HAVE A GOOD WEEK

                              Nurses are special!

Updated 5/25

How good are your communication skills?
Have you helped your coworker today?

Have a good week.

Enjoy watching the video:

The New Nurse - Communication Skills

The Nursing Process is described as having five steps.
Assessment, Diagnosis, Planning, Implementation and
Evaluation.

WHAT DO SAH AND MENINGITIS HAVE IN COMMON?

Updated 7/25

Meningitis is the inflammation of the meningeal 

coverings of the brain. Meningitis may be cause

 by a virus, bacteria, fungi, tumors or chemical
irritants.

Learn more by clicking on the link: 

Meningitis and quiz questions

Learn more about : ICP Monitoring

Learn more about : Stroke and ICP Monitoring

RECEPTIVE AND EXPRESSIVE APHASIA

Updated 1/25

Dear nurses,

Assessment in the Clinical Setting is no longer available.

Receptive aphasia - In the image above, Alice had
a stroke which involved Wernicke's area. She has 
difficulty understanding when spoken to.Wernicke's
area is responsible for speech comprehension.

Expressive aphasia - Martha had a stroke that
involved Broca's area. She knows what she
wishes to say, but has difficulty expressing
herself. She gets frustrated and cries a lot.
This is sometimes described as " confused",
is not the case

For additional updated information on this topic visit:

Stroke assessment and brain involvement

or watch the video:

Sessions 65 - Stroke or no Stroke

The largest of the cranial nerves, is the Trigeminal.
                 This nerve contains three branches:
                Opthalmic ( corneal blink reflex). 
                           Maxillary - which supplies the upper jaw

                   Mandibular - controls the lower jaw.

Cranial nerve 7 - is the facial nerve , this is

checked with the trigeminal nerve.

Learning for the layperson

BRAIN TEASERS FOR NURSES AND MORE

Updated 9 /25

Dear nurses,

Stroke Series is no longer available.

See below for new information.

Here are some brain teasers:

Q -What is the normal distance for testing visual acuity?

A- 14-20 feet away.

Q - What does stereognosis mean?

A- The ability to identify objects by touching.

Q - What part of the brain is responsible for blance
and coordination?

A- The cerebellum, which lies below the cerebrum.

Q- What does word salad mean?
A- A collection of words that have no real meaning.

Q- What is anisocoria?

A- Unequal pupils which occur in about 20% of the 
population.

Learn more about: Why Therapy and The Aging Process

Please watch the video:  Sessions 62-
Medical terminology in the Clinical Setting.
 Topics include:
- DKA ( Diabetic Ketoacidosis )
- Hypothermia in the postoperative patient
- Malignant Hyperthermia its causes and treatment
So, just click on the link:
Medical terminology in the Clinical setting
and enjoy learning!

Learn more about : Stroke prevention

MAY GOD BLESS YOU NURSES, ENJOY LEARNING MORE!

Updated 6/25

Dear nurses,

New topics have been added below. Enjoy learning!

Here are some diagnostic tests that are done frequently.

Follow the links below:

1. Chest X ray
2. CAT scan
3. EKG
4. MRI scan
5. Ultrasound
6. Echocardiogram

      Be cautious, prevent falls!

    Learn more about: Organizational skills

HYPOTHERMIA IN THE PACU PATIENT

                           

                                             

 In the image above, a patient has just arrived
 in the PACU. The core temperature is 95
 degrees Fahrenheit. Warm blankets or a Bair
 Hugger may be used.

Defining Hypothermia
Hypothermia is defined as a drop in core temperature
of less than 95 Fahrenheit(35 Celsius). Regardless of
the cause, it is considered to be life - threatening. 

Hypothermia increases the body's demand for oxygen. 
If left untreated, it may lead to a myocardial infarction

 (heart attack). 

Trauma Care - Part 1 is no longer available
                             

Trauma resulting in excessive blood loss,

     as well as alcohol ingestion, may also         
lead to hypothermia.Symptoms include:
shivering, blue lips, decrease in level

of consciousness and cold extremities. IV
fluids may have to be warmed. 

                                           

ANTICOAGULATION THERAPY IN THE PACU

Updated 9/25

In the image above, a patient has just arrived
in PACU, following surgical intervention on
her spine. She is also receiving Anticoagulation
 therapy for a past history of Atrial fibrillation.

The patient on Anticoagulation therapy is at risk
for bleeding. This should be reflected in the plan
of care.

Enjoy the video: Anticoagulation therapy

Learn more about : The Nursing Process

Reperfusion Therapy is a form of treatment used
for patients who have a myocardial infarction with 
STEMI ( ST segment elevation myocardial infarction).
See above image for an example of STEMI.

