<<

ED_NURSE_ENCOUNTER T 0 0 0 0 1 0 0 0 0 0 0

GPA-N-ED-10 (Implemented 08-15-

2016)(Updated 12-1-2016 by CCC until 3-1-

17)(Revised 3-23-17 by CCC)

D 0 0 0 0 0 0 0 0 0 0 0 R

le-012502-Nursing Assessment

C 0 19 1 Page 44 ED_NURSE_ENCOUNTER 0 1 20 0 0 0 0 0

Used in

Multiple ED templates

Patient

Parent/Guardian

Spouse

Family Member

Friend

Transport Personnel

Medical Escort

Guard/Police Escort

E 0 20 0 0 0 20 0 0 0 0 0 X 0 17 0 0 0 0 0 0 0 0 0

Name

Date of birth

Chart number

Other -

E 0 40 0 0 Page 45 ED_NURSE_ENCOUNTER 0 40 0 0 0 0 0 W 0 60 0 0 0 2 0 0 0 0 0 C 0 34 0 0 0 34 0 0 0 0 0

Numeric Pain Rating Scale 1-10

Wong-Baker FACES Pain Rating Scale

FLACC Pain Scale

E 0 40 0 0 0 40 0 0 0 0 0 E 0 40 0 0 0 40 Page 46 ED_NURSE_ENCOUNTER 0 0 0 0 0 N 0 0 0 0 0 0 0 0 0 100 0 C 0 7 0 0 0 0 0 0 0 0 0

Minutes

Hours

Days

Weeks

Months

Years

X 0 0 0 0 1 0 2 2 0 0 0

Aching

Burning

Cramping

Pressure

Sharp

Stabbing

Numbness

Page 47 ED_NURSE_ENCOUNTER

Throbbing

Tingling

Other:

X 0 0 0 0 1 0 2 2 0 0 0

Constant

Intermittent

Interrupts sleep

Activity induced

X 0 0 0 0 0 0 0 0 0 0 0

Yes

No

C 0 8 0 0 0 0 0 0 0 0 0

0 (No)

25 (Yes)

C Page 48 ED_NURSE_ENCOUNTER 0 8 0 0 0 0 0 0 0 0 0

0 (No)

15 (Yes)

C 0 29 0 0 0 0 0 0 0 0 0

0 (None/bedrest/nurse assist)

15 (Crutches/cane/walker)

30 (Furniture)

C 0 8 0 0 0 0 0 0 0 0 0

0 (No)

20 (Yes)

C 0 41 0 0 0 0 0 0 Page 49 ED_NURSE_ENCOUNTER 0 0 0

0 (Normal/bedrest/wheelchair)

10 (Weak: short steps,stoops,light touch)

20 (Impaired: unsteady)

C 0 38 0 0 0 0 0 0 0 0 0

0 (Oriented to own ability)

15 (Overestimates/forgets limitations)

E 0 10 0 0 0 10 0 0 0 0 0 R 0 0 0 0 1 0 3 1 0 0 0

No Risk (0-24)

Low Risk (25-50)

High Risk (> 51)

Page 50 ED_NURSE_ENCOUNTER X 0 5 0 0 1 2 0 0 0 0 0 D http://

Rails Up

Gown On

Family at Bedside

Sitting in Chair

X 0 80 0 0 1 80 3 0 0 0 0 D http://

A - Alert (Alert, oriented x3, able to obtain subjective information)

V - Verbal (Responds to verbal stimuli-opens eyes, not fully oriented)

P - Painful (Responds to painful stimuli only)

U - Unresponsive (Nonverbal and does not respond to painful stimulus)

X 0 0 0 0 0 0 0 0 0 0 0

PERRL

Brisk

Sluggish

Fixed

Dilated

Page 51 ED_NURSE_ENCOUNTER
C 0 37 0 0 0 0 0 0 0 0 0

4 - Eyes open spontaneously

3 - Eyes open in response to sound

2 - Eyes open in response to pressure

1 - No eye opening response

NT - Non testable

C 0 38 0 0 0 0 0 0 0 0 0

5 - Oriented, e.g. to time, place,

person.

4 - Confused, speaks but is

disoriented.

