Nursing Tips

Check out these easy-to-remember nursing tips, tricks and hacks. Includes fun mnemonics that make recall a breeze.

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Blood pressure may be taken in either arm except when the patient has an IV infusion running, or has had a mastectomy, PICC line, or AV fistula.

Taking Blood Pressure

Health Assessment
Blood pressure may be taken in either arm except when the patient has an IV infusion running, or has had a mastectomy, PICC line, or AV fistula.
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Educate patients taking proton pump inhibitors (e.g., omeprazole, pantoprazole) to report watery diarrhea, as these medications can cause C. diff by decreasing stomach acid production.

Proton Pump Inhibitors: Patient Teaching

Gastrointestinal Pharmacology
Educate patients taking proton pump inhibitors (e.g., omeprazole, pantoprazole) to report watery diarrhea, as these medications can cause C. diff by decreasing stomach acid production.
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As a patient ages, their thirst mechanism decreases. This puts the older adult at increased risk for dehydration.

Dehydration in Older Adults

Gerontology Fundamentals
As a patient ages, their thirst mechanism decreases. This puts the older adult at increased risk for dehydration.
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Cranial Nerve III (Oculomotor), IV (Trochlear), and VI (Abducens) can be assessed using the corneal light reflex, the cover test, and/or the six cardinal positions of gaze.

Cranial Nerve Assessment: III, IV, and VI

Health Assessment
Cranial Nerve III (Oculomotor), IV (Trochlear), and VI (Abducens) can be assessed using the corneal light reflex, the cover test, and/or the six cardinal positions of gaze.
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VEAL CHOP

VEAL CHOP

Labor & Delivery Maternity

To understand the cause of different fetal heart rate patterns, remember VEAL CHOP.

Variable decelerations -> Cord compression.

Early deceleration -> Head compression.

Accelerations -> OK.

Late decelerations -> Placental Insufficiency. 

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Failure to Thrive (FTT) is indicated by a child's weight being less than the fifth percentile. Assess for both organic causes and parental bonding/care of the child.

Failure to Thrive (FTT)

Gastrointestinal Pediatrics
Failure to Thrive (FTT) is indicated by a child's weight being less than the fifth percentile. Assess for both organic causes and parental bonding/care of the child.
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A patient with a Central Venous Catheter (CVC) should have the dressing changed 24 hours after insertion and weekly thereafter (or per facility policy) using sterile technique.

Central Venous Catheter (CVC)

Pharmacology
A patient with a Central Venous Catheter (CVC) should have the dressing changed 24 hours after insertion and weekly thereafter (or per facility policy) using sterile technique.
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When caring for a restrained patient, a new order is required every 24 hours.

Caring for a restrained patient

Practice & Skills Fundamentals
When caring for a restrained patient, a new order is required every 24 hours.
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Unlicensed Assistive Personnel (UAPs) may perform hygiene, bathing, CPR, patient ambulation, routine vital signs, and charting of I&Os.

Unlicensed Assistive Personnel (UAPs)

Leadership Fundamentals
Unlicensed Assistive Personnel (UAPs) may perform hygiene, bathing, CPR, patient ambulation, routine vital signs, and charting of I&Os. 
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Some important nationally notifiable diseases include anthrax, botulism, chlamydia, gonorrhea, Lyme disease, meningococcal disease, pertussis, syphilis, and tuberculosis.

Nationally Notifiable Diseases

Community Fundamentals
Some important nationally notifiable diseases include anthrax, botulism, chlamydia, gonorrhea, Lyme disease, meningococcal disease, pertussis, syphilis, and tuberculosis.
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An ethics committee is an interdisciplinary team that may be used to provide guidance in the face of an ethical dilemma.

Ethics Committee

Principles Fundamentals
An ethics committee is an interdisciplinary team that may be used to provide guidance in the face of an ethical dilemma. 
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Vitamin C deficiency is known as scurvy, and it causes swollen/bleeding gums, tooth loss, and poor wound healing.

Scurvy

Nutrition
Vitamin C deficiency is known as scurvy, and it causes swollen/bleeding gums, tooth loss, and poor wound healing. 
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An occupational health nurse provides screening, surveillance, and education to prevent workplace illness and injury.

Occupational Health Nurse

Community Fundamentals
An occupational health nurse provides screening, surveillance, and education to prevent workplace illness and injury.
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The oliguric phase of acute kidney injury (AKI) is marked by urine output less than 400 mL/day. In the diuresis phase of AKI, urine output can reach 4 - 5 L/day.

Acute Kidney Injury (AKI) : Oliguric Phase

Renal Med-Surg
The oliguric phase of acute kidney injury (AKI) is marked by urine output less than 400 mL/day. In the diuresis phase of AKI, urine output can reach 4 - 5 L/day.
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Do not wait until the end of the shift to document. Instead, complete charting as soon as possible after performing a task or procedure.

Documentation

Leadership Fundamentals
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After a tonic-clonic seizure, a patient enters the "postictal phase," and may exhibit confusion, sleepiness, or agitation.

Tonic-clonic Seizure

Nervous Med-Surg
After a tonic-clonic seizure, a patient enters the "postictal phase," and may exhibit confusion, sleepiness, or agitation.
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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.

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.
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Key nursing interventions for patients with Alzheimer's Disease: Provide frequent reorientation; Provide consistency with caretakers; Keep communication short, simple, and clear.

Alzheimer's Disease Key Interventions

Disorders Psychiatric Mental Health
Key nursing interventions for Alzheimer's Disease: Provide frequent reorientation, consistency with caretakers; Keep communication short, simple, and clear.
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Anthrax is a deadly infectious disease which may be used as a bioterrorism agent. It can be treated with antitoxins and antibiotics (e.g., doxycycline, ciprofloxacin).

