain from focusing on any other thoughts


name: Instruct the patient to take a deep breath through the abdomen and hold for a few seconds and then exhale slowly


name: Have the patient repeat the deep breathing several times, asking the patient to imagine the tension being released from the body with each exhale


name: Have the patient tense systematically, for 5 to 10 seconds, each of 8 to 16 major muscle groups progressively from head to toe


name: Begin by asking the patient to take a deep breath and tighten the muscles in the forehead by raising the eyebrows as high as possible for 5 to 10 seconds and then release the tension, focusing on the feeling of the muscles relaxing as he/she exhales


name: Pause for 10 seconds before moving on to the next muscle group


name: Establish interval of initial prompted voiding schedule based upon voiding pattern


name: Establish beginning and ending time for the prompted voiding schedule if not for 24 hours


name: Prompt (maximum of three times) to use toilet or substitute regardless of continence status


name: Offer assistance with toileting regardless of continence status


name: Determine the cause of the pruritus (i.e., contact dermatitis, systemic disorder, medications)


name: Perform a physical examination to identify skin disruptions (i.e., lesions, blisters, ulcers, abrasions)


name: Administer opiate antagonists as indicated


name: Participate in selection and development of quality indicators appropriate to clinical setting and patient population


name: Include structure, process, and outcome quality indicators


name: Promote and use electronic health records for collection, exchange, and analysis of data


name: Negotiate solutions cognizant of local work loads


name: Participate on evidence based practice and quality improvement committees, as appropriate


name: Participate on intradisciplinary and interdisciplinary problem-solving teams


name: Monitor pretreatment workups for patients at risk for earlier onset, longer duration, and more distressing side effects


name: Provide information to patient and family regarding radiation effect on malignant cells


name: Utilize recommended radiation precautions in the management of patients with cardiac pacemakers


name: Provide special skin care to tissue folds that are prone to infection (e.g., buttocks, perineum, and groin)


name: Avoid application of deodorants and aftershave lotions to treated areas


name: Discuss the need for skin care, such as maintenance of dye markings, avoidance of soap, and other ointments, and protection during sunbathing or heat application


name: Encourage good oral hygiene with use of dental cleansing devices, such as unwaxed nonshredding floss, sonic toothbrushes, or water pics, as appropriate


name: Initiate oral health restoration activities, such as use of artificial saliva, saliva stimulants, non-alcohol-based mouth sprays, sugarless mints, and fluoride treatments, as appropriate


name: Teach patient need for frequent dental follow-up care as dental caries can form rapidly


name: Promote therapeutic diet to prevent complications


name: Encourage rest immediately after treatments


name: Assist patient in achieving adequate comfort levels through the use of pain management techniques that are effective and acceptable to the patient


name: Teach patient and family about the effects of therapy on bone marrow functioning, as appropriate


name: Instruct patient and family on ways to prevent infection, such as avoiding crowds, using good hygiene, and handwashing techniques, as appropriate


name: Institute neutropenic and bleeding precautions, as indicated


name: Initiate and maintain protection according to agency protocol for patient receiving internal radiation treatment (e.g., gold seed placement or radiopharmaceutical agents)


name: Explain protection protocols to patient, family, and visitors


name: Limit visitor time in room, as appropriate


name: Limit staff time in the room if patient is isolated for radiation precautions


name: Distance oneself from the radiation sources while giving care (e.g., stand at the head of the bed of patient with uterine implants), as appropriate


name: Document whether patient has showered, douched, or bathed after incident


name: Use a consistent approach (e.g., kind firmness, active friendliness, passive friendliness, matter-of-fact, and no demands) that reflects the particular needs and capabilities of the patient


name: Speak in a distinct manner with an appropriate pace, volume, and tone


name: Avoid frustrating the patient by demands that exceed capacity (e.g., repeated orientation questions that cannot be answered, abstract thinking when patient can think only in concrete terms, activities that cannot be performed, decision making beyond preference or capacity)


name: Present reality in manner that preserves the patient's dignity (e.g., provides an alternate explanation, avoids arguing, and avoids attempts to convince the patient)


name: Repeat patient's last expressed thought, as appropriate


name: Interrupt confabulation by changing the subject or responding to the feeling or theme rather than the content of the verbalization


name: Engage patient in concrete "here and now" activities (e.g., ADLs) that focus on something outside self that is concrete and reality oriented


name: Provide physical prompting and posturing (e.g., moving patient's hand through necessary motions to brush teeth), as necessary for task completion


name: Recommend patient wear personal clothing and assist, as needed


name: Provide objects that symbolize gender identity (e.g., purse or cap), as appropriate


name: Provide for adequate rest and sleep, including short-term, daytime naps, as needed


name: Encourage family to participate in care based on abilities, needs, and preferences


name: Modulate human and environmental sensory stimuli (e.g., visiting sessions, sights, sounds, lighting, smells, and tactile stimulation) based on patient's needs


name: Remove stimuli (e.g., pictures on the wall and television) that create misperception in a particular patient, when possible.


name: Provide psychoeducation to family and significant others regarding promotion of reality orientation


name: Monitor for changes in orientation, cognitive and behavioral functioning, and quality of life


name: Identify any deficits that may limit participation in recreational activities (e.g., mobility, cognitive, economic)


name: Assist patient to identify meaningful recreational activities (e.g., sports, drama, games, arts and crafts)


name: Monitor patient's physical and mental capacities while participating in recreational activities


name: Provide new recreational activities that are age and ability appropriate


name: Monitor emotional, physical, and social response to recreational activity


name: Place a warm water or saline soaked cloth over the protruding bowel to protect it from drying


name: Determine whether appropriate supportive care is available in the home or community


name: Evaluate accessibility of environmental needs for the patient in the home or community


name: Inform patient of appropriate Internet sites for use after discharge


name: Contact appropriate agency or health care provider


name: Minimize time between discharge and appointment with next provider


name: Send written referral and patient's plan of care electronically, as appropriate


name: Provide patient or family member with a copy of the referral information, as appropriate


name: Create a calm and comfortable environment


name: Use aroma or gentle music to create a healing atmosphere


name: Ask about the chief complaints, such as the presence of pain in certain areas or the presence of a particular illness


name: Have the Reiki receiver sit comfortably or lay down on a massage table, fully clothed, in a supine position


name: Relax your mind and take a few deep breaths to focus yourself


name: Remember: the Reiki does the work, not the practitioner


name: Begin by sending Reiki from about 3 feet away as a gentle way of beginning the session, if possible


name: Follow a specific series of hand placements: over eyes, over ears, one hand on forehead and one hand on top of head, hands under head, over the neck, upper chest, upper abdomen, lower abdomen, thighs (one at a time), knees (one at a time), lower legs, ankles, feet, bottoms of feet, have client roll over on to stomach, shoulders, waist area, lower back, backs of legs and front of legs


name: Draw or visualize Reiki symbols (e.g., power, mental or emotional, distance) as guided by your intuition


name: Allow your intuition to guide your movements by placing hands on (or a few inches over) the part of the body that most requires healing


name: Stay in each area for 5 to 15 minutes or until you feel the energy flow more slowly or your intuition informs you it is time to move hand position


name: Ask for specific permission during the session to work on sexual organs or parts of the body that would be considered inappropriate, if so guided


name: Move one hand at a time so that you maintain contact as much as possible


name: Note whether the patient has experienced a relaxation response and any related changes


name: Describe the rationale for relaxation and the benefits, limits, and types of relaxation available (e.g., music, meditation, rhythmic breathing, jaw relaxation, and progressive muscle relaxation)


name: Screen for current decreased energy level, inability to concentrate, or other concurrent symptoms that may interfere with cognitive ability to focus on relaxation technique


name: Use soft tone of voice with a slow, rhythmical pace of words


name: Provide undisturbed time because patient may fall asleep


name: Regularly evaluate individual's report of relaxation achieved, and periodically monitor muscle tension, heart rate, blood pressure, and skin temperature, as appropriate


name: Use relaxation as an adjuvant strategy with pain medication or in conjunction with other measures, as appropriate


name: Refer to religious advisor of the patient's choice


name: Make arrangements for individual's personal items to be in place before relocating


name: Monitor for physiological and psychological signs and symptoms of relocation (e.g., anorexia, anxiety, depression, increased demands, and hopelessness)


name: Assist the individual to grieve and work through the losses of home, friends, and independence


name: Evaluate the effect of disruption of lifestyle, loss of home, and adaptation to a new environment


name: Identify, with the patient, a theme for each session (e.g., work life)


name: Determine which method of reminiscence (e.g., taped autobiography, journal, structured life review, scrapbook, open discussion, and storytelling) is most effective


name: Introduce props (e.g., music for auditory, photo albums for visual, perfume for olfactory), addressing all five senses to stimulate recall


name: Encourage verbal expression of both positive and negative feelings of past events


name: Maintain focus of sessions, more on the process than on an end product


name: Assist the patient in creating or adding to a family tree, or to write his/her oral history


name: Use direct questions to refocus back to life events, as necessary


name: Instruct patient about ovulation prediction and detection techniques (e.g., basal temperature and urine testing)


