Quiz me Nurse

  Most people who anticipate taking a long plane flight may hardly stop to think about dehydration and its consequences. Making sure appropriate clothing is packed, arriving at the airport on time, and making sure pets or children are cared for are just a few of the concerns a traveler might have. Skipping a meal as a result of anxiety may very readily happen. To further complicate matters, there are significant changes in time zones on a long flight across the globe. Someone who has been on a long flight and sitting for a considerable length of time, coupled with inadequate fluid intake, may be at risk for DVT (Deep Vein Thrombosis) . It is worth noting that taking the time to drink extra fluids before and during a long flight will help prevent dehydration. To learn more about Dehydration, you can watch a video here or  here . More helpful information:  Dehydration for the layperson

Scenario: Tim was involved in a car accident about a week ago. He is responsive but lethargic. The doctor ordered enteral feeding as Tim has difficulty swallowing. Why is enteral feeding ordered? Enteral feeding may be ordered by the doctor for a patient who is unable to swallow. The patient with a brain injury, stroke, or on mechanical ventilation may require tube feeding. How can aspiration pneumonia be avoided? Aspiration pneumonia can be avoided by the nurse being vigilant. The head of the bed is generally kept at 30 degrees while tube feeding is running unless otherwise ordered. Helpful Hints: - Follow MD orders - Check lung/bowel sounds - Check for residuals - Check abdominal distention - Follow MD orders for high residual volume Notes for Nurses: - The potential for aspiration of tube feeding should be reflected in the plan of care. - Documentation of the quantity of stomach contents should be done. Enjoy watching the video: Enteral and Parenteral tube

Why is a pacemaker implanted? Pacemaker implantation may be done for different reasons . Any damage to the heart muscle or the electrical conduction which will interfere with the ability of the heart to function normally may be indications for a pacemaker. Sick sinus syndrome (though rare) or myocardial infarction are examples. What are some symptoms of a dysfunctionl natural pacemaker? Patients who have dysfunction of their own natural pacemaker may experience dizziness, syncopal episodes (temporary loss of consciousness), chest pain, shortness of breath, fatigue, and a decrease in blood pressure (hypotension). Why do these symptoms occur? These symptoms are due to a lack of blood flow to the body's organs. Notes for Nurses: - See the sample of an EKG above showing a pacemaker lead (wire) in the ventricle. There is normally a spike in front of the QRS. The spike may not appear if the pacemaker malfunctions. - Spikes in front of P and QRS means both chambers are paced

What is the difference between ischemia and infarction? When an area of the heart muscle is ischemic or infarcted, that area is deprived of blood and oxygen. Infarction results in the complete death of muscle, whereas ischemia results from a shortage of blood and oxygen and there is a chance of recovery for the muscle. What are some causes of ischemia and infarction? Causes include : - A blood clot obstructing a blood vessel - Fatty deposits in blood vessel

Scenario: Sara is describing the symptoms she had over the last few days. These include abdominal pain, nausea, and vomiting. The nurse notes Sara's complaints and also does an assessment. She noted that there was tenderness over the abdomen. CT scan and lab values are ordered by the doctor. Lab values such as lipase and electrolytes may be ordered for the patient with pancreatitis. What is Turner's Sign? Turner's sign is an indication of acute pancreatitis. It shows as a bruising around the flank. Documentation should be done. What is pancreatitis? Pancreatitis is defined as inflammation of the pancreas. This condition may be acute or chronic . The Islets of Langerhans, which produce insulin, are in the pancreas. Insulin controls blood glucose. How does pancreatitis develop? Pancreatitis may be caused by: - Alcohol ingestion in excess - Trauma - Tumors - Certain medications, and more - Gallstones: blockage of the common bile duct with gallstones from t

What is HNKS? HNKS stands for Hyperglycemic Hyperosmolar Nonketotic Syndrome. Who is affected by HNKS? Patients who exhibit this condition are usually older and have type 2 diabetes. What are some symptoms of HNKS? Severe dehydration (due to high blood glucose), mental confusion, hypotension , and seizures may result.  How is HNKS treated? Medical management is necessary. Fluid replacement therapy to combat dehydration and correction of electrolyte imbalances are ordered by the doctor. What is the difference between Hyperglycemia and Hypoglycemia? Hyperglycemia is high blood sugar and may complicated diabetes. Hypoglycemia is low blood sugar and may result from insulin being given and mealtime being skipped. Note for Nurses: Monitoring blood glucose is an essential part of managing the diabetic patient . Hypoglycemic agents or insulin or both will be ordered by the doctor to meet the patient's needs.   Scenario: Tom is a 35 year o

