Nursing Tips
Practice & Skills (39)

Chest Physiotherapy
Schedule chest physiotherapy before meals or 1 - 2 hours after meals to avoid vomiting. Administer a bronchodilator 30 - 60 minutes prior to treatment.
Chest Physiotherapy
Schedule chest physiotherapy before meals or 1 - 2 hours after meals to avoid vomiting. Administer a bronchodilator 30 - 60 minutes prior to treatment.

SBAR Communication
SBAR communication (which stands for situation, background, assessment, recommendation) is a technique to organize and facilitate communication with interdisciplinary team members.
SBAR Communication
SBAR communication (which stands for situation, background, assessment, recommendation) is a technique to organize and facilitate communication with interdisciplinary team members.

"Time Out" Procedure
Prior to beginning a surgery, a "time out" procedure should be done to verify the patient identity and the correct surgical site.
"Time Out" Procedure
Prior to beginning a surgery, a "time out" procedure should be done to verify the patient identity and the correct surgical site.

Incentive Spirometer
Educate patients on the use of the incentive spirometer. They should inhale slowly and deeply, and use the device ~ 10 times an hour while awake.
Incentive Spirometer
Educate patients on the use of the incentive spirometer. They should inhale slowly and deeply, and use the device ~ 10 times an hour while awake.

Patients with Artificial Airways
Patients with artificial airways may be unable to speak. Use alternative communication methods (e.g., writing board) to allow the patient to convey their needs.
Patients with Artificial Airways
Patients with artificial airways may be unable to speak. Use alternative communication methods (e.g., writing board) to allow the patient to convey their needs.

Recording I&Os
When recording I&Os, ice chips should be recorded as half their volume. For example, 8 oz of ice chips count as 4 oz of water.
Recording I&Os
When recording I&Os, ice chips should be recorded as half their volume. For example, 8 oz of ice chips count as 4 oz of water.

Denture Care
When providing denture care, place towels into the sink to prevent damage should they fall during cleaning.
Denture Care
When providing denture care, place towels into the sink to prevent damage should they fall during cleaning.

Venturi Devices
Venturi devices are used to provide the most precise FiO2 delivery (up to 40%) without intubation. The flow rate depends on the mask to which the device is attached.
Venturi Devices
Venturi devices are used to provide the most precise FiO2 delivery (up to 40%) without intubation. The flow rate depends on the mask to which the device is attached.

Combatting the Effects of Immobility
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
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...

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

Clean Catch Urine Specimen Collection
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
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...

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

Preventing Hospital-Acquired Infections (HAIs)
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)
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: When to Remove
Restraints should be removed immediately once a patient is no longer a risk to themselves or others.
Restraints: When to Remove
Restraints should be removed immediately once a patient is no longer a risk to themselves or others.

Restraints
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
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).

General Anesthesia: Nursing Care
After general anesthesia, keep a patient NPO until their gag reflex/swallowing ability returns.
General Anesthesia: Nursing Care
After general anesthesia, keep a patient NPO until their gag reflex/swallowing ability returns.

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

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

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

Seizure Precautions
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
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.

Sterile Field Preparation
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
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...

Closed Drain: Nursing Care
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
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.

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

Enemas: Nursing Care
Patients receiving enemas may report cramping. Lower the solution container if cramping is reported.
Enemas: Nursing Care
Patients receiving enemas may report cramping. Lower the solution container if cramping is reported.

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

Protective/Reverse Isolation
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
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.

24-Hour Urine Collection
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
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.

Clear Liquid Diets
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
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).

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

Braden Scale: Pressure Injuries
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
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.


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

Blood Glucose Key Points
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
Blood Glucose Key Points
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

Abdominal Wound Dehiscence
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
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
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
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.

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

Maintaining A Sterile Field
Key points about maintaining a sterile field
Maintaining A Sterile Field
Key points about maintaining a sterile field

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