Nursing Tips

Educate patients to immediately report a rash when taking lamotrigine, as this may be due to Stevens-Johnson Syndrome, a life-threatening complication!

Lamotrigine: Patient Teaching

Cathy Parkes

Educate patients to immediately report a rash when taking lamotrigine, as this may be due to Stevens-Johnson Syndrome, a life-threatening complication!

Lamotrigine: Patient Teaching

Cathy Parkes

Educate patients to immediately report a rash when taking lamotrigine, as this may be due to Stevens-Johnson Syndrome, a life-threatening complication!

Thrombolytics may be given within three hours of the onset of symptoms in the case of an ischemic stroke, but are NOT indicated for hemorrhagic strokes.

Thrombolytics

Cathy Parkes

Thrombolytics may be given within three hours of the onset of symptoms in the case of an ischemic stroke, but are NOT indicated for hemorrhagic strokes.

Thrombolytics

Cathy Parkes

Thrombolytics may be given within three hours of the onset of symptoms in the case of an ischemic stroke, but are NOT indicated for hemorrhagic strokes.

Stroke: Right versus Left Hemisphere

Stroke: Right versus Left Hemisphere

Cathy Parkes

A patient experiencing a left hemisphere stroke is likely to have expressive aphasia (difficulty speaking/understanding language) or reading/writing difficulty. A stroke affecting the right hemisphere may lead to poor judgement...

Stroke: Right versus Left Hemisphere

Cathy Parkes

A patient experiencing a left hemisphere stroke is likely to have expressive aphasia (difficulty speaking/understanding language) or reading/writing difficulty. A stroke affecting the right hemisphere may lead to poor judgement...

The autonomic nervous system is comprised of two parts: the sympathetic nervous system ("fight or flight" responses) and the parasympathetic nervous system ("rest and digest" functions).

Autonomic Nervous System

Cathy Parkes

The autonomic nervous system is comprised of two parts: the sympathetic nervous system ("fight or flight" responses) and the parasympathetic nervous system ("rest and digest" functions).

Autonomic Nervous System

Cathy Parkes

The autonomic nervous system is comprised of two parts: the sympathetic nervous system ("fight or flight" responses) and the parasympathetic nervous system ("rest and digest" functions).

The central nervous system (CNS) is composed of the brain and spinal cord.

Central Nervous System (CNS)

Cathy Parkes

The central nervous system (CNS) is composed of the brain and spinal cord.

Central Nervous System (CNS)

Cathy Parkes

The central nervous system (CNS) is composed of the brain and spinal cord.

A patient with a spinal cord injury is at risk for experiencing life-threatening hypertension known as autonomic dysreflexia.

Autonomic Dysreflexia

Cathy Parkes

A patient with a spinal cord injury is at risk for experiencing life-threatening hypertension known as autonomic dysreflexia. 

Autonomic Dysreflexia

Cathy Parkes

A patient with a spinal cord injury is at risk for experiencing life-threatening hypertension known as autonomic dysreflexia. 

After a tonic-clonic seizure, a patient enters the "postictal phase," and may exhibit confusion, sleepiness, or agitation.

Tonic-clonic Seizure

Cathy Parkes

After a tonic-clonic seizure, a patient enters the "postictal phase," and may exhibit confusion, sleepiness, or agitation.

Tonic-clonic Seizure

Cathy Parkes

After a tonic-clonic seizure, a patient enters the "postictal phase," and may exhibit confusion, sleepiness, or agitation.

The most common seizure disorder in children is febrile seizures.

Febrile Seizures

Cathy Parkes

The most common seizure disorder in children is febrile seizures.

Febrile Seizures

Cathy Parkes

The most common seizure disorder in children is febrile seizures.

When performing a Snellen exam for visual acuity, an adult should stand 20 feet away from the chart, but a child should stand 10 feet from the chart.

Performing a Snellen Exam

Cathy Parkes

When performing a Snellen exam for visual acuity, an adult should stand 20 feet away from the chart, but a child should stand 10 feet from the chart.

Performing a Snellen Exam

Cathy Parkes

When performing a Snellen exam for visual acuity, an adult should stand 20 feet away from the chart, but a child should stand 10 feet from the chart.

A patient reporting a loss of central vision should be evaluated for macular degeneration.

Loss of Central Vision

Cathy Parkes

A patient reporting a loss of central vision should be evaluated for macular degeneration.

Loss of Central Vision

Cathy Parkes

A patient reporting a loss of central vision should be evaluated for macular degeneration.

Acetaminophen, a non-opioid analgesic, can cause hepatotoxicity in high doses. Educate patients to take no more than 4 g per day, and to read the labels of OTC medications as many contain acetaminophen!

Acetaminophen: Patient Teaching

Cathy Parkes

Acetaminophen, a non-opioid analgesic, can cause hepatotoxicity in high doses. 