name: Schedule tests based on the menstrual cycle, as needed


name: Collaborate with in vitro fertilization team in screening and selecting gamete donors


name: Draw specimens for endocrine determination


name: Perform ultrasound examinations to ascertain follicular growth


name: Inform about ectopic pregnancy precautions


name: Schedule follow-up medication, tests, and ultrasound examinations


name: Refer for genetic counseling related to maternal age at conception, as needed


name: Encourage the development and adherence to family routines and traditions (e.g., birthdays, holidays)


name: Encourage family involvement with child's schoolwork and activities


name: Assist youth in developing friendship-making skills


name: Monitor breathing patterns (e.g., bradypnea, tachypnea, hyperventilation, Kussmaul respirations, Cheyne-Stokes respirations, apneustic, Biot's respiration, ataxic patterns)


name: Monitor oxygen saturation levels continuously in sedated patients (e.g., SaO2, SvO2, SpO2), per agency policy and as indicated


name: Provide for noninvasive continuous oxygen sensors (e.g., finger, nose, or forehead devices) with appropriate alarm systems in patients with risk factors (e.g., morbidly obese, confirmed obstructive sleep apnea, history of respiratory problems requiring oxygen therapy, extremes of age), per agency policy and as indicated


name: Monitor for diaphragmatic muscle fatigue, as indicated by paradoxical motion


name: Note changes in SaO2, SvO2, end tidal CO2, and ABG values, as appropriate


name: Provide frequent intermittent monitoring of respiratory status in at-risk patients (e.g., opioid therapy, newborn, mechanical ventilation, facial or chest burns, neuromuscular disorders)


name: Establish a therapeutic relationship with patient and family


name: Inform patient and family of available state funding for respite care


name: Coordinate community support services (i.e., meals, day care, summer camp)


name: Monitor skill level of respite care provider


name: Provide a program of suitable activities, as appropriate


name: Evaluate unresponsiveness to determine appropriate action


name: Obtain the automated external defibrillator (AED)


name: Attach the AED and implement specified actions


name: Initiate 30 chest compressions at specified rate and depth, allowing for complete chest recoil between compressions, minimizing interruptions in compressions, and avoiding excessive ventilation


name: Provide two rescue breaths after initial 30 chest compressions completed


name: Tailor rescue actions to the most likely cause of arrest (e.g., cardiac or respiratory arrest)


name: Monitor patient response to resuscitation efforts


name: Clear oral, nasal, and tracheal secretions when possible and without interfering with chest compressions, as appropriate


name: Administer manual ventilation when possible and without interfering with chest compressions, as appropriate


name: Connect the person to an ECG monitor if needed when defibrillation is completed


name: Interpret ECG and deliver cardioversion or defibrillation, as needed


name: Assist with insertion of endotracheal tube (ET), as indicated


name: Assess lung sounds after intubation for proper ET position


name: Assure organized post cardiac arrest care (e.g., safe transport to appropriate nursing care unit)


name: Offer family members opportunities to be present during resuscitation when in the best interests of the patient


name: Support family members who are present during resuscitation (e.g., ensure safe environment, provide explanations and commentary, allow appropriate communication with patient, continually assess needs, provide opportunities to reflect on resuscitation efforts after event)


name: Monitor fetal vital signs using auscultation and palpation or electronic fetal monitor, as appropriate


name: Discontinue syntocinon to decrease uterine activity


name: Reposition mother to left lateral or hands-and-knees position


name: Apply oxygen at 10 to 15 L/min if positioning is ineffective in correcting nonreassuring (abnormal) pattern of fetal heart rate


name: Give a bolus of 1 L crystalloid IV fluid


name: Administer IV vasopressor if blood pressure is low


name: Perform a vaginal examination with fetal scalp stimulation


name: Use fetal scalp electrode if fetal heart rate tracing is suboptimal


name: Perform amnioinfusion for nonreassuring (abnormal) variable decelerations in fetal heart rate or meconium-stained amniotic fluid


name: Coach to decrease pushing efforts for nonreassuring (abnormal) fetal heart signs to allow reestablishment of placental perfusion


name: Open the airway by slightly extending the neck, placing in the "sniffing" position


name: Monitor oxygen saturations by placing an oximeter probe on the right wrist


name: Initiate positive-pressure ventilation for apnea, gasping, or heart rate lower than 100 beats per minute


name: Set oxygen blender at 21% at 5 to 8 L to fill resuscitation bag and titrate based on oxygen saturations, as necessary


name: Give chest compression for heart rate of less than 60 beats per minute or if greater than 80 beats per minute with no increase


name: Continue compressions until heart rate is greater than or equal to 60 beats per minute


name: Prepare medications (e.g., narcotic antagonists, epinephrine, volume expanders, and sodium bicarbonate), as needed


name: Review past health history and documents for evidence of existing or previous medical and nursing diagnoses and treatments


name: Review data derived from routine risk assessment measures


name: Determine availability and quality of resources (e.g., psychological, financial, education level, family and other social, and community)


name: Identify biological, environmental, and behavioral risks and their interrelationships


name: Instruct on risk factors and plan for risk reduction


name: Consider criteria useful in prioritizing areas for risk reduction (e.g., awareness and motivation level, effectiveness, cost, feasibility, preferences, equity, stigmatization, and severity of outcomes if risks remain unaddressed)


name: Discuss and plan for risk reduction activities in collaboration with individual or group


name: Plan for long-term monitoring of health risks


name: Plan for long-term follow-up of risk reduction strategies and activities


name: Determine residential status of mother (e.g., place of residence, homelessness, living with someone, immigration status)


name: Determine outcomes of all prior pregnancies


name: Determine prior history of abuse and violence


name: Determine prior history of depression or other mental illness


name: Review, update, and complete information as pregnancy develops and at intrapartum, postpartum, and neonatal admissions, as needed


name: Review maternal history of chemical dependency, noting duration, type of drugs used (including alcohol), and time and strength of last dose before delivery


name: Document psychosocial adaptation to pregnancy by the patient, the father, other children and adults in the household, family members, and others in close relationship to the pregnant woman


name: Note presence of multiple gestation and consider challenges of raising multiples


name: Note any medications (e.g., sedative, anesthetic, or analgesic) administered to mother during intrapartal period


name: Note maternal morbidities that could delay attachment (e.g., prolonged labor, infection, sedating medications)


name: Note fetal and neonatal morbidities (e.g., fetal distress, hypoxia, oligohydramnios or polyhydramnios, hyperglycemia or hypoglycemia) that could delay its ability to interact with caretakers


name: Note attachment behaviors to multiples (e.g., twins, triplets)


name: Promote family attachment through patient education


name: Implement activities that promote attachment


name: Evaluate behavioral assessment of neonates during early pediatric visits for possible indications of parenting adjustment problems


name: Promote a postpartum maternal follow-up at 2 to 6 weeks to a qualified health care professional


name: Promote newborn follow-up at 2 and 6 weeks by a qualified health care professional


name: Prioritize areas for risk reduction in collaboration with the individual or family


name: Promote newborn safety by requiring newborn discharge into an approved car seat


name: Refer to the appropriate community agency for follow-up if risk of parenting problems or a lag in attachment has been identified


name: Obtain or review environment (e.g., potential teratogen and carcinogen exposures) and lifestyle (e.g., tobacco, alcohol, street, or prescription drug exposure) history


name: Discuss issues in testing other family members as relevant


name: Refer to genetic health care specialists for genetic counseling, as needed


name: Assist patient to identify various roles in life cycle


name: Assist patient to identify role transition periods throughout the lifespan


name: Assist patient to identify behaviors needed for role development


name: Remove all items from seclusion area that patient might use to harm self or others


name: Inform patient of video surveillance, as appropriate


name: Explain reasons for the video monitoring


name: Give careful consideration to who is responsible for watching the video monitor for changes in patient status


name: Reassure patient of safety within the seclusion area during monitoring


name: Distinguish direct visual inspection from checks performed through video monitoring and document appropriately


name: Reduce sensory stimuli around the seclusion area


name: Involve patient in making decisions to move to a more or less restrictive intervention, when appropriate


name: Document rationale for restrictive intervention, patient's response to intervention, patient's physical condition, nursing care provided throughout intervention, and rationale for terminating the intervention


name: Ensure emergency resuscitation equipment is readily available, specifically a source to deliver 100% oxygen, emergency medications, and a defibrillator


name: Monitor the patient's level of consciousness and vital signs, oxygen saturation, and EKG, as per agency protocol


name: Determine whether the patient meets discharge or transfer criteria (i.e., Aldrete scale), as per agency protocol


name: Discharge or transfer patient, as per agency protocol


name: Provide written discharge instructions, as per agency protocol


name: Record seizure characteristics (e.g., body parts involved, motor activity, and seizure progression)


name: Assist patient to identify the effect of illness on self-concept


name: Consider the culture of the patient when promoting self-care activities


name: Provide a therapeutic environment by ensuring a warm, relaxing, private, and personalized experience


name: Place towels, soap, deodorant, shaving equipment, and other needed accessories at bedside or in bathroom


