DIABETIC TEACHING FOR NURSES AND PATIENT

Dear nurses,

Are you still very new to managing the diabetic patient? The Clinical Setting Step by Step

(Chapter 12), is packed with helpful information. This chapter is coming soon. In the meantime, if the diabetic patient in your care needs teaching, UNDERSTANDING DIABETES FOR THE LAYPERSON may be helpful. Just click on the link: http://www.dearnurses.com/diabetes_for_the_lay_person.
Also enjoy our video on: Healthy Living.

BRAIN TEASER FOR NURSES

Updated 3/26

Dear nurses,

Can you identify the six food items in this picture? 

Have a fun time searching!

New topics have been added below.

Common causes of medication errors

Learn more about : Nursing communication

Learn more about: ICP MONITORING for the layperson

Dear nurses,

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

Here 

 

RED ALERT

Updated 6/25

Dear nurses,

It is always a pleasure to be of service to you. I strive
to do the best job that I can, providing information
as accurately as possible. It is still the responsibility

of every nurse to follow MD orders and the institution's
 policies and procedures.

          Learn more about: Your Critical Thinking

NURSES, IMPROVE YOUR EKG LEARNING CURVE!

Dearnurses.net is no longer available. See below for update.

Updated 1/25                  

Dear nurses,

            The EKG

The SA (Sinoatrial node) is the pacemaker of 
the heart. It is located in the right atrium.This
can best be described as a light switch being
turned on. To learn more, please click on the link:

The EKG and Quiz

Scenarios: There are two scenarios above:

1) Jeanne has a healthy heart and has no problem
walking the treadmill.

2) Sam is having severe chest pain, with radiation
to the jaw.

Enjoy watching the video: for more information:

Hemodynamic Monitoring

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

Learn more about : ARDS, DVT and PE

Scenario: Nick was admitted to the hospital with a history
of lung cancer. He calls the nurse with complaints of a sudden
onset of shortness of breath and sharp chest pain.This topic
continues : Here

EKG RHYTHMS - STEP BY STEP

 Updated 10 /25              

 Dearnurses.net is no longer available.

Dear nurses,

The topics above are no longer available.
New information and links have been added.
below.

Poor circulation may occur for a number of reasons.
The patient in heart failure, is at risk for stroke.

Myocardial infarction

A MI (myocardial infarction ) is also known as a heart
attack. It results from obstruction to blood flow. Fatty
deposits may cause this. 

Death of the heart muscle surrounding the obstructed
blood vessel will result. Symptoms such as lack of oxygen,
shortness of breath and chest pain will occur.

 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.

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.

- Myocardial infarction

- Atrial fibrillation

- Lethal rhythms

- CABG

INFERIOR WALL MYOCARDIAL INFARCTION - WHERE IS IT?

Updated 5/26

Dear nurses,

The EKG series is no longer available.

New topics and links have been added below.

Learn more about : Inferior wall Myocardial infarction 

What is Multiple Sclerosis?
Multiple Sclerosis is a very debilitating illness
which affects the Central Nervous System. It is
considered to be an autoimmune disease and
progresses over a period of time.

What are some symptoms of Multiple Sclerosis?
- Arm and/or leg weakness
- Visual disturbances like diplopia (double vision)
- Ataxia (unsteady gait)
- Tremors
- Fatigue

Learn more about : Anticoagulation Therapy and

Enjoy the video: Anticoagulation therapy

Learn more about: The Circulatory System

ADDRESSING CABG ( CORONARY ARTERY BYPASS GRAFT)

Updated 1/26

Dearnurses.net is no longer available.

CABG (Coronary Artery Bypass Graft) is pronounced
cabbage, but is far off from its meaning. This is a 

surgical procedure which is done to improve blood 
supply  to the heart. 

This topic continues here: CABG 

Hemodynamics and its meaning

Hemodynamics refers to blood flow.

 The heart is a pump, which pumps blood around the body.
 If there is damage, like a myocardial infarction, the heart's
 function will be impaired.

Learn more : Hemodynamics

Chest pain is a very common complaint . It may occur anywhere
and anytime, even at rest. It may be related to stress or actual
damage to the heart. A patient having a heart attack, may very
readily complain of chest pain.

   The Nursing Process

Ischemia vs. Infarction

When an area of the heart muscle is ischemic or infarcted,
that area is deprived of blood and oxygen. Infarction results
in the complete death of muscle. Ischemia on the other hand,
results from a shortage of blood and oxygen and there is a
 chance of recovery for the muscle.

Causes include :
- A blood clot obstructing a blood vessel
- Fatty deposits in a blood vessel.

To learn more about a myocardial infarction, please
click on the link : Cardiogenic shock

Joe had good outcomes!

ATRIAL FIBRILLATION AND STROKE

Updated 2/26

Atrial fibrillation is a rapid , irregular arrhythmia.
 It is caused by the atria (upper heart chambers)
beating rapidly and out of character. There is no P

 wave on the EKG. This topic continues : Here

Scenario: The patient above, had surgery three days ago.
He is on anticoagulation therapy (Heparin) for DVT. 
Anticoagulants are blood thinners. Their purpose is to
 prevent blood from clotting too easily. 

 Patients with atrial fibrillation may be placed on
 anticoagulation therapy.

