Deterioration

Question 1

What happens to BP during deterioration?

Answer 1

-Decreases (usually a late sign)

Question 2

What happens to HR during deterioration?

Answer 2

-Tachy (Usually a late sign)

Question 3

What is normal respiratory rate?

Answer 3

11-17

Question 4

What happens to RR during deterioration? What should the nurse look out for?

Answer 4

RR change
Note: (first signs, observe)
-WOB
-Use of accessory muscles 
-Lung expansion 
-Colour of pt

Question 5

What are other things to notice?

Answer 5

Change in:

• Temp
• Pain
• Fluid balance
• Blood analysis
• Family concerns

Question 6

What are the nursing interventions?

Answer 6

• Airway
• Breathing
• circulation
• Disability
• Exposure (escalation)
• Document
• Review notes and trends
• ECG
• Meds where appropriate.