Nursing Tips

Practice & Skills (31)

Combatting the Effects of Immobility - LevelUpRN

Combatting the Effects of Immobility

Cathy Parkes

In order to combat the effects of immobility, encourage coughing/deep breathing/use of incentive spirometer, apply TED hose or SCDs to promote blood return, provide anticoagulation as ordered, and reposition the...

Combatting the Effects of Immobility

Cathy Parkes

In order to combat the effects of immobility, encourage coughing/deep breathing/use of incentive spirometer, apply TED hose or SCDs to promote blood return, provide anticoagulation as ordered, and reposition the...

In the presence of blood, a fecal occult blood test card will turn blue. Report this finding to the provider for further evaluation.

Fecal Occult Blood Test

Cathy Parkes

In the presence of blood, a fecal occult blood test card will turn blue. Report this finding to the provider for further evaluation.

Fecal Occult Blood Test

Cathy Parkes

In the presence of blood, a fecal occult blood test card will turn blue. Report this finding to the provider for further evaluation.

When collecting a clean catch urine specimen, educate patients to clean the urethra with sterile wipes, waste the initial amount into the toilet and then position the sterile container into the stream.

Clean Catch Urine Specimen Collection

Cathy Parkes

When collecting a clean catch urine specimen, educate patients to clean the urethra with sterile wipes, waste the initial amount into the toilet and then position the sterile container into...

Clean Catch Urine Specimen Collection

Cathy Parkes

When collecting a clean catch urine specimen, educate patients to clean the urethra with sterile wipes, waste the initial amount into the toilet and then position the sterile container into...

When administering enemas, lubricate the tip and insert it approximately 3 - 4" into the rectum with the tip angled towards the umbilicus.

Administering an Enema

Cathy Parkes

When administering enemas, lubricate the tip and insert it approximately 3 - 4" into the rectum with the tip angled towards the umbilicus.

Administering an Enema

Cathy Parkes

When administering enemas, lubricate the tip and insert it approximately 3 - 4" into the rectum with the tip angled towards the umbilicus.

Ways to prevent hospital-acquired infections (HAIs) include performing proper hand hygiene, performing line/tube/drain care per evidence-based facility policy, limiting invasive procedures, and removing invasive devices as soon as indicated.

Preventing Hospital-Acquired Infections (HAIs)

Cathy Parkes

Ways to prevent hospital-acquired infections (HAIs) include performing proper hand hygiene, performing line/tube/drain care per evidence-based facility policy, limiting invasive procedures, and removing invasive devices as soon as indicated.

Preventing Hospital-Acquired Infections (HAIs)

Cathy Parkes

Ways to prevent hospital-acquired infections (HAIs) include performing proper hand hygiene, performing line/tube/drain care per evidence-based facility policy, limiting invasive procedures, and removing invasive devices as soon as indicated.

Restraints should be removed immediately once a patient is no longer a risk to themselves or others.

Restraints: When to Remove

Cathy Parkes

Restraints should be removed immediately once a patient is no longer a risk to themselves or others.

Restraints: When to Remove

Cathy Parkes

Restraints should be removed immediately once a patient is no longer a risk to themselves or others.

Restraints should be applied to a portion of the bed frame which moves up and down with the bed, but cannot move on its own (i.e., not the side rail).

Restraints

Cathy Parkes

Restraints should be applied to a portion of the bed frame which moves up and down with the bed, but cannot move on its own (i.e., not the side rail).

Restraints

Cathy Parkes

Restraints should be applied to a portion of the bed frame which moves up and down with the bed, but cannot move on its own (i.e., not the side rail).

After general anesthesia, keep a patient NPO until their gag reflex/swallowing ability returns.

General Anesthesia: Nursing Care

Cathy Parkes

After general anesthesia, keep a patient NPO until their gag reflex/swallowing ability returns.

General Anesthesia: Nursing Care

Cathy Parkes

After general anesthesia, keep a patient NPO until their gag reflex/swallowing ability returns.

Cutaneous pain involves the skin (e.g., a paper cut) while somatic pain involves deeper tissues such as bones and joints.

Cutaneous Pain

Cathy Parkes

Cutaneous pain involves the skin (e.g., a paper cut) while somatic pain involves deeper tissues such as bones and joints.

Cutaneous Pain

Cathy Parkes

Cutaneous pain involves the skin (e.g., a paper cut) while somatic pain involves deeper tissues such as bones and joints.

Isotonic fluids do not change the volume of the body's cells.

Isotonic Fluids

Cathy Parkes

Isotonic fluids do not change the volume of the body's cells. 

Isotonic Fluids

Cathy Parkes

Isotonic fluids do not change the volume of the body's cells. 

When caring for a restrained patient, a new order is required every 24 hours.

Caring for a restrained patient

Cathy Parkes

When caring for a restrained patient, a new order is required every 24 hours.