name: Provide desired personal articles (e.g., deodorant, toothbrush, bath soap, shampoo, lotion, and aromatherapy products)


name: Facilitate assistance of a barber or beautician as necessary


name: Ensure proper patient positioning to facilitate chewing and swallowing


name: Fix food on tray as necessary, such as cutting meat or peeling an egg


name: Provide preferred foods and drinks, as appropriate


name: Monitor patient's weight, as appropriate


name: Monitor patient's hydration status, as appropriate


name: Encourage patient to eat in dining room if available


name: Provide social interaction, as appropriate


name: Use unbreakable and weighted dishes and glasses as necessary


name: Determine needs for safety-related changes in the home (e.g., wider door frames to allow for wheelchair access to bathroom, removal of scatter-rugs)


name: Obtain transportation enhancements to offset disabilities (e.g., hand controls on cars, wide rear-view mirror), as appropriate


name: Obtain tools to assist in daily activities (e.g., ability to reach items in cupboards, in closets, on countertops, on stovetops, and in refrigerator, and ability to operate household equipment such as stoves and microwaves)


name: Verify adequacy of lighting throughout house, especially in working areas (e.g., kitchen, bathroom) and at night (e.g., appropriately placed nightlights)


name: Instruct individual not to smoke in bed, while reclining, or after taking mind-altering medication


name: Verify presence of safety equipment in home (e.g., smoke detectors, carbon monoxide detectors, fire extinguishers, hot water heater set to 120° F)


name: Instruct individual and caregiver on what to do in the event the individual suffers from a fall or other injury (e.g., what to do, how to gain access to emergency services, how to prevent further injury)


name: Determine current ability of patient to transfer self (e.g., mobility level, limitations of movement, endurance, ability to stand and bear weight, medical or orthopedic instability, level of consciousness, ability to cooperate, ability to comprehend instructions)


name: Select transfer technique that is appropriate for patient


name: Instruct patient in all appropriate techniques with the goal of reaching the highest level of independence


name: Instruct individual on techniques for transfer from one area to another (e.g., bed to chair, wheelchair to vehicle)


name: Instruct individual in use of ambulatory aids (e.g., crutches, wheelchairs, walkers, trapeze bars, cane)


name: Make sure equipment works before using it


name: Provide privacy, avoid drafts, and preserve the patient's modesty


name: Use proper body mechanics during movements


name: Keep patient body in proper alignment during movements


name: Raise and move patient with a hydraulic lift as necessary


name: Move patient using a transfer board as necessary


name: Evaluate patient at end of transfer for proper body alignment, nonocclusion of tubes, wrinkled linens, unnecessarily exposed skin, adequate patient level of comfort, raised side rails, and call bell within reach


name: Provide encouragement to patient as he/she learns to transfer independently


name: Explore individual's perception of his/her capability to perform the desired behavior


name: Explore individual's perception of benefits of executing the desired behavior


name: Identify individual's perception of risks of not executing the desired behavior


name: Provide information about the desired behavior


name: Assist individual to commit to a plan of action for changing behavior


name: Reinforce confidence in making behavior changes and taking action


name: Provide an environment supportive to learning knowledge and skills needed to carry out the behavior


name: Use teaching strategies that are culturally and age appropriate (e.g., games, computer-assisted instruction, or conversation maps)


name: Engage in role play to rehearse behavior


name: Provide positive reinforcement and emotional support during the learning process and while implementing the behavior


name: Provide opportunities for mastery experiences (e.g., successful implementation of the behavior)


name: Use positive persuasive statements regarding the individual's ability to carry out the behavior


name: Encourage interaction with other individuals who are successfully changing their behavior (e.g., support group or group education participation)


name: Prepare individual for the physiological and emotional states that may be experienced during initial attempts to carry out a new behavior


name: Encourage patient to engage in self-talk and to verbalize positive affirmations daily to self


name: Assist the patient to cope with bullying or teasing


name: Explore previous achievements of success


name: Assist patient to identify significance of culture, religion, race, gender, and age on self-esteem


name: Instruct parents to recognize children's accomplishments


name: Determine whether the patient is an appropriate candidate for self-hypnosis


name: Utilize self-hypnosis as an adjunct to other treatment modalities (e.g., individual hypnotherapy by a therapist, individual psychotherapy, group therapy, family therapy, etc.)


name: Obtain history of the problem to be treated by self-hypnosis


name: Determine goals for self-hypnosis with patient


name: Determine patient's receptivity about using self-hypnosis


name: Correct myths and misconceptions of self-hypnosis


name: Assist the patient to identify appropriate induction techniques (e.g., Chevreul's pendulum illusion, relaxation, imagining walking down a staircase, eye closure, arm levitation, simple muscle relaxation, visualization exercises, attention to breathing, repetition of key words/phrases, and others)


name: Assist the patient to evaluate progress made toward therapy goals


name: Encourage the patient to examine personal values and beliefs and his or her satisfaction with them


name: Assist the patient in identifying the target behaviors' effects on social and environmental surroundings


name: Assist the patient in identifying the stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination


name: Encourage the patient to identify appropriate, meaningful reinforcers and rewards


name: Encourage the patient to choose a reinforcer or reward that is significant enough to sustain the behavior


name: Foster moving toward primary reliance on self-reinforcement instead of family or nurse for rewards


name: Encourage the patient to adjust the shaping plan to enhance behavior change (e.g., size of steps or reward), if needed


name: Explore with the patient the option of using a technological device in organizing coding sheets, change data, cue analysis, and visual measures of change (e.g., computer, smart phone)


name: Explore with the patient the potential use of imagery, meditation, or progressive relaxation in attempting behavior change


name: Facilitate the patient and family to make choices concerning their care, as appropriate


name: Ensure patients and family members have the appropriate resources to assume more responsibility


name: Provide opportunities for self-evaluation and self-reflection


name: Assist parents in identifying age-appropriate tasks for which a child could be responsible, as appropriate


name: Encourage patient to verbalize fears and to ask questions about sexual functioning


name: Collect the client's sexual history paying close attention to normal patterns of functioning and the terms used by the patient to describe sexual function


name: Determine the duration of sexual dysfunction and potential causes


name: Monitor for stress, anxiety, and depression as possible causes of sexual dysfunction


name: Determine the knowledge level of the patient and understanding about sexuality in general


name: Discuss the effect of the health and illness on sexuality


name: Discuss the effect of medications and supplements on sexuality, as appropriate


name: Discuss the effect of changes in sexuality on significant other


name: Help patient to express grief and anger about alterations in body functioning or appearance, as appropriate


name: Instruct the patient on use of medication(s) and devices to enhance ability to perform sexually, as appropriate


name: Include the significant other in the counseling as much as possible, as appropriate


name: Use humor and encourage patient to use humor to relieve anxiety or embarrassment, being careful to use humor that is appropriate to the situation, tactful, and respectful of patient beliefs and cultural background


name: Draw arterial blood gases and monitor tissue oxygenation


name: Monitor trends in hemodynamic parameters (e.g., CVP, MAP, pulmonary capillary/artery wedge pressure)


name: Monitor determinants of tissue oxygen delivery (e.g., PaO2, SaO2, hemoglobin levels, CO) if available


name: Monitor sublingual carbon dioxide levels and/or gastric tonometry, as appropriate


name: Monitor laboratory values (e.g., CBC with differential, coagulation profile, ABG, lactate level, cultures, and chemistry profile)


name: Administer IV fluid challenge while monitoring hemodynamic pressures and urinary output, as appropriate


name: Administer crystalloid or colloid intravenous fluids, as appropriate


name: Administer packed red blood cells, fresh frozen plasma, and/or platelets, as appropriate


name: Monitor for hyperdynamic state of septic shock post fluid resuscitation (e.g., increased CO, decreased SVR, flushed skin, or increased temperature)


name: Monitor fluid status, including daily weights, hourly urine output, I&O


name: Monitor renal function (e.g., BUN, Cr levels, creatinine clearance)


name: Administer continuous renal replacement therapy or hemodialysis, as appropriate


name: Insert nasogastric tube to suction and monitor secretions, as appropriate


name: Administer recombinant activated protein C, as appropriate


name: Administer low dose vasopressin, as appropriate


name: Administer corticosteroids, as appropriate


name: Administer DVT and stress ulcer prophylaxis, as appropriate


name: Offer emotional support to the patient and family, encouraging realistic expectations


name: Monitor for signs and symptoms of decreased cardiac output


name: Monitor for inadequate coronary artery perfusion (ST changes on EKG, elevated cardiac enzymes, angina), as appropriate


name: Monitor and evaluate indicators of tissue hypoxia (mixed venous oxygen saturation, central venous oxygen saturation, serum lactate levels, sublingual capnometry)


name: Administer supplemental oxygen, as appropriate


name: Maintain optimal preload by administering IV fluids or diuretics, as appropriate


name: Prepare patient for cardiac revascularization (percutaneous coronary intervention or coronary artery bypass graft)


name: Administer positive inotropic/contractility medications, as appropriate


name: Promote optimal preload while minimizing afterload (e.g., administer nitrates while maintaining pulmonary artery occlusion pressure within prescribed range), as appropriate


