EMERGENCY SITUATION FOR NURSES

Updated 5/25

A nurse who works in the ER can appreciate,
there are countless ways that an emergency
may occur. A patient who has a car accident
may be admitted for a pneumothorax, or a
patient may be admitted for a  heart attack,
stroke and more.

The clinical scenario above demonstrates
the situation of a new nurse.
She is assigned to the ER and is really
scared. She does not know how to get organized.

** A word of caution. Nursing is a wonderful 
profession. Taking care of the sick and helping
 them to get well, is a great accomplishment.
Perfecting good clinical judgement and
performance, cannot be  accomplished
 by high scores only. 

Scenario: A teenager in the ICU has been
declared brain dead after a gunshot wound. 
An angry family stands outside.

How should a nurse deal with this situation?

A nurse should use good communication skills 
to decrease the anxiety the family is feeling.
A compassionate nurse uses good communication
and tact to win them over.

                 

              
Aortic rupture may occur as a result of trauma.
Shortness of breath, chest or upper back pain
are some of the symptoms.

Cardiac Tamponade may be caused by penetrating 
trauma such as a knife wound. Pericardiocentesis
is usually done to remove the blood in the pericardial
sac. Learn more, by clicking on the links below:
 Nursing Fundamentals-Part3

The Circulatory System


The heart is always at work. Hemodynamics
refers to blood flow. Any obstruction to the
flow of blood in and around the heart, may
lead to failure.

Learn more about: Cardiac assessment, by

clicking on the link below.

Sessions 42 - Clinical scenarios in review  

Dear nurses,

It is important to recognize the importance 
of being a safe nurse. Linda's story continues :

Here 

EMERGENCY FOR NURSES

Updated 7/24

Dear nurses,

This has been a very sad week for many who had to be
 evacuated and lost their homes, due to fires in Southern
California, USA. My prayers go out to all who were involved
in one way or another.

Have you ever been in an emergency situation?
Have you ever been unable to get home and take
 care of your daily responsibilities? 

Whether the answer is yes or no, here are some helpful pointers:-
- try to keep an extra change of clothes and toiletries in your car,

  for emergency use.
- have a contact number to reach someone who can pick up your 

   kids etc. if you are unable to do so.
- keep some non-perishable foods in your car , so you can have 

  something to eat in an emergency.
- if there is a co-worker who has had a tragic lost, try to share 

  your love and maybe pick up a collection to help out. 

  Have a great week!
  For more clinical information, click on the link:
 Emergency Room 

It takes "all hands on deck" to complete the work.

It is important to recognize that classroom skills
are different from clinical skills. A nurse's
performance in the work place takes on a different 
challenge from the classroom.

Learn more about: Hemodynamic Monitoring and

Cardiac Assessment.

An intravenous infusion may be started in a peripheral
site or a central line site.

Learn more by clicking on the link:
IV assessment

Trauma can sometimes be prevented!

CRANIAL NERVE ASSESSMENT

CRANIAL NERVE -3, THE OCULOMOTOR NERVE is responsible for constriction of the pupils.

Damage to this nerve may occur after trauma or surgical intervention.

For more helpful information on this topic, just click on the link:
STROKE SERIES -ASSESSMENT IN THE CLINICAL SETTING.

ADDRESSING CRANIAL NERVE ASSESSMENT

 Updated 3/24

 

Dear nurses,

New information is  available regarding cranial
nerves and stroke assessment.
Please click on the links below:

Cranial nerves
Stroke assessment

Learn more about : Neurological assessment

Learn more about: Medical abbreviations - Part 2

            
Aortic rupture may occur as a result of trauma.
Shortness of breath, chest or upper back pain
are some of the symptoms.

Cardiac Tamponade may be caused by penetrating 
trauma such as a knife wound. Pericardiocentesis
is usually done to remove the blood in the pericardial
sac. Learn more, by clicking on the link below:
 The Circulatory System

                                                     

UNDERSTANDING THE CRANIAL NERVES

Updated 6/24

Dear nurses,

There are twelve pairs of cranial nerves. Patients who have

brain injuries or surgical intervention , may need to have the

cranial nerves checked.To learn more, simply click on the
link : Cranial nerves

and enjoy learning.

SIMPLIFYING THE CRANIAL NERVES

Updated 1/26

Dear nurses,

Dearnurses.com is no longer available. 

It is important to recognize that, following 
a stroke or traumatic brain injury, a patient
may have damage to the cranial nerves.

Below, the cranial nerves are listed.

Additional topics of interest are also 
addressed.

.

                                 THE CRANIAL NERVES

Learn more about : Stroke Assessment 

Learn more about : Sepsis

Learn more about: Basal skull fracture

IDENTIFYING CRANIAL NERVES

                                               Cranial nerves

Dear nurses,

Updated 10 /25

Updated information can be accessed 
by clicking on the links below.

Dearnurses.net is no longer available.

Learn more about: Stroke assessment

Stroke for the layperson

Learn more about: ICP Monitoring

Learn more about : Nursing communication

HYDROCHLORIC ACID IN DIGESTION

Every nurse at some time or another is put in the position of taking care of a patient with an order for NPO or NG tube insertion. When ordered by the doctor, the stomach is kept empty

for example before surgical procedures or after trauma.

If a Nasogastic tube is inserted, instructions are usually given by the MD to put NG to suction to remove excess gastric contents. There are cases when suction is not ordered. Hydrochloric acid is present in gastric contents. Above is an overview.