  What are the adrenal glands, and what is their function? The adrenal glands are small endocrine glands which are situated one on top of each kidney . The hormone adrenaline (epinephrine) is produced by the adrenal glands. This hormone is commonly known as the one of "fight, flight, and right". Scenario 1 : Tina is a patient in the ICU. She is on the surgery schedule in the morning. Her family members are at the bedside to comfort her. The nurse did an assessment and vital signs. She noticed that Tina's blood pressure was elevated and heart rate was rapid. Tina is obviously scared. his is just one of a number of ways that adrenaline (epinephrine) goes to work in times of stress. The blood pressure or heart rate may increase due to stimulation of the hormone adrenaline.   Scenario 2 : Tim is being admitted to the hospital for a workup. Over the last few weeks, he noticed unusual symptoms that caused concern. They include: feeling depressed, nausea

Scenario : Tom has Peripheral Vascular Disease and type 2 diabetes. High blood glucose affects blood circulation . Tom complains of "intermittent claudication". What is PVD? PVD means Peripheral Vascular Disease.  What are the implications of intermittent claudication and PVD? Intermittent claudication affects diabetics . Patients experience pain on walking, but this usually resolves at rest. Circulation to the legs is affected and gangrene may result. Amputation may also result from PVD.   How should you treat blood glucose? Monitoring blood glucose is essential to maintain glucose within normal limits. Normal blood glucose is 60-120. Typically blood glucose is measured before mealtime. This will make for a more accurate reading. There are many different blood glucose meters on the market. How do you monitor blood glucose? Finger sticking for glucose monitoring is usually done off to the side of the finger. Rotation of sites is essentia

Scenario : Medical staff members are gathered around the bedside in the ICU . Mrs. T has been vomiting blood (hematemesis). The doctor orders CBC and IV fluids. Lab results reveal low H/H. The doctor additionally orders 1 unit PRBCs to be given via IV over 3 hours. What are some common abbreviations used in the clinical setting? - ICU = Intensive Care Unit - CBC = Complete Blood Count - IV = Intravenous - H/H = Hemoglobin and Hematocrit - PRBCs = Packed Red Blood Cells Learning more about this topic by clicking on the link:  The New Nurse - Medical Abbreviations Parts 1/2/3

Scenario: It's diaper changing time. Yes, this is a restaurant. Then why is the baby's diaper being changed on the table? Sometimes people do not consider the consequences of their actions. Without a doubt, a restaurant table is not the appropriate place to change a baby's diaper. Restrooms are well equipped for baby changing.

What is hemodialysis? Hemodialysis is a form of treatment for the patient in renal failure. This may occur for a number of reasons. Whatever the cause, hemodialysis may be used for a long or short period of time. What is the function of the kidneys? The kidneys filter out waste products from the blood. This is passed out as urine . The kidneys are located in the abdominal cavity and are bean shaped. Which body system are the kidneys part of? The kidneys are part of the excretory system. If they are unable to perform their normal functions , renal failure may result. What are some causes of renal failure? Possible causes of renal failure may include: - Diabetes Mellitus, pancreatitis - Trauma, liver failure, and more

Scenario : A teenager in the ICU has been declared brain dead after a gunshot wound. An angry family stands outside. How should a nurse deal with this situation? A nurse should use good communication skills to decrease the anxiety the family is feeling. A compassionate nurse uses good communication and tact to win them over.  

What are some common diabetic misconceptions? "I do not believe high blood sugar can affect my vision. I need new glasses" -- diabetes and high blood sugar can indeed affect your vision and have many other negative effects on the body. "My doctor talks about blood sugar control, but I find the easy thing to do is to add a few more units of insulin after an ice cream cone" -- blood sugar control starts with controlling sugar intake, not treating it once it is already in your body. "I love sugar free donuts. I treat myself to 3 each morning " -- something advertised as sugar free does not necessarily make it better or okay to over-indulge. It is important for the nurse to remember when educating the diabetic patient that misconceptions like the ones discussed should be addressed. It is not uncommon for a person with limited knowledge of an illness to have a different point of view about the correct way to manage illness.

Scenario 1: Mrs. S is a 38 year old female who has just been diagnosed with renal failure. The doctor discusses hemodialysis to improve the situation . What are the kidneys? The kidneys are two bean-shaped organs located in the abdominal cavity on either side of the spine. They work to filter out waste products from the blood.   Scenario 2: Tim was diagnosed with acute renal failure. A decrease in urinary output and recent antibiotic therapy were some of the factors that confirmed his diagnosis. Hemodialysis is ordered by the doctor. Special trained staff follow instructions ordered by the doctor. A nurse carries out the treatment ordered and monitors the patient during hemodialysis. What is renal failure? Renal failure occurs when the kidneys are no longer able to perform their normal function and unable to filter the blood. Depending on the cause, renal failure may be acute or chronic. Enjoy watching he video: The New Nurse - liver and kidneys at work Wha