3 - Intelligible single words

2 - Only moans/groans, sounds

1 - No audible response

NT - Non testable, factor interfering

with communication

C 0 38 0 0 0 0 0 0 0 0 0

6 - Obeys 2-part request, commands

Page 52 ED_NURSE_ENCOUNTER

5 - Localizes painful stimulus

4 - Normal flexion, no predominant

abnormality

3 - Abnormal flexion, clearly

predominantly abnormal

2 - Extension, abnormal decerebrate

posturing

1 - No movement or posturing

NT - Non testable, paralysed or other

limiting factor

E 0 5 0 0 0 5 0 0 0 0 0 C 0 28 0 0 0 0 0 0 0 0 0

Spontaneous (4 points)

To verbal command (3 points)

To pain (2 points)

Absent (1 point)

C 0 36 0 0 1 0 0 0 0 0 0

Appropriate words/phrases (5 points)

Inappropriate words (4 points)

Persistant crying to pain(3 Points)

Page 53 ED_NURSE_ENCOUNTER

Grunts/Moans to Pain (2 points)

Absent (1 point)

C 0 36 0 0 1 0 0 0 0 0 0

Obeys commands(6 points)

Localizes Pain(5 points)

Withdraws to Pain(4 points)

Abnormal Flexion to pain(3 points)

Abnormal Extension to pain(2 points)

Absent(1 point)

T 0 0 0 0 1 0 0 0 0 0 0

Score (Interpretation)

< 8 (Severe Head Injury and Coma)

9-12 (Moderate Brain Injury)

13-15 (Mild Brain Injury)

E 0 5 0 1 0 5 0 0 0 0 0 W 0 Page 54 ED_NURSE_ENCOUNTER 74 0 0 0 3 0 0 0 0 0 C 0 34 1 0 0 0 0 0 0 0 0

4 - Eyes open spontaneously

3 - Eyes open in response to voice

2 - Eyes open in response to pain

1 - No eye opening response

C 0 36 1 0 0 0 0 0 0 0 0

5 - Coos, babbles

4 - Irritable cry, consolable

3 - Cries persistently, inconsolable

2 - Moans/Grunts

1 - No response

C 0 32 1 0 0 0 0 0 Page 55 ED_NURSE_ENCOUNTER 0 0 0

6 - Normal, spontaneous movement

5 - Withdraws to touch

4 - Withdraws to pain

3 - Decorticate flexion

2 - Decerebrate extention

1 - No response

X 0 1 0 0 0 1 0 0 0 0 0

Object/debris

Loose teeth

Injury

Fluid

Singed nasal hair

Blood/debris in sputum

Stridor

C 0 14 0 0 0 0 0 0 0 0 0

Midline

Deviated Left

Deviated Right

R 0 0 0 0 0 0 0 Page 56 ED_NURSE_ENCOUNTER 0 0 0 0

Flat

Distended

R 0 0 0 0 0 0 0 0 0 0 0

No

Yes

X 0 0 0 0 0 0 0 0 0 0 0

Labored

Non-labored

Retractions

Nasal flaring

Stridor

Grunting

X 0 0 0 0 0 0 0 0 0 0 0 Page 57 ED_NURSE_ENCOUNTER

Clear

Abnormal -

R 0 1 0 0 0 1 0 0 0 0 0

Regular

Irregular

Pacemaker

R 0 0 0 0 0 0 0 0 0 0 0

Normal

Pale

Cyanotic

Mottled

Jaundiced

Flushed

R 0 0 0 0 0 0 0 0 0 0 0

[<3] secs

[>3] secs

Page 58 ED_NURSE_ENCOUNTER R 0 0 0 0 0 0 0 0 0 0 0

pink

pale

dusky/cyanotic

E 0 15 0 0 0 15 0 0 0 0 0 R 0 0 0 0 0 0 0 0 0 0 0

Absent

Present -

X 0 0 0 0 0 0 0 0 0 0 Page 59 ED_NURSE_ENCOUNTER 0

None

Dysuria

Hematuria

Frequency

Urgency

Difficulty starting/stopping stream

Incontinence

Pruritus

Vaginal bleeding

Vaginal discharge

D 0 0 0 0 0 0 0 0 0 0 0 D R 0 0 0 0 0 0 0 0 0 0 0

N/A

X 0 0 0 0 1 0 2 0 0 0 0

Soft

Non-tender

Tender

Page 60 ED_NURSE_ENCOUNTER

Flat

Distended

Rigid

Nausea

Vomiting

Diarrhea

C 0 11 0 0 0 0 0 0 0 0 0

Present

Absent

Hypoactive

Hyperactive

C 0 12 0 0 0 12 0 0 0 0 0

x4 quadrants

RUQ

RLQ

LUQ

LLQ

D 0 0 0 0 0 0 5 2 0 0 0 Page 61 ED_NURSE_ENCOUNTER D

Edited indent from 15 to 0, for use in template.

