Nursing Tips

Administration Set Priming for Blood Transfusion

Administration Set Priming for Blood Transfusion

Cathy Parkes

For blood transfusion, prime the administration set with 0.9% NaCl ONLY.

Administration Set Priming for Blood Transfusion

Cathy Parkes

For blood transfusion, prime the administration set with 0.9% NaCl ONLY.

REPORT urine output that is less than 30ml/hr!  Decreased urine output can be indicative of shock, sepsis, and kidney failure.

Reporting Urine Output

Cathy Parkes

REPORT urine output that is less than 30ml/hr! Decreased urine output can be indicative of shock, sepsis, and kidney failure.

Reporting Urine Output

Cathy Parkes

REPORT urine output that is less than 30ml/hr! Decreased urine output can be indicative of shock, sepsis, and kidney failure.

For a patient at risk for suicide:  Do NOT place a patient at risk for suicide in a private room. Provide 1:1 observation at all times.

Patient at risk for suicide

Cathy Parkes

For a patient at risk for suicide: Do NOT place a patient at risk for suicide in a private room. Provide 1:1 observation at all times.

Patient at risk for suicide

Cathy Parkes

For a patient at risk for suicide: Do NOT place a patient at risk for suicide in a private room. Provide 1:1 observation at all times.

Finasteride is an Androgen Inhibitor used to treat Benign Prostatic Hyperplasia (BPH) and baldness. HINT: Finasteride kind of looks like "Fine ride." That guy over there has a fine ride, but he is also bald with BPH.

Finasteride

Cathy Parkes

Finasteride is an Androgen Inhibitor used to treat Benign Prostatic Hyperplasia (BPH) and baldness.

Finasteride

Cathy Parkes

Finasteride is an Androgen Inhibitor used to treat Benign Prostatic Hyperplasia (BPH) and baldness.

Expected weight gain during pregnancy  Normal weight women: 25-35 pounds. Underweight women: 28-40 pounds. Overweight patients: 15-25 pounds.

Pregnancy Weight Gain

Cathy Parkes

Expected weight gain during pregnancy differs depending on the mother's pre-pregnancy weight.

Pregnancy Weight Gain

Cathy Parkes

Expected weight gain during pregnancy differs depending on the mother's pre-pregnancy weight.

Extrapyramidal side effects (EPS) are common with Conventional Antipsychotics. Symptoms of EPS include: Dystonia, Parkinson's symptoms, Tardive dyskinesia, Akathisia.

Extrapyramidal Side Effects

Cathy Parkes

Extrapyramidal side effects (EPS) are common with Conventional Antipsychotics. Symptoms of EPS include: Dystonia, Parkinson's symptoms, Tardive dyskinesia, Akathisia.

Extrapyramidal Side Effects

Cathy Parkes

Extrapyramidal side effects (EPS) are common with Conventional Antipsychotics. Symptoms of EPS include: Dystonia, Parkinson's symptoms, Tardive dyskinesia, Akathisia.

Key points about maintaining a sterile field:  1" edge of field is NOT sterile. Never turn your back on, reach across, or walk away from a sterile field. Objects held below the waist is consider non-sterile.

Maintaining A Sterile Field

Cathy Parkes

Key points about maintaining a sterile field

Maintaining A Sterile Field

Cathy Parkes

Key points about maintaining a sterile field

Giving Medication to Children - LevelUpRN

Giving Medication to Children

Cathy Parkes

Educate families that when giving medication to children, they must use a calibrated device

Giving Medication to Children

Cathy Parkes

Educate families that when giving medication to children, they must use a calibrated device

A nurse should always protect patient privacy per HIPAA laws, except when there is a duty to warn! If the patient poses a serious threat to another person, the nurse must protect the third party!

Duty to Warn

Cathy Parkes

A nurse should always protect patient privacy per HIPAA laws, except when there is a duty to warn! 

Duty to Warn

Cathy Parkes

A nurse should always protect patient privacy per HIPAA laws, except when there is a duty to warn! 

