Normal narrative bank — stable / at-baseline
Seven upgraded normal narratives. Each shows what was assessed, the objective finding, the baseline comparison, and the skilled reason the visit required a nurse — edit to the actual visit.
N1 Nares patent, cannula skin intact on oxygen | Skilled nasal assessment in a patient on continuous oxygen. The nares are patent bilaterally without obstruction; there is no epistaxis; the skin under and around the cannula — the nares, the columella, and behind the ears — is intact without pressure marks at 2 L/min, with padding in place. The patent airway and intact cannula skin, assessed because continuous oxygen places the nares at pressure-injury risk, confirm no breakdown; cannula skin care and repositioning were reinforced, with the caregiver return-demonstrating skin checks correctly (oxygen management in Respiratory/COPD). |
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N2 No epistaxis, humidification effective | Skilled assessment of a patient with a history of epistaxis on oxygen. There is no active bleeding; the anterior mucosa is moist without crusting; humidification is in use and effective. The absence of bleeding and the moist mucosa, compared to the prior dry, crusting baseline, confirm the humidification plan is preventing recurrence; humidification, gentle nasal care, and epistaxis-control technique were reinforced, with the patient return-demonstrating pressure technique correctly. |
N3 Sinus symptoms at baseline | Skilled assessment of a patient with chronic sinus symptoms. There is no new facial pain, purulent drainage, or fever; any pressure is at the patient’s chronic baseline and there is no facial swelling. The absence of acute change, compared to the chronic baseline, confirms no infectious process requiring escalation; sinus self-care and the warning signs that would warrant evaluation (fever, facial swelling, purulent drainage) were taught, with the patient verbalizing them correctly. |
N4 Smell intact at baseline | Skilled assessment including smell in a patient at nutritional risk. Smell is at the patient’s baseline without new loss, supporting appetite; there is no nasal obstruction to account for a change. The preserved smell, assessed because loss affects appetite and safety, confirms no new contributor to poor intake; the patient was taught to report any new loss of smell given its effect on eating and hazard detection, and verbalized this correctly (cross-reference Taste/Swallowing, Nutrition). |
N5 Post-nasal drip managed | Skilled assessment of a patient with post-nasal drainage. The drainage is clear and reduced from the prior visit with the current measures; there is no purulence, cough-related distress, or sinus tenderness. The reduced clear drainage, compared to baseline, confirms the management is effective; hydration, humidification, and the signs that would warrant evaluation were reinforced, with the patient verbalizing them correctly. |
N6 Cannula skin care mastered | Skilled assessment of a patient newly on continuous oxygen. The nares and peri-cannula skin are intact; the patient and caregiver, after coaching, correctly demonstrated padding the tubing, checking the skin, and rotating pressure points. The intact skin and mastered technique on return demonstration confirm effective prevention; skin surveillance and the early signs of a pressure injury were reinforced, with the caregiver return-demonstrating correctly (cross-reference Wounds, Respiratory). |
N7 Epistaxis-prevention plan effective on anticoagulant | Skilled assessment of an anticoagulated patient with prior epistaxis now stable. There have been no bleeds since the prevention plan was implemented; the mucosa is moist with humidification and the patient avoids trauma and forceful blowing. The absence of bleeding with an effective plan, compared to the prior pattern, confirms the prevention is working; epistaxis-control technique, the lower threshold to seek care on anticoagulation, and humidification were reinforced, with the patient return-demonstrating pressure technique correctly (cross-reference Anticoagulation). |