name: Promote adequate organ system perfusion (with fluid resuscitation and/or vasopressors to maintain mean arterial pressure greater than or equal to 60 mm Hg, as appropriate


name: Monitor for physiological changes related to loss of vascular tone (e.g., note decreased BP, bradycardia, tachypnea, reduced pulse pressure, anxiety, oliguria)


name: Consider Trendelenburg position if head injury has been ruled out


name: Administer high flow oxygen, as appropriate


name: Administer epinephrine via SQ, IV, or ET routes for anaphylaxis, if appropriate


name: Assist in early endotracheal intubation, as appropriate


name: Administer atropine for bradycardia, as appropriate


name: Utilize transcutaneous pacing, as appropriate


name: Monitor pneumatic antishock garment, as appropriate


name: Maintain two large-bore intravascular access sites


name: Administer isotonic crystalloids as bolus doses, keeping systolic pressure at 90 mm Hg or more, as appropriate


name: Administer antihistamine and/or corticosteroid, as appropriate


name: Treat overdoses with appropriate reversal agent


name: Insert NG tube and administer charcoal lavage, as appropriate


name: Monitor trends in hemodynamic parameters (e.g., CVP, MAP, PAWP, or PCWP wedge pressure)


name: Administer antiinflammatory medications, as appropriate


name: Avoid stimuli that will precipitate neurogenic reaction (e.g., skin stimulation, distended bladder, or constipation)


name: Monitor for sudden loss of blood, severe dehydration, or persistent bleeding


name: Check all secretions for frank or occult blood


name: Monitor for fall in systolic blood pressure to less than 90 mm Hg or a fall of 30 mm Hg in hypertensive patients


name: Monitor sublingual carbon dioxide levels


name: Monitor for signs/symptoms of hypovolemic shock (e.g., increased thirst, increased HR, increased SVR, decreased urine output, decreased bowel sounds, decreased peripheral perfusion, altered mental status, or altered respirations)


name: Administer IV fluids such as isotonic crystalloids or colloids, as appropriate


name: Administer warmed IV fluids and blood products, as indicated


name: Administer blood products (e.g., packed red blood cells, platelets, or fresh frozen plasma), as appropriate


name: Monitor laboratory studies (e.g., serum lactate, acid-base balance, metabolic profiles, and electrolytes)


name: Monitor for early compensatory shock responses (e.g., normal blood pressure, narrowed pulse pressure, mild orthostatic hypotension [15 to 25 mm Hg], slight delayed capillary refill, pale/cool skin or flushed skin, slight tachypnea, nausea and vomiting, increased thirst, or weakness)


name: Monitor for early signs of systemic inflammatory response syndrome (e.g., increased temperature, tachycardia, tachypnea, hypocarbia, leukocytosis, or leucopenia)


name: Monitor for early signs of cardiac compromise (e.g., declining CO and urinary output, increasing SVR and PCWP, crackles in the lungs, S3 and S4 heart sounds, and tachycardia)


name: Monitor possible sources of fluid loss (e.g., chest tube, wound, and nasogastric drainage; diarrhea; vomiting; and increasing abdominal and extremity girth, hematemesis, or hematochezia)


name: Monitor for signs of inadequate tissue oxygenation (e.g., apprehension, increased anxiety, changes in mental status, agitation, oliguria, and cool, mottled periphery)


name: Monitor daily weights, intake, and output


name: Monitor laboratory values, especially Hgb and Hct levels, clotting profile, ABG, lactate level, electrolyte levels, cultures, and chemistry profile


name: Monitor invasive hemodynamic parameters (e.g., CVP, MAP, and central/mixed venous oxygen saturation), as appropriate


name: Monitor sublingual CO2 or gastric tonometry, as appropriate


name: Test urine for blood, and protein, as appropriate


name: Monitor for signs/symptoms of ascites and abdominal or back pain


name: Place patient in supine, legs elevated position (volume, vasogenic) or supine, head and shoulders elevated (cardiogenic), as appropriate


name: Insert and maintain large-bore IV access, as appropriate


name: Administer antiarrhythmics, diuretics, and/or vasopressors, as appropriate


name: Monitor blood glucose and administer insulin therapy, as appropriate


name: Administer IV, intraosseous, or endotracheal epinephrine, as appropriate


name: Advise patients at risk to wear or carry medical alert information


name: Assist sibling to maintain and/or modify usual routines and activities of daily living as necessary


name: Assist parents to be fair in terms of discipline, resources, and attention


name: Teach sibling strategies for meeting own emotional and developmental needs


name: Communicate situation to the school nurse to promote support for younger sibling in accord with parental wishes


name: Verify that a complete history and physical have been obtained before skin graft surgery


name: Cover donor site for skin autografts postoperatively with an alginate and a transparent, semiocclusive dressing, as per agency protocol


name: Inspect the dressing daily, as per agency protocol


name: Apply dressings made of cotton or gauze to maintain adequate tension on the graft site, as per agency protocol


name: Elevate graft site until graft-host circulation develops (approximately 1 week); then allow the graft site to be in a dependent position for progressively longer periods of time, per agency protocol


name: Utilize needle aspiration to evacuate fluids from beneath the graft in order to maintain close contact between the recipient bed and the graft during the postoperative revascularization period


name: Monitor color, warmth, capillary refill, and turgor of graft, if not dressed


name: Instruct patients to regularly apply artificial lubrication to graft site as necessary


name: Instruct patient that protection of graft site may be necessary for years after the graft


name: Inspect skin daily for those at risk of breakdown


name: Inspect skin and mucous membranes for redness, extreme warmth, edema, or drainage


name: Use an assessment tool to identify patients at risk for skin breakdown (e.g., Braden Scale)


name: Monitor skin and mucous membranes for areas of discoloration, bruising, and breakdown


name: Document skin or mucous membrane changes


name: Institute measures to prevent further deterioration (e.g., overlay mattress, repositioning schedule)


name: Facilitate maintenance of patient's usual bedtime routines, presleep cues/props, and familiar objects (e.g., for children-a favorite blanket/toy, rocking, pacifier, or story; for adults-a book to read, etc.), as appropriate


name: Provide pamphlet with information about sleep-enhancement techniques


name: Help choose best method for giving up cigarettes when patient is ready to quit


name: Help motivated patients to set a quit date


name: Advise to avoid smokeless tobacco, dipping, and chewing as these can lead to addiction and/or health problems, including oral cancer, gum problems, loss of teeth, and heart problems


name: Follow patient for 2 years after quitting to provide encouragement, if possible


name: Help patient deal with any lapses (e.g., reassure patient that he/she is not a "failure"; reassure that much can be learned from this temporary regression; and assist patient in identifying reasons for the relapse)


name: Support patient who begins smoking again by helping identify what has been learned


name: Maintain focus on the target audience through all activities


name: Cultivate partnerships with the target audience and appropriate professionals


name: Identify the overall goal to be achieved in collaboration with the target audience


name: Identify the key formal, social, and governmental groups involved


name: Conduct a needs assessment of the environment, identifying target audience desires


name: Conduct organization or group assessment


name: Identify appropriate quantitative and qualitative research to provide information, support, and indicators of success


name: Design a plan of action based on mutually agreed-upon goals


name: Nurture the voluntary basis of the planned social change


name: Identify the product (behavior change), the price (consumer's actions), and the place (how the product reaches the consumer)


name: Consider the financial resources necessary and available


name: Identify specific activities for each goal, including naming of appropriate participants


name: Implement the plan in collaboration with the target population


name: Control the plan through monitoring of assigned tasks


name: Provide appropriate reports on a timely basis


name: Evaluate the plan for achievement of goals with consideration of sustainability and affordability


name: Promote relationships with persons who have common interests and goals


name: Promote sharing of common problems with others


name: Promote involvement in totally new interests


name: Facilitate the use of sensory deficit aids, such as eyeglasses and hearing aids


name: Encourage participation in group and/or individual reminiscence activities


name: Facilitate patient participation in storytelling groups


name: Apply special specimen collection devices for infants, toddlers, or impaired adults, as needed


name: Label specimen with appropriate data before leaving the patient


name: Demonstrate caring presence and comfort by spending time with patient, patient's family/significant other(s)


name: Refer to support groups, mutual self-help, or other spiritually based programs, as appropriate


name: Use therapeutic communications to establish trust and empathic caring


name: Arrange visits by individual's spiritual advisor


name: Provide spiritual music, literature, or radio or television programs to the individual


name: Monitor circulation (e.g., pulse, capillary refill, and sensation) in injured body part


name: Cover open wound with dressing and control bleeding before applying splint


name: Minimize movement of patient, especially injured body part


name: Identify most appropriate splint material (e.g., rigid, soft, anatomical, or traction)


name: Immobilize joint above and joint below injury site


name: Place injured hand or wrist in position of function


name: Apply splint in position injured body part is found, using hands to support injury site, minimizing movement, and using the assistance of another health care team member when possible


