When you begin taking care of patients who are on cardiac monitoring (AKA “tele monitoring”) you’ll need to chart a few key ECG measurements once per shift and any time there is a change in the rhythm. These are the PR interval, the QRS, the QT and the QTc. You probably are already very familiar with the PR interval and QRS measurements…but what is a QT and why do you need to measure it?
If there’s one thing that will separate the rookie nurse from the seasoned pro is how an elevated lactate is interpreted. The gut reaction in many cases is to scream SEPSIS from the rooftops. After all, sepsis is very serious and catching it early plays an enormous role in reducing mortality. And yes, one of the signs of sepsis IS an elevated lactate. However, loads of other things can cause it to be high, and knowing what these are will not only make you come across as incredibly competent, you’ll be prepared to take even better care of your patients.
In this episode we talk about the basics of ARDS – Acute Respiratory Distress Syndrome. It is the most severe form of acute lung injury and is something we see pretty regularly in the MICU. Learn about the different stages that occur as ARDS develops, what you’re going to assess and how the patient is going to be treated in this episode of the Straight A Nursing Podcast.
ECMO (otherwise known as extracorporeal membraneous oxygenation) is essentially a life support measure used when the lungs or both heart and lungs cannot function adequately with traditional mechanical ventilation support. In ECMO, blood is drained from the body, diverted to an oxygenator where gas exchange takes place, then returned to the patient. There! Now you know everything you need to know about ECMO. Just kidding! Let’s start at the very beginning.
It’s your first shift of four-in-a-row and little do you know that you are in for a tough stretch! Your shift starts out calmly enough, but at 0200 you take report on a 23-yr old post-surgical trauma patient who came in through the ED due to a pedestrian vs auto incident. The patient was crossing the road on a dark, rainy night when she was struck by a vehicle at approximately 30 mph. Her injuries are:
Taking care of patients with neurological injury means managing their intracranial pressure, or as it’s commonly called, ICP. And when we say neurological injury, keep in mind that we’re not just talking about people getting bonked on the head with a 2 x 4. We’re talking about space-occupying lesions, hydrocephalus, intracranial hemorrhage, subdural/epidural hematoma, even severe hyponatremia…basically anything that’s a key player in (drum roll please….) the Monro-Kellie doctrine.
The phrase you will hear most often in your nursing school career isn’t, “This is on the test” or “Choose the members for your group project” or even “Get comfy for six hours of lecture.” Nope…the most common phrase (and probably the most important one) is “What are you going to do about it?” It’s also the most common thought running through your head once you’re out there doing your thang as an RN! Here’s what I mean by that…
Ah, the kidneys…who doesn’t love ‘em? These two little bean-shaped organs will come into play with just about every single patient you deal with. In some cases it will be a chronic and devastating case of renal failure, (such as those patients requiring dialysis), but in most cases it will be moderate and more subtle. In all cases, renal function will tell you volumes about the patient’s fluid balance, electrolytes, blood pressure, infection and perfusion. Keeping an eye on renal function is a basic skill you’ll use every day as a beside RN…so let’s get to it!