A reactive (normal) test is indicated by a FHR with a normal rate, moderate variability, and two accelerations (greater than or equal to 15 bpm for greater than or equal to 15 seconds) in 20 minutes.

Nonstress Test (NST)

Cathy Parkes

A nonstress test (NST) is a non-invasive test done to examine the fetal heart rate and response to fetal movement.

Nonstress Test (NST)

Cathy Parkes

A nonstress test (NST) is a non-invasive test done to examine the fetal heart rate and response to fetal movement.

Don't get TIPSY when taking your TB meds! Alcohol is contraindicated for these TB meds: Isoniazid, Rifampin, Pyrazinamide, Ethambutol. All carry a risk for hepatotoxicity!

TB Meds

Cathy Parkes

Don't get TIPSY when taking your TB meds! Alcohol is contraindicated for these TB meds: Isoniazid, Rifampin, Pyrazinamide, Ethambutol. All carry a risk for hepatotoxicity!

TB Meds

Cathy Parkes

Don't get TIPSY when taking your TB meds! Alcohol is contraindicated for these TB meds: Isoniazid, Rifampin, Pyrazinamide, Ethambutol. All carry a risk for hepatotoxicity!

Enteral feeding (NG or G-tube): Confirm placement with x-ray before feeding! Measure gastric contents every 4 hours. Hold feeding if residual exceeds ~500ml. Flush tubes with 30 mL sterile water every 4 hours.

Enteral Feeding

Cathy Parkes

Enteral feeding: Confirm placement with x-ray; Measure gastric contents; Hold feeding if residual exceeds ~500ml; Flush feeding tubes.

Enteral Feeding

Cathy Parkes

Enteral feeding: Confirm placement with x-ray; Measure gastric contents; Hold feeding if residual exceeds ~500ml; Flush feeding tubes.

Early signs of increased ICP in infants:  Irritability, high-pitched cry, poor feeding, bulging fontanels, separation of cranial sutures “setting-sun” phenomenon.

Early Signs of Increased ICP in Infants

Cathy Parkes

Early signs of increased ICP in infants: irritability, high-pitched cry, poor feeding, “setting-sun” phenomenon, bulging fontanels, separation of cranial sutures.

1 comment

Early Signs of Increased ICP in Infants

Cathy Parkes

Early signs of increased ICP in infants: irritability, high-pitched cry, poor feeding, “setting-sun” phenomenon, bulging fontanels, separation of cranial sutures.

1 comment
Don't confuse clozapine with clonidine! Clozapine is an antipsychotic (note both cloZapine and schiZophrenia have a Z). Clonidine is an antihypertensive.

Clozapine vs. Clonidine

Cathy Parkes

Don't confuse clozapine with clonidine! Clonidine is an antihypertensive. Clozapine is an antipsychotic.

Clozapine vs. Clonidine

Cathy Parkes

Don't confuse clozapine with clonidine! Clonidine is an antihypertensive. Clozapine is an antipsychotic.

A Bishop score is used to determine maternal readiness for labor induction based on cervical readiness. A score >8 in a multiparous patient, or >10 in a nulliparous patient indicates readiness for induction.

Bishop Score

Cathy Parkes

A Bishop score is used to determine maternal readiness for labor induction based on cervical readiness.

Bishop Score

Cathy Parkes

A Bishop score is used to determine maternal readiness for labor induction based on cervical readiness.

Colchicine is a medication used to treat an acute gout attack. Gout causes tophi (accumulation of uric acid crystals, often found in the BIG toe)

Colchicine

Cathy Parkes

Colchicine is a medication used to treat an acute gout attack.

Colchicine

Cathy Parkes

Colchicine is a medication used to treat an acute gout attack.

Criteria for hospitalization of patients with Anorexia Nervosa:  Body weight < 75% of ideal body weight; Body fat < 10%; Heart rate < 45/min; SBP < 90mmHg; Body temp < 96 degrees F; EKG abnormalities

Criteria for hospitalization of patients with anorexia

Cathy Parkes

Criteria for hospitalization of patients with Anorexia Nervosa.