Anthrax

Community Fundamentals
Anthrax is a deadly infectious disease which may be used as a bioterrorism agent. It can be treated with antitoxins and antibiotics (e.g., doxycycline, ciprofloxacin).
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An epidemic describes an increase in the number of cases of a disease above what is normally expected in a population or area.

Epidemic

Principles Fundamentals
An epidemic describes an increase in the number of cases of a disease above what is normally expected in a population or area.
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A patient with atrial fibrillation (A-Fib) experiences rapid but disorganized depolarization of the atria, causing them to quiver instead of fully squeezing.

Atrial Fibrillation (A-Fib)

Cardiovascular Med-Surg
A patient with atrial fibrillation (A-Fib) experiences rapid but disorganized depolarization of the atria, causing them to quiver instead of fully squeezing. 
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QD or Q.D. is an abbreviation meaning "daily."

QD & Q.D.: Error-Prone Abbreviations

Pharmacology Pharmacology Basics

QD or Q.D. is an abbreviation meaning "daily." However, it is an error-prone abbreviation as it may be confused with QOD (every other day) or QID (four times a day). Instead, use the word "daily" when documenting.

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Disaster preparedness involves planning, training, and providing education for unavoidable disasters.

Disaster Preparedness

Community Fundamentals
Disaster preparedness involves planning, training, and providing education for unavoidable disasters.
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A patient with fibrocystic breast changes may experience breast pain and/or movable, tender, rubber-like cysts in the upper outer quadrant of the breast.

Fibrocystic Breast Changes: Patient Education

Reproductive Med-Surg
A patient with fibrocystic breast changes may experience breast pain and/or movable, tender, rubber-like cysts in the upper outer quadrant of the breast.
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An employee who is chemically-impaired while on the job should be immediately removed from the work setting, provided safe transportation home, and should attend a formal meeting to discuss the incident within 24 hours.

Chemically-impaired Employee

Leadership Fundamentals
An employee who is chemically-impaired while on the job should be immediately removed from the work setting, provided safe transportation home, and should attend a formal meeting to discuss the incident within 24 hours.
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Determinants of health include environmental factors (e.g., access to healthy food, pollution, public safety) and social factors (e.g., racism, support systems, education).

Determinants of Health

Community Fundamentals
Determinants of health include environmental factors (e.g., access to healthy food, pollution, public safety) and social factors (e.g., racism, support systems, education).
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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!

Abdominal Aortic Aneurysm

Cardiovascular Med-Surg
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!
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Migrant Workers: Increased Risks - LevelUpRN

Migrant Workers: Increased Risks

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

Positional Plagiocephaly

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

Sinus Bradycardia

Cardiovascular Med-Surg
A patient with sinus bradycardia will likely require no treatment. However, if they are symptomatic, treatment with atropine or a pacemaker may be indicated.
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Although most older adults do experience some decline in cognitive function, dementia is not an expected part of aging!

Dementia

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

Edema Scoring

Health Assessment
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.
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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.

Sterile Field Preparation

Practice & Skills Fundamentals
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.
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A patient with hyperpituitarism may require surgical treatment with a hypophysectomy.

Hyperpituitarism

Endocrine Med-Surg
A patient with hyperpituitarism may require surgical treatment with a hypophysectomy. 
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Educate patients that canes should be held on the strong side with the handle at the level of the wrist.

Canes: Patient Teaching

Principles Fundamentals
Educate patients that canes should be held on the strong side with the handle at the level of the wrist.
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Bethanechol, used to treat non-obstructive urinary retention, stimulates cholinergic receptors

Bethanechol

Renal Pharmacology
Bethanechol, used to treat non-obstructive urinary retention, stimulates cholinergic receptors
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Sundowning is a common finding in Alzheimer's Disease, which is increased confusion or agitation in the evening.

Sundowning

Fundamentals
Sundowning is a common finding in Alzheimer's Disease, which is increased confusion or agitation in the evening.
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A patient with paradoxical pulse and an EKG showing electrical alternans should be evaluated for cardiac tamponade.

Cardiac Tamponade

Cardiovascular Med-Surg
A patient with paradoxical pulse and an EKG showing electrical alternans should be evaluated for cardiac tamponade.
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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.
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Cranial Nerve VIII (Vestibulocochlear/Acoustic) function can be assessed with the whisper test, Rinne test, and/or Weber test.

Cranial Nerve VIII Function Assessment

Health Assessment
Cranial Nerve VIII (Vestibulocochlear/Acoustic) function can be assessed with the whisper test, Rinne test, and/or Weber test.
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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.
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Because atropine has anticholinergic side effects, it is often administered during surgery to decrease secretions.

Atropine: Nursing Care

1 Comment

Cardiovascular Pharmacology
Because atropine has anticholinergic side effects, it is often administered during surgery to decrease secretions.
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Lordosis (excessive curvature of the lumbar spine) is a common finding in pregnancy and in toddlers.

Lordosis, Kyphosis, and Scoliosis

Health Assessment
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.
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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!

Tension Pneumothorax

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

What is an Aggregate?

Community Fundamentals
An aggregate is a subgroup or population that share characteristics or concerns (e.g., LGBT+ residents of the same neighborhood).
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A patient taking ethambutol for tuberculosis should be educated to have regular vision screenings and report changes in vision to the prescriber.

Ethambutol: Patient Teaching

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

Cranial Nerve I (Olfactory) Assessment

Health Assessment
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.
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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.

Hearing Loss: Nursing Care

Fundamentals
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.
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