Enjoy reading more about the Clinical Setting.

and watch  SESSIONS 14   - ENTERAL AND PARENTERAL FEEDING

BROWN SEQUARD SYNDROME

Updated 6/25

   Brown Sequard syndrome is a rare condition.
   Penetrating wounds like stab wound to the back
   or neck, a tumor which may obstruct blood flow,
   to the spine, may cause this condition.

  Hemisection of the spinal cord results in loss of
  motor control on one side and loss of sensation
  like temperature, on the other side.

    Learn more: Spinal injury

In the above image, examples of how brain injuries
can occur are shown. Click on the links:
ICP monitoring

Stroke and ICP

for more information.

DERMATOMES IN SPINAL INJURY

Updated  6/25

Dear nurses,

Dermatomes is done to check the sensation of the patient 

post spinal injury.

Please click on the link for more updated version:

Defining dermatomes

Dearnurses.com is no longer available. Abdominal Aortic Aneutysm may result

from hypertension. A stroke may also result from hypertension.

Assessment of these nerves is shown in the image above.

Learn more about : Cranial nerves

THE NURSE'S ROLE IN TH CLINICAL SETTING

The Clinical Setting step by step is no longer available.

Updated 8/23

Dear nurses,

Have you ever considered the s role the nurse plays in the clinical setting?
Do you have the knowledge base to handle challenging situations? 

Just click on the links:

Cardiogenic shock

Clinical videos

Enjoy learning!

THE NURSE'S ROLE IN THE CLINICAL SETTING

The Clinical Setting Step by Step is no longer available.

Updated 11/25

Dear nurses,

Have you ever considered the important role a
nurse has to play in the Clinical Setting? Many
hours are spent at the bedside. 

Having a good knowledge base in order to do
an effective job, is of paramount importance.
If you wish to improve your knowledge base, 

enjoy the topics and links below.

Learn more about: Organizational skills in the clinical setting

Learn more about : Nursing communication

Learn more about : Critical thinking

RECOGNIZING ANASARCA IN THE CLINICAL SETTING

Dear nurses,

Updated 3/24

The Clinical Setting Step by Step is no longer 
available. 

Anasarca (generalised edema)may have numerous causes. 
Low albumin (hypoalbuminemia), burns, heart problems, 

kidney and liver failure are some of the causes. 

Serous fluid seeps into the tissues and accumulates. 

There is usually an increase in the patient's weight.
The edema may be pitting or non-pitting. In pitting edema,
 if the finger is pressed into the skin, a depression is left. 

The stretching of the skin, results in skin breakdown.

Learn more about Hepatic encephalopathy

ANASARCA CAUSES AND TREATMENT

Updated 10/25

Anasarca and its causes

Anasarca, which is also known as generalised edema, may
be caused by a number of conditions. These include:

- Heart, renal or liver failure

- Low albumin (hypoalbuminemia), burns

- Corticosteroids and more

This topic, including quiz questions, continues here:

Anasarca 

Learn more about : Organ failure and transplantation

In the above image, Mrs. had surgical intervention for a hip
fracture. She will be confined to bed for some time. Preventing 
pneumonia, DVT and skin breakdown will be included in
the plan of care.

Physical therapy will also be ordered by the doctor.

ANASARCA CAUSES AND TREATMENT

Anasarca and its causes

Anasarca, which is also known as generalised edema, may
be caused by a number of conditions. These include:

- Heart, renal or liver failure

- Low albumin (hypoalbuminemia), burns

- Corticosteroids and more

This topic, including quiz questions, continues here:

Anasarca 

Learn more about : Organ failure and transplantation
and Hepatic encephalopathy

Updated 3/25

HELPFUL INFORMATION ABOUT INTRAVENOUS INFILTRATION

Updated 10 /25

IV therapy is commonly used in the clinical setting.
It is very important to assess and document the condition
of the IV site. 

Helpful hint: If the patient who is in your care, complains
of pain or sensitivity at the IV site, immediate steps should
be taken to carefully examine the site. 

There are drugs such as, Dilantin, Dopamine and Potassium 
that may damage the soft tissue around the IV site, if there
is an infiltration.

Learn more about: IV assessment and quiz

and The New nurse - blood transfusion

Learn more about : Neurological assessment

Learn more about: Medical abbreviations - Part 2

                                                     

Learn more about : Critical thinking

Learn more about: Triage

 

ATRIAL FIBRILLATION ( CASE STUDY )

Updated 1/26  

Dear nurses, 

For updated information, please click on the link:

Atrial fibrillation, an overview        

Clinical scenarios are a normal part of nursing.

Above there are five clinical scenarios unfolding.

Scenario 1- A patient who is admittCed to a healthcare

facility and will need teaching. Click on the link:

ER experience for the layperson

Scenario 2- The patient on mechanical ventilation
and the nurse is unsure what to do.Click on the link:

  The patient on mechanical ventilation

Scenario 3 -A patient has arrived in the Emergency
Room, both the doctor and nurse are at the bedside
to do an assessment. Learn more by clicking on the link:

An ER experience
 

Scenario 4 - A nurse does an assessment. Click on the links:

IV assessment
An arterial line

Scenario 5 - A nurse tries to encourage a patient to
do breathing exercises. Click on the link:

Care planning

   The Nursing Process