Nursing Tips (579)

Physical Assessment Order

Physical Assessment Order

Cathy Parkes

Order of physical assessment: Inspect, palpate, percuss, auscultate. EXCEPT for assessing the abdomen: Inspect, auscultate, percuss, palpate (to avoid altering bowel sounds).

1 comment

Physical Assessment Order

Cathy Parkes

Order of physical assessment: Inspect, palpate, percuss, auscultate. EXCEPT for assessing the abdomen: Inspect, auscultate, percuss, palpate (to avoid altering bowel sounds).

1 comment
Contrast Dye

Contrast Dye

Cathy Parkes

Any time your patient needs to have a procedure that uses contrast dye (ex: angiogram, CT/MRI with contrast, hysterosalpingography), be sure to check for an allergy to shellfish and iodine...

Contrast Dye

Cathy Parkes

Any time your patient needs to have a procedure that uses contrast dye (ex: angiogram, CT/MRI with contrast, hysterosalpingography), be sure to check for an allergy to shellfish and iodine...

Sildenafil

Sildenafil

Cathy Parkes

Sildenafil is used to treat erectile dysfunction. If you use sildenafil it will help you fill out "down there".

Sildenafil

Cathy Parkes

Sildenafil is used to treat erectile dysfunction. If you use sildenafil it will help you fill out "down there".

Left Shift in WBCs

Left Shift in WBCs

Cathy Parkes

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

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.

Guaifenesin

Guaifenesin

Cathy Parkes

Guaifenesin is an expectorant. "Gauif" sounds like "Cough". It reduces the viscosity of secretions, making coughs more productive.

Guaifenesin

Cathy Parkes

Guaifenesin is an expectorant. "Gauif" sounds like "Cough". It reduces the viscosity of secretions, making coughs more productive.

Turbutaline Sulfate

Terbutaline Sulfate

Cathy Parkes

Terbutaline sulfate is a medication used to treat pre-term labor. HINT: Terbutaline looks like turbulence, and when flying, turbulence delays arrival time.

Terbutaline Sulfate

Cathy Parkes

Terbutaline sulfate is a medication used to treat pre-term labor. HINT: Terbutaline looks like turbulence, and when flying, turbulence delays arrival time.

Key Patient Teaching: IUDs

Key Patient Teaching: IUDs

Cathy Parkes

Key patient teaching with IUDs: Report foul smelling discharge, change in IUD string length, fever/chills, or pain with intercourse!

Key Patient Teaching: IUDs

Cathy Parkes

Key patient teaching with IUDs: Report foul smelling discharge, change in IUD string length, fever/chills, or pain with intercourse!

Ondansetron

Ondansetron

Cathy Parkes

Ondansetron is an antiemetic (used to prevent nausea and vomiting). Hint: "I threw up on DAN. Better get me some ondansetron."

Ondansetron

Cathy Parkes

Ondansetron is an antiemetic (used to prevent nausea and vomiting). Hint: "I threw up on DAN. Better get me some ondansetron."

Contact Precautions

Contact Precautions

Cathy Parkes

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

Contact Precautions

Cathy Parkes

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

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

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.

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...

Misoprostol and Pregnancy

Misoprostol and Pregnancy

Cathy Parkes

Misoprostol can be used to prevent gastric ulcers in patients taking NSAIDs. Do NOT administer to a patient who might be pregnant (because it can cause a miscarriage). HINT: "Me...

Misoprostol and Pregnancy

Cathy Parkes

Misoprostol can be used to prevent gastric ulcers in patients taking NSAIDs. Do NOT administer to a patient who might be pregnant (because it can cause a miscarriage). HINT: "Me...

Discharge Planning

Discharge Planning

Cathy Parkes

DISCHARGE planning for a patient starts at ADMISSION.

Discharge Planning

Cathy Parkes

DISCHARGE planning for a patient starts at ADMISSION.

Histamine 2 Receptor Antagonists and DINE-ing

Histamine 2 Receptor Antagonists and DINE-ing

Cathy Parkes

Histamine 2 receptor antagonists (ex: ranitidine and famotidine) are used to treat ulcers and GERD. These meds will help you feel better when you "dine".

Histamine 2 Receptor Antagonists and DINE-ing

Cathy Parkes

Histamine 2 receptor antagonists (ex: ranitidine and famotidine) are used to treat ulcers and GERD. These meds will help you feel better when you "dine".

Try less invasive interventions first

Try less invasive interventions first

Cathy Parkes

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

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

Prioritizing Typical Diagnoses

Prioritizing Typical Diagnoses

Cathy Parkes

Patients with EXPECTED findings for their diagnosis are typically NOT the priority. Examples: COPD patient with spO2 of 90% Stroke patient with facial drooping MS patient with ataxia

Prioritizing Typical Diagnoses

Cathy Parkes

Patients with EXPECTED findings for their diagnosis are typically NOT the priority. Examples: COPD patient with spO2 of 90% Stroke patient with facial drooping MS patient with ataxia

Assess before action

Assess before action

Cathy Parkes

Always ASSESS before taking ACTION. Ex: If a patient has dyspnea, check their O2 saturation and listen to breath sounds BEFORE notifying the provider.