Criteria for hospitalization of patients with anorexia

Cathy Parkes

Criteria for hospitalization of patients with Anorexia Nervosa.

Do NOT administer any medications through a patient's parenteral nutrition (i.e. TPN) IV line! You need to use a separate line.

Medications in Nutrition IV Line

Cathy Parkes

Do NOT administer any medications through a patient's parenteral nutrition (i.e. TPN) IV line! You need to use a separate line.

Medications in Nutrition IV Line

Cathy Parkes

Do NOT administer any medications through a patient's parenteral nutrition (i.e. TPN) IV line! You need to use a separate line.

Things you can delegate to your CNA/tech partner:  Bathing, toileting, dressing, ambulating, positioning, vital signs, bed making, specimen collection, feeding patients without swallowing precautions.

Delegating to your CNA

Cathy Parkes

Things can delegate to your CNA/tech partner: Bathing, toileting, dressing, ambulating, positioning, vital signs, bed making, specimen collection...

Delegating to your CNA

Cathy Parkes

Things can delegate to your CNA/tech partner: Bathing, toileting, dressing, ambulating, positioning, vital signs, bed making, specimen collection...

For symptoms of compartment syndrome, remember the 5Ps: Paresthesia, Paralysis, Pallor, Pulselessness, Intense Pain (unrelieved by drugs and/or with passive movement)

Compartment Syndrome 5Ps

Cathy Parkes

For symptoms of compartment syndrome, remember the 5Ps: Paresthesia, Paralysis, Pallor, Pulselessness, Intense Pain

Compartment Syndrome 5Ps

Cathy Parkes

For symptoms of compartment syndrome, remember the 5Ps: Paresthesia, Paralysis, Pallor, Pulselessness, Intense Pain

Windshield Survey:
Collect data by literally driving around and looking out your windshield. Assess people and environment. Use the data to develop a Community Health Plan.

Windshield Survey

Cathy Parkes

Windshield Survey: Collect data by literally driving around and look out your windshield.

1 comment

Windshield Survey

Cathy Parkes

Windshield Survey: Collect data by literally driving around and look out your windshield.

1 comment
Crib safety: Place infants on BACK to sleep. Do not place anything in the crib with the baby. Ensure crib slats are ≤ 2 3/8 inches apart. Babies who sleep on their backs are much less likely to die of SIDS than babies who sleep on their stomachs or sides!

Crib Safety

Cathy Parkes

Crib safety: Infants on back to sleep, nothing in crib, and width of crib slats

Crib Safety

Cathy Parkes

Crib safety: Infants on back to sleep, nothing in crib, and width of crib slats

Antitussives ABCD Tip: ABCD = Antitussives include Benzonatate, Codeine, Dextromethorphan.

Antitussives ABCD Tip

Cathy Parkes

ABCD = Antitussives include Benzonatate, Codeine, Dextromethorphan.

Antitussives ABCD Tip

Cathy Parkes

ABCD = Antitussives include Benzonatate, Codeine, Dextromethorphan.

Smallpox Signs/Symptoms include RASH that begins on the FACE and spreads down, High fever, Headache, Vomiting

Smallpox Symptoms

Cathy Parkes

Smallpox: Symptoms include a RASH that begins on the FACE and spreads down, high fever, headache, vomiting.

Smallpox Symptoms

Cathy Parkes

Smallpox: Symptoms include a RASH that begins on the FACE and spreads down, high fever, headache, vomiting.

Chest physiotherapy is a key intervention for Cystic Fibrosis! Since it uses percussion, vibration, postural drainage and breathing exercises to loosen respiratory secretions, should be scheduled BEFORE meals or 1-2 hrs after meals to avoid vomiting.

Chest Physiotherapy Treatments

Cathy Parkes

Chest physiotherapy treatments should be included 1 hour before or 2 hours after meals to avoid vomiting.

