WHAT IF YOUR PATIENT IS IN A COMA

It is important to be very careful what we say over the patient in a coma.
When some comatose patients(Sessions 3) finally awaken, they have been
known to repeat what they have been listening to.

For more helpful information on assessment and managemnt of the neurological patient,

just click on the link: STROKE SERIES -ASSESSMENT IN THE CLINICAL SETTING.

WHAT IF YOUR PATIENT IS IN A COMA

Hi all,

Hope you had a good week. Have you ever taken care of a patient in a coma ? Do you believe this patient has no idea what is going on? Think again. Patients can hear what you are saying.

I have had more than one experience where someone who has been in a coma has come back to relate all that has been said. So, CAREFUL WHAT YOU SAY AND WHERE YOU SAY IT.

Enjoy learning more about the Neurological Patient.

or watching the video :

http://www.dearnurses.com/clinical_nursing_videos_called_sessions

(Sessions 3)

WHAT IS A NEUROMUSCULAR BLOCKADE

A neuromuscular blockade includes such drugs as Pavulon, Vecuronium, Nimbex and Anectine.To learn more about the use of neuromuscular blockades, simply click on the link:
http://www.dearnurses.net/the_clinical_setting_step_by_step
and enjoy reading Adult Respiratory Distress syndrome, Chapter5.

WHAT IF YOUR PATIENT HAD AN NMB ORDER

Hi all,

Hope you had a good week.
Would you know what a Neuromuscular blockade (SESSIONS 13)
is used for, if your patient had it ordered?
Here are some helpful hints :
- Follow MD orders
Neuroblockades are paralysing agents. They are typically used in the Critical care setting or in OR. Patients who have traumatic injuries and require ventilatory support for lung problems such as ARDS may require NMB. When patients are put to sleep in the OR, NMBs are used. They cause paralysis of all the muscles in the body.
-They should NEVER be given without VENTILATORY SUPPORT.
- patients need monitoring if neuromuscular blockades are being used.
- SEDATION should always accompany the use of NMB drugs.
Patients who are given NMBs without sedation have related terrible experiences. Some felt like
they were buried alive.

For more updated information on this topisc, simply click on the link:

http://www.dearnurses.net/the_clinical_setting_step_by_step

and enjoy reading topics such as Adult Respiratory Distress Syndrome(Chapter5).

REST IS BEST FOR THE NEUROLOGICAL PATIENT

Updated 6/24

It has been suggested, after years of experience, that for the neurological patient, 
too much stimulation demands more oxygen and may result in secondary injury.

Pain medication and adequate rest make for better results. Enjoy watching the video:

Nursing communication

 

WHAT IS A BRAIN HEMORRHAGE?

Update 6/24

There are numerous reasons a brain hemorrhage may occur.
These include but are not confined to:
 - Stroke (hemorrhagic)
 - trauma

 and more.

Enjoy the video:

ICP monitoring

EPIDURAL BLEEDING

Updated 4/24

Dear nurses,

The Clinical Setting Step by Step is no longer available.

Please click on the link for more updated information:

Subarachnoid hemorrhage

Tim was on a ladder at work.He lost his balance and fell to the ground.

He has an EPIDURAL BLEED of the meningeal artery. He had a brief period

of consciousness, became lucid, then became lethargic.

For more updated and helpful information, click on the link:

STROKE SERIES ASSESSMENT IN THE CLINICAL SETTING OR

THE CLINICAL SETTING STEP BY STEP, CHAPTER 9.

WHAT IF PATIENT HAS A BLEED INTO THE BRAIN?

Signs of meningitis         

                                                       

                                                      Repair of an aneurysm

                                                        Overview of aneurysm

Updated 10/24

Dear nurses,

Dearnurses.com is no longer available. 

IF YOUR PATIENT HAS A BLEED, HERE ARE SOME HELPFUL HINTS:
- follow MD orders.
- closely monitor neuro status and document findings
- monitor for possible seizure activity.
- monitor vital signs and oxygen saturation. 
- medicate for pain and document results. Encourage patient to rest ,
  as this will decrease the need for lots of pain medication. Too much
  pain medication may mask any changes in neurological status.
- it is important to educate family members about the need for rest ,
   as this will decrease the need for too much pain medication.
  A decrease in stimulation, helps.

EPIDURAL OR SUBDURAL BLEEDING

Updated 4/24

Dear nurses.

The Clinical Setting Step by Step is no longer available.

Please click on the link :
Subarachnoid hemorrhage

for more updated information.

Epidural bleeding occurs above the dura mater, which is the outermost covering of the brain. As blood collects, a hematoma forms. Subdural bleeding occurs under the dura mater and blood collects, forming a hematoma.

FOR ADDITIONAL INFORMATION ON BRAIN INJURY, CLICK ON THE

LINKS: STROKE SERIES ASSESSMENT IN THE CLINICAL SETTING.AND

http://www.dearnurses.com/clinical_nursing_videos_(sessions 7)

EPIDURAL VS. SUBDURAL BLEED

                                                         Epidural vs. subdural bleed

Scenario 1: Tim was on a ladder at work.He lost his balance and fell to the ground.