Assess before action

Cathy Parkes

Always ASSESS before taking ACTION. Ex: If a patient has dyspnea, check their O2 saturation and listen to breath sounds BEFORE notifying the provider.

Incident Reports

Incident Reports

Cathy Parkes

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

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

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

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

Home safety interventions for Alzheimer's patients

Home safety interventions for Alzheimer's patients

Cathy Parkes

KEY home safety interventions for Alzheimer's patients: NO scatter rugs, do have door locks, mark step edges with colored tape, place the mattress on the floor.

Home safety interventions for Alzheimer's patients

Cathy Parkes

KEY home safety interventions for Alzheimer's patients: NO scatter rugs, do have door locks, mark step edges with colored tape, place the mattress on the floor.

Priority for Patients with Depression

Priority for Patients with Depression

Cathy Parkes

If a patient has depression, your PRIORITY is to assess the patient's risk of suicide and implement 1:1 observation if indicated.

Priority for Patients with Depression

Cathy Parkes

If a patient has depression, your PRIORITY is to assess the patient's risk of suicide and implement 1:1 observation if indicated.

Signs/Symptoms of PTSD

Signs and Symptoms of PTSD

Cathy Parkes

Signs/Symptoms of PTSD: flashbacks, distressing dreams, difficulty concentrating, insomnia, anxiety, irritability, detachment from others, hyper-vigilance, exaggerated startle response, feeling of guilt, and negative self-image.

Signs and Symptoms of PTSD

Cathy Parkes

Signs/Symptoms of PTSD: flashbacks, distressing dreams, difficulty concentrating, insomnia, anxiety, irritability, detachment from others, hyper-vigilance, exaggerated startle response, feeling of guilt, and negative self-image.

Transference vs. Countertransference:  Transference: Patient views nurse as being similar to an important person in his/her life.  Countertransference: Patient reminds the nurse of someone in his/her life.

Transference vs. Countertransference

Cathy Parkes

Transference vs. Countertransference: Transference: Patient views nurse as being similar to an important person in his/her life. Countertransference: Patient reminds the nurse of someone in his/her life.

Transference vs. Countertransference

Cathy Parkes

Transference vs. Countertransference: Transference: Patient views nurse as being similar to an important person in his/her life. Countertransference: Patient reminds the nurse of someone in his/her life.

Suspicion of Abuse

Suspicion of Abuse

Cathy Parkes

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

Suspicion of Abuse

Cathy Parkes

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

Oral Iron Supplements

Oral Iron Supplements

Cathy Parkes

Oral iron supplements can cause teeth staining!  Administer with a straw.

Oral Iron Supplements

Cathy Parkes

Oral iron supplements can cause teeth staining!  Administer with a straw.

Hemolysis

Hemolysis

Cathy Parkes

If an Rh-negative person receives Rh-positive blood, it will cause hemolysis—destruction of RBCs (red blood cells)!

Hemolysis

Cathy Parkes

If an Rh-negative person receives Rh-positive blood, it will cause hemolysis—destruction of RBCs (red blood cells)!

What blood type can receive what blood type?

What blood type can receive what blood type?

Cathy Parkes

Know what types each blood type can receive: Type O: Can receive O Type A: Can receive A and O Type B: Can receive B and O Type AB: Can receive  A, B,...

What blood type can receive what blood type?

Cathy Parkes

Know what types each blood type can receive: Type O: Can receive O Type A: Can receive A and O Type B: Can receive B and O Type AB: Can receive  A, B,...

Administering misoprostol

Administering misoprostol

Cathy Parkes

When administering a misoprostol (for prevention of gastric ulcers) to a person of child-bearing age, be sure to run a PREGNANCY test first as this medication can cause a miscarriage!

Administering misoprostol

Cathy Parkes

When administering a misoprostol (for prevention of gastric ulcers) to a person of child-bearing age, be sure to run a PREGNANCY test first as this medication can cause a miscarriage!

Know your antidotes for anticoagulants

Know your antidotes for anticoagulants

Cathy Parkes

Know your antidotes for anticoagulants: Vitamin K for warfarin, Protamine for Heparin.

Know your antidotes for anticoagulants

Cathy Parkes

Know your antidotes for anticoagulants: Vitamin K for warfarin, Protamine for Heparin.

Therapeutic INR for patients receiving warfarin

Therapeutic INR for patients receiving warfarin

Cathy Parkes

Therapeutic INR is 2-3 for patients receiving warfarin.

Therapeutic INR for patients receiving warfarin

Cathy Parkes

Therapeutic INR is 2-3 for patients receiving warfarin.

