HYPOTHERMIA OUTDOORS AND INDOORS

 

Hypothermia may occur outdoors or indoors. The key
to prevention, is taking necessary measures to stop this.
It is important to understand the causes and ways to
prevent the occasion. Here are some helpful hints:

- THINK AHEAD if going hiking , skiing or engaging in other
  outdoor activities.
- Always carry an extra set of warm clothing and enough fluids.
- Try to keep small children well hydrated  and avoid prolonged 
  overexposure of small children to very cold weather.

Scenario: In the image above, a patient has just arrived in PACU.
His core temperature is 95 degrees ( Fahrenheit).The above patient
is also at risk for a cardiac event, due to lack of oxygen.

Hypothermia increases the body's need for oxygen, A lethal cardiac
arrhythmia such as asystole may result.

A bair hugger or warm blankets may be used to combat hypothermia

in PACU. 

A CODE BLUE IN PROGRESS AND THIS HAPPENS

 

Scenario: A Code Blue is in progress. in the Emergency Room The medical staff
have gathered around the bedside to assist. Unfortunately, the nurse on the left got 
distracted . She begins to move the paddles towards the nurse on the right.

How could this happen? It is easy to make a mistake when there is so much going
on in a confined space. It is important to follow all the security guidelines for a 
Code Blue, like making sure no one is close to the bedside prior to defibrillation.

DIABETIC COMPLICATIONS

 The diabetic patient is at risk for many complications. Here are some of 

The complications that may occur:

- DKA- diabetic ketoacidosis

- Retinopathy

- PVD 

- Poor wound healing

- Hypo/ hyperglycemia

The nurse is responsible for diabetic teaching. This will help to eliminate

complications. There are also misconceptions which should also be addressed.

Please watch the videos for more helpful information:

Patient  education

Diabetic and seizure patients

INFECTION CONTROL AND ITS IMPORTANCE

Infection control

  Preventing the spread of infection should be a priority for every healthcare worker.
  In-service education in a healthcare facility, is done on a regular basis, to provide
the staff with tips to prevent infection. 

  Maintaining a safe work environment is crucial. There are ways to accomplish this.
Examples include: 
- Correct disposal of needles and syringes
- Ensuring needle holders are not too full 
                         - Using gloves appropriately, not like another pair of hands
- IV sites are maintained per protocol      

- Proper disposal of IV solutions.           
The consequences of  improper disposal can be fatal!   

 This is an example of what could happen when someone did not take the time to
dispose of IV fluids the correct way.

WHAT IS A SEIZURE?

What is a seizure?

A seizure is considered to be a sudden outburst of
uncontrollable electrical activity from the neurons
in the brain. Involuntary contraction of muscles
usually occur and last for a short period. Seizures
may vary in duration and frequency.

Types of seizures

Generalized ( grand mal ) seizure - can be seen
when a patient has sudden, jerky movements
throughout the body. A patient may fall to the
ground and have loss of consciousness. Types
of generalized seizures include: tonic, clonic
and myotonic.

A partial (focal ) seizure, is also sudden and
confined to one part of the body.

Postictal - following a seizure, a patient may
 stay in a stuporous state for some minutes.

EEG ( Electroencephalogram) A diagnostic test ,
which is done to monitor seizure activity. This
test is usually ordered by the doctor.

Patient safety during a seizure

When a seizure occurs, patient safety should

 be a major concern. A patient who has a 
history of seizures, should already be on
anticonvulsant medications. 
A "seizure precations " sign is usually
posted over the bed.

Here are some helpful hints:

- Follow MD orders

- Protect the patient from harm

- Maintaining a patent airway; turn head to the side, if necessary,
  to prevent airway obstruction

- Keeping bed rails up , to prevent the patient falling out of bed

- Monitoring duration and character of seizure

- After seizure, assessment and documentation of, vital signs, O2 saturation,

- notifying MD of patient status

 

It is important to protect the seizure patient from falling and getting injured.

 

THE MAR ( MEDICATION ADMINISTRATION RECORD}

 

What is the MAR?

The MAR is the medication administration record.
It is a complete record which is kept on every patient.

It includes the patient's name, age, diagnosis, height,
weight and allergies. All medications ordered by the
doctor and a place to sign when medications are given.

Five rights:

There are 5 basic rights for medication administration.
Over time, more rights have been recognized. This may 
vary from 7 or more. Always follow your Institution's
policies and procedures, in order to avoid error.

NEUMERICAL PAIN SCALE ASSESSMENT

 

Scenario: Paul had surgery on his back two days prior.
He is having pain and requests medication. The nurse
does an assessment.

Neumerical pain scale assessment

This a very useful tool when assessing pain. It is 
based on a scale of 0-10 ( 10 being the worst).
A ladder starts from the ground which is the
lowest point. It escalates to the highest point,
so does the pain. Pain scale:

0 = no pain
1-3 = mild pain
4-6 = pain is considered moderate
7-10 = pain is extreme or severe

Helpful hints:

Medication that is given by mouth, takes
longer to be absorbed than when it is given 
IM or IV.

It is important to do a pain assessment after
medication has been given. Documentation 
of the effect it has and any side effects, is 
also helpful. Learn more:
Safe medication administration