BCA -5/3/01

X 0 0 0 0 0 0 0 0 0 0 0

Injury

Weakness

Decreased movement

Decreased strength

Limited ROM

Amputation

W 0 70 0 0 0 2 0 0 0 0 0 X 0 74 0 0 1 2 2 2 0 0 0

No rashes

No induration

No nodules

Warm/Dry

Well Perfused

Page 62 ED_NURSE_ENCOUNTER T 0 0 0 0 1 0 2 0 0 0 0

Significant findings:

W 0 74 0 0 0 2 2 2 0 0 0 R 0 0 0 0 0 0 0 0 0 0 0

Right

Left

E 0 30 0 0 0 32 0 0 0 0 0 Page 63 ED_NURSE_ENCOUNTER X 0 0 0 0 0 0 0 0 0 0 0

round

oval

trapezoid

irregular

linear

E 0 5 0 0 0 5 0 0 0 0 0 B 0 0 1 0 0 0 0 0 0 0 0

cm

mm

C 0 30 0 0 0 30 0 0 Page 64 ED_NURSE_ENCOUNTER 0 0 0

STAGE 1, SUPERFICIAL

STAGE 2, EPIDERMIS

STAGE 3, DERMIS

STAGE 4, MUSCLE/SUB CUT FASCIA

STAGE 5, BONE

X 0 17 0 0 1 0 4 1 0 0 0

healthy

much granulation

moderate granulation

minimum granulation

necrotic

fibrinous exudate

bleeding

X 0 0 0 0 1 0 4 1 0 0 0

None

Scant

Moderate

Copious

E 0 20 0 0 0 20 0 Page 65 ED_NURSE_ENCOUNTER 0 0 0 0 W 0 70 0 0 0 2 4 4 0 0 0 C 0 12 0 0 0 25 0 0 0 0 0

Simple

Intermediate

Complicated

X 0 0 0 0 1 0 4 1 0 0 0

Suture

Staples

Derma Bond

Steri

E 0 10 0 Page 66 ED_NURSE_ENCOUNTER 0 0 10 0 0 0 0 0 D 0 0 0 0 0 0 0 0 0 0 0 R

le-012502-Nursing Assessment

Post Fall

E 0 6 0 0 0 6 0 0 0 0 0 E 0 7 0 0 0 9 0 0 0 0 0 X 0 0 0 1 1 Page 67 ED_NURSE_ENCOUNTER 0 0 0 0 0 0

0 Nausea and Vomiting

1 Mild Nausea with no Vomiting

2

3

4 Intermittent Nausea with Dry Heaves

5

6

7 Constant nausea,frequent dry Heaves

and vomiting

Document Observation 2,3,5,6

X 0 0 0 1 1 0 0 0 0 0 0

0 Not Present

1 Very mild harshness or or ability to frighten

2 Mild harshness or ability to frighten

3 Moderate harshness or ability to frighten

4 Moderately severe hallucinations

5 Severe hallucinations

6 Extremely severe hallucinations

7 Continuous hallucinations

X 0 0 0 1 1 0 0 0 0 0 0

0 Not Present

1 Very Mild

2 Mild

3 Moderate

4 Moderately Severe

5 Severe

Page 68 ED_NURSE_ENCOUNTER

6 Very Severe

7 Extremely Severe

X 0 0 0 1 1 0 0 0 0 0 0

0 None

1 Very mild itching,pins and needles, burning or numbness

2 Mild itching,pins and needles,burning or numbness

3 Moderate itching,pins and needles,burning or numbness

4 Moderate severe hallucinations

5 Severe hallucinations

6 Extremely severe hallucinations

7 Continuous hallucinations

X 0 0 0 1 1 0 0 0 0 0 0

0 No sweat visible

1 Barley perceptible sweating, palms moist

2

3

4 Beads of sweat obvious on forehead

5

6

7 Drenching sweats

Document Observation if level 2,3,5,6

X 0 0 0 1 1 0 0 0 Page 69 ED_NURSE_ENCOUNTER 0 0 0

0 Normal Activity

1 Somewhat more than normal activity

2

3

4 Moderately fidgety and restless

5

6

7 Paces back and forth during most of the interview, or constantly thrashes about

