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Nursing Tips
Check out these easy-to-remember nursing tips, tricks and hacks. Includes fun mnemonics that make recall a breeze.
Body System
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Topic
Admission Tasks
Discharge planning for a patient starts at admission. Other important admission tasks include confirming the patient's code status, identifying allergies, assessing fall risk, and assessing for swallowing issues.
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Lab Values: Magnesium
Magnesium (Mg) expected range: 1.3 - 2.1 mEq/L HINT: MGs are very small British cars - you can only fit 1-2 people in them.
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Testing for Infertility
When beginning testing for infertility, semen analysis is often the first test performed. This is non-invasive and less expensive than further testing!
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Treatment for Infertility
Treatment for infertility is unique to the individual, but some treatments include: Intrauterine Insemination (IUI), In Vitro Fertilization (IVF), Embryo Transfer (ET), the use of donor eggs/sperm/embryo, and the use of a gestational carrier (surrogate).
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Toxoplasmosis
Toxoplasmosis is a teratogenic parasitic infection acquired by consumption of raw or undercooked meat, or by handling cat feces.
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Assessing Fetal Heart Tones
The fetal heart tones cannot be assessed using a doppler until around 12 weeks gestational age. Prior to this time, heart tones can only be identified using ultrasound.
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Scabies in Children
A child with scabies is likely to exhibit white lines in between fingers, toes, or skin folds. The whole family should be examined and treated!
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Probable Signs of Pregnancy
Probable signs of pregnancy include Chadwick's Sign, Goodell's Sign, Hegar's Sign, ballottement, and a positive pregnancy test. These findings are probably related to pregnancy, but could have other explanations.
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Osteogenesis in Children
A child with Osteogenesis Imperfecta may exhibit a blue color of the sclera. Be sure to report this finding to the provider for further evaluation.
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Naegele's Rule
A patient's estimated date of delivery can be determined using Naegele's Rule. After determining the first day of the patient's last period, subtract 3 months, then add 1 week and 1 year.
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Meningocele and Myelomeningocele in Children
A child with meningocele or myelomeningocele is at risk for injury due to the exposed spinal cord. Cover the sac with sterile, saline-moistened, non-adherent dressing. Place infant prone with the hips flexed.
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Asynchronous Pacemaker
An asynchronous pacemaker fires at a constant rate regardless of the heart's electrical activity.
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Supine Hypotensive Syndrome
Supine hypotensive syndrome is caused by a pregnant patient's heavy uterus compressing the inferior vena cava when lying supine. Educate patients to rest either in a side-lying position, or with a pillow under one hip.
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The Respiratory System and Acid/Base Balance
The respiratory system is the second line of defense in maintaining acid/base balance.
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Disseminated Intravascular Coagulopathy (DIC)
A client experiencing shock is at risk for Disseminated Intravascular Coagulopathy (DIC). Monitor for signs of clotting/bleeding and report any of these findings promptly.
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MMR Vaccine and Pregnancy
A patient who was rubella non-immune during pregnancy should receive the MMR vaccine after delivery (this vaccine is contraindicated during pregnancy).
Educate the patient that pregnancy must be avoided for at least 28 days after immunization.
Meningitis in Children
A child with meningitis is likely to have a fever, headache, nausea, vomiting, irritability, nuchal (neck) rigidity, photophobia, and + Kernig's and Brudzinski's signs.
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Synchronous Pacemaker
A synchronous pacemaker only fires when the heart's intrinsic rate falls below a certain rate.
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Macrosomic Infants
A macrosomic infant (large for gestational age) is one who is over 4,000 g (or 8 lbs., 13 oz.).
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Chemical Buffers
Chemical buffers are the first line of defense in maintaining acid/base balance.
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Sick Cell Anemia and Vaso-occlusive Crisis
A child with Sickle Cell Anemia experiencing vaso-occlusive crisis should be treated with scheduled opioid analgesia (non-opioid analgesia will not be sufficient!).
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Ostomy Patient Teaching
Ostomy patient teaching:
Read Article- Cut opening in skin barrier ≤ 1/8" bigger than the measured stoma size to prevent skin damage from contact with ostomy output.
- Assess stoma regularly - should be pink/moist. Pale/blue stoma indicates ischemia.
Meckel's Diverticulum
A child with Meckel's Diverticulum is likely to exhibit painless rectal bleeding and stool with the consistency and appearance of "currant jelly."