Acetaminophen: Patient Teaching

Cathy Parkes

Acetaminophen, a non-opioid analgesic, can cause hepatotoxicity in high doses. 

A child with meningocele or myelomeningocele is at risk for injury due to the exposed spinal cord. Cover the sac with sterile, saline-moistened, non-adherent dressing. Place infant prone with the hips flexed.

Meningocele and Myelomeningocele in Children

Cathy Parkes

A child with meningocele or myelomeningocele is at risk for injury due to the exposed spinal cord. Cover the sac with sterile, saline-moistened, non-adherent dressing. Place infant prone with the...

Meningocele and Myelomeningocele in Children

Cathy Parkes

A child with meningocele or myelomeningocele is at risk for injury due to the exposed spinal cord. Cover the sac with sterile, saline-moistened, non-adherent dressing. Place infant prone with the...

A child with meningitis is likely to have a fever, headache, nausea, vomiting, irritability, nuchal (neck) rigidity, photophobia, and positive Kernig's and Brudzinski's signs.

Meningitis in Children

Cathy Parkes

A child with meningitis is likely to have a fever, headache, nausea, vomiting, irritability, nuchal (neck) rigidity, photophobia, and + Kernig's and Brudzinski's signs. 

Meningitis in Children

Cathy Parkes

A child with meningitis is likely to have a fever, headache, nausea, vomiting, irritability, nuchal (neck) rigidity, photophobia, and + Kernig's and Brudzinski's signs. 

A key finding in Huntington's Disease is chorea, which is a type of abnormal and excessive involuntary movement. Tetrabenazine may be given to treat this symptom.

Chorea and Huntington's Disease

Cathy Parkes

A key finding in Huntington's Disease is chorea, which is a type of abnormal and excessive involuntary movement. Tetrabenazine may be given to treat this symptom.

Chorea and Huntington's Disease

Cathy Parkes

A key finding in Huntington's Disease is chorea, which is a type of abnormal and excessive involuntary movement. Tetrabenazine may be given to treat this symptom.

A key side effect of phenytoin (an anti-seizure medication) is gingival hyperplasia. Educate patients to maintain regular dental checkups.

Phenytoin and Gingival Hyperplasia

Cathy Parkes

A key side effect of phenytoin (an anti-seizure medication) is gingival hyperplasia. Educate patients to maintain regular dental checkups.

Phenytoin and Gingival Hyperplasia

Cathy Parkes

A key side effect of phenytoin (an anti-seizure medication) is gingival hyperplasia. Educate patients to maintain regular dental checkups.

A child with a head injury is at risk for elevated intracranial pressure (ICP).

Intracranial Pressure (ICP); Nursing Care

Cathy Parkes

A child with a head injury is at risk for elevated intracranial pressure (ICP). Nursing care to decrease ICP includes reducing hypercapnia by hyperventilating the patient, avoiding oral suctioning, keeping...

Intracranial Pressure (ICP); Nursing Care

Cathy Parkes

A child with a head injury is at risk for elevated intracranial pressure (ICP). Nursing care to decrease ICP includes reducing hypercapnia by hyperventilating the patient, avoiding oral suctioning, keeping...

A child with ADHD may be treated with CNS stimulants such as amphetamine mixtures or methylphenidate.

ADHD in Children: Treatment and Nursing Care

Cathy Parkes

A child with ADHD may be treated with CNS stimulants such as amphetamine mixtures or methylphenidate. 

ADHD in Children: Treatment and Nursing Care

Cathy Parkes

A child with ADHD may be treated with CNS stimulants such as amphetamine mixtures or methylphenidate. 

A child who presents with an abnormal tuft of hair, a dimple, or a birthmark on the spine should be evaluated for spina bifida occulta, a form of spina bifida. Report these findings to the provider.

Spina Bifida Occulta

Cathy Parkes

A child who presents with an abnormal tuft of hair, a dimple, or a birthmark on the spine should be evaluated for spina bifida occulta, a form of spina bifida....

Spina Bifida Occulta

Cathy Parkes

A child who presents with an abnormal tuft of hair, a dimple, or a birthmark on the spine should be evaluated for spina bifida occulta, a form of spina bifida....

A child who appears to be frequently "day dreaming" or often exhibits blank staring, eye fluttering, lip smacking, or picking at clothes should be evaluated for absence seizures.

Absence Seizures: Signs and Symptoms

Cathy Parkes

A child who appears to be frequently "day dreaming" or often exhibits blank staring, eye fluttering, lip smacking, or picking at clothes should be evaluated for absence seizures.

Absence Seizures: Signs and Symptoms

Cathy Parkes

A child who appears to be frequently "day dreaming" or often exhibits blank staring, eye fluttering, lip smacking, or picking at clothes should be evaluated for absence seizures.

