Quiz me Nurse

  Scenario : The patient above, had surgery three days ago. He is on  anticoagulation therapy  (Heparin) for  DVT.   Anticoagulants are blood thinners. Their purpose is to  prevent blood from clotting too easily. Patients with atrial fibrillation may be placed on anticoagulants, in order to prevent a stroke. The patient on anticoagulation therapy, is at risk for bleeding. This may occur at the IV or  dressing site, gums, urine and more. The  care plan  is used to reflect the potential for bleeding. The nurse started an  IV infusion  of potassium, per MD orders. It  must be remembered that IV potassium , even when administered correctly, may cause irritation to the veins. Enjoy the video: Anticoagulation therapy

Scenario : Ron is transferred to CCU. The cardiologist in CCU (Coronary Care Unit) ordered an echocardiogram and cardiac catheterization. How is an echocardiogram performed? An echocardiogram is performed using ultrasound. It can provide information such as heart valve disease, blood clots, and more. The ejection fraction (the amount of blood ejected from the left ventricle each time the heart contracts) is also measured. There are different types of echocardiograms. What are the different types of echocardiograms? The one described above is the standard kind. The Transesophageal Echocardiogram  (TEE) is done using the esophageal approach. Dopamine stress echocardiogram is yet  another type which may be done. What is cardiac catheterization ? Cardiac catheterization is a valuable diagnostic tool. It is performed in a special  laboratory. A small catheter  is inserted into the heart via the arm or groin. It is an invasive procedure and is done under...

                                Pneumothorax Scenario : A patient was involved in a car accident.  Trauma to the chest area, has resulted in a pneumothorax. He was also having difficulty breathing , so the medical team initiated CPR and placed an ETT ( endotracheal tube).  An AMBU bag is being used to deliver oxygen, while being transported to a healthcare facility.  Signs and symptoms of a pneumothorax : - shortness of breath - breath sounds are diminished on the affected side - tracheal deviation away from the side of the pneumothorax - distended neck veins - the heart may also become compressed Defining Pneumothorax   There are two lungs ( right and left) located in the chest cavity. There are two membranes that cover the lungs. The inner membrane is in direct contact with the lungs. The outer layer is in contact with the chest wall. There is serous fluid between these layers, a...

  Why is a pacemaker implanted? Pacemaker implantation may be done for different reasons. Any damage to the heart muscle, or the electrical conduction system, will interfere with the ability of the heart to function normally.This may be an indication 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) .Learn more: Sessions 18 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 Q...

                                                                Atrial Fibrillation        Atrial fibrillation is a rapid , irregular arrhythmia. It is caused by the atria     ( upper heart chambers) beating rapidly and out of character. There is no P      wave on the EKG.     The SA ( sinoatrial node) is the pacemaker of the heart. When the SA      node fires, the atria contract simultaneously. This causes blood to be     pumped into the ventricles.    In Atrial fibrillation the atria beats rapidly and there are no real contractions.    The atria "quiver", but not contract.An irritable focus in the atria, seeks to do    the work of the SA node.This results in ineffective emptying of the atria.    Ultimately,...

The image below, demonstrates chest pain brought on by stress. Mrs. K has an overly demanding boss. Not only is she experiencing  chest pain related to stress, but her heart is having PVC's ( premature ventricular contractions), as reflected in the EKG. Chest pain may occur anywhere and anytime, even at rest. It may be related to stress or actual damage to the heart. A patient having a heart attack , usually complains of chest pain.  Helpful hints: It is important to do a pain assessment on a scale of 1-10 and document findings. Chest pain may be sharp, severe and stabbing. It may also feel like pressure in the chest or  Like a pair of hands squeezing the chest. It is also of note, to ask the patient to describe the character and duration of the pain. Always remember to document all interventions. Follow your Institution's policies, procedures and MD orders for chest pain. Watch the video: Do you know your heart Simple EKG interpretation: The EKG (Electrocardiogram) is...

The Endocrine System The Endocrine System is made up of glands that secrete hormones. Hormones are necessary for regulating normal body functions.             The information provided on hormones and the endocrine system is intended to help the nurse understand this complex system.                               There are Parts 1, 2, 3 and 4 , including quiz questions in each part.                                                    Learn more by watching the video: The Endocrine System                                                                            ...

The Thyroid gland  The Thyroid gland is  described as the largest of the endocrine glands. It is situated in the front of the neck and is butterfly  shaped. It is controlled by the pituitary gland and secrets two important hormones : T3 and T4. Iodine is taken from the foods  we eat and used to produce its hormones. The hypothalamus produces ADH ( antidiuretic hormone).It is stored in the posterior pituitary gland. ADH plays a great role in the  amount of urine which is excreted by the kidneys.           Diabetes Insipidus ( DI) should not be confused with Diabetes Mellitus.        Diabetes Insipidus is caused by a lack of ADH ( antidiuretic hormone). Surgical intervention may cause this problem.                                 Patients  who develop DI, dump large quantities of dilute urine.       If left unt...

                                                      The Adrenal glands The adrenal glands are small endocrine glands and are situated one on top of each kidney. The hormone adrenaline ( epinephrine) is secreted by the  adrenals. This hormone is commonly known as  the gland of " fight, flight and fright". Aldosterone is also a hormone produced by the adrenals. It has a direct effect on the kidneys, by stimulating the absorption of sodium and potassium  by them. This also has an impact on blood pressure. Scenario : 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, poor appetite, fatigue , and wanting to eat only salty foods. Tim is going to be examined by the doctor, who will order tests to determine his diagnosis. ...

INSULIN - A HORMONE Insulin is a hormone which is produced  in the pancreas, by special glands known  as the Islets of Langerhans. When we eat a meal like hamburger,fries and milkshake, Insulin is  released in the blood stream to control blood glucose. The liver  stores glucose in the form of glycogen. If the pancreas is not able  to produce insulin, diabetes ensues. Diabetes Mellitus may be Type 1 or Type 2.  Enjoy learning more : Diabetic instructions QUIZ QUESTIONS 1. What is Insulin? 2. Where is Insulin produced? 3.Where is Insulin stored? Diabetes Insipidus should not be confused with Diabetes Mellitus. For more helpful information, please read Part 2. PATIENT EDUCATION AND DIABETIC MISCONCEPTIONS It is important to remember when educating the diabetic patient,  that misconceptions like the ones shown, should be addressed. The image above, provides examples of misconceptions about Diabetes.  Diabetes may be further complicated by DKA ( Dia...

  During pregnancy , the placenta or afterbirth develops inside the uterus .  If the placenta develops in the bottom of the uterus, it blocks the cervix  ( neck of the uterus) and will ultimately make vaginal delivery almost impossible. Sudden painless bleeding which may be mild or heavy is a warning sign. The diagnosis will be confirmed by Ultrasound. Close fetal monitoring  is usually done. C-section may be necessary at the time of delivery. PROM ( Premature Rupture of membranes) Premature Rupture occurs if the membranes Rupture before the 37th week week of pregnancy. There are risks such as a premature birth, as well as a  risk of infection. A warning sign , is amniotic fluid leaking slowly or may gush out via the vagina. it is important for the mother to seek medical advice.