Caring for a restrained patient

Cathy Parkes

When caring for a restrained patient, a new order is required every 24 hours.

If a patient is on seizure precautions, pad the bed side rails, and ensure oxygen, suction, and vital signs equipment is in the patient's room.

Seizure Precautions

Cathy Parkes

If a patient is on seizure precautions, pad the bed side rails, and ensure oxygen, suction, and vital signs equipment is in the patient's room.

Seizure Precautions

Cathy Parkes

If a patient is on seizure precautions, pad the bed side rails, and ensure oxygen, suction, and vital signs equipment is in the patient's room.

During sterile field preparation, open the top flap away from your body first. Then open the flap on the right side using the right hand, and the left side using the left hand. Lastly, open the final flap towards your body.

Sterile Field Preparation

Cathy Parkes

During sterile field preparation, open the top flap away from your body first. Then open the flap on the right side using the right hand, and the left side using...

Sterile Field Preparation

Cathy Parkes

During sterile field preparation, open the top flap away from your body first. Then open the flap on the right side using the right hand, and the left side using...

After emptying a closed drain (e.g., Jackson-Pratt, Hemovac), fully compress the canister and replace cap in order to ensure negative pressure is applied to the area.

Closed Drain: Nursing Care

Cathy Parkes

After emptying a closed drain (e.g., Jackson-Pratt, Hemovac), fully compress the canister and replace cap in order to ensure negative pressure is applied to the area.

Closed Drain: Nursing Care

Cathy Parkes

After emptying a closed drain (e.g., Jackson-Pratt, Hemovac), fully compress the canister and replace cap in order to ensure negative pressure is applied to the area.

A pressure wound base which is covered in slough or eschar is considered to be unstageable.

Unstageable Pressure Wound

Cathy Parkes

A pressure wound base which is covered in slough or eschar is considered to be unstageable.

Unstageable Pressure Wound

Cathy Parkes

A pressure wound base which is covered in slough or eschar is considered to be unstageable.

Patients receiving enemas may report cramping. Lower the solution container if cramping is reported.

Enemas: Nursing Care

Cathy Parkes

Patients receiving enemas may report cramping. Lower the solution container if cramping is reported.

Enemas: Nursing Care

Cathy Parkes

Patients receiving enemas may report cramping. Lower the solution container if cramping is reported.

A patient using crutches should be taught to ascend stairs leading with the strong leg and descend by leading with the weaker leg.

Crutches: Patient Teaching

Cathy Parkes

A patient using crutches should be taught to ascend stairs leading with the strong leg and descend by leading with the weaker leg.

Crutches: Patient Teaching

Cathy Parkes

A patient using crutches should be taught to ascend stairs leading with the strong leg and descend by leading with the weaker leg.

Patient Controlled Analgesia (PCA) pumps should only be used by the patient. Educate families/visitors not to press the button for the patient!

Patient Controlled Analgesia (PCA) Pumps

Cathy Parkes

Patient Controlled Analgesia (PCA) pumps should only be used by the patient. Educate families/visitors not to press the button for the patient!

Patient Controlled Analgesia (PCA) Pumps

Cathy Parkes

Patient Controlled Analgesia (PCA) pumps should only be used by the patient. Educate families/visitors not to press the button for the patient!

A patient on protective/reverse isolation should be provided a private room with positive-pressure airflow. Do not allow flowers or live plants into the room, and screen all visitors for illness.

Protective/Reverse Isolation

Cathy Parkes

A patient on protective/reverse isolation should be provided a private room with positive-pressure airflow. Do not allow flowers or live plants into the room, and screen all visitors for illness.

Protective/Reverse Isolation

Cathy Parkes

A patient on protective/reverse isolation should be provided a private room with positive-pressure airflow. Do not allow flowers or live plants into the room, and screen all visitors for illness.

A patient asked to do a 24-hour urine collection should be taught to discard the first void and then collect all urine voided over the following 24 hours.

24-Hour Urine Collection

Cathy Parkes

A patient asked to do a 24-hour urine collection should be taught to discard the first void and then collect all urine voided over the following 24 hours.

24-Hour Urine Collection

Cathy Parkes

A patient asked to do a 24-hour urine collection should be taught to discard the first void and then collect all urine voided over the following 24 hours.

A patient on a clear liquid diet may have items that are transparent and liquid at room temperature (e.g., water, clear sodas, pulp-free juices, popsicles, jello, black coffee, clear broth).

Clear Liquid Diets

Cathy Parkes

A patient on a clear liquid diet may have items that are transparent and liquid at room temperature (e.g., water, clear sodas, pulp-free juices, popsicles, jello, black coffee, clear broth).

Clear Liquid Diets

Cathy Parkes

A patient on a clear liquid diet may have items that are transparent and liquid at room temperature (e.g., water, clear sodas, pulp-free juices, popsicles, jello, black coffee, clear broth).