STEMI 

Typically, the patient with a completely blocked
coronary artery, would demonstrate STEMI on 
the EKG. Death of the heart muscle caused by a
blood clot, would obstruct blood flow and cause
lack of oxygen. 

Severe chest pain, shortness of breath and possible
fainting may occur. Quick intervention would be
necessary to prevent further damage. 

TPA

TPA ( Thrombolytic Plasminogen Activator) is
a " clot buster" that is used in the treatment of 
embolic stroke and myocardial infarction with
STEMI. 

TPA  is not without its side effects. Bleeding, 

particularly into the brain and at injection sites,
 seizures and possible anaphylaxis may occur.

Labetolol , an antihypertensive may be ordered.
ICP monitoring may also be ordered by the doctor.

Diabetic Retinopathy

 This condition affects the blood vessels in the eye.
 Poor vision and possible blindness may result from
 leaking and weakening of the blood vessels.

The consequences of poor circulation

The patient who has heart failure,
is also at risk for stroke or renal failure.
The diabetetic patient is also at risk for stroke.

AIRWAY MANAGEMENT OF THE PACU PATIENT

When a patient arrives in PACU, airway management
should not be ignored. Conditions such as hypoxia may result. 

Patients who have a prior history of respiratory problems, may
not be extubated following surgery. They may require ventilatory
support. An ABG may be ordered by the doctor, to evaluate any
hypoxia.

See the above image for more helpful information.

Scenario: The patient above, was in respiratory distress
and placed  on mechanical ventilation. It is difficult
for the patient on a ventilator to describe pain. Knowing
how to assess is very important.

This topic , including quiz questions continue here:

Mechanical ventilation

HAVE A GOOD WEEK AND ENJOY LEARNING

Updated 6/25 Dear nurses,

It is always a pleasure to serve you. New topics 
have been added below.

Every new nurse has to start from somewhere, in 
the clinical setting. Sometimes a new nurse may be
off to a rough start, if the Preceptor is not willing
to help.

There are ways to prepare yourself, should such
an occasion arise. 
Learn more about: The Nurse's Critical Thinking

Learn more about: The Triage Nurse

Above, two nurses are transporting a patient to the ER.
Learn more about : X-Ray and pulse oximeter

BRAIN STEM FUNCTION

 Updated 2/24

Dear nurses,

The Clinical Setting Step by Step is no longer available. Please

click on the link : Cranial nerves

for more updated information.

When the neurological assessment is done, do you fully understand what part of the brain is involved and what to look for? For more helpful information on brain stem function, please go to

THE CLINICAL SETTING STEP BY STEP (Chapter 9 )and enjoy learning.

EPIDURAL VS. SUBDURAL BLEEDING AND HEMATOMA

Updated 1/25

Dear nurses,

The Clinical Setting Step by Step is no longer available.

Epidural vs. subdural bleed

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 ( hematoma) 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.

                      Learn more about:  Subarachnoid hemorrhage

PAIN MANAGEMENT

Updated 6/25

Dear nurses, 

It is important to remember that pain assessment,
should not be overlooked. Always follow MD orders

for pain management.

Documentation of pain relief is also necessary.

Chest pain is a very common complaint. It may
occur anywhere and anytime, even at rest.
Learn more about : Chest pain

The Numerical Pain Scale is a useful tool when
assessing pain. It is based on a scale of 0-10.
A ladder starts from the ground and escalates to|
the highest point, so does pain start from 0-10.

It is important to do a pain assessment after pain
medication has been given. See image for more
information.

HAVE A GOOD WEEK AND ENJOY LEARNING

Updated 6/25
Dear nurses,

It is always a pleasure to serve you. 
New topics have been added below.

Have a good week!

Please watch the video: Bowel obstruction

Here are some diagnostic tests that are done frequently.
Follow the links below:

1. Chest X ray
2. CAT scan
3. EKG
4. MRI scan
5. Ultrasound
6. Echocardiogram

THE POSTOPERATIVE PATIENT AND PACU

Updated 6/25

                                               

PACU ( Post Anesthesia Care Unit)

Following surgical intervention, a patient is transferred
to an area known as PACU. . Upon arrival, a nurse will
 reorient the patient to his surroundings and do an
 assessment. 

The nurse will also follow MD orders regarding: 

- monitoring vital signs and oxygen saturation,

- administer pain medication, replace IV fluids,

- check dressings at surgical sites for bleeding 

- check drainage tubes and carry out any other

  instructions.

What is an ileus?

 An ileus may develop in the postoperative patient,

 following abdominal surgery. It may also occur from
the use of narcotics.

The warning signs include: abdominal pain, distention
and absent bowel sounds.

Learn more about:

Medical terminology in the Clinical setting

Topics include:

- DKA ( Diabetic Ketoacidosis )
- Hypothermia in the postoperative patient
- Malignant Hyperthermia its causes and treatment