name: Instruct patient or family how to care for the splint


name: Encourage general fitness as prerequisite to sport participation


name: Assist athlete in finding a sport that is a good fit with interests and abilities and will promote the development of lifelong fitness behaviors


name: Monitor sports physicals to insure they are complete before participation


name: Encourage use of warm up and cool down activities to prevent injuries


name: Inform parents and athletes of signs and symptoms of overuse injuries, dehydration, heat exhaustion, use of performance enhancing drugs, eating disorders, menstrual dysfunction, and stress


name: Assure coaches are well informed of normal childhood development and the physical, emotional, and social needs of children


name: Design methods of preassessment, postassessment, and evaluation


name: Ensure that staff members provide care within their approved scopes of practice


name: Ensure that staff members have current licensure, as appropriate


name: Incorporate understanding of generational differences when assigning and evaluating work


name: Initiate disciplinary action, as appropriate, adhering to policies and procedures


name: Ensure the product to be infused has been prepared, labeled, and classified according to institution protocol


name: Explain the procedure and the aim of the infusion of hematopoietic stem cells to patients and caregivers


name: Inform the patient and the family about the possible negative effects (e.g., transfusion reaction, volume overload, pulmonary embolism, changes in vital signs, and nausea/vomiting) that may appear during infusion


name: Use peppermint oil or hard candy to counteract the offensive smell and taste of preservative


name: Prepare infusion equipment without filter and other necessary materials (e.g., physiological serum 0.9%, venous pressure measurement systems, sphygmomanometer, phonendoscope, thermometer, and pulsometer)


name: Verify that the infusion equipment has no filter and no infusion pumps to avoid cellular damage


name: Use saline solution to flush the equipment


name: Prepare emergency material and drugs to treat serious negative reactions, including anaphylaxis kit, oxygen administration equipment, and suction equipment


name: Use gloves during the manipulation of the infusion product


name: Ensure aseptic manipulation of equipment, connections, and product


name: Administer prehydration solution according to the protocol


name: Coordinate immediate administration of the defrosted infusion product


name: Administer premedication prescribed according to the protocol of the institution


name: Avoid irradiation and any type of mechanical or physical damage to the infusion product


name: Make sure that the infusion product is received in optimal isolation and refrigeration conditions (1° to 24° C)


name: Verify the labeling and the identification of both the bags and the patient (using patient name and hospital number) immediately before infusion


name: Administer the infusion through a central venous catheter through the largest lumen available for ease of flow


name: Infuse each bag at the rate, sequence, and time established in the protocol guidelines of the institution and according to the tolerance of the patient


name: Monitor for possible adverse reactions (e.g., nausea, vomiting, abdominal cramps, diarrhea, facial flare, arrhythmia, dyspnea) and stop the infusion and call the physician, if necessary


name: Irrigate the infusion catheter with saline solution after the infusion of each bag


name: Irrigate the intravenous line with saline solution if syringes were used to infuse the product in order to reduce the loss of stem cells that could remain in the lumen of the catheter or infusion system


name: Dispose of spare material and hazardous waste according to agency protocol


name: Monitor vital signs according to institutional protocol during and after the procedure


name: Record volume of stem cells and normal saline administered


name: Monitor the elimination of urine, paying attention to volume, color, and osmolality


name: Observe for signs and symptoms of circulatory overload


name: Record the patient's response (e.g., tolerance and negative effects) according to the protocol of the institution


name: Document adverse events according to agency protocol


name: Bed rest with bedside commode, as appropriate


name: Restrict television, radio, and other stimulants


name: Provide information to patient and family regarding need for environmental modifications and visiting limitations


name: Notify physician of neurological deterioration


name: Monitor CSF output and characteristics, if indicated


name: Instruct patient not to strain or perform Valsalva maneuver


name: Foster a trusting relationship while setting clear limits (i.e., provide gentle but firm evidence of dysfunction, stay focused on substance abuse or dependency, and inspire hope)


name: Consider presence of comorbidity, or cooccurring psychiatric or medical disorder, making changes in treatment accordingly


name: Assist patient in understanding disorder as a disease related to several factors (e.g., genetic, psychological, and situational circumstances)


name: Inform patient that the volume and frequency of substance use leading to dysfunction varies greatly between people


name: Instruct patient on effects of substance used (e.g., physical, psychological, and social)


name: Discuss treatment needs for associated medical, psychological, social, vocational, housing, and legal difficulties


name: Encourage or praise patient efforts to accept responsibility for substance use-related dysfunction and treatment


name: Administer medications (e.g., disulfiram, acamprosate, methadone, naltrexone, nicotine patches or gum, or buprenorphine), as indicated


name: Instruct patient or family about medications used for treatment


name: Provide therapy (e.g., cognitive therapy, motivational therapy, counseling, family support, family therapy, or adolescent community reinforcement approach), as indicated


name: Establish multidisciplinary programs (e.g., short-term inpatient residential therapy, detoxification program, or residential therapeutic community treatment), if appropriate


name: Encourage patient to participate in self-help support program during and after treatment (e.g., 12-step programs, Women for Sobriety, or Rational Recovery)


name: Discuss importance of abstaining from substance use, identifying most appropriate treatment goal (e.g., complete abstinence, day-by-day sobriety, or use of substance in moderation)


name: Coordinate and facilitate group confrontation strategy to address use of and role defenses play in substance use (e.g., denial)


name: Instruct patient on stress management techniques (e.g., exercise, meditation, and relaxation therapy)


name: Assist patient in developing healthy, effective coping mechanisms


name: Identify and address dysfunctional relationship patterns in patient's familial or other social ties (e.g., codependency and enabling)


name: Assist in identifying and facilitating connections with supportive persons


name: Assist in resocialization, rebuilding relationships, and decreasing self-centeredness


name: Monitor for substance use during treatment (e.g., urine screens and breath analysis)


name: Monitor for infectious disease (e.g., HIV/AIDS, hepatitis B and C, and tuberculosis), treating and providing assistance to modify behaviors, if necessary


name: Assist patient in developing self-worth, encouraging positive efforts and motivation


name: Participate in efforts to remain abreast of available programs, resources, and legislation aimed at education, prevention, and treatment of substance use disorders


name: Instruct patient on symptoms or behaviors that increase chances of relapse (e.g., exhaustion, depression, dishonesty, and complacency)


name: Develop plan for relapse prevention (e.g., contracting, identify resources for various needs in stressful situation, and identify health promoting activities to take place of substance use)


name: Instruct family on substance use disorder and related dysfunction and include in treatment planning and activities


name: Encourage family to participate in recovery efforts


name: Monitor respiratory and cardiac systems (e.g., hypertension, tachycardia, and bradypnea)


name: Monitor for changes in level of consciousness


name: Implement precautions for patient at risk for suicide


name: Monitor withdrawal symptoms (e.g., fatigue, sensory disturbances, irritability, violence, depression, panic attacks, cravings, insomnia, agitation, muscle pain, appetite changes, yawning, weakness, headache, runny nose, dilated pupils, chills, anxiety, sweating, nausea, vomiting, tremors, psychosis, and ataxia)


name: Administer medications (e.g., benzodiazepines, chlorpromazine, diazepam, nicotine replacement, phenobarbital, clonidine, trazodone, methadone, alpha-2 adrenergic agonists, and antipsychotics), remaining aware of cross-tolerance


name: Implement precautions for patient at risk for seizures


name: Provide adequate nutrition (e.g., small amounts of fluids frequently and high-calorie foods)


name: Implement precautions for patient at risk for falling


name: Maintain low-stimulation environment (e.g., talk in a low, calm voice; provide reassurance about safety; and ensure a comfortable, darkened, quiet, and nonthreatening environment)


name: Encourage patient to participate in follow-up support (e.g., peer group therapy, individual or family counseling, and drug recovery educational programs)


name: Offer supportive assistance (e.g., provision of food and shelter, structured psychotherapy)


name: Facilitate support by family and significant others


name: Instruct patient and family on process of drug use and dependency


name: Monitor respiratory, cardiac, gastrointestinal, renal, and neurological status


name: Place patient in most appropriate position (e.g., semi-Fowler's position if patient is awake; left lateral recumbent position if patient is unresponsive)


name: Provide safe environment (i.e., pad side rails, keep bed in lowest position, remove dangerous objects, and position safety officer near patient's room)


name: Establish rapport with patient or family (i.e., use nonjudgmental approach; do not reprimand)


name: Perform necessary toxicology screening and system function tests (e.g., urine and serum drug screening, arterial blood gases, electrolyte levels, liver enzymes, blood urea nitrogen, and creatinine)


name: Contact poison control center for assistance in determining definitive treatment


name: Establish intravenous access, administering infusions as prescribed


name: Monitor for symptoms specific to drug consumed (e.g., constricted pupils, hypotension, and bradycardia for opiate overdose; nausea, vomiting, diaphoresis, and right upper quadrant pain 48 to 72 hours after acetaminophen overdose; and dilated pupils, tachycardia, seizures, and chest pain for cocaine overdose)


name: Administer agents specific to substance consumed and patient symptoms (e.g., antiemetics, naloxone, thiamine, glucose, flumazenil, calcium, vasopressors, antiarrhythmics, and inotropics


