NURSE WITH A PULSE 🫀

*4pm CLINICAL SKILL*

_SHOCK HACK_‼️

if you are dealing with critical patient and you want to know the patient will get into shock over few hours use what we call shock index 🕺✍️
With shock index you take the heart rate and divide by systolic blood pressure..HR/SBP ..if the index is less than 0.7 then it's normal patient is safe and if the index is above 0.7 it's abnormal and your patient will go into shock in the next few hours ✅

this patients tend to have normal blood pressure but high HR

When you see a patient with high HR and normal BP in critical case you must be curious,.that high HR is like a compensatory mechanism to sustain the BP and it always fails later

Hope this helps someone ✍️📌
Keep learning 🕺✅




Have you ever met such patient, how did you address the cause of the impending shock 😝

Student nurses guide to blood transfusion reactions

A blood transfusion reaction occurs when a patient’s immune system reacts adversely to the transfused blood or its components.

Types of reactions
Febrile non-haemolytic reaction (most common)
- Cause: sensitivity to white blood cells, platelets or plasma proteins
- Symptoms: Fever, chills, headache, muscle pain, nausea
- Onset: 1-6 hours post transfusion

Allergic reaction
- Cause: Allergic response to plasma proteins
- Symptoms: Uritcaria (hives), itching, flushing, severe cases may result in anaphylaxis
- Onset: During or shortly after transfusion

Haemolytic reaction (acute or delayed)
- Cause: Mismatched blood type or antibodies attacking donor red blood cells
- Symptoms: Fever, chills, flank pain, hypotension, tachycardia, haemoglobinuria
- Onset: Acute = within minutes to hours, delayed = days to weeks

Transfusion-associated circulatory overload
- Cause: rapid or excessive transfusion leading to fluid overload
- Symptoms: dyspnoea, hypertension, tachycardia, pulmonary oedema
- Onset: During or shortly after transfusion

Transfusion-related acute lung injury
- Cause: Antibodies in donor plasma reacting with patient leukocytes, causing lung inflammation
- Symptoms: sudden respiratory distress, hypoxia, fever, hypotention
- Onset: Within 6 hours of transfusion

Empowering your nursing journey

⁣
Class: Anticoagulant⁣
⁣
Indication: Used to prevent and treat blood clots, reducing the risk of stroke and heart attack⁣
⁣
How It Works:⁣
Warfarin inhibits vitamin K-dependent clotting factors (II, VII, IX, and X), slowing down the blood clotting process⁣
⁣
Key Points:⁣
* Monitoring: Regular INR checks are essential to ensure therapeutic levels (typically 2.0-3.0 for most indications).⁣
* Common Side Effects: Bleeding, bruising, and potential interactions with other medications and foods.⁣
* Dosing: may need to be adjusted based on INR results⁣
* Antidote = Vitamin K⁣
⁣
Tip for Memorization:⁣
Use the acronym “WARF” to remember key aspects:⁣
* W - Watch INR levels⁣
* A - Avoid foods high in vitamin K (e.g., spinach, kale)⁣
* R - Report any unusual bleeding or bruising⁣
* F - Follow up regularly with healthcare provider⁣
⁣
Patient Education:⁣
Educate patients on the importance of consistency with vitamin K intake and adherence to blood tests.⁣
⁣

*@keivhack 12 pm big skill scenario* 💯

A newborn weighing 4 kg is delivered to a mother with a history of opioid addiction. The baby has an APGAR score of 9 at 1 minute and 10 at 5 minutes but exhibits mild signs of respiratory depression.😎

Will you administer naloxone? Justify your decision, explaining the potential benefits and risks of administering naloxone in this scenario.🪐😊

Colloids vs. crystalloids 💧

🩸Colloids have large molecules that stay in the bloodstream longer, making them more efficient at increasing blood volume.
→ Examples of colloids are packed RBCs, FFP, and albumin

💎Crystalloids have small molecules that are quickly distributed in the body, providing immediate fluid resuscitation for dehydration or shock.
→ Examples of crystalloids are common IV fluids (hypertonic, isotonic, or hypotonic solutions)

*1pm recap 👁️*

- Neural Tube Defects -

🦴Spina Bifida Occulta
Patho: Vertebral splits are too small to allow protrusion
S&S: typically asymptomatic, skin at site may appear normal or have hair or dimpling

🦴Meningocele
Patho: Meninges are forced into vertebral gaps
S&S: Limited symptoms - no damage to nerve tissue, sac protrudes from spinal area, sac is enclosed; no protrusion

🦴Myelomeningocele
Patho: A sac forms over the meningeal membranes that cover the spinal cord enclosing the spinal elements and nerves
S&S: Spinal cord protrudes through unfused portion of the spinal column

Hello! Happy New Year everyone!!! 🎊🎆🎊🎆 We wish everyone the best for the year ahead 🙏

We are also excited to invite you to Session 3 of the series, where we will discuss *Cardiogenic Shock* on Wednesday *Jan 15*

Registration link: https://us06web.zoom.us/meeting/register/tZEqceuvqD8pGtYEYnNTdswA7yMRcObHjQRa

Even if you attended session 1 or 2, you must register for a *new link* each time.