Chest Physiotherapy Treatments

Cathy Parkes

Chest physiotherapy treatments should be included 1 hour before or 2 hours after meals to avoid vomiting.

Ciprofloxacin is a fluoroquinolone antibiotic used to treat UTIs. A unique side effect of this medication is "achilles tendon rupture".
HINT: If you take CIPRO, you might SLIP due to your achilles tendon rupturing.

Ciprofloxacin

Cathy Parkes

Ciprofloxacin is a fluoroquinolone antibiotic used to treat UTIs. A unique side effect of this medication is "achilles tendon rupture". HINT: If you take CIPRO, you might SLIP due to...

1 comment

Ciprofloxacin

Cathy Parkes

Ciprofloxacin is a fluoroquinolone antibiotic used to treat UTIs. A unique side effect of this medication is "achilles tendon rupture". HINT: If you take CIPRO, you might SLIP due to...

1 comment
An Indirect Coombs test is used to determine if a pregnant patient is Rh-positive or Rh-negative.

Rh-Negative Patients

Cathy Parkes

An Indirect Coombs test is used to determine if a pregnant patient is Rh-positive or Rh-negative.

Rh-Negative Patients

Cathy Parkes

An Indirect Coombs test is used to determine if a pregnant patient is Rh-positive or Rh-negative.

Calcium channel blockers are Very Nice Drugs: Verapamil, Nifedipine, Diltiazem. Key side effects: hypotension, bradycardia, dysrhythmias, peripheral edema.

Calcium Channel Blockers

Cathy Parkes

Calcium channel blockers are Very Nice Drugs: Verapamil, Nifedipine, Diltiazem.

Calcium Channel Blockers

Cathy Parkes

Calcium channel blockers are Very Nice Drugs: Verapamil, Nifedipine, Diltiazem.

Ask your patient directly about hallucinations, including command hallucinations which are when a patient hears a voice instructing them to perform an action.

Patient with hallucinations

Cathy Parkes

Ask your patient directly about hallucinations, including command hallucinations. Implement 1:1 observation if indicated!

Patient with hallucinations

Cathy Parkes

Ask your patient directly about hallucinations, including command hallucinations. Implement 1:1 observation if indicated!

Beta 2 adrenergic agonists: Albuterol is SHORT-acting (for acute episodes) and Salmeterol is LONG-acting. HINT: Salmeterol looks like "salmon". Eating salmon can help you lead a LONG life.

Beta 2 Adrenergic Agonists

Cathy Parkes

Beta 2 adrenergic agonists: Albuterol is SHORT-acting (for acute episodes) and Salmeterol is LONG-acting.

Beta 2 Adrenergic Agonists

Cathy Parkes

Beta 2 adrenergic agonists: Albuterol is SHORT-acting (for acute episodes) and Salmeterol is LONG-acting.

Injury prevention in the home:  Make sure water heater setting is set to LESS than 120 degrees F to prevent burns.

Water Heater Settings

Cathy Parkes

Injury prevention in the home: Make sure water heater setting is set to LESS than 120 degrees F to prevent burns.

Water Heater Settings

Cathy Parkes

Injury prevention in the home: Make sure water heater setting is set to LESS than 120 degrees F to prevent burns.

Antidiuretic hormones (ex: vasopressin and desmopressin) are used to treat Diabetes Insipidus. These medications decrease urine output and increase urine osmolarity. HINT: "Vasopressin and desmopressin will suppress all that urine!"

Antidiuretic Hormones

Cathy Parkes

Antidiuretic hormones (ex: vasopressin and desmopressin) are used to treat Diabetes Insipidus.

Antidiuretic Hormones

Cathy Parkes

Antidiuretic hormones (ex: vasopressin and desmopressin) are used to treat Diabetes Insipidus.

Fat soluble vitamins are: Vitamin A, D, E, K.  HINT: "A fat deck of cards".

Fat-Soluble Vitamins

Cathy Parkes

Fat-soluble vitamins are: Vitamin A, D, E, K.