name: Administer agents or perform procedures to impair drug absorption and increase drug excretion (e.g., ipecac, activated charcoal, gastric lavage, hemodialysis, cathartics, exchange transfusion, altering urine and serum pH, and whole-bowel irrigation)


name: Communicate with patient, providing reassurance, addressing hallucinations or delusions, and conveying understanding of fears or other feelings


name: Treat hyperthermia (i.e., apply ice packs for fever caused by amphetamine or cocaine intoxication)


name: Provide instruction on proper use of drug


name: Assist patient in identifying ways to minimize potential for accidental overdose (e.g., store medications in original container, address issues with confusion or memory, and store medications out of children's reach)


name: Instruct family or caregiver on patient's need for follow-up care


name: Instruct family or caregiver on aspiration and seizure precautions


name: Provide referral (e.g., home health agency, social worker, psychiatry, or drug use treatment program)


name: Determine whether patient has available means to follow through with suicide plan


name: Advocate for quality of life and pain control issues


name: Conduct mouth checks after medication administration to ensure that patient is not "cheeking" the medications for later overdose attempt


name: Provide small amounts of prescriptive medications that may be lethal to those at risk to decrease the opportunity for suicide, as appropriate


name: Utilize direct, nonjudgmental approach in discussing suicide


name: Avoid repeated discussion of past suicide history by keeping discussions focused on the present and the future


name: Discuss plans for dealing with suicidal ideation in the future (e.g., precipitating factors, who to contact, where to go for help, ways to alleviate feelings of self-harm)


name: Explain suicide precautions and relevant safety issues to the patient/family/significant others (e.g., purpose, duration, behavioral expectations, and behavioral consequences)


name: Refer patient to mental health care provider (e.g., psychiatrist or psychiatric/mental health advanced practice nurse) for evaluation and treatment of suicide ideation and behavior, as needed


name: Work with physicians and others to standardize the specifications for products and reduce total number of supplies


name: Assist in the automation and upkeep of the inventory list to avoid overstocking and overspending


name: Coordinate purchases with other departments to reduce costs, as appropriate


name: Work with suppliers and vendors to ensure best product at lowest cost, as needed


name: Have supplies shipped directly to patient's home, as appropriate


name: Review supply budget and inventory costs, as appropriate


name: Participate in the value analysis process to determine whether it is the "right product" at the "right price"


name: Participate in the governing agency's integrated supply chain management process, as appropriate


name: Understand how the use of GS1 Global Traceability Standard to identify items and locations can improve patient safety and reduce costs of supplies


name: Determine the most appropriate venue for the group's meeting (e.g., face to face or online)


name: Identify faith-based groups as available options for clients, as appropriate


name: Use a written contract if deemed appropriate


name: Form a group of optimal size (e.g., 5 to 12 members)


name: Schedule a limited number of sessions (e.g., 6 to 12) in which the work of the group will be accomplished


name: Assist the group to progress through the stages of group development, from orientation through cohesiveness to termination


name: Refer the patient to other specialist, as appropriate


name: Identify psychological response to situation and availability of support system


name: Identify degree of family support, financial support, and other resources


name: Determine barriers to unused and underused support systems


name: Monitor current family situation and the support network


name: Refer to a self-help group or Internet-based resource, as appropriate


name: Identify community resource strengths and weaknesses and advocate for change, when appropriate


name: Refer to a community-based prevention or treatment program, as appropriate


name: Involve family/significant other(s) and friends in the care and planning


name: Identify available resources for caregiver support


name: Perform surgical hand antisepsis in accordance with the hospital protocol or rules


name: Don a sterile gown and gloves using aseptic technique


name: Assist the surgical team while they don gown and gloves


name: Adopt a position that allows you to keep the surgical field in sight throughout the surgery


name: Ensure that appropriate instruments, supplies, and equipment are sterile and in good working order


name: Transfer the scalpel or dermatographic pencil to the surgeon, as appropriate


name: Provide the instruments in an appropriate safe manner


name: Maintain the sterility of the surgical field throughout the procedure, disposing of contaminated elements, and taking measures to preserve surgical integrity and asepsis


name: Remove soiled sponges and deposit them in an appropriate place, replacing them with clean ones


name: Clean the incision site and drains of blood, secretions, and residual skin antiseptic


name: Assist in the closing of the surgical wound


name: Dry the skin at the incision site and drains


name: Apply reinforcement bands, dressings, or bandages to the surgical wound


name: Connect the drains to their collection systems, attach them, and keep them in the appropriate position


name: Assist in transferring patient to the cart or bed and transport to appropriate postanesthesia or postoperative area


name: Document information, as per agency policy


name: Consult surgical schedules, check operating room assignments, and obtain information on the surgical procedure and anesthetic technique


name: Change into the scrubs, footwear, cap, and mask specific to the surgical area before entering the operating room


name: Place tables containing instruments and equipment in the appropriate areas


name: Keep sharp and pointed objects (e.g., scalpel blades and needles) separate from other objects in order to avoid injuries during preparation


name: Verify the safety and proper operation of the equipment and instruments required for patient care (e.g., surgical table, perfusion pumps, temperature regulating equipment, electric scalpels)


name: Obtain the sterile supplies and materials appropriate to the surgery, observing aseptic technique


name: Confirm the integrity of the packages or wrappings, expiration dates, and sterility controls, and follow the traceability of the materials in keeping with hospital regulations


name: Prepare the consumable clothing and supplies appropriate to the type of surgery


name: Drape the instrument tables, Mayo tables, and auxiliary tables with sterile cloth or impermeable fields, as appropriate


name: Establish a safety perimeter around the tables and materials with regard to other professional and nonsterile areas


name: Provide towels/pads for the surgical team to dry their hands on


name: Secure devices in the surgical field (e.g., cables, circuit cameras, aspirators)


name: Remove instruments and supplies from the surgical table once the surgery is finished


name: Remove field forceps, aspirator tube, electric scalpel, and other elements from the surgical field after the conclusion of the operation


name: Roll up the fields, sheets, and surgical drapes used in the surgery, avoiding the spread and contamination of the air, and dispose of them in an appropriate container


name: Remove scalpel blades from their handles, needles, sharp and pointed objects and deposit them in appropriate containers


name: Separate the clean materials and instruments from the dirty or highly contaminated ones to facilitate cleaning, disinfection, and later sterilization


name: Coordinate and assist in the cleaning and preparation of the operating room for the next patient (i.e., collect and put away machines, supports, and other supplies)


name: Arrange the oxygenation and artificial ventilation equipment and material (e.g., laryngoscopes, tubes, aspirator, masks, Magill forceps, stiffening wires, phonendoscope)


name: Monitor the accessories specific to the required surgical position (e.g., supports, stirrups, fasteners)


name: Participate in a preoperative briefing with others, as per agency policy


name: Welcome the patient, establishing a relationship of trust and offering counsel


name: Ask patient or appropriate other to state patient's name and birth date


name: Participate in the preoperative "time out" to verify correct patient, procedure, and site, as per agency policy


name: Assist in the transfer of the patient to the surgical table while monitoring devices


name: Preserve the patient's privacy, avoiding unnecessary exposure or chills


name: Count sponges, sharps, and instruments before, during, and after surgery, as per agency policy


name: Record results of counts, as per agency policy


name: Provide a sterile container for depositing sharp objects


name: Verify that prep solutions are nonflammable or that flammable prep agents have evaporated before draping


name: Remove residual flammable prep agents before the start of surgery


name: Evacuate oxygen from under surgical drapes


name: Take precautions before the surgery starts against ionizing radiation or use protective equipment in situations that require it


name: Deposit waste materials in the appropriate containers


name: Assist in the transfer of the patient, verifying the proper position of tubes, catheters, and drains, and adopting the position appropriate to the surgery performed


name: Cover the patient to avoid unnecessary exposure and loss of heat


name: Participate in a postoperative debriefing, as per agency policy


name: Identify patient's level of anxiety or fear concerning the surgical procedure


name: Ensure that a completed history and physical is recorded in the chart


name: Assure that the surgical site is marked with a permanent marker by the surgeon, as indicated


name: Involve the patient in marking the surgical site, as indicated


name: Verify that the required laboratory and diagnostic test results are in the chart


name: Verify that an ECG has been completed, as appropriate


name: Communicate special care considerations such as blindness, hearing loss, or handicap to operating room staff, as appropriate


name: Remove jewelry and tape rings in place, as appropriate


name: Remove dentures, glasses, contacts, or other prostheses, as appropriate


name: Send required medications or equipment with patient to the operating room, as appropriate


name: Administer surgical shave, scrub, shower, enema, or douche, as appropriate


name: Instruct patient to void immediately before preoperative medications, as appropriate


name: Check that patient is in proper attire based on institutional policy


name: Support patient with high anxiety or fear level


name: Assist patient onto cart for transport, as appropriate


name: Provide time for family members to speak with patient before transport


name: Encourage parents to accompany child to the operating room, as appropriate


name: Prepare room for patient's return postoperative


name: Ask patient for her or his perception of health status


name: Select appropriate patient indices for ongoing monitoring based on patient's condition