Signs/Symptoms of Autism

Signs and Symptoms of Autism

Cathy Parkes

Key signs/symptoms of Autism: Lack of eye contact Repetitive motions/actions Delayed speech and language skills Strict adherence to routines Unusual eating or sleeping habits Digestive problems.

Signs and Symptoms of Autism

Cathy Parkes

Key signs/symptoms of Autism: Lack of eye contact Repetitive motions/actions Delayed speech and language skills Strict adherence to routines Unusual eating or sleeping habits Digestive problems.

Extrapyramidal side effects (EPS) are common with Conventional Antipsychotics. Symptoms of EPS include: Dystonia, Parkinson's symptoms, Tardive dyskinesia, Akathisia.

Extrapyramidal Side Effects

Cathy Parkes

Extrapyramidal side effects (EPS) are common with Conventional Antipsychotics. Symptoms of EPS include: Dystonia, Parkinson's symptoms, Tardive dyskinesia, Akathisia.

Extrapyramidal Side Effects

Cathy Parkes

Extrapyramidal side effects (EPS) are common with Conventional Antipsychotics. Symptoms of EPS include: Dystonia, Parkinson's symptoms, Tardive dyskinesia, Akathisia.

Early signs of increased ICP in infants:  Irritability, high-pitched cry, poor feeding, bulging fontanels, separation of cranial sutures “setting-sun” phenomenon.

Early Signs of Increased ICP in Infants

Cathy Parkes

Early signs of increased ICP in infants: irritability, high-pitched cry, poor feeding, “setting-sun” phenomenon, bulging fontanels, separation of cranial sutures.

1 comment

Early Signs of Increased ICP in Infants

Cathy Parkes

Early signs of increased ICP in infants: irritability, high-pitched cry, poor feeding, “setting-sun” phenomenon, bulging fontanels, separation of cranial sutures.

1 comment
Don't confuse clozapine with clonidine! Clozapine is an antipsychotic (note both cloZapine and schiZophrenia have a Z). Clonidine is an antihypertensive.

Clozapine vs. Clonidine

Cathy Parkes

Don't confuse clozapine with clonidine! Clonidine is an antihypertensive. Clozapine is an antipsychotic.

Clozapine vs. Clonidine

Cathy Parkes

Don't confuse clozapine with clonidine! Clonidine is an antihypertensive. Clozapine is an antipsychotic.

Dementia has slow onset, does NOT alter vital signs, and is irreversible. Delirium has rapid onset, can alter vital signs and level of consciousness, and is reversible.

Dementia vs. delirium

Cathy Parkes

Dementia vs delirium: Dementia has slow onset, does NOT alter vital signs, and is irreversible. Delirium has rapid onset, can alter vital signs and level of consciousness, and is reversible.

Dementia vs. delirium

Cathy Parkes

Dementia vs delirium: Dementia has slow onset, does NOT alter vital signs, and is irreversible. Delirium has rapid onset, can alter vital signs and level of consciousness, and is reversible.

Donepezil is a KEY medication used for Alzheimer's disease. It does NOT cure the disease, but it may improve memory, cognition, and an individual’s ability to perform ADLs.

Donepezil & Alzheimer's

Cathy Parkes

Donepezil is a KEY medication used for Alzheimer's disease. It does NOT cure the disease, but it may improve memory, cognition, and an individual’s ability to perform ADLs.

Donepezil & Alzheimer's

Cathy Parkes

Donepezil is a KEY medication used for Alzheimer's disease. It does NOT cure the disease, but it may improve memory, cognition, and an individual’s ability to perform ADLs.

Amitriptyline

Amitriptyline

Cathy Parkes

Amitriptyline is a Tricyclic Antidepressant. "Amy tripped over a tricycle in the desert". Desert helps you remember anticholinergic side effects (urinary retention, constipation, dry mouth, blurry vision, photophobia, tachycardia)

Amitriptyline

Cathy Parkes

Amitriptyline is a Tricyclic Antidepressant. "Amy tripped over a tricycle in the desert". Desert helps you remember anticholinergic side effects (urinary retention, constipation, dry mouth, blurry vision, photophobia, tachycardia)

ADHD medications (e.g. methylphenidate and amphetamine mixtures) cause decreased appetite and weight loss in children.  Key Nursing Intervention: Monitor child's weight during therapy!

ADHD Medication and Children's Weight

Cathy Parkes

ADHD medications cause decreased appetite and weight loss in children.

ADHD Medication and Children's Weight

Cathy Parkes

ADHD medications cause decreased appetite and weight loss in children.

Diagnosis of meningitis is done by analyzing the patient's CSF (cerebrospinal fluid).  Bacterial meningitis: CSF is cloudy with ↓ glucose. Viral meningitis: CSF is clear and glucose levels are typically normal.

