| PLAN |
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- Assess for causative and contributing factors.
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- Other
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- Monitor vital signs, breath sounds, weight, and intake and output.
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- Monitor neurologic status for changes in mentation or level of consciousness, peripheral pulses, skin color and temperature, sensation and movement.
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- Monitor EKG for dysrhythmias and treat as indicated.
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- Monitor lab work and notify physician of significant abnormalities.
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- Administer oxygen to maximize tissue perfusion.
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- Titrate medications/drips, per protocol.
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- Provide calm, quiet environment with adequate rest periods between activities.
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- Educate patient/family regarding procedures to be done, activity limitation, medication, signs and symptoms to report such as bleeding, pain, and numbness.
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