Fat-Soluble Vitamins

Cathy Parkes

Fat-soluble vitamins are: Vitamin A, D, E, K.

Community Oriented Nursing is focused on health promotion and disease prevention in the community. No direct care for individuals!  Community Based Nursing is focused on illness care for individuals and families.

Community Nursing

Cathy Parkes

Community Oriented Nursing is focused on health promotion and disease prevention in the community. No direct care for individuals! Community Based Nursing is focused on illness care for individuals and families.

Community Nursing

Cathy Parkes

Community Oriented Nursing is focused on health promotion and disease prevention in the community. No direct care for individuals! Community Based Nursing is focused on illness care for individuals and families.

Amphotericin B is only used for life-threatening fungal infections, because the side effects will "terrorize" your body. These side effects include: hepatotoxicity, nephrotoxicity, and bone marrow suppression.

Amphotericin B

Cathy Parkes

Amphotericin B is only used for life-threatening fungal infections, because the side effects will "terrorize" your body. These side effects include: hepatotoxicity, nephrotoxicity, and bone marrow suppression.

Amphotericin B

Cathy Parkes

Amphotericin B is only used for life-threatening fungal infections, because the side effects will "terrorize" your body. These side effects include: hepatotoxicity, nephrotoxicity, and bone marrow suppression.

Best practices for patients with DYSPHAGIA: Sit patient in upright position (High-fowler's). Lightly stroke chin/throat to promote swallowing. Teach patient to tuck their chin towards their chest when swallowing. Thicken thin liquids.

Dysphagia Best Practices

Cathy Parkes

Best practices for patients with DYSPHAGIA

Dysphagia Best Practices

Cathy Parkes

Best practices for patients with DYSPHAGIA

Best practices for telephone orders: Have second RN listen in on call. Repeat prescription back. Have provider sign prescription within 24 hr.

Telephone Orders

Cathy Parkes

Best practices for telephone orders

Telephone Orders

Cathy Parkes

Best practices for telephone orders

Calcium gluconate is used for emergency treatment of hyperkalemia and hypermagnesemia!

Calcium Gluconate

Cathy Parkes

Calcium gluconate is used for emergency treatment of hyperkalemia and hypermagnesemia!

Calcium Gluconate

Cathy Parkes

Calcium gluconate is used for emergency treatment of hyperkalemia and hypermagnesemia!

Dementia has slow onset, does NOT alter vital signs, and is irreversible. Delirium has rapid onset, can alter vital signs and level of consciousness, and is reversible.

Dementia vs. delirium

Cathy Parkes

Dementia vs delirium: Dementia has slow onset, does NOT alter vital signs, and is irreversible. Delirium has rapid onset, can alter vital signs and level of consciousness, and is reversible.

Dementia vs. delirium

Cathy Parkes

Dementia vs delirium: Dementia has slow onset, does NOT alter vital signs, and is irreversible. Delirium has rapid onset, can alter vital signs and level of consciousness, and is reversible.

Acyclovir and Ganciclovir are antiviral medications. Both medications have a key side effect of nephrotoxicity. Ganciclovir can also cause bone marrow suppression (anemia, neutropenia, thrombocytopenia).

Acyclovir and Ganciclovir

Cathy Parkes

Acyclovir and Ganciclovir are antiviral medications. Both medications have a key side effect of nephrotoxicity. Ganciclovir can also cause bone marrow suppression (anemia, neutropenia, thrombocytopenia).

Acyclovir and Ganciclovir

Cathy Parkes

Acyclovir and Ganciclovir are antiviral medications. Both medications have a key side effect of nephrotoxicity. Ganciclovir can also cause bone marrow suppression (anemia, neutropenia, thrombocytopenia).

Alpha-fetoprotein (AFP) levels are measured with prenatal bloodwork or with an amniocentesis.  HIGH levels of AFP are associated with neural tube defects. LOW levels of AFP are associated with chromosomal disorders (such as Down Syndrome).

