Nursing Tips

A patient with an Abdominal Aortic Aneurysm may have a pulsating abdominal mass with a bruit. Do NOT palpate this due to the risk for rupture!

Migrant workers are at increased risk for work-related injuries, pesticide/chemical exposure, skin cancer, dermatitis, communicable disease, and dental problems.

Positional plagiocephaly is cranial asymmetry caused by prolonged pressure on one side of the skull. A child with this diagnosis may require helmet therapy, where a custom-made helmet is worn up to 23 hours per day for ~ 3 months.

A patient with sinus bradycardia will likely require no treatment. However, if they are symptomatic, treatment with atropine or a pacemaker may be indicated.

Although most older adults do experience some decline in cognitive function, dementia is not an expected part of aging!

Edema is documented by the depth of the indentation left by pressing a finger over the edematous area. A score of 0 means there is no pitting edema.

During sterile field preparation, open the top flap away from your body first. Then open the flap on the right side using the right hand, and the left side using the left hand. Lastly, open the final flap towards your body.

A patient with hyperpituitarism may require surgical treatment with a hypophysectomy. 

Educate patients that canes should be held on the strong side with the handle at the level of the wrist.

Bethanechol, used to treat non-obstructive urinary retention, stimulates cholinergic receptors

Sundowning is a common finding in Alzheimer's Disease, which is increased confusion or agitation in the evening.

A patient with paradoxical pulse and an EKG showing electrical alternans should be evaluated for cardiac tamponade.

After emptying a closed drain (e.g., Jackson-Pratt, Hemovac), fully compress the canister and replace cap in order to ensure negative pressure is applied to the area.

Cranial Nerve VIII (Vestibulocochlear/Acoustic) function can be assessed with the whisper test, Rinne test, and/or Weber test.

A pressure wound base which is covered in slough or eschar is considered to be unstageable.

Because atropine has anticholinergic side effects, it is often administered during surgery to decrease secretions.

Lordosis (excessive curvature of the lumbar spine) is a common finding in pregnancy and in toddlers. Kyphosis (excessive curvature of the thoracic spine) is a common finding in the older adults. Scoliosis (lateral curvature of the spine) is always abnormal.

A patient with a tension pneumothorax is likely to have tracheal deviation towards the unaffected side. Assess respiratory status in any patient with this finding!

An aggregate is a subgroup or population that share characteristics or concerns (e.g., LGBT+ residents of the same neighborhood).

A patient taking ethambutol for tuberculosis should be educated to have regular vision screenings and report changes in vision to the prescriber.

Cranial Nerve I (Olfactory) can be assessed by asking the patient to identify a scent (e.g., soap, coffee) while occluding one nostril at a time.

For patients with hearing loss, decrease background noise, face the patient, do not shout, and rephrase (but do not repeat) if they do not understand.

A patient with elevated hBNP (> 100 pg/mL) should be evaluated for Heart Failure.

Bowel sounds cannot be called "absent" until the nurse has listened for five minutes without hearing bowel activity.

The most common seizure disorder in children is febrile seizures.

Because spironolactone is a potassium-sparing diuretic, monitor the patient for signs of hyperkalemia. Educate patients to avoid salt substitutes, as most of these contain potassium.

Food deserts are geographic areas that lack sufficient access to grocery stores and healthy food options.

Bulimia Nervosa is an eating disorder characterized by binge eating followed by compensatory measures to avoid weight gain (e.g., vomiting, laxative use, extreme exercise).

Anorexia Nervosa is an eating disorder characterized by restriction of caloric intake.

All assessments should involve identifying the patient with two patient identifiers (e.g., name, DOB, MRN#). Remember: room number is NOT a valid patient identifier!

Adenosine (Adenocard) is a Class V antiarrhythmic medication used for supraventricular tachycardia.

Calcium (Ca) expected range: 9 - 10.5 mEq/L HINT: California (CA) is due for a big earthquake that may measure 9 - 10.5 on the Richter scale.

Filgrastim is a medication used to stimulate the growth of neutrophils in patients with neutropenia.

A patient who experienced a long-bone fracture is at risk for a fat embolism. Immediately report any dyspnea, confusion, tachypnea, tachycardia, or chest pain to the provider.

Authoritarian parents are those who are strict and require high control but offer little warmth. Authoritative parents have moderate-high control, but offer high amounts of warmth. 

Because oxybutynin is used to treat overactive bladder by inhibiting acetylcholine in the bladder, assess for anticholinergic symptoms. These include dry mouth, urinary retention, constipation, and blurred vision.

A patient with appendicitis is likely to have RLQ pain at McBurney's Point along with rebound tenderness, nausea/vomiting, and fever.

A patient undergoing hemodialysis may have an arteriovenous fistula in the arm. Educate patient that blood pressures, IVs, and blood draws must be done from the arm without the shunt. Also educate patients not to sleep on the arm with the fistula, and perform hand exercises to mature a new fistula.

Patients taking corticosteroids (e.g., prednisone, hydrocortisone) are at increased risk of infection. Monitor for signs of infection, and educate patients taking these medications to avoid crowded areas and perform frequent hand hygiene.

Written educational materials should be provided in the patient's primary language using layman's terms and an appropriate reading level.

When performing a Snellen exam for visual acuity, an adult should stand 20 feet away from the chart, but a child should stand 10 feet from the chart.

Because of the unpleasant GI side effects of metformin, educate patients to take this medication with a meal.

Vitamin B9 (folic acid) is needed to prevent neural tube defects in a developing fetus.

A patient with asthma who is experiencing airway obstruction unresponsive to usual therapy is experiencing status asthmaticus. Administer oxygen and prepare for emergency intubation!

Avoid recapping needles to prevent sharps injury. If recapping is unavoidable, use the scoop method to minimize the risk of injury.

When caring for a child with appendicitis, report to the provider any sudden relief of pain. This may indicate that the appendix has perforated and requires emergency surgery!

A patient who experiences prolonged standing (like nurses!) is at risk for developing varicose veins. Educate patients with this risk factor to wear compression stockings and elevate the legs when possible.

Because hypokalemia increases a patient's risk of digoxin toxicity, be sure to closely monitor the potassium levels for patients taking digoxin!

Patients receiving enemas may report cramping. Lower the solution container if cramping is reported.