name: Determine presence of patient trigger areas for immediate response (e.g., change in vital signs, low or elevated heart rate, low or elevated blood pressure, difficulty breathing, low oxygen saturation despite increasing oxygen delivery, change in level of consciousness, repeated or prolonged seizures, chest pain, acute changes in mental status, or when nurse or patient "just feels something is wrong")


name: Activate the rapid response team if indicated by presence of trigger areas, per agency protocol


name: Establish the frequency of data collection and interpretation as indicated by status of the patient


name: Monitor unstable or critically ill stable patients (e.g., patients who require frequent neurological assessments, patients experiencing cardiac dysrhythmias, patients receiving continuous intravenous infusions of medications such as nitroglycerine or insulin)


name: Involve patient and family in monitoring activities, as appropriate


name: Institute appropriate treatment, using standing protocols


name: Provide proper environment for desirable patient outcomes (e.g., match nurse competency to patient care needs, provide required patient to nurse ratio, provide adequate auxiliary staffing, ensure continuity of care)


name: Collect data related to health events, such as diseases and injuries, to be reported


name: Determine maternal-fetal health risks through patient interview


name: Monitor behavior of patient and support person


name: Implement electronic fetal monitoring, as appropriate


name: Retrieve and interpret laboratory data and contact physician, as appropriate


name: Initiate interventions for IV therapy, fluid resuscitation, and medication administration, as needed


name: Perform speculum examination for diagnosis of spontaneous rupture of amniotic membranes unless there is evidence of frank bleeding


name: Prioritize actions based on patient status (e.g., treat, continue to observe, admit, or discharge)


name: Interpret results of diagnostic indicators such as vital signs, glucose readings, ECGs


name: Collaborate/consult with physician resources as necessary


name: Initiate skin surveillance in high-risk patient when high resolution video monitoring in use


name: Coordinate placement/replacement/set-up of equipment/supplies


name: Compare current status with previous status to detect improvements and/or deterioration in patient's condition


name: Initiate and/or change medical treatment to maintain patient parameter with the limits ordered by the physician, using established guidelines


name: Determine need and establish time intervals for further intermittent assessment


name: Inform individual/families about how to access local food pantries and free lunch programs


name: Inform about rental laws and protections


name: Arrange for individual/families transportation to job services, if necessary


name: Assist individual/families to complete forms for assistance, such as forms for housing and financial aid


name: Identify patient allergies to anesthetics, suture materials, sterile adhesive strips, tape, and povidone-iodine or other topical solutions


name: Shave hair from the immediate wound site using proper technique


name: Use sterile technique during suture procedure


name: Select an appropriate gauge suture needle and suturing material


name: Pull the suture tight enough to avoid buckling the skin


name: Apply sterile adhesive strips to enhance wound closure (e.g., place perpendicular to incision line; place across suture ends to prevent slippage or excessive pulling), as appropriate


name: Cleanse the sutured area before applying an antiseptic or dressing


name: Instruct patient concerning care of the suture line or sterile adhesive strips, including signs and symptoms of infection


name: Instruct patient on sutures or sterile adhesive strips removal


name: Remove sutures within 1 to 2 weeks of their placement, depending on the anatomical location (on the face, remove in 5 to 7 days; on the neck, 7 days; on the scalp, 10 days; on the trunk and upper extremities, 10 to 14 days; and on the lower extremities, 14 to 21 days), as indicated


name: Use proper technique in removing sutures (i.e., gently elevate with forceps, cut, grasp by knot pull toward suture line)


name: Remove distractions from environment before working with patient on swallowing


name: Assist to maintain sitting position for 30 minutes after completing meal


name: Monitor for signs of fatigue during eating, drinking, and swallowing


name: Instruct patient/caregiver on nutritional requirements and dietary modifications in collaboration with dietician


name: Explore with patients what they have already done to manage the symptoms


name: Recommend toe nail and callus trimming by a specialist, as appropriate


name: Determine capacity to carry out foot care, (e.g., visual acuity, physical mobility, and judgment)


name: Recommend assistance of a significant other with foot care if vision impaired or if there are problems with mobility


name: Instruct to use a mirror or the assistance of another to carry out foot inspection, as needed


name: Recommend daily washing of feet using warm water and mild soap


name: Advise regarding when it is appropriate to contact a health professional, including the presence of a nonhealing or infected lesion


name: Instruct on proper technique for toenail trimming, (i.e., cutting relatively straight across, following the contour of the toe, and filing sharp edges with an emery board)


name: Instruct on care of soft calluses, including gentle buffing with a towel or pumice stone after a bath


name: Recommend specialist care for thick fungal or ingrown toenails, corns, or calluses, as indicated


name: Describe appropriate socks, (i.e., absorbent material and nonconstricting)


name: Recommend guidelines to be followed when purchasing new shoes, including having feet properly measured and fitted at the time of purchase


name: Recommend wearing new shoes only for a few hours at a time for the first 2 weeks


name: Instruct to inspect inside shoes daily for foreign objects, nail points, torn linings, and rough areas


name: Instruct to change shoes two times, (e.g., 12 noon and 5 p.m.) each day to avoid local repetitive pressure


name: Caution about activities that cause pressure on nerves and blood vessels, including elastic bands on socks or crossing legs


name: Include the family/significant other(s) in instruction, as appropriate


name: Coordinate resources within the facility to form a planning/advisory committee, which can contribute to positive outcomes for the program and provide a forum for ensuring commitment to the program


name: Revise teaching strategies/learning activities to increase learning, if necessary


name: Communicate evaluation of the program's goal attainment to the planning/advisory committee


name: Refer the patients to other specialists/agencies to meet the learning objectives, as appropriate


name: Determine the patient's ability to learn specific information (e.g., developmental level, physiological status, orientation, pain, fatigue, unfulfilled basic needs, emotional state, and adaptation to illness)


name: Determine the patient's motivation to learn specific information (e.g., health beliefs, past noncompliance, bad experiences with health care or learning, and conflicting goals)


name: Refer the patient to other specialists or agencies to meet the learning objectives, as appropriate


name: Instruct parent/caregiver to feed only breast milk or formula for first year (no solids before 4 months)


name: Instruct parent/caregiver to always hold infant when giving bottle


name: Instruct parent/caregiver to never prop bottle or give bottle in bed


name: Instruct parent/caregiver to avoid putting cereal in bottle (only formula or breast milk)


name: Instruct parent/caregiver to limit water intake to oz to 1 oz at a time, 4 oz daily


name: Instruct parent/caregiver to avoid use of honey or corn syrup


name: Instruct parent/caregiver to allow nonnutritive sucking


name: Instruct parent/caregiver to discard leftover formula and clean bottle after every feeding


name: Instruct parent/caregiver to introduce solids (pureed) without added salt or sugar


name: Instruct parent/caregiver to introduce iron-fortified infant cereal


name: Instruct parent/caregiver to introduce one new food at a time


name: Instruct parent/caregiver to avoid giving juice or sweetened drinks


name: Instruct parent/caregiver to feed from a spoon only


name: Instruct parent/caregiver to introduce finger foods when infant can sit up


name: Instruct parent/caregiver to introduce cup when infant can sit up


name: Instruct parent/caregiver to have infant join family at meal times


name: Instruct parent/caregiver to let infant begin self-feedings and observe to avoid choking


name: Instruct parent/caregiver to offer fluids after solids


name: Instruct parent/caregiver to avoid sugary desserts and soda


name: Instruct parent/caregiver to offer a variety of foods according to the food pyramid


name: Instruct parent/caregiver to introduce limited amounts of diluted juice in a cup


name: Instruct parent/caregiver to offer three meals and healthy snacks


name: Instruct parent/caregiver to begin to wean from bottle


name: Instruct parent/caregiver to avoid fruit drinks and flavored milk


name: Instruct parent/caregiver to begin table foods


name: Instruct parent/caregiver to allow infant to feed self with a spoon


name: Instruct parent/caregiver to install and use car seat according to manufacturer's recommendations


name: Instruct parent/caregiver to place infant on back to sleep and keep loose bedding, pillows, and toys out of crib


name: Instruct parent/caregiver to use only cribs that are safe


name: Instruct parent/caregiver to avoid use of jewelry or cords/chains on infant


name: Instruct parent/caregiver to use and maintain all equipment properly (e.g., swings, strollers, playpens, port-a-cribs)


name: Instruct parent/caregiver to avoid holding infant while smoking or drinking hot liquids


name: Instruct parent/caregiver to hold infant when feeding, avoid propping of bottle, and test formula temperature


name: Instruct parent/caregiver to monitor experienced/trained childcare providers


name: Instruct parent/caregiver how to prevent falls


name: Instruct parent/caregiver to test water temperature of bath


name: Instruct parent/caregiver to keep pets a safe distance from infant


name: Instruct parent/caregiver never to shake, toss, or swing infant in the air


name: Instruct parent/caregiver to avoid use of walkers or jumpers due to danger of injury and detrimental effects on muscle development


name: Instruct parent/caregiver never to leave infant unattended in the bath, grocery cart, high chair, on sofa, etc