Meningitis diagnosis

Cathy Parkes

Diagnosis of meningitis is done by analyzing the patient's CSF (cerebrospinal fluid).

Meningitis diagnosis

Cathy Parkes

Diagnosis of meningitis is done by analyzing the patient's CSF (cerebrospinal fluid).

During a patient's seizure: Lower patient to the bed or floor if standing/sitting. Turn the patient to his/her side. Loosen restrictive clothing. Do NOT put anything in the patient’s mouth. Do NOT restrain patient. Note onset/duration of seizure.

Seizures

Cathy Parkes

During a seizure, take these important nursing actions

Seizures

Cathy Parkes

During a seizure, take these important nursing actions

Nursing Tips - Halo Traction Devices

Halo Traction Devices

Cathy Parkes

If your patient has a halo traction device in place, make sure wrench/screwdriver are attached to the vest to release patient from the device in the event of an emergency.

Halo Traction Devices

Cathy Parkes

If your patient has a halo traction device in place, make sure wrench/screwdriver are attached to the vest to release patient from the device in the event of an emergency.

Lithium

Lithium

Cathy Parkes

Lithium is a mood stabilizer, used for Bipolar Disorder. Patients on lithium need adequate fluid and sodium intake! Diuretics, anticholinergics, NSAIDs are not recommended.

Lithium

Cathy Parkes

Lithium is a mood stabilizer, used for Bipolar Disorder. Patients on lithium need adequate fluid and sodium intake! Diuretics, anticholinergics, NSAIDs are not recommended.

MAOIS for Depression

MAOIS for Depression

Cathy Parkes

MAOIs are used to treat depression. Important points about MAOIs: They interact with MANY other medications. Eating foods rich in tyramine can cause a hypertensive crisis. Foods rich in tyramine include...

MAOIS for Depression

Cathy Parkes

MAOIs are used to treat depression. Important points about MAOIs: They interact with MANY other medications. Eating foods rich in tyramine can cause a hypertensive crisis. Foods rich in tyramine include...

Valproic Acid

Valproic Acid

Cathy Parkes

Valproic acid is an antiepileptic drug. Key side effect is hepatotoxicity! Carefully monitor liver lab values (ex: AST, ALT).

Valproic Acid

Cathy Parkes

Valproic acid is an antiepileptic drug. Key side effect is hepatotoxicity! Carefully monitor liver lab values (ex: AST, ALT).

Sumatriptan

Sumatriptan

Cathy Parkes

Sumatriptan is a medication used to treat migraines by causing vasoconstriction of the intracranial arteries. If a SUMO wrestler sits on your head, that will also cause vasoconstriction.

Sumatriptan

Cathy Parkes

Sumatriptan is a medication used to treat migraines by causing vasoconstriction of the intracranial arteries. If a SUMO wrestler sits on your head, that will also cause vasoconstriction.

Zolpidem (Ambien) Uses

Zolpidem (Ambien) Uses

Cathy Parkes

Zolpidem (Ambien) is used for insomnia. Zolpidem will help you catch some ZZZs...

Zolpidem (Ambien) Uses

Cathy Parkes

Zolpidem (Ambien) is used for insomnia. Zolpidem will help you catch some ZZZs...

Major Risk Factor for Reye's Syndrome

Major Risk Factor for Reye's Syndrome

Cathy Parkes

Major risk factor for Reye's syndrome: Use of aspirin to treat fever associated with a viral infection.

Major Risk Factor for Reye's Syndrome

Cathy Parkes

Major risk factor for Reye's syndrome: Use of aspirin to treat fever associated with a viral infection.

Lithium Side Effects vs. Toxicity

Lithium Side Effects vs. Toxicity

Cathy Parkes

Lithium: fine hand tremors are an EXPECTED side effect, coarse hand tremors indicate TOXICITY.

Lithium Side Effects vs. Toxicity

Cathy Parkes

Lithium: fine hand tremors are an EXPECTED side effect, coarse hand tremors indicate TOXICITY.

SSRIs and Serotonin Syndrome

SSRIs and Serotonin Syndrome

Cathy Parkes

For patients taking SSRIs, watch for serotonin syndrome! Symptoms: agitation, hallucinations, fever, diaphoresis, tremors.

SSRIs and Serotonin Syndrome

Cathy Parkes

For patients taking SSRIs, watch for serotonin syndrome! Symptoms: agitation, hallucinations, fever, diaphoresis, tremors.

How to treat a seizure

How to treat a seizure

Cathy Parkes

During a seizure, turn the patient to his/her side, loosen restrictive clothing, and DO NOT insert airway or restrain patient.

How to treat a seizure

Cathy Parkes

During a seizure, turn the patient to his/her side, loosen restrictive clothing, and DO NOT insert airway or restrain patient.