Nursing Tips

Fundamentals (119)

Community Oriented Nursing is focused on health promotion and disease prevention in the community. No direct care for individuals!  Community Based Nursing is focused on illness care for individuals and families.

Community Nursing

Cathy Parkes RN, BSN, PHN, CWCN

Community Oriented Nursing is focused on health promotion and disease prevention in the community. No direct care for individuals! Community Based Nursing is focused on illness care for individuals and families.

1 comment

Community Nursing

Cathy Parkes RN, BSN, PHN, CWCN

Community Oriented Nursing is focused on health promotion and disease prevention in the community. No direct care for individuals! Community Based Nursing is focused on illness care for individuals and families.

1 comment
Best practices for telephone orders: Have second RN listen in on call. Repeat prescription back. Have provider sign prescription within 24 hr.

Telephone Orders

Cathy Parkes RN, BSN, PHN, CWCN

Best practices for telephone orders

Telephone Orders

Cathy Parkes RN, BSN, PHN, CWCN

Best practices for telephone orders

A patient is POSITIVE for orthostatic hypotension if: The SBP decreases more than 20mmHg when changing position AND/OR the DBP decreases more than 10mmHg

Orthostatic Hypotension

Cathy Parkes RN, BSN, PHN, CWCN

A patient is POSITIVE for orthostatic hypotension if: The SBP decreases more than 20mmHg when changing position AND/OR the DBP decreases more than 10mmHg

Orthostatic Hypotension

Cathy Parkes RN, BSN, PHN, CWCN

A patient is POSITIVE for orthostatic hypotension if: The SBP decreases more than 20mmHg when changing position AND/OR the DBP decreases more than 10mmHg

For enteral feeding tubes (Nasogastric tubes, G-tubes): Flush tubing with 15-30ml of water before, after, and in between medications

Enteral feeding tubes

Cathy Parkes RN, BSN, PHN, CWCN

For enteral feeding tubes, flush tubing with 15-30ml of water before, after, and in between medications

Enteral feeding tubes

Cathy Parkes RN, BSN, PHN, CWCN

For enteral feeding tubes, flush tubing with 15-30ml of water before, after, and in between medications

Triage for a Mass Casualty event: Class I (red tag): Immediate threat to life. Class II (yellow tag): Major injury. Class III (green tag): Minor injury. Class IV (black tag): Patient is expected, allowed to die.

Triage for a Mass Casualty event

Cathy Parkes RN, BSN, PHN, CWCN

Triage for a Mass Casualty event: Class I (red tag), Class II (yellow tag), Class III (green tag), Class IV (black tag)

Triage for a Mass Casualty event

Cathy Parkes RN, BSN, PHN, CWCN

Triage for a Mass Casualty event: Class I (red tag), Class II (yellow tag), Class III (green tag), Class IV (black tag)

Non-opiod analgesics are use to treat MILD to MODERATE pain. NSAIDs carry risk of GI bleeding, renal toxicity, and GI upset. Opioid analgesics are used to treat MODERATE to SEVERE pain. Monitor for respiratory depression. Naloxone is the antidote!

Opioid and Non-opioid Analgesics

Cathy Parkes RN, BSN, PHN, CWCN

Non-opiod analgesics are use to treat MILD to MODERATE pain. Opioid analgesics are used to treat MODERATE to SEVERE pain.

Opioid and Non-opioid Analgesics

Cathy Parkes RN, BSN, PHN, CWCN

Non-opiod analgesics are use to treat MILD to MODERATE pain. Opioid analgesics are used to treat MODERATE to SEVERE pain.

Key points about Therapeutic Communication: Avoid asking "Why...?" Ask OPEN ended questions. Ex: "Tell me more...." Do not offer your opinion, give false reassurance, or change the subject.

Therapeutic Communication Key Points

Cathy Parkes RN, BSN, PHN, CWCN

Key points about Therapeutic Communication: Avoid asking "Why...?" Ask OPEN ended questions. Don't offer opinion, give false reassurance, or change subject.

Therapeutic Communication Key Points

Cathy Parkes RN, BSN, PHN, CWCN

Key points about Therapeutic Communication: Avoid asking "Why...?" Ask OPEN ended questions. Don't offer opinion, give false reassurance, or change subject.

Who can give informed consent? An unimpaired adult (i.e. not under the influence of drugs/alcohol, not experiencing command hallucinations). Emancipated minor. Parent or legal guardian of a minor.

Giving Informed Consent

Cathy Parkes RN, BSN, PHN, CWCN

Who can give informed consent? An unimpaired adult (i.e. not under the influence of drugs/alcohol, not experiencing command hallucinations). Emancipated minor. Parent or legal guardian of a minor.

Giving Informed Consent

Cathy Parkes RN, BSN, PHN, CWCN

Who can give informed consent? An unimpaired adult (i.e. not under the influence of drugs/alcohol, not experiencing command hallucinations). Emancipated minor. Parent or legal guardian of a minor.

Hyperkolemia & Hypokolemia

Hyperkolemia & Hypokolemia

Cathy Parkes RN, BSN, PHN, CWCN

The MOST important side effect to know for BOTH hyperkalemia and hypokalemia is DYSRHYTHMIAS.

Hyperkolemia & Hypokolemia

Cathy Parkes RN, BSN, PHN, CWCN

The MOST important side effect to know for BOTH hyperkalemia and hypokalemia is DYSRHYTHMIAS.

Hospice Care

Hospice Care

Cathy Parkes RN, BSN, PHN, CWCN

Hospice care is focused on palliative care (i.e. symptom management), NOT on curing a disease.

