CPNE Question

Boostisadrug85 · Sep 24, 2011

Also wanted to ask, with checking fulids i wanna make sure I have this correct. The only fluids i need to write on my form is fluids they take in while i'm doing my PCS. So if they don't drink anything or have an IV bag changed then they didn't take any fluid in and we just leave the spot blank? Or do we look at what the bag has in it and then what it has when we leave and put that down? Im probably reading into everything to much but I wanna be 100% sure on everything Im doing. Thanks for everyones help.

agldragonRN · Sep 24, 2011

just curious, are you doing any cpne workshops? all my questions were answered and everything made sense after the workshop.

i don't want to give you wrong information because there's been a new cpne edition since i took my cpne.

good luck with the cpne.

cheers,

angel

LoopsRN2 · Sep 24, 2011

Also wanted to ask, with checking fulids i wanna make sure I have this correct. The only fluids i need to write on my form is fluids they take in while i'm doing my PCS. So if they don't drink anything or have an IV bag changed then they didn't take any fluid in and we just leave the spot blank? Or do we look at what the bag has in it and then what it has when we leave and put that down? Im probably reading into everything to much but I wanna be 100% sure on everything Im doing. Thanks for everyones help.

Hi Boostiadrug; I am studying for CPNE right now too under the 18th edition.

For enteral intake we count everything they consume by mouth, including liquid meds, and if under enteral/parental feeding if one is finishing, then I believe we document it under enteral/parental feeding; Pg 145 of the 17th edition #4, a) ) states: When enteral and/or parental intake is assigned, measure the amount ingested/infused.

Also see on pg 154, top paragraph: If the primary IV is continuously infusing and has not been interrupted, you are not required to record this as intake.

It is a slippery slope, isn't it, lol! Don't forget: Medicine fluid-cough syrup, liquid meds for babys, flushes all need to recorded under intake as well :) Personally I really don't care for the PCS recording form. I have been practicing on that darn form for 3 months now, and I would bet that thing could be made a bit more user friendly, like the narrative notes. I hope this has helped, good luck with your studies.

Boostisadrug85 · Sep 25, 2011

Thanks so much for that answere it helped a lot. That's what I was thinking was the case but I just wanted to be sure. What about the transferring of a patient? It the question in my first post on this thread.

LoopsRN2 · Sep 25, 2011

Thanks so much for that answere it helped a lot. That's what I was thinking was the case but I just wanted to be sure. What about the transferring of a patient? It the question in my first post on this thread.

Mobility I think will depend on what you are going to be assigned to do for your patient, how you will be receiving your patient, what areas of care need to be done first, if they have to go the bathroom etc. For my morning adult patients, I may find them sitting in bed eating their tray. I will wash, go in, introduce, ID and 20 minute check. Maybe they will finish eating, and I will do if assigned, resp assess, abdominal assess, o2 manage next. At some point from here I hope to do musculoskeletal manage, mobility, dressing changes, etc. Now, if my patient is up in a chair when I receive them, it is noon and they have finished their tray, the order may be reversed. For infants/children all may be different. When do you test?

Boostisadrug85 · Sep 25, 2011

So every patient those we had to do a transfer of some sort on right? So let say they are in bed an don't need to use the bathroom during the PCS can we move them to the chair after everything is done and then leave or do we need to do it early enough that we transfer them back to the bed before we leave. I test in one month. I've gotten to the point that I'm making things to complicated but I'm trying to cover every little detail I can come up with.

LoopsRN2 · Sep 25, 2011

So every patient those we had to do a transfer of some sort on right? So let say they are in bed an don't need to use the bathroom during the PCS can we move them to the chair after everything is done and then leave or do we need to do it early enough that we transfer them back to the bed before we leave. I test in one month. I've gotten to the point that I'm making things to complicated but I'm trying to cover every little detail I can come up with.

Hmm....maybe someone who has actually been to the CPNE can help us out here, not sure I exactly understand. We may not actually need to do a transfer, the patient may only be require repositioning-may be confined to bed, traction, etc. I do believe that if they have up in chair privledges, we may get them up and leave them up in chair, call light, phone within reach, etc. I am testing November 4th in Madison if I don't get a cancellation sooner.

shona123 · Sep 25, 2011

just thought i should chip in my 2cents. have recently started studying for cpne..am way behind you guys. but, from what i am reading in 18th edition of study guide..page 142.. mobility is evaluated during all phases of pcs for all patients. Assess first b4 u move pt cos movement might increase HR. after u complete yo assessment of balance and safety needs, you will escort an ambulatory pt to bathroom or help the pt to move to chair or just repostion the pt.. also, read the case study on same page 142.. also, on all kardex examples in guide, under mobility it tells u exactly what to do with pt

As for fluids, i agree with what Loops has said. and also, make sure you offer fluids for each pcs..some pple have failed by not offering pts fluids..Good luck with studies

Boostisadrug85 · Sep 29, 2011

So if on the Kardex it has ambulatory status checked and says "assistance with 1 person assist x1 during pcs" does that just mean once during the pcs we need to get the patient up and move to he bathroom or something at least once or what? I see where there's a spot to be Becker for out of bed to chair transfer.

BeachieRN84 · Sep 29, 2011

So every patient those we had to do a transfer of some sort on right? So let say they are in bed an don't need to use the bathroom during the PCS can we move them to the chair after everything is done and then leave or do we need to do it early enough that we transfer them back to the bed before we leave. I test in one month. I've gotten to the point that I'm making things to complicated but I'm trying to cover every little detail I can come up with.

Every patient you have you will be assigned some aspect of mobility, whether it be repositioning in bed, OOB to chair, ambulate in hallway, etc, your CE will specify this for you on your Kardex. I used the mneumonic MADATOPS for mobility, Mobility level, Abnormalities, Device (and remember this include nurse and side rail), Ambulate, Turn, Offload, Position and Socks. My first patient I was assigned reposition but when I got report I asked the nurse how she was going to the bathroom and she said she could get up so we walked to the bathroom and I used that for mobility. My second patient I was assigned ambualte in hallways so we walked around the hallway twice. Third patient I was assigned OOB to chair and when the pt was done eating I sat her up in the chair and changed her bed for her since I had comfort measures.

You are required to do some kind of mobility during your PCS unless the patient refuses. I believe if you ask twice and they refuse twice you are covered. I also know for one of my patients PT came in right when my PCS was ending and if PT is working with the patient you can do your mobility then.

You are going to be in a time block from 7:15-10:20 and from like 10:30-1:00 for your PCS's so believe me when I tell you that either the tray is there or it's coming and you will be interrupted by PT , primary RN, patient's family, doctors, etc, etc during that time. The 2 and a half hours flies by. My best advice is to let your Kardex be your guide, if you are assigned OOB to chair and you have respiratory assessment and comfort management, get them OOB to chair, you have already positioned them for listening to their lungs, rub their back, put the TV on, change linens, you're done! You have the whole PCS to do mobility but it's easy to get it out of the way. Don't worry about getting them back to bed unless they ask before you leave.

I hope this helps. :-)

shona123 · Oct 8, 2011

hie

i came across this link with CPNE tips and thought it was quite interestingtips

http://www.emt-trainingcenter-911.com/CPNE_TIPS_from_Kimo.html

all the best in your studies.