name: Instruct parent/caregiver to evaluate hanging crib toys


name: Instruct parent/caregiver to use a safe high chair when infant is able to sit


name: Instruct parent/caregiver to feed only soft or mashed foods


name: Instruct parent/caregiver to remove small objects from infant's reach


name: Instruct parent/caregiver to avoid sources of lead poisoning


name: Instruct parent/caregiver to keep dangerous items out of infant's reach


name: Instruct parent/caregiver to provide barriers to dangerous areas


name: Instruct parent/caregiver to supervise infant's activity at all times


name: Instruct parent/caregiver to provide protection from glass furniture, sharp edges, unstable furniture, and appliances


name: Instruct parent/caregiver to store all cleaning supplies, medications, and personal care products out of infant's reach


name: Instruct parent/caregiver to use childproof latches on cupboards


name: Instruct parent/caregiver to prevent infant's access to upper story windows, balconies, and stairs


name: Instruct parent/caregiver to keep infant away from ponds, pools, toilets, and all containers with liquid to prevent drowning


name: Instruct parent/caregiver to select toys according to manufacturer's age recommendations


name: Instruct parent/caregiver to ensure multiple barriers to pool/hot tub area


name: Instruct parents to promote face-to-face interaction with infant


name: Instruct parents to talk, sing, and smile at infant while giving care


name: Instruct parents to praise infant for all efforts to respond to stimulation


name: Instruct parents to tell infant his or her name frequently


name: Instruct parents to encourage touching and hugging infant frequently


name: Instruct parents to respond to crying by holding, rocking, singing, talking, walking, repositioning, rubbing/massaging back, and wrapping, as appropriate


name: Instruct parents to rock infant in either an upright position or cradle position


name: Instruct parents to sponge or tub bathe using various massaging strokes with a soft wash cloth or sponge and pat dry with soft towel


name: Instruct parents to massage infant by rubbing lotion in gentle but firm strokes


name: Instruct parents to rub soft toys on infant's body


name: Instruct parents to encourage infant to feel different textures and identify them for infant


name: Instruct parents to blow air in circles on alert infant's arms, legs, and tummy


name: Instruct parents to encourage infant to grasp soft toys or caregiver's fingers


name: Instruct parents to promote shaking of rattles, encouraging auditory following of sounds


name: Instruct parents to provide opportunities for infant to reach for objects


name: Instruct parents to encourage visual following of objects


name: Instruct parents to reposition infant every hour unless sleeping, by placing in infant seat, swing, stroller, as appropriate


name: Instruct parents to place infant on tummy while awake to encourage head lifting


name: Instruct parents to position infant on back under cradle gym


name: Instruct parents to play peek-a-boo with infant


name: Instruct parents to encourage infant to look in mirror


name: Instruct parents to place infant on tummy, putting caregiver's palms on soles of infant's feet and pushing gently forward


name: Instruct parents to stand infant on caregiver's lap, swaying side to side


name: Instruct parents to encourage infant to lie on back and kick with feet


name: Instruct parents to lay infant on back or tummy and help to roll over


name: Instruct parents to provide opportunity for infant to explore cloth or soft plastic books


name: Instruct parents to introduce infant to body parts


name: Instruct parents to encourage infant to use toys for teething


name: Instruct parents to play pat-a-cake with infant


name: Instruct parents to play hide-and-seek with infant


name: Instruct parents to encourage infant to bang toys together


name: Instruct parents to encourage hand transfer of toys


name: Instruct parents to place infant in high chair, encouraging infant to feel food and feed self


name: Instruct parents to dance with infant while holding infant upright


name: Instruct parents to pull infant to standing, holding onto hands for stabilization


name: Instruct parents to guide infant to walk holding infant by hands/wrists with arms above head


name: Instruct parents to encourage ball play (e.g., rolling, grasping, stopping, retrieving)


name: Instruct parents to introduce use of cup at meal times, assisting infant to grasp and put to mouth


name: Instruct parents to wave bye-bye to infant while encouraging infant to imitate


name: Instruct parents to take infant on a house tour, identifying objects and rooms


name: Instruct parents to play follow-the-leader, practicing imitation of infant noises, animals, or songs


name: Instruct parents to say words to infant, encouraging infant to say them back


name: Instruct parents to demonstrate how to remove and replace objects from a container


name: Instruct parents to demonstrate stacking objects


name: Inform the patient and family of the scheduled date, time, and location of surgery


name: Inform the patient and family how long the surgery is expected to last


name: Determine the patient's previous surgical experiences, background, culture, and level of knowledge related to surgery


name: Appraise the patient's and family's anxiety relating to surgery


name: Inform the family of the location to wait for the results of the surgery, as appropriate


name: Conduct a tour of the postsurgical unit and waiting area, as appropriate


name: Describe the postoperative routines and equipment (e.g., medications, respiratory treatments, tubes, machines, support hose, surgical dressings, ambulation, diet, family visitation) and explain their purpose


name: Evaluate the patient's ability to demonstrate splinting incision, coughing, and deep breathing


name: Evaluate the patient's ability to demonstrate proper use of the incentive spirometer


name: Evaluate the patient's ability to demonstrate leg exercises


name: Inform the patient how to assist in recuperation


name: Instruct patient in regard to smoking cessation, as appropriate


name: Instruct in a way that matches the patient's style of learning, including the use of holistic approaches and educational materials, as appropriate


name: Document teaching, including patient's response to teaching


name: Appraise the patient's current and past eating patterns as well as preferred foods and current eating habits


name: Determine the patient's and family's perspectives, cultural backgrounds, and other factors that may affect the patient's willingness to follow prescribed diet


name: Determine any financial limitations that may affect food purchases


name: Explain the purpose of diet adherence to overall health


name: Reinforce the importance of continued monitoring and changing needs that may require further alteration of dietary plan of care


name: Refer patient to dietitian, as appropriate


name: Monitor the patient for physiological and psychological limitations, as well as background and culture


name: Assist the patient in setting goals for slow, steady increase in exercise


name: Instruct patient regarding use of pain medication and alternative methods of pain control before exercise, as needed


name: Instruct patient to report signs of possible problems, (e.g., pain, dizziness, and swelling) to health care provider


name: Assist the patient to incorporate exercise regimen into daily routine


name: Refer the patient to physical therapist, occupational therapist, or exercise physiologist, as appropriate


name: Provide written information or diagrams for continued reference


name: Provide frequent feedback to prevent bad habits from forming


name: Instruct the patient on possible adverse side effects of each medication


name: Instruct patients on proper disposal of needles and syringes at home, as appropriate, and where to dispose of the sharps container in their community


name: Provide the patient with written information about the action, purpose, side effects, and so on of medications


name: Instruct the patient to carry documentation of his or her prescribed medication regimen


name: Instruct the patient how to fill his or her prescription(s), as appropriate


name: Inform the patient/significant other(s) about who will be performing the procedure/treatment


name: Involve child in procedure (hold bandage) but don't give a choice about completing procedure


name: Inform patients on how they can aid in recuperation


name: Provide distraction for child that will divert attention away from procedure


name: Provide information on when and where results will be available and who will explain them


name: Establish level of patient ability in performing skill


name: Adjust teaching methodology to accommodate patient age and ability, as needed


name: Guide patients' bodies so that they can experience the physical sensations that accompany the correct motions, as appropriate


name: Provide frequent feedback to patients on what they are doing correctly and incorrectly, so that bad habits are not formed


name: Obtain sexual history, including number of past sexual partners, frequency of intercourse, and past occurrences of and treatments for sexually transmitted infections (STIs)


name: Instruct patient on anatomy and physiology of human reproduction


name: Instruct patient on STI and conception, as necessary


name: Instruct patient on factors that increase risk of STI (e.g., unprotected sexual intercourse, increased genital mucosal surface area, increased number of sexual contacts, presence of genital sores, advanced illness, and sexual intercourse during menstruation)


name: Discuss patient's knowledge, understanding, motivation, and commitment level regarding various sexual protection methods


name: Discuss methods of sexual protection for sexual intercourse and oral sex (e.g., medication-free, barrier, vaccination, hormonal, intrauterine device, abstinence, and sterilization), including effectiveness, side effects, contraindications, and signs and symptoms that warrant reporting to a health care professional


name: Discuss religious, cultural, developmental, socioeconomical, and individual considerations pertaining to sexual protection choice


name: Provide accurate information pertaining to the implications of having multiple sexual partners


name: Instruct patient on the importance of good hygiene, using a water-soluble lubricant, and voiding after intercourse to decrease the susceptibility to infections


name: Instruct patient on proper use of condoms (e.g., how to choose, keep intact, apply, and remove)


name: Provide patient with sexual protection products (e.g., condoms and dental dams)


name: Encourage patient to obtain routine examinations and report signs and symptoms of STIs to a health care provider


name: Encourage patient to discuss sexual histories and safe sex practices with partner


name: Discuss with patient importance of sexual partner notification when diagnosed with STI


name: Consider population-based factors affecting safe sex education (e.g., culturally tailored interventions, ethnically matched providers)