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Respiratory Treatment Form

This document provides instructions for documenting respiratory treatments and monitoring patient response. It includes: 1) Instructions for administering a 15-minute nebulizer treatment and monitoring the patient's condition before and after. 2) A treatment administration record form for documenting date, time, vital signs, lung sounds, sputum, adverse reactions, and response to treatment. 3) Coding instructions for documenting lung sounds, sputum, adverse reactions, and treatment outcome/response.

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314 views1 page

Respiratory Treatment Form

This document provides instructions for documenting respiratory treatments and monitoring patient response. It includes: 1) Instructions for administering a 15-minute nebulizer treatment and monitoring the patient's condition before and after. 2) A treatment administration record form for documenting date, time, vital signs, lung sounds, sputum, adverse reactions, and response to treatment. 3) Coding instructions for documenting lung sounds, sputum, adverse reactions, and treatment outcome/response.

Uploaded by

payo972
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Nursing Respiratory Treatment – Document specific order and administration of treatment of Treatment Administration Record

Nebulizer - Resident is instructed to breathe as calmly, deeply, and evenly as possible until no more mist is formed in the nebulizer chamber (approx. 15 minutes).
Monitor & chart resident’s pre and post treatment condition and response to treatment below
P LEASE D OCUMENT E VERY T REATMENT – PRN AND S CHEDULED
CODING
Circle appropriate lung sound results prior to and post treatment. Columns nine (9) through eleven (11) should be coded as outlined below.
Sputum: B = Bloody G = Green Y = Yellow C = Clear N = None Adverse Reaction: Y = Yes N = No Outcome/Response: W = Worsened I = Improved NC = No
Change
Time/ RR O2 Lung Sounds Lung Sounds RR O2 Sats Adverse Sputu Response/ F/U Actions
Date TX Prior Sats Prior to Tx (circle) Post Tx (circle) Post Post Reactions m Outcome & Comments Initials
Clear Congested Clear Congested
Rhonchi Rales Rhonchi Rales
Crackles Rub Crackles Rub
Diminished Wheezes Diminished Wheezes
Clear Congested Clear Congested
Rhonchi Rales Rhonchi Rales
Crackles Rub Crackles Rub
Diminished Wheezes Diminished Wheezes
Clear Congested Clear Congested
Rhonchi Rales Rhonchi Rales
Crackles Rub Crackles Rub
Diminished Wheezes Diminished Wheezes
Clear Congested Clear Congested
Rhonchi Rales Rhonchi Rales
Crackles Rub Crackles Rub
Diminished Wheezes Diminished Wheezes
Clear Congested Clear Congested
Rhonchi Rales Rhonchi Rales
Crackles Rub Crackles Rub
Diminished Wheezes Diminished Wheezes
Clear Congested Clear Congested
Rhonchi Rales Rhonchi Rales
Crackles Rub Crackles Rub
Diminished Wheezes Diminished Wheezes
Clear Congested Clear Congested
Rhonchi Rales Rhonchi Rales
Crackles Rub Crackles Rub
Diminished Wheezes Diminished Wheezes
Clear Congested Clear Congested
Rhonchi Rales Rhonchi Rales
Crackles Rub Crackles Rub
Diminished Wheezes Diminished Wheezes
Clear Congested Clear Congested
Rhonchi Rales Rhonchi Rales
Crackles Rub Crackles Rub
Diminished Wheezes Diminished Wheezes
Clear Congested Clear Congested
Rhonchi Rales Rhonchi Rales
Crackles Rub Crackles Rub
Diminished Wheezes Diminished Wheezes

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