Scenario: Tom was admitted to the ICU for the clinical picture of a patient in diabetic ketoacidosis (DKA). His blood glucose was 600. Tom has an altered level of consciousness (LOC). He also has hyperglycemia (elevated blood glucose). What are some symptoms of DKA? The patient in DKA requires immediate intervention and a level of care like ICU. Some symptoms that may appear include: - Tachycardia (rapid heart rate) - Tachypnea (rapid breathing) - Polyuria ( excessive urination) - Polydipsia (excessive thirst) - Flushed face - Breath has a fruity odor

What is the function of the heart? The heart is a pump which pumps blood all around the body. When the heart becomes damaged either by injury such as myocardial infarction , trauma, or cardiomyopathy (weakness of the heart muscle), a state of shock may occur. The heart loses its ability to deliver oxygenated blood to the entire body.Learn more: Cardiopulmonary arrest What is Cardiogenic Shock? Cardiogenic shock is also known as pump failure. The mortality rate for this condition is fairly high. Quick action and accurate assessment is needed to recognize and treat cardiogenic shock. Learn more: Cardiogenic shock How is Cardiogenic Shock diagnosed and treated? Cardiac studies (determined by the doctor) will be done to confirm the diagnosis . Ventilatory support may be necessary to ensure adequate oxygenation. Patient and family education will help to relieve the anxiety associated with this condition. Learn more: Chest pain assessment and quiz What is Ventricular

Scenario: Anna loves to brush her teeth and wash her hands. Sometimes her gums may even bleed. What is OCD? OCD stands for obsessive compulsive disorder. How is OCD treated? Cognitive Behavioral Therapy (CBT) is a form of Psychotherapy which is sometimes used. This involves redirection of the thought processes in order to stop the compulsive actions. Antidepressants can also be used. Some antidepressants which are approved by the FDA for treating this condition include, but are not confined to: - Sertraline (Zoloft) - Fluoxetine (Prozac) - Paroxetine (Paxil) What are some side effects of antidepressants? Antidepressants may have side effects such as: - Gastrointestinal upset - Drowsiness Enjoy watching the video: Healthy living

Do you know the function of theses cranial nerves? Cranial nerves 3, 4, and 6 are responsible for extraocular eye movement and work smoothly together. Cranial nerve-3 (oculomotor) constricts the pupils when light is shone into the eyes. Cranial nerve-4 (trochlear) moves eyes downward and inward. Cranial nerve-6 (abducens) abducts eyes. What does the brain stem consist of? The brain stem consists of the midbrain, pons, and medulla oblongata.

What is Cardioversion? Cardioversion is a form of electrical treatment used to change the heart from atrial fibrillation to a normal rhythm (sinus rhythm). It is usually done in a synchronized manner (the R wave of the EKG rhythm). What is defibrillation? Defibrillation is a form of electrical shock treatment used to change the heart from a life-threatening cardiac rhythm to a normal one. It is usually done by a medically trained person. Learn more about: Chest pain  assessment and the EKG What is the difference between Cardioversion and Defibrillation? Cardioversion is not done as an emergency, whereas defibrillation is usually done emergently. The level of electrical energy used is decided by the doctor. ACLS protocols are usually followed. Learn more: Lessons to be learnt about CPR

What is the role of the nurse educator? The nurse educator is fully engaged in teaching the student nurses about the importance of taking the necessary precautions to prevent the spread of infection in the hospital setting. Learn more about: The Immune system What actions need to be taken when patient isolation is ordered? The nurse is responsible for making sure the necessary equipment is made available to medical personnel as well as visitors. A special cart with disposable gowns, gloves, and masks is provided for use prior to entering the patient's room. Helpful Hints: - Handwashing is important in preventing the spread of infection - A full needle holder can become a source of contamination. Getting stuck with a dirty needle poses a risk of infection .

What is an arterial line? An Arterial line is a pressure line which is inserted into the artery. Typically, the radial at the wrist is used. The brachial artery at the inside of the elbow joint or the femoral in the groin area may also be used. What are some of the uses of the arterial line? Uses of the line include: - Constant blood pressure monitoring - Lab values can be done without always sticking the patient Helpful Hints: - Monitor tracing, per protocol - Check site for any disconnection or hematoma formation - Change and date tubing, per protocol, to prevent infection How is the phlebostatic axis used? The phlebostatic axis is used as a reference point when zeroing pressure lines. CVP, PA, and arterial lines are usually zeroed daily or per ICU protocol. The new nurse should familiarize herself with this landmark. More Helpful Hints: - Check pressure bag to ensure enough fluid - Date and time tubing; change per hospital's protocol

