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 TEASERS

Dear nurses,

Can you identify the six food items in this picture? Have a fun time searching!

Also enjoy learning more about the Clinical Setting.

and the Clinical videos.

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

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?

THE CLINICAL SETTING STEP BY STEP , CHAPTER 11 has just been completed. If the patient in your care has a myocardial infarction, would you know where to look on the EKG?

to learn more, please click on the link:

http://www.dearnurses.net/the_clinical_setting_step_by_step (Chapter11)

You may also enjoy watching the Clinical videos (Sessions 16, 17 and 18).

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

When a patient complains of chest pain and shortness of breath, would you know if that patient was having ischemic changes or a myocardial infarction? To learn more, simply click on the link:

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

Also enjoy watching the Clinical videos.

MYOCARDIAL INFARCTION - SNAP SHOT

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

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. 

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. 

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

Hi guys,

A continuation of the basic EKG SERIES has been prepared just for you. If you have learnt the basics and would like to expand your knowledge, please take a moment to click on the link:http://www.dearnurses.com/ekg_series_-_where_is_that_myocardial_infarction.

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

SIMPLIFYING SICKLE CELL ANEMIA

Sickle cell anemia is considered to be genetic in nature. It is 
said to be common to people in certain parts of the world like 
Africa, the Caribbean, Mediterranean and South America.

In this type of anemia, the cells are not rounded, but shaped 
like a sickle. This abnormal shape of the blood cells, impedes 
the flow of blood through the blood vessels.

Patients with sickle cell anemia, may experience symptoms
such as: difficulty breathing, anxiety, chest and abdominal
pain, pain to arms and legs.

 A Mediterranean scene

Sickle cell crisis:

Patients with sickle cell anemia may experience a crisis.
Helpful suggestions to prevent crisis include : 
- avoiding over exhaustion or severe weather 
that may lead to dehydration.

-  Staying in optimum health to avoid colds and flu.

Treatment includes:

Pain management, close monitoring, oxygen and antibiotic
therapy if needed. Blood transfusions and bone marrow transplant
are also types of treatment used for some patients.

WHAT IS APLASTIC ANEMIA?

Scenario: Jim has been diagnosed with Aplastic anemia.

He received radiation treatment for cancer in the past. He

was admitted to the hospital with symptoms of fatigue,

dizziness and tachycardia.

Aplastic anemia is a form of anemia which may be idiopathic
or acquired. Idiopathic means the cause is unknown. Acquired
may be due to radiation therapy, anticonvulsants, or autoimmune
diseases. Aplastic anemia is said to be rare.

Bleeding under the skin may result from low platelet count. 
Blood transfusion and BMT( bone marrow transplant) are
forms of treatment. 

Learn more about the above topic by clicking on the link:
Chemo and BMT

ENJOY LEARNING ABOUT HEART, KIDNEY AND LIVER TRANSPLANTATION

Dear nurses,

I have just completed The Clinical Setting Step by Step, Chapter 10. This chapter is full of helpful information on heart, kidney and liver failure and transplantation. To learn more, simply click on the link:http://www.dearnurses.net/the_clinical_setting_step_by_step, chapter 10.

Also enjoy watching Clinical Video Sessions 47 Organ Transplantation

Coming soon THE 12 LEAD EKG AND IDENTIFYING MYOCARDIAL INFARCTION ON THE EKG.

Stay posted and have a good week!

LEARN MORE ABOUT THE CLINICAL SETTING

Updated 8 /25

A nurse who is new to the clinical setting, knows all
too well it is a challenge.
Learn more about: Care planning

Please use the links to access new information.
- Anasarca

- Cardiogenic shock

- Kidney failure

- Organ transplantation

HEART FAILURE AND TRANSPLANTATION

Updated 1/25

Simple heart facts: The heart is a pump that pumps blood to all the
organs around the body. Any damage to the heart muscle such as a
myocardial infarction may cause lack of blood supply and oxygen
deprivation. This results in chest pain and shortness of breath.

Hemodynamics refers to blood flow.See below.

         Dearnurses.net is no longer available.

Heart transplantation

Scenario: Tim was admitted to the ICU with extreme
shortness of breath, fatigue and chest pain. History includes:

Coronary artery disease and two MIs.
The doctor inserted a PAC ( Pulmonary Artery
Catheter ) in Tim's heart.

Tim was also put on medications like:
- Dobutrex to improve cardiac output
- Nipride to increase vasodilation

He will be cared for in the ICU by specially trained
staff members. Three weeks later a match has been
made and Tim is being prepared for surgery.

Postoperative care is very important in the plan of care.

ASTERIXIS AND ENCEPHALOPATHY IN LIVER FAILURE

Updated 3/ 2023

Would you know how to identify asterixis or encephalopathy if your patient was in liver failure?

To learn more on these topics, simply click on the links:

Liver failure and quiz

Also enjoy watching: Dearnurses videos


 

HEART, KIDNEY AND LIVER TRANSPLANTATION

You may never have taken care of a patient in end-stage heart, kidney or liver failure, but that does not mean you cannot familiarize yourself with what is involved.

The Clinical Setting Step by Step, Chapter 10, has been prepared just for those who are not familiar with these clinical situations.

Also enjoy watching the Clinical videos. Sessions 47 Organ Transplantation

WHEN YOUR PATIENT NEEDS AN ORGAN TRANSPLANTATION

Have you ever taken care of a patient with organ failure? Do you understand what is involved if organ transplantation is needed ?Learn more about heart, kidney and liver transplantation.

Simply click on the link:

The Clinical Setting Step by Step, Chapter 10.

Also enjoy watching the Clinical videos.