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Pap Tests
A pap test to screen for cervical cancer should be performed every three years starting three years after a patient's first instance of sexual intercourse, or by age 21.
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Positive Signs of Pregnancy
Positive signs of pregnancy include identification of fetal heart sounds, fetal movement felt by a healthcare provider, and ultrasound visualization of the fetus. There is no other explanation for these findings than pregnancy.
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Medication Half-life
A medication's half-life is the amount of time it takes for the amount of medication in the body to be reduced by 50%.
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Infective Endocarditis in Children
A child with infective endocarditis will require IV antibiotics via PICC line for 2 - 6 weeks, and may require a valve repair or replacement.
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Negative Feedback Loop
A negative feedback loop governs most endocrine hormones. In this type of feedback, when the body senses there is not enough of a hormone circulating in the blood, changes are initiated to increase production of that hormone. Once the body senses there is too much of that hormone, changes are initiated to decrease production of that hormone.
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Infertility Test: Hysterosalpingogram (HSG)
One test that can be performed for infertility is a hysterosalpingogram (HSG). Because this test uses contrast dye to assess the patency of the fallopian tubes, be sure to assess for allergies to shellfish or iodine prior to the procedure!
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Nursing Interventions for the Restrained Patient
The timing of nursing interventions for the restrained patient is crucial! 1) Assess the patient's status every 15 minutes. 2) Offer fluids, ROM exercises, and toileting every 2 hours. 3) Immediately remove restraints once the patient is no longer a danger to themselves or others.
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Hemophilia in Children: Signs and Treatment
A child with Hemophilia A is deficient in Factor VIII. In Hemophilia B the deficiency is with Factor IX. Treatment of these conditions will include replacement of the missing factor, desmopressin, and aminocaproic acid.
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Peptic Ulcer Disease: Signs and Symptoms
A major complication of peptic ulcer disease is perforation of an ulcer. Assess for symptoms of perforation such as severe pain, fever, or a rigid/boardlike abdomen.
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Natural Family Planning
Natural family planning methods involve avoiding intercourse during fertile periods by tracking the patient's menstrual cycle, or assessing the basal body temperature or cervical mucus consistency daily.
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Sublimation
Sublimation is marked by an individual transforming unacceptable impulses into socially acceptable behaviors.
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Growth Hormone Deficiency
A child with Growth Hormone Deficiency would have an average birth weight/length, but show delayed growth through childhood.
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Chorea and Huntington's Disease
A key finding in Huntington's Disease is chorea, which is a type of abnormal and excessive involuntary movement. Tetrabenazine may be given to treat this symptom.
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Maternal Serum Alpha-fetoprotein (MSAFP)
Maternal Serum Alpha-fetoprotein (MSAFP) is a test for genetic abnormalities performed between 15 and 20 weeks gestation.
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When to Perform a Medication Reconciliation
A medication reconciliation should be done during admission, upon transfer to another floor/unit/facility, and at discharge.
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Therapeutic Relaxation Techniques
Progressive Relaxation involves tightening and relaxing muscle groups. Guided Imagery helps a patient relax by visualizing detailed images. Meditation can improve health and well-being by helping an individual focus on a word or sensation.
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Phenytoin and Gingival Hyperplasia
A key side effect of phenytoin (an anti-seizure medication) is gingival hyperplasia. Educate patients to maintain regular dental checkups.
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Intracranial Pressure (ICP); Nursing Care
A child with a head injury is at risk for elevated intracranial pressure (ICP). Nursing care to decrease ICP includes reducing hypercapnia by hyperventilating the patient, avoiding oral suctioning, keeping the HOB at 30 degrees, and keeping the head in a neutral/midline position.
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High Pressure Alarm: Causes
A high pressure alarm from a ventilator could indicate Pulmonary edema, Pneumothorax, Bronchospasm, Biting of the tube, Secretion excess, Coughing, or a Kink in the tubing.
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Lab Tests for First Trimester
First trimester lab testing should include: CBC, urinalysis, STI testing, pap test, blood typing (including Rh factor), rubella titer, Hepatitis B, and HIV. High risk patients may also require quantitative hCG level testing.
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What is a Living Will?
A living will is an advance directive indicating a patient's desired or prohibited medical interventions (e.g., tube feeding, ventilation).
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