This topic continues : Here

Scenario: In the image above, Ann is an opera
singer. While on stage, she suddenly starts having
trouble getting her words out. Her right arm also
feels weak. These symptoms are classic of someone
experiencing a stroke. This topic continues : Here

EKG SERIES - WHERE IS THAT MYOCARDIAL INFARCTION

Learn more about: Anterior wall Myocardial infarction

Updated 5/26

Dear nurses,

Dearnurses.com is no longer available.

Learn more about: The Circulatory System

Learn more about  : Chest pain and the EKG

Learn more about : Organizational skills

MYOCARDIAL INFARCTION - NURSING ASSESSMENT

Updated 12/25          Dearnurses.com is no longer available.

Dear nurses,

New topics and links have been added below.

The 12 lead EKG is done to analyze a myocardial
infarction's location. The electrical activity of the
heart is taken from 12 different angles, just like a
camera taking a picture from different views. 

Learn more about this topic by watching the video:

The new nurse - Easy read EKG

Scenario: Mrs. R is a 48 year-old female who has a history
of a previous myocardial infarction. She was admitted 2 days
 ago with mild chest pain. She was resting comfortably when
she suddenly started feeling short of breath. She is anxious 
and calls the nurse.

What actions did the nurse take?
The nurse reassures Mrs. R. She does an assessment, vital signs
, and oxygen saturation. She gives oxygen per protocol.

-The nurse notifies the doctor of what has occurred and her
assessment findings. She also mentions the vital signs, low
oxygen saturation, and steps that were taken to correct the
saturation. The doctor gives further orders, including a
transfer to CCU.

Why chest pain assessment?
It must be remembered that a patient with heart damage
 will also experience chest pain. Assessment of the pain
should also be included. This may be sharp, with radiation
 to the shoulder/jaw, or it may feel like chest pressure.

Helpful Hint:
Chest pain should always be assessed.
 Enjoy learning more about this topic by clicking on the link:
Simplifying Cardiogenic Shock

How do you read an EKG?

P wave = atrial contraction
QRS waves = ventricular contraction
T wave = resting time before the next contraction

 Learn more about this topic by watching the video:

The new nurse - Easy read EKG

Hemodynamics refers to blood flow. The heart is a pump,
which pumps blood around the body. If there is damage, 
like a myocardial infarction, the heart's function will be 

impaired. 

Learn more about: Congestive heart failure

A patient who has a straight line on the monitor,

requires immediate intervention. The nurse should
check the patient to make sure an electrode is not 
disconnected. 

If there is no disconnection, the patient may have 
gone into Cardiopulmonary arrest. This calls for 
CPR.

A Cardiopulmonary arrest is called a Code Blue.
This means the heart has stopped beating and the
body's cells are deprived of blood supply and oxygen.

Immediate action is taken by the staff , to call a Code
Blue overhead. This summons trained personnel to
that patient's bedside. 

EKG SERIES - MYOCARDIAL INFARCTION

Learn more about: Anterior wall Myocardial infarction

Updated 5/26

Dear nurses,

Dearnurses.com is no longer available.

Learn more about: The Circulatory System

Learn more about  : Chest pain and the EKG

Learn more about : Organizational skills

Dear nurses,

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

Here 

NURSES - LEARN MORE ABOUT ANEMIA

Updated 1/25

Dear nurses,

Dearnurses.net is no longer available.
New topics have been added below.

Topics include:

Anemia

SLE (Systemic Lupus Erythematosus)

Multiple Sclerosis

Blood transfusion

Also enjoy watching the video:

Sessions 52

Learn more about: Why TherapyEnjoy watching the video:
Stress and its impact on the body
Learn more about the topics listed above : Sessions 36 and Dysphagia

SIMPLIFYING ANEMIA

Updated 1/25

                                     Simplifying anemia

Red blood cells are produced in the bone marrow.
They carry oxygen around the body. When a patient
does not have enough red blood cells to carry oxygen,
anemia is said to result. Symptoms such as fatigue,
dizziness, shortness and tachycardia may be noticed.

CBC ( complete blood count) is usually done to check
the hemoglobin. Blood transfusion may be ordered by
 the doctor if anemia is severe.

                 Blood transfusion

Pernicious anemia s a condition which is caused by
a lack of intrinsic factor.This is a protein which is
 produced in the stomach and is responsible for the
absorption of Vitamin B12. Vitamin B12 injections
are ordered by the doctorand given for the rest of
the patient's life.

IRON DEFICIENCY AND PERNICIOUS ANEMIA

Scenario: Sara is experiencing the symptoms of iron
deficiency anemia.She complains of dizziness, shortness
of breath, tachycardia and a desire to eat  paper
( this condition is known as PICA).

Iron deficiency anemia is a condition which may
result in dizziness,fatigue and shortness of breath.
It may be mild and go unnoticed. More severe forms
result in extreme fatigue and difficulty breathing.
Depending on the severity, the doctor may order
iron supplements or a blood transfusion.

Pernicious anemia is a condition which is caused by
a lack of intrinsic factor. This is a protein which is
 produced in the stomach and is responsible
for the absorption of Vitamin B12. Vitamin B12
injections are ordered by the doctor and given for
the rest of the patient's life.

                  Learn more about OCD