Physiological Integrity: Reduction of Risk Potential
Reduction of Risk Potential tests the PN's ability to spot complications early, interpret common lab and diagnostic findings, and act before harm occurs.
Monitoring
- Know common ranges: potassium 3.5-5.0 mEq/L, sodium 135-145 mEq/L, and INR 2-3 for most warfarin therapy.
- After surgery, watch for hemorrhage, infection, atelectasis, DVT, and paralytic ileus. Report a rising pulse with falling blood pressure, new confusion, decreased urine output, or unilateral calf pain.
- Before a procedure, verify consent, allergies, NPO status, and required lab work. After a procedure, monitor sedation, bleeding, and vital signs.
Worked example
On postoperative day 2, a client reports calf pain. The PN notes unilateral swelling, warmth, and tenderness. The PN does not massage the leg, notifies the provider, keeps the client on bed rest as ordered, and anticipates an ultrasound and anticoagulation. Reasoning: these findings suggest deep vein thrombosis. Massage could dislodge a clot and cause pulmonary embolism. Early recognition and reporting are the PN's key contributions.
Risk tools
Use fall-risk and pressure-injury risk scales, medication reconciliation, allergy bands, and standardized handoffs. Check glucose before insulin, platelet counts before heparin, and renal function before nephrotoxic drugs. Report abnormal results according to policy rather than waiting for the next shift.
Traps
Massaging a suspected DVT; ignoring new confusion in an older client; assuming a low hemoglobin is harmless without assessing for bleeding; letting a client eat before a procedure without checking NPO status; failing to report a critical lab value.