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Name: __________________________________________ Date: _____________ Score: _____________
Procedure 39–8 Steps
Start Time: End Time: Total Time:
Steps
Possible
Points
First
Attempt
Second
Attempt
Third
Attempt
1. Assemble equipment and supplies; wash hands.
Incorporate critical thinking skills when performing
patient assessment and care.
15
2. Identify the patient, introduce yourself, and explain
the rationale for performance of the procedure.
Show awareness of the patient’s concerns related to
the procedure being performed.
15
3. Be sure the patient is in a comfortable position and any
restrictive clothing (such as a tie or collar) is loosened
before initiating the procedure.
15
4. Set the indicator to the bottom (lowest number) of the
scale.
15
5. Instruct the patient to take in a deep breath, place the
meter to mouth, close lips around the mouthpiece, and
blow as hard as he or she can.
15
6. Write down the number the patient achieved. 15
7. Repeat steps 5 and 6 two more times. 15
8. Instruct the patient to do a peak flow 2–3 times a day. 15
9. Explain to the patient how to establish his or her
“personal best”; explain the “Three Zone” system and
how to record results in his or her peak flow diary.
15
10. Dispose of mouthpiece in the waste container. 15
11. Document. 15
Points Awarded / Points Possible ____/
165