He will later be diagnosed with an epidural bleed. 

Scenario 2 :Mrs. A has a history of alcohol ingestion in excess. She has been falling
a lot. She is now unconscious

Meningeal coverings and  Epidural vs. subdural bleed

Updated 6/24

An epidural bleed is an arterial bleed. The patient has a brief period of unconsciousness following injury. He then becomes lucid and quickly progresses to unconsciousness and possible coma. A common site for injury is the meningeal artery which runs close to the surface, behind the ear.

A subdural bleed is venous and progresses slowly. The patient may not experience any symptoms for a few days. It may even become chronic. Suspect a subdural bleed , if the patient had a fall / head injury and was initially okay, then later becomes unconscious. It is common in alcoholics.

E- COLI CASE

                                          E -Coli ( Eschereshia Coli )

Updated 7/24

Scenario: Mr. N ate at the local salad bar about 6 pm last evening.
Sad to say,he is awakened at 2 am, with severe abdominal cramps.
and a great desire to use the bathroom.

Mr. N had several bouts of diarrhea and is beginning to feel tired and
weak. He calls his doctor and is advised to go to the Emergeny Room. 
Mr. N would be diagnosed with E-Coli.

E-Coli is a strain of bacteria that lives in the bowel.
When it gets into food, gastrointestinal symptoms
like nausea, vomiting and diarrhea may develop.
Poor hygiene may cause this to happen. 

Also enjoy watching Sessions 38 and Sessions 61

WHAT IF YOUR PATIENT HAD E-COLI?

Hi guys,

Hope you had a good Easter. This last week in Orange County, California, there was an E-coli scare at a salad bar. There is still doubt how this all got started. Several customers reported food poisoning and I guess some hospitalization was involved. WHAT IF YOUR PATIENT IS ADMITTED WITH E- COLI , WOULD YOU KNOW WHAT IT REALLY MEANS?
E-coli is a type of bacteria that normally live in the intestines. If it gets into food, it can cause gastro-intestinal symptoms.Vomiting, diarrhea, weakness, dehydration from excessive fluid loss are signs and symptoms. If your patient has a diagnosis of E-coli infection , here are some helpful hints :
- follow MD orders.
- careful handwashing and disposal of linen etc. Avoid putting linens on the floor, especially if they are soiled.
- monitor and document the frequency of BMs , color and quantity.
- document quantity, color and frequency of emesis .
- monitor vital signs ; a drop in blood pressure and a rapid pulse are signs of dehydration.

For more helpful Clinical information , simply click on the link:

http://www.dearnurses.net/the_clinical_setting_step_by_step

and enjoy reading.

HAPPY EASTER TO ALL NURSES

MR.O IS TRANSFERRED TO ICU

For helpful information on EKG reading, simply click on the link:
http://www.dearnurses.com/ekg_series_-_what_is_wrong_with_this_ekg
and enjoy learning.

SEE BELOW FOR THE FOLLOW UP OF MR. O'S STATUS

MR. O HAS A BOUT OF V-TACH

To learn more about the patient in Ventricular Tachycardia, simply click on the link:http://www.dearnurses.com/ekg_series_-_what_is_wrong_with_this_ekg
and enjoy reading.

WHAT IF THIS IS DISPLAYED

Would you know what to do, if the monitor displayed the above rhythms? Ventricular Tachycardia and Ventricular Fibrillation are both rhythms that require immediate intervention. to learn more, simply click on the link:
http://www.dearnurses.com/ekg_series_-_what_is_wrong_with_this_ekg
and enjoy learning.

WHAT IF IT IS V-TACH OR V-FIB

Ventricular Tachycardia is a lethal rhythm.Quick action is necessary. To learn more about this topic and how to intervene, simply click on the link:
http://www.dearnurses.com/ekg_series_-_what_is_wrong_with_this_ekg
and enjoy learning.

UNDERSTANDING V-TACH

If the patient in your care develops Ventricular Tachycardia would you know what to do? To learn more about this and many more rhythms, simply click on the link:
http://www.dearnurses.com/ekg_series_-_what_is_wrong_with_this_ekg
and enjoy learning.

WHAT IF YOU SEE VENTRICULAR TACHYCARDIA

Updated 

Dear nurses,

                                                   

Dearnurses.com is no longer available.
                               For more updated information, please click on the link:
Chest pain and the EKG.

Ventricular tachycardia may or may not have a pulse. Ventricular fibrillation does not have a pulse. Both rhythms require immediate treatment.

IF YOU SHOULD BE FLOATED TO A MONITORED UNIT AND YOUR PATIENT DISPLAYS
ANY OF THE ABOVE RHYTHMS, DO NOT PANIC! TAKE QUICK ACTION.
HERE ARE SOME HELPFUL HINTS:
- Assess your patient at once
- if there is no response , press the code button and start CPR .

To learn more about this lethal rhythm, simply click on the links:

http://www.dearnurses.com/ekg_series_-_what_is_wrong_with_this_ekg

and

Clinical videos for nurses (Sessions 16-18).