Nursing Tips: Practice & Skills

Isotonic Fluids

Practice & Skills Fundamentals

Isotonic fluids do not change the volume of the body's cells.

Caring for a restrained patient

Practice & Skills Fundamentals

When caring for a restrained patient, a new order is required every 24 hours.

Seizure Precautions

Practice & Skills Fundamentals

If a patient is on seizure precautions, pad the bed side rails, and ensure oxygen, suction, and vital signs equipment is in the patient's room.

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.

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.

Closed Drain: Nursing Care

Practice & Skills Fundamentals

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.

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

Unstageable Pressure Wound

Practice & Skills Fundamentals

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

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

Enemas: Nursing Care

Practice & Skills Fundamentals

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

A patient using crutches should be taught to ascend stairs leading with the strong leg and descend by leading with the weaker leg.

Crutches: Patient Teaching

Practice & Skills Fundamentals

A patient using crutches should be taught to ascend stairs leading with the strong leg and descend by leading with the weaker leg.

Patient Controlled Analgesia (PCA) Pumps

Practice & Skills Fundamentals

Patient Controlled Analgesia (PCA) pumps should only be used by the patient. Educate families/visitors not to press the button for the patient!

Protective/Reverse Isolation

Practice & Skills Fundamentals

A patient on protective/reverse isolation should be provided a private room with positive-pressure airflow. Do not allow flowers or live plants into the room, and screen all visitors for illness.

24-Hour Urine Collection

Practice & Skills Fundamentals

A patient asked to do a 24-hour urine collection should be taught to discard the first void and then collect all urine voided over the following 24 hours.

A patient on a clear liquid diet may have items that are transparent and liquid at room temperature (e.g., water, clear sodas, pulp-free juices, popsicles, jello, black coffee, clear broth).

Clear Liquid Diets

Practice & Skills Fundamentals

A patient on a clear liquid diet may have items that are transparent and liquid at room temperature (e.g., water, clear sodas, pulp-free juices, popsicles, jello, black coffee, clear broth).

A medication reconciliation should be done during admission, upon transfer to another floor/unit/facility, and at discharge.

When to Perform a Medication Reconciliation

Practice & Skills Fundamentals

A medication reconciliation should be done during admission, upon transfer to another floor/unit/facility, and at discharge.

A Braden scale score ≤ 18 indicates a patient is at risk for pressure injuries. In this case, take measures to prevent injuries of this type.

Braden Scale: Pressure Injuries

Practice & Skills Fundamentals

A Braden scale score ≤ 18 indicates a patient is at risk for pressure injuries. In this case, take measures to prevent injuries of this type.

Wound Irrigation

Practice & Skills Fundamentals

Wound irrigation points to remember!

Suctioning

Practice & Skills Fundamentals

When performing suctioning, apply suction intermittently while withdrawing the catheter and rotating it for 10-15 seconds.

Key points when taking a patient's blood glucose: Place hand in dependent position; Pierce the outer edge of the fingertip (not the pad); Wipe away first drop of blood; Hold test strip NEXT to the blood drop (do not smear blood on strip).

Blood Glucose Key Points

Practice & Skills Fundamentals

Key points when taking a patient's blood glucose: Place hand in dependent position; Pierce outer; Wipe away first drop of blood; Hold test trip NEXT to the blood drop

Abdominal Wound Dehiscence

Practice & Skills Fundamentals

For abdominal wound dehiscence with evisceration: Place saline-soaked gauze over wound; Don't try to reinsert organs!; Prepare patient for possible surgery.

Applying Restraints

Practice & Skills Fundamentals

When applying restraints, make sure 2 fingers can fit between restraint and patient, se a quick release knot, and don't place restraints on side rail.