Document observation if 2,3,5,6

X 0 0 0 1 1 0 0 0 0 0 0

0 None

1 Not visible, but can be felt fingertip to fingertip

2

3

4 Moderate, with patient' arms extended

5

6

7 Severe, even with arms not extended

Document Observation if level 2,3,5,6

X 0 0 0 1 1 0 0 0 0 0 0

0 Not Present

1 Very mild sensitivity

2 Mild sensitivity

3 Moderate sensitivity

4 Moderate severe hallucinations

4 Extremely severe hallucinations

5 Continuous hallucinations

Page 70 ED_NURSE_ENCOUNTER
X 0 0 0 1 1 0 0 0 0 0 0

0 Oriented and can do serial additions

1 Cannot do serial additions or is uncertain about date

2 Disoriented with date by no more than two calendar day

3 Disoriented with date by more than two calendar day

4 Disoriented with place or person

X 0 0 0 1 1 0 0 0 0 0 0

0 No anxiety, at ease

1 Mildy anxious

2

3

4 Moderately anxious, or guarded, so anxiety inferred

5

6

7 Equivalent to acute panic states as seen in severe delirium or acute schizophrenic reactions

X 0 0 0 0 1 0 0 0 0 0 0

Blood Drawn

Flushes Easily

Page 71 ED_NURSE_ENCOUNTER

No Indications of infection

Dressing Clean, Dry and Intact

Other:

E 0 40 0 0 0 240 0 0 0 0 0 B 0 0 1 0 0 0 0 0 0 0 0

left

right

B 0 0 0 0 0 0 0 0 0 0 0

Antecubital

Hand

Forearm

Wrist

Foot

Upper Arm

Scalps

E 0 Page 72 ED_NURSE_ENCOUNTER 20 0 0 0 62 0 0 0 0 0 C 0 20 0 0 1 0 0 0 0 0 0

Peripheral Line

Saline Lock

CL Hickman

CL PICC

CL Subclavian

CL Jugular

CL Femoral

CL Port-A-Cath

CL Midline

CL Quintin

Other {FLD:GEN TEXT BOX}

R 0 0 0 0 0 0 0 0 0 0 0

18 gauge

20 gauge

22 gauge

24 gauge

25 gauge

T 0 0 Page 73 ED_NURSE_ENCOUNTER 0 0 1 0 0 0 0 0 0

Other/Comments:

E 0 60 0 0 0 120 0 0 0 0 0 T 0 0 0 0 1 0 0 0 0 0 0

(CLICK HERE TO ADD FREE TEXT INFORMATION)

W 0 50 0 0 0 2 0 0 0 0 0 B 0 0 2 Page 74 ED_NURSE_ENCOUNTER 0 0 0 0 0 0 0 0

antecubital

hand

forearm

Chest

C 0 2 0 0 0 0 0 0 0 0 0

1

2

3

4

5

6

7

8

9

10

C 0 18 0 0 0 0 0 0 0 0 0

nasal cannula

simple face mask

blow by

non-rebreather

parital rebreather

ventimask

Page 75 ED_NURSE_ENCOUNTER
D 0 0 0 0 0 0 0 0 0 0 0 T E 0 5 0 1 0 5 0 0 0 0 0 E 0 10 0 0 0 10 0 0 0 0 0 R 0 0 0 0 0 0 0 0 0 0 0

le-Resident's Note-

021102

Page 76 ED_NURSE_ENCOUNTER

Yes

No

W 0 74 0 0 0 3 0 0 0 0 0 X 0 0 0 0 1 0 1 1 0 0 0

Yes

No-explain

W 0 74 0 0 0 2 0 0 0 0 0

HLB 9/26/01

X 0 0 0 0 1 0 0 0 Page 77 ED_NURSE_ENCOUNTER 0 0 0

Sutures

I&D

Intubation

Pelvic Exam

Other:

C 0 10 0 0 0 10 0 0 0 0 0

CT

Ultrasound

X-Ray

Other:

W 0 45 0 0 0 2 0 0 0 0 0 X 0 0 0 0 1 0 0 0 0 0 0

Urine

Blood

Other:

Page 78 ED_NURSE_ENCOUNTER
T 0 0 0 0 1 0 0 0 0 0 0

GPA-N-ED-4 (Implemented 08-15-

2016)(Revised 3-23-17 by CCC)