A medication reconciliation should be done during admission, upon transfer to another floor/unit/facility, and at discharge.

When to Perform a Medication Reconciliation

Cathy Parkes

A medication reconciliation should be done during admission, upon transfer to another floor/unit/facility, and at discharge.

When to Perform a Medication Reconciliation

Cathy Parkes

A medication reconciliation should be done during admission, upon transfer to another floor/unit/facility, and at discharge.

A Braden scale score ≤ 18 indicates a patient is at risk for pressure injuries. In this case, take measures to prevent injuries of this type.

Braden Scale: Pressure Injuries

Cathy Parkes

A Braden scale score ≤ 18 indicates a patient is at risk for pressure injuries. In this case, take measures to prevent injuries of this type.

Braden Scale: Pressure Injuries

Cathy Parkes

A Braden scale score ≤ 18 indicates a patient is at risk for pressure injuries. In this case, take measures to prevent injuries of this type.

Wound irrigation points to remember

Wound Irrigation

Cathy Parkes

Wound irrigation points to remember!

Wound Irrigation

Cathy Parkes

Wound irrigation points to remember!

When performing suctioning, apply suction intermittently while withdrawing the catheter and rotating it for 10-15 seconds. For endotrachial suctioning, hyperoxygenate patient prior to suctioning. Use a suction pressure between 120 - 150 mmHg.

Suctioning

Cathy Parkes

When performing suctioning, apply suction intermittently while withdrawing the catheter and rotating it for 10-15 seconds.

Suctioning

Cathy Parkes

When performing suctioning, apply suction intermittently while withdrawing the catheter and rotating it for 10-15 seconds.

Key points when taking a patient's blood glucose: Place hand in dependent position; Pierce the outer edge of the fingertip (not the pad); Wipe away first drop of blood; Hold test strip NEXT to the blood drop (do not smear blood on strip).

Blood Glucose Key Points

Cathy Parkes

Key points when taking a patient's blood glucose: Place hand in dependent position; Pierce outer; Wipe away first drop of blood; Hold test trip NEXT to the blood drop

1 comment

Blood Glucose Key Points

Cathy Parkes

Key points when taking a patient's blood glucose: Place hand in dependent position; Pierce outer; Wipe away first drop of blood; Hold test trip NEXT to the blood drop

1 comment
For abdominal wound dehiscence with evisceration (protruding internal organs): Place saline-soaked gauze over wound and protruding organs; Do NOT try and reinsert organs!; Notify provider and prepare the patient for possible surgery (NPO).

Abdominal Wound Dehiscence

Cathy Parkes

For abdominal wound dehiscence with evisceration: Place saline-soaked gauze over wound; Don't try to reinsert organs!; Prepare patient for possible surgery.

Abdominal Wound Dehiscence

Cathy Parkes

For abdominal wound dehiscence with evisceration: Place saline-soaked gauze over wound; Don't try to reinsert organs!; Prepare patient for possible surgery.

Applying Restraints

Applying Restraints

Cathy Parkes

When applying restraints, make sure 2 fingers can fit between restraint and patient, se a quick release knot, and don't place restraints on side rail.

Applying Restraints

Cathy Parkes

When applying restraints, make sure 2 fingers can fit between restraint and patient, se a quick release knot, and don't place restraints on side rail.

REPORT urine output that is less than 30ml/hr!  Decreased urine output can be indicative of shock, sepsis, and kidney failure.

Reporting Urine Output

Cathy Parkes

REPORT urine output that is less than 30ml/hr! Decreased urine output can be indicative of shock, sepsis, and kidney failure.

Reporting Urine Output

Cathy Parkes

REPORT urine output that is less than 30ml/hr! Decreased urine output can be indicative of shock, sepsis, and kidney failure.

Key points about maintaining a sterile field:  1" edge of field is NOT sterile. Never turn your back on, reach across, or walk away from a sterile field. Objects held below the waist is consider non-sterile.

Maintaining A Sterile Field

Cathy Parkes

Key points about maintaining a sterile field

Maintaining A Sterile Field

Cathy Parkes

Key points about maintaining a sterile field

Enteral feeding (NG or G-tube): Confirm placement with x-ray before feeding! Measure gastric contents every 4 hours. Hold feeding if residual exceeds ~500ml. Flush tubes with 30 mL sterile water every 4 hours.

Enteral Feeding

Cathy Parkes

Enteral feeding: Confirm placement with x-ray; Measure gastric contents; Hold feeding if residual exceeds ~500ml; Flush feeding tubes.

Enteral Feeding

Cathy Parkes

Enteral feeding: Confirm placement with x-ray; Measure gastric contents; Hold feeding if residual exceeds ~500ml; Flush feeding tubes.