AFP measurement

Cathy Parkes

During amniocentesis, alpha-fetoprotein (AFP) levels are measured. HIGH levels of AFP are associated with neural tube defects. LOW levels of AFP are associated with chromosomal disorders (such as Down Syndrome)....

AFP measurement

Cathy Parkes

During amniocentesis, alpha-fetoprotein (AFP) levels are measured. HIGH levels of AFP are associated with neural tube defects. LOW levels of AFP are associated with chromosomal disorders (such as Down Syndrome)....

Alendronate is a bisphosphonate used to treat osteoporosis. Key side effect is esophagitis. HINT: "Alen drones on and on about his esophagitis."

Alendronate

Cathy Parkes

Alendronate is a bisphosphonate used to treat osteoporosis. Key side effect is esophagitis. HINT: "Alen drones on and on about his esophagitis."

Alendronate

Cathy Parkes

Alendronate is a bisphosphonate used to treat osteoporosis. Key side effect is esophagitis. HINT: "Alen drones on and on about his esophagitis."

Key S&S of bulemia nervosa: normal (or slightly higher) body weight, calluses on knuckles, parotid gland enlargement, tooth erosion.

Bulimia Nervosa

Cathy Parkes

Key S&S of bulimia nervosa: normal (or slightly higher) body weight, calluses on knuckles, parotid gland enlargement, tooth erosion.

Bulimia Nervosa

Cathy Parkes

Key S&S of bulimia nervosa: normal (or slightly higher) body weight, calluses on knuckles, parotid gland enlargement, tooth erosion.

Iron supplements can cause dark green/black stools. This is expected and harmless.

Iron supplements and stool

Cathy Parkes

Iron supplements can cause dark green/black stools. This is expected and harmless.

Iron supplements and stool

Cathy Parkes

Iron supplements can cause dark green/black stools. This is expected and harmless.

2 key beliefs of preschoolers:  (1) Magical thinking: Thoughts can cause events to occur. (2) Animism: Inanimate objects are alive.

Key Beliefs of Preschoolers

Cathy Parkes

2 Key beliefs of preschoolers: (1) Magical thinking: thoughts can cause events to occur, and (2) Animism: inanimate objects are alive.

Key Beliefs of Preschoolers

Cathy Parkes

2 Key beliefs of preschoolers: (1) Magical thinking: thoughts can cause events to occur, and (2) Animism: inanimate objects are alive.

POSITIVE symptoms in schizophrenia include the presence of things that are NOT normally present. This includes:  Hallucinations, delusions, paranoia, speech alterations, abnormal body movements

Positive Schizophrenia Symptoms

Cathy Parkes

POSITIVE symptoms in schizophrenia include the presence of things that are NOT normally present.

Positive Schizophrenia Symptoms

Cathy Parkes

POSITIVE symptoms in schizophrenia include the presence of things that are NOT normally present.

Donepezil is a KEY medication used for Alzheimer's disease. It does NOT cure the disease, but it may improve memory, cognition, and an individual’s ability to perform ADLs.

Donepezil & Alzheimer's

Cathy Parkes

Donepezil is a KEY medication used for Alzheimer's disease. It does NOT cure the disease, but it may improve memory, cognition, and an individual’s ability to perform ADLs.

Donepezil & Alzheimer's

Cathy Parkes

Donepezil is a KEY medication used for Alzheimer's disease. It does NOT cure the disease, but it may improve memory, cognition, and an individual’s ability to perform ADLs.

A patient is POSITIVE for orthostatic hypotension if: The SBP decreases more than 20mmHg when changing position AND/OR the DBP decreases more than 10mmHg

Orthostatic Hypotension

Cathy Parkes

A patient is POSITIVE for orthostatic hypotension if: The SBP decreases more than 20mmHg when changing position AND/OR the DBP decreases more than 10mmHg

Orthostatic Hypotension

Cathy Parkes

A patient is POSITIVE for orthostatic hypotension if: The SBP decreases more than 20mmHg when changing position AND/OR the DBP decreases more than 10mmHg