Therapeutic aPTT for patients receiving Heparin

Therapeutic aPTT for patients receiving Heparin

Cathy Parkes

Therapeutic aPTT is 1.5-2 times baseline (baseline = 30-40 sec) for patients receiving Heparin.

Therapeutic aPTT for patients receiving Heparin

Cathy Parkes

Therapeutic aPTT is 1.5-2 times baseline (baseline = 30-40 sec) for patients receiving Heparin.

Major Risk Factor for Rheumatic Fever

Major Risk Factor for Rheumatic Fever

Cathy Parkes

Major risk factor for rheumatic fever: untreated or partially treated upper respiratory infection with Group A beta-hemolytic streptococcus (GABHS).

Major Risk Factor for Rheumatic Fever

Cathy Parkes

Major risk factor for rheumatic fever: untreated or partially treated upper respiratory infection with Group A beta-hemolytic streptococcus (GABHS).

What to Do if You Suspect Epiglottitis

What to Do if You Suspect Epiglottitis

Cathy Parkes

If you suspect that a patient has epiglottitis, DO NOT take a throat culture or place a tongue blade in the patient's mouth!

What to Do if You Suspect Epiglottitis

Cathy Parkes

If you suspect that a patient has epiglottitis, DO NOT take a throat culture or place a tongue blade in the patient's mouth!

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.

Meds that Promote Alcohol Abstinence

Meds that Promote Alcohol Abstinence

Cathy Parkes

Meds that promote alcohol abstinence: disulfiram, naltrexone, acamprosate. These meds are NOT used during alcohol withdrawal!

Meds that Promote Alcohol Abstinence

Cathy Parkes

Meds that promote alcohol abstinence: disulfiram, naltrexone, acamprosate. These meds are NOT used during alcohol withdrawal!

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.

Informed Consent

Informed Consent

Cathy Parkes

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

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

Signs of abuse in children

Signs of abuse in children

Cathy Parkes

Signs of abuse in children: bruising in unusual locations (bruising on arms/legs expected!), bruising in different stages of healing, forearm spiral fractures.

Signs of abuse in children

Cathy Parkes

Signs of abuse in children: bruising in unusual locations (bruising on arms/legs expected!), bruising in different stages of healing, forearm spiral fractures.

Patients in a crisis

Patients in a crisis

Cathy Parkes

When assisting a patient with a crisis, be sure to ask him/her about past ways of coping.

Patients in a crisis

Cathy Parkes

When assisting a patient with a crisis, be sure to ask him/her about past ways of coping.

Electro convulsive therapy

Electro convulsive therapy

Cathy Parkes

Short-term memory loss is EXPECTED after electroconvulsive therapy.

Electro convulsive therapy

Cathy Parkes

Short-term memory loss is EXPECTED after electroconvulsive therapy.

Older adult home safety

Older adult home safety

Cathy Parkes

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

Older adult home safety

Cathy Parkes

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

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.

Bone loss and aging

Bone loss and aging

Cathy Parkes

Bone loss begins at 35 years old. In order to prevent osteoporosis, individuals should engage in weight-bearing exercises. FYI - swimming is NOT weight-bearing.

Bone loss and aging

Cathy Parkes

Bone loss begins at 35 years old. In order to prevent osteoporosis, individuals should engage in weight-bearing exercises. FYI - swimming is NOT weight-bearing.

Choking hazard foods

Choking hazard foods

Cathy Parkes

The following foods pose a choking hazard for small children: popcorn, raisins, peanuts, grapes, raw carrots, hotdogs, celery, peanut butter, candy, tough meat.

Choking hazard foods

Cathy Parkes

The following foods pose a choking hazard for small children: popcorn, raisins, peanuts, grapes, raw carrots, hotdogs, celery, peanut butter, candy, tough meat.

BMI ranges to learn

BMI ranges to learn

Cathy Parkes

Know your BMI ranges: <18.5 = underweight, 18.5-24.9 = healthy, 25-29.9 = overweight, 30 or more = obese.

BMI ranges to learn

Cathy Parkes

Know your BMI ranges: <18.5 = underweight, 18.5-24.9 = healthy, 25-29.9 = overweight, 30 or more = obese.

Albumin and prealbumin

Albumin and prealbumin

Cathy Parkes

When evaluating a patient's nutritional status, be sure to check: albumin (normal range: 3.5-5) and prealbumin levels (normal range 15-36).

Albumin and prealbumin

Cathy Parkes

When evaluating a patient's nutritional status, be sure to check: albumin (normal range: 3.5-5) and prealbumin levels (normal range 15-36).

Folic acid and pregnancy

Folic acid and pregnancy

Cathy Parkes

Folic acid is SUPER important during pregnancy because it helps to prevent neural tube defects.

Folic acid and pregnancy

Cathy Parkes

Folic acid is SUPER important during pregnancy because it helps to prevent neural tube defects.