Assessment
What is the best pulse to determine brain profusion (adult)?
Carotid
Post-MI Diet education
Low fat: Avoid fried foods, cheese, butter,
Low sodium
Increase fiber
Reduced sugar
Atrial fibrillation can cause _____. Patients should be placed on a ______ to prevent this.
Stroke, a blood thinner (warfarin, rivaroxaban, etc.)
DVT Care
Elevate affected leg
Apply warm compress
Never rub the affected leg
Bed rest to reduce embolus
Administer blood thinners as ordered
Pain control
Monitor for PE: Watch HR/O2/BP
Verapamil education
Calcium channel blocker:
Avoid grapefruit
Take as prescribed
Change position slowly to avoid orthostatic hypotension
Don't stop suddenly (rebound hypertension)
Monitor BP regularly
Symptoms of anaphylactic shock
Airway edema, stridor
hypotension
Tachycardia
Cyanosis
Absent deep tendon reflexes r/t decreased is
Remember anaphylaxis is a type of distributive shock
Carbon Monoxide education
Carbon monoxide (CO) is poisonous and prolonged exposure to it can cause brain damage, unconsciousness, and death.
Carbon monoxide gas is odorless, tasteless, and colorless.
A carbon monoxide detector is the best protection against prolonged exposure to carbon monoxide in the home.
Carbon monoxide can cause headaches and nausea, then coma and death
Treated with 100% O2 (usually NRB, hyperbaric chamber if severe and chamber is available)
Strip 1 - Identify
V-tach (monomorphic)
PAD Symptoms
Atenolol education
Beta-blocker:
May cause bradycardia
Take as prescribed
Change position slowly: avoid orthostatic hypotension.
Monitor BP regularly
Do not stop abruptly (rebound HTN)
What are basic assessment priorities in nursing?
1. AIRWAY
2. Breathing
3. Circulation
Teaching for anaphylaxis history
Keep IM epinephrine on hand:
Epinephrine, an adrenergic agonist, reverses the most severe manifestations of anaphylactic shock and is the first medication to be administered
Benadryl can be taken AFTER epi
Albuterol may be administered AFTER epi if ordered
Strip 2: Prepare for _____
Defibrillation
What reasons would you call an RRT?
When would you NOT call an RRT?
RRT:
Change in mental status (newly confused, decreased LOC)
New onset shortness of breath
New onset severe hypertension >200/90
New onset chest pain
Concerning change in VS (hypotension, bradycardia, tachycardia)
NO RRT:
More pain medication
Upset patient and would like to talk to the provider as soon as possible.
Warfarin education
Take as prescribed
Monitor for bleeding: avoid injury, soft toothbrush and electric razors, and seek help if you sustain a head injury, internal injury, MVC, etc.).
Regular monitoring: INR checks
Dietary: Limit vitamin K-rich foods (green leafy vegetables)
Over-the-counter meds/supplements: communicate to the provider due to interactions.
Puncture wounds are a high risk of _____.
The nurse should assess the need for ___________ administration
Infection
Tetanus vaccine
Additionally, individuals who experience a wound that puts them at risk for tetanus (such as a puncture wound or deep cut) and who have not received a tetanus vaccine in the past 5 years may require a tetanus booster shot, usually in the form of Td vaccine.
DNR education
The patient needs an order to be DNR
If alert and oriented patient makes all decisions
Forms may require explanation (DNR/DNI/COMFORT etc.)
Strip 2: identify
a fib
Deep laceration: Initial intervention
#1 APPLY PRESSURE
Then, raise the extremity above the level of the heart
A tourniquet is a last resort
What cardiac arrhythmia is adenosine given for? How is it administered?
SVT
6mg rapid PIV push, AC vein or higher
If unsuccessful, may give second dose of 12mg
Symptoms of hypovolemic shock
Hypotension
Tachycardia
Tachypnea
Pale cool/clammy skin
Slow capillary refill
Decrease urine output
AMS
Decreased bowel tones
Falls.
Strip 2: What medication should be prescribed to the patient to prevent complications?
Blood thinner (warfarin, rivaroxaban)
GCS of the table?
= 3
What cardiac arrhythmia is atropine administered for?
Symptomatic bradycardia