C 0 20 0 0 1 0 0 0 0 0 0

Peripheral Line

Saline Lock

CL Hickman

CL PICC

CL Subclavian

CL Jugular

CL Femoral

CL Port-A-Cath

CL Midline

CL Quintin

Other {FLD:GEN TEXT BOX}

B 0 0 2 0 0 0 0 0 0 0 0

antecubital

hand

Page 79 ED_NURSE_ENCOUNTER

forearm

Chest

C 0 2 0 0 0 0 0 0 0 0 0

1

2

3

4

5

6

7

8

9

10

R 0 0 0 0 0 0 0 0 0 0 0

Right

Left

D 0 0 0 1 0 0 0 0 0 0 0 R Page 80 ED_NURSE_ENCOUNTER R 0 0 0 0 0 0 0 0 0 0 0

Intact

Not intact

R 0 0 0 0 0 0 0 0 0 0 0

Warm

Hot

Cool

Cold

R 0 0 0 0 0 0 0 0 0 0 0

Normal

Dry

Moist

Diaphoretic

C 0 20 Page 81 ED_NURSE_ENCOUNTER 0 0 1 0 0 0 0 0 0

Peripheral Line

Saline Lock

CL Hickman

CL PICC

CL Subclavian

CL Jugular

CL Femoral

CL Port-A-Cath

CL Midline

CL Quintin

Other {FLD:GEN TEXT BOX}

C 0 2 0 0 0 0 0 0 0 0 0

1

2

3

4

5

6

7

8

9

10

R 0 0 0 0 1 0 0 0 0 0 0 Page 82 ED_NURSE_ENCOUNTER

0 - Alert

1 - Not alert, but arousable with minimal stimulation

2 - Not alert, requires repeated stimulation to attend

3 - Coma

R 0 0 0 0 1 0 0 0 0 0 0

0 - Answers both correctly

1 - Answers one correctly

2 - Both incorrect

R 0 0 0 0 1 0 0 0 0 0 0

0 - Obeys correctly

1 - Obeys one correctly

2 - Both incorrect

R 0 0 0 0 1 0 0 0 0 0 0

0 - Normal

1 - Partial gaze palsy

2 - Forced deviation

Page 83 ED_NURSE_ENCOUNTER
R 0 0 0 0 1 0 0 0 0 0 0

0 - No visual field loss

1 - Partial hemianopia

2 - Complete hemianopia

3 - Bilateral hemianopia

R 0 0 0 0 1 0 0 0 0 0 0

0 - Normal symmetrical movement

1 - Minor paralysis

2 - Partial paralysis (total or near total of lower face)

3 - Complete paralysis of one or both sides

R 0 0 0 0 1 0 0 0 0 0 0

0 - Normal

1 - Drift

2 - Some effort against gravity

3 - No effort against gravity

4 - No movement

0 - Untestable*

Page 84 ED_NURSE_ENCOUNTER R 0 0 0 0 1 0 0 0 0 0 0

0 - Normal

1 - Drift

2 - Some effort against gravity

3 - No effort against gravity

4 - No movement

0 - Untestable*

R 0 0 0 0 1 0 0 0 0 0 0

0 - Normal

1 - Drift

2 - Some effort against gravity

3 - No effort against gravity

4 - No movement

0 - Untestable*

R 0 0 0 0 1 0 0 0 0 0 0

0 - Normal

1 - Drift

2 - Some effort against gravity

3 - No effort against gravity

4 - No movement

Page 85 ED_NURSE_ENCOUNTER

0 - Untestable*

R 0 0 0 0 1 0 0 0 0 0 0

0 - None

1 - One limb

2 - Two limbs

R 0 0 0 0 1 0 0 0 0 0 0

0 - Normal

1 - Mild to moderate decrease in sensation

2 - Severe to total sensory loss

R 0 0 0 0 1 0 0 0 0 0 0

0 - No aphasia

1 - Mild-Moderate aphasia

2 - Severe aphasia

3 - No speech production

R Page 86 ED_NURSE_ENCOUNTER 0 0 0 0 1 0 0 0 0 0 0

0 - None

1 - Mild-Moderate slurring

2 - Severe

0 - Intubated or other physical impediment to testing

R 0 0 0 0 1 0 0 0 0 0 0

0 - Normal

1 - Inattention or extinction to bilateral simultaneous stimulation in one of the sensory modalities

2 - Severe hemi-inattention or hemi-inattention to more than one modality

T 0 0 0 0 1 0 0 0 0 0 0

0 No stroke symptoms

1-4 Minor stroke

5-15 Moderate stroke

16-20 Moderate to severe stroke

21-42 Severe stroke

Page 87