The nightmares have officially begun. I had a dream that one of my old (favorite) clinical instructors walked me through my first PCS and I failed it because the patient stole my paperwork and flushed it down the toilet.
Anyway, my biggest problem that I forsee is the I/O.
I understand we have to record every drop of water/liquid that goes into their body and out, but how? What is the best way to do this?! I am afraid that this one thing is going to cause me to fail because I am horrible with this type of thing. Do you measure their cup, do you keep them NPO? Do they always have a catheter? Do they already have a hat in the toilet, or do you need to bring one of those in? Do you start counting the IV solution going in from the moment you start and then calculate based on the minutes/hours you are in with the patient?
I tested this weekend past. The instructor places the hat in the toilet before you even arrive in the room. WRITE DOWN the amount of fluid in the patient's cup(s) when you start as you will NOT remember. I recorded everything as it was. 240 ml of hot cereal 120 ml of water 180 ml of cranberry juice. I just wrote out what I saw. I did not total it I just wrote each thing on its own line in the box. You only have to encourage fluids if you are assigned to do so and that will be documented on your PCS Kardex. You only document an IV that empties on you. NOT what infuses during your time in the patients room. If the patient has a foley the CE will empty it into a graduate and hand it to you for measuring and recording. You CAN do this just do not stress and focus on what is in front of you RIGHT THEN. If you try to think ahead too much it will fail you. It is a very in the moment type of test. I hope that makes sense.
I tested this weekend past. The instructor places the hat in the toilet before you even arrive in the room. WRITE DOWN the amount of fluid in the patient's cup(s) when you start as you will NOT remember. I recorded everything as it was. 240 ml of hot cereal 120 ml of water 180 ml of cranberry juice. I just wrote out what I saw. I did not total it I just wrote each thing on its own line in the box. You only have to encourage fluids if you are assigned to do so and that will be documented on your PCS Kardex. You only document an IV that empties on you. NOT what infuses during your time in the patients room. If the patient has a foley the CE will empty it into a graduate and hand it to you for measuring and recording. You CAN do this just do not stress and focus on what is in front of you RIGHT THEN. If you try to think ahead too much it will fail you. It is a very in the moment type of test. I hope that makes sense.
The best thing to do is to ask your CE. I counted everything on the tray (she provided me with these tiny med cups I had to use, it was annoying but it worked). Then the pt had poured some of the milk in the cereal but never ate it so I asked the CE what she wanted me to do about it. She said not to worry about it. For all my pts (none were on any kind of fluid restriction) I brought in a full cup of water when I started so I knew how much I was starting with. That made life much easier. And two out of three of my patients didn't drink anything (well the third guy did but only the small med cup to swallow pills). I got worked up about this too, but it's really not so bad. Take a deep breath and you got it. Stick to your grid and know your AOC's!!!
Conqueror+, BSN, RN
1,457 Posts
I tested this weekend past. The instructor places the hat in the toilet before you even arrive in the room. WRITE DOWN the amount of fluid in the patient's cup(s) when you start as you will NOT remember. I recorded everything as it was. 240 ml of hot cereal 120 ml of water 180 ml of cranberry juice. I just wrote out what I saw. I did not total it I just wrote each thing on its own line in the box. You only have to encourage fluids if you are assigned to do so and that will be documented on your PCS Kardex. You only document an IV that empties on you. NOT what infuses during your time in the patients room. If the patient has a foley the CE will empty it into a graduate and hand it to you for measuring and recording. You CAN do this just do not stress and focus on what is in front of you RIGHT THEN. If you try to think ahead too much it will fail you. It is a very in the moment type of test. I hope that makes sense.