Hospice Care

Cathy Parkes RN, BSN, PHN, CWCN

Hospice care is focused on palliative care (i.e. symptom management), NOT on curing a disease.

Types of Immunity

Types of Immunity

Cathy Parkes RN, BSN, PHN, CWCN

Types of immunity: Active natural: Body produces antibodies in response to exposure to a live pathogen. Active artificial: Body produces antibodies in response to a vaccine.  Passive natural: Antibodies are passed from the...

2 comments

Types of Immunity

Cathy Parkes RN, BSN, PHN, CWCN

Types of immunity: Active natural: Body produces antibodies in response to exposure to a live pathogen. Active artificial: Body produces antibodies in response to a vaccine.  Passive natural: Antibodies are passed from the...

2 comments
BP Cuffs

BP Cuffs

Cathy Parkes RN, BSN, PHN, CWCN

Blood pressure cuffs: If the cuff is too large, you will get a falsely low reading. If the cuff is too small, you will get a falsely high reading.

BP Cuffs

Cathy Parkes RN, BSN, PHN, CWCN

Blood pressure cuffs: If the cuff is too large, you will get a falsely low reading. If the cuff is too small, you will get a falsely high reading.

Apical Pulse

Apical Pulse

Cathy Parkes RN, BSN, PHN, CWCN

Apical pulse is taken at the fifth intercostal space at the left midclavicular line.

Apical Pulse

Cathy Parkes RN, BSN, PHN, CWCN

Apical pulse is taken at the fifth intercostal space at the left midclavicular line.

Left Shift in WBCs

Left Shift in WBCs

Cathy Parkes RN, BSN, PHN, CWCN

If labwork indicates there is a "Left Shift" in WBCs, this means that the body is fighting an infection and releasing many immature WBCs in response.

Left Shift in WBCs

Cathy Parkes RN, BSN, PHN, CWCN

If labwork indicates there is a "Left Shift" in WBCs, this means that the body is fighting an infection and releasing many immature WBCs in response.

Contact Precautions

Contact Precautions

Cathy Parkes RN, BSN, PHN, CWCN

Contact precautions require caregivers and visitors to wear a gown and gloves when going into the patient's room.

Contact Precautions

Cathy Parkes RN, BSN, PHN, CWCN

Contact precautions require caregivers and visitors to wear a gown and gloves when going into the patient's room.

Speech Language Pathologist

Speech Language Pathologist

Cathy Parkes RN, BSN, PHN, CWCN

The  Speech Language Pathologist is a key member of your interprofessional team. In addition to helping patients with speech and language issues, they evaluate and assist with SWALLOWING issues.

Speech Language Pathologist

Cathy Parkes RN, BSN, PHN, CWCN

The  Speech Language Pathologist is a key member of your interprofessional team. In addition to helping patients with speech and language issues, they evaluate and assist with SWALLOWING issues.

Discharge Planning

Discharge Planning

Cathy Parkes RN, BSN, PHN, CWCN

DISCHARGE planning for a patient starts at ADMISSION.

Discharge Planning

Cathy Parkes RN, BSN, PHN, CWCN

DISCHARGE planning for a patient starts at ADMISSION.

Try less invasive interventions first

Try less invasive interventions first

Cathy Parkes RN, BSN, PHN, CWCN

Always try LESS invasive interventions FIRST. Example: Move a patient at risk for falls to a room near the nursing station vs. placing restraints.

Try less invasive interventions first

Cathy Parkes RN, BSN, PHN, CWCN

Always try LESS invasive interventions FIRST. Example: Move a patient at risk for falls to a room near the nursing station vs. placing restraints.

Incident Reports

Incident Reports

Cathy Parkes RN, BSN, PHN, CWCN

Incident reports should NOT be part of the patient's chart, and incident reports should NOT be referenced in the patient's chart.

Incident Reports

Cathy Parkes RN, BSN, PHN, CWCN

Incident reports should NOT be part of the patient's chart, and incident reports should NOT be referenced in the patient's chart.

Preventing falls

Preventing falls

Cathy Parkes RN, BSN, PHN, CWCN

Preventing falls: Do not place all 4 bed rails UP for patient who try to get out of bed on their own.

Preventing falls

Cathy Parkes RN, BSN, PHN, CWCN

Preventing falls: Do not place all 4 bed rails UP for patient who try to get out of bed on their own.

Suspicion of Abuse

Suspicion of Abuse

Cathy Parkes RN, BSN, PHN, CWCN

Nurses are required to report suspicion of abuse.  You do not need to gather more information or provide proof.

Suspicion of Abuse

Cathy Parkes RN, BSN, PHN, CWCN

Nurses are required to report suspicion of abuse.  You do not need to gather more information or provide proof.

Informed Consent

Informed Consent

Cathy Parkes RN, BSN, PHN, CWCN

In order to give informed consent, a patient must be an unimpaired adult (ex: no drugs, alcohol, hallucinations) or an emancipated minor.

Informed Consent

Cathy Parkes RN, BSN, PHN, CWCN

In order to give informed consent, a patient must be an unimpaired adult (ex: no drugs, alcohol, hallucinations) or an emancipated minor.

Older adult home safety

Older adult home safety

Cathy Parkes RN, BSN, PHN, CWCN

When assessing HOME safety for older adults, it is important to remove scatter rugs!

Older adult home safety

Cathy Parkes RN, BSN, PHN, CWCN

When assessing HOME safety for older adults, it is important to remove scatter rugs!