What happens during cardiogenic shock? The left ventricle receives its blood supply from the left anterior descending (LAD) artery. When a myocardial infarction (MI) occurs, lack of blood supply to the left ventricle results in pump failure. Why does cardiogenic shock occur? Cardiogenic shock may result from pump failure. ICU care is necessary for the patient in cardiogenic shock. What are some signs of cardiogenic shock? - Hypotension as the heart loses the ability to pump enough blood - Cool, clammy skin due to poor tissue perfusion - Oliguria, which is a decrease in urinary output What is a Myocardial Infarction (MI)? A myocardial infarction is also known as a heart attack in layman's terms. What is a MI caused by? MI is caused by a lack of blood supply and oxygen to the heart muscle. A blood clot or plaque may obstruct the flow of blood. This typically occurs in the patient with coronary artery disease (CAD). What are some symptoms of MI? - Chest

Scenario: Jenna is scheduled for a colonoscopy. Over the last week, she noticed blood in the stool and irregularities. The doctor has now ordered a colonoscopy. Why would a patient need a colonoscopy? A colonoscopy may be done for different reasons, such as removal of colonic polyps and blood in the stool. What happens before and after a colonoscopy? Prior to a colonoscopy, special preparation is done. This may include enemas and clear liquids. During a colonoscopy, a fiber-optic instrument is inserted into the colon, which allows for visualization of the lower portion of the large intestine. Post procedure, abdominal cramps and gas have been reported by some patients. What is peritonitis? Peritonitis is an infection of the peritoneum. This is the lining of the abdominal cavity and its organs. Why does peritonitis occur? It may occur for a number of reasons. They include: - Abdominal trauma - Surgical intervention - Peritoneal dialysis What are some symptoms of p

Scenario 1 : Sam had a stroke involving the occipital area of the brain. His vision was affected.   He was advised by his doctor to give up his driving privileges. He refused and drove into a tree. Scenario 2 : Tina's stroke involved the parietal lobe. She is having difficulty with distinguishing right from left and math calculations. Enjoy the video:  The stroke patient What testing is done after a stroke? An eye exam may become necessary to check for visual deficits. Visual acuity testing is done from about 20 feet away. What is stereognosis? The normal ability to identify objects by touching. Can you identify brain lobe involvement after a stroke? Scenario 3 : Tom had a stroke which involved the temporal lobe. He now has difficulty with his hearing and memory loss. Scenario 4 : Ellen was diagnosed with a brain tumor in the frontal lobe. A tumor resection was done. Ellen is now showing signs of impaired judgement and unsteady gait. What is the human brain made u

What is a stroke? A stroke is also known as a brain attack. What kind of strokes are there? It may be hemorrhagic (caused by bleeding) or ischemic ( embolic ) caused by a clot or plaque in a blood vessel. Bleeding into the brain may be caused by trauma or rupture of a blood vessel due to high blood pressure. In an embolic stroke, a blood clot may obstruct the flow of blood in the brain. How is a stroke diagnosed? A CAT scan or MRI are diagnostics tests done to confirm the diagnosis. Why is ICP Monitoring done? Intracranial Pressure (ICP) Monitoring is done to monitor the ICP and take measures to decrease brain swelling. This may be done by medications such as Mannitol or insertion of an EVD through the Foramen Magnum at the base of the skull to prevent herniation caused by untreated brain swelling. What are the roles of health care providers? The doctor orders vital signs, frequency of ICP recordings, pain, and other medications . The nurse has an impo

How is blood pressure measured? Blood pressure is measured by an instrument called a sphygmomanometer, which includes a blood pressure cuff that is placed on the arm above the elbow. A stethoscope is used to listen to the blood pressure. What do the numbers recorded for blood pressure indicate? When the blood pressure is recorded, there is a higher and lower number. The higher number is called the systolic blood pressure. The lower number is called the diastolic blood pressure.

What are some indications for blood transfusion? Blood transfusion may be ordered by the doctor for many reasons, which include: - Trauma resulting in massive blood loss (like a femur fracture) that may lead to hypovolemic shock : Simple facts about Hypovolemc Shock - Anemias (such as aplastic and iron deficiency) - Thrombocytopenia and other blood disorders Enjoy watching the video: The New Nurse-Blood transfusion

What does SCI mean? SCI means Spinal cord Injury. What impact might this have on the spinal column? It is important for the nurse to document her findings  when an assessment is done.  Here are some of the problems that may result from SCI: - injuries above C3 may affect breathing Mechanical ventilation may be necessary - C3-C7 will involve some degree of weakness involving shoulders, arms, hands and fingers - T 1-T12 injuries may paraplegia - L1-L5 injuries may affect the thighs, knees, feet and toes For more information, please click on the link: Defining dermatomes