Time: 3PM GMT | 4PM WAT | 5PM CAT | 6PM EAT

Did you miss session 1 or 2 and want to catch up?

You can find the slides and recordings on the Learning Resource Center - register for free today!

https://www.stanesglobal.com/course/foundations-of-critical-care

Please feel free to share this invite widely with your colleagues and networks. See you then!!!

*29th dec 10am insight* 💯

You the point of care health worker a mother comes in with hx of incomplete abortion, @16 weeks ,
Guide us how you going to manage her ,

Goodday 💯✍️

Which of the following observe in this image?
A)venturi mask
B)NRM
C)PRBM
D)CPAP

Which of the following observe by nurse in this image?
A)PICC line
B)Hickman
C)Thompson test
D)homans test

QUIZ MODE ✍️💯

📚Blood Transfusion Facts🩸

💦Normal saline is the only compatible solution to use with blood or blood components

🩸All blood products require a filter to remove clots, lumps of platelets & WBCs during the infusion

⏰The first 15 minutes of administration are the MOST CRITICAL. You must be in the room monitoring your patient for any transfusion reactions!

✋STOP the transfusion if a reaction occurs (ex: Tachycardia, hypotension, fever, back pain, etc)

Who has had a patient in clinicals requiring a blood transfusion?👩‍⚕️

*1pm OBSTETRICS SKILL*

_PREECLAMPSIA HACK_

Patient at risk are
Obesity, extreme of age , multiple gestation,past hx of preeclampsia
Change of male partner, chronic hypertension ✅✍️ and many more

If you see this patient kindly advise them for preeclampsia as a complication during their gestation period,.✅

Now when they come to your premise and you curious you can prevent preeclampsia during early stages by
📌Give them vitamin D and folic acid before 16 weeks gestation that is for low risk patient ✅
📌For more than 3 risk mentioned above you give them junior aspirin JASA 150 mg nocte before 16 weeks i.e 11-28 weeks safe✅

Note : we always stop JASA post delivery ,or when preeclampsia sets in .

Hope this helps someone 📌✍️
Keep learning ✍️📞

*8pm HEPARIN SKILLS ADMINISTRATION💉 📌*


parin Administration Explained 💉

1️⃣Attach the needle to the syringe (blunt needle if preferred)
⭐️Rationale: if you insert an injection needle into someone after piercing a vial, it may become slightly blunted and cause discomfort to the patient; blunt fill needles minimize the risk of needlestick injuries

2️⃣Uncap & clean vial

3️⃣Inject air (equal to volume in mL)

4️⃣Draw back heparin (volume in mL)

5️⃣Remove the needle & attach the appropriate needle for SUBQ injection

6️⃣Clean the site with an alcohol pad & wait for the skin to dry naturally
⭐️Best absorbed in the abdomen

7️⃣Pinch & inject at 45-90 degree angle

8️⃣Inject medication & wait for 3 seconds before removing the needle & engage safety
⭐️Dispose safely in sharps container

have you ever administered one💉??
You gat it💉✅📌

*5PM Christmas outburst*
**
Let's say we get a client with ESKD, with potassium 7.2 , BUN 35 , creatinine 3.8 ,and urine output of 300 ML in 24 hours ,
WHAT IS YOUR PRIORITY NOW ,😉 give rationale

GTPAL: an acronym used to quickly help assess pregnancy outcomes

🤰Gravidity: Total number of pregnancies
-Includes current pregnancy
-Includes miscarriages/abortions

🤰Term births: Number born at term > 37 weeks gestation
-Includes alive or stillborn

🤰Preterm births: Number of pregnancies delivered between the 20th and 36 6/7th weeks of gestation
-Includes alive or stillborn

🤰Abortions/Miscarriages: Number of pregnancies delivered before 20 weeks gestation
-Counts towards gravidity (the number of pregnancies)

🤰Living children: Number of current living children
-Twins/triplets count individually

⭐️When considering twins, triplets, or multiple infants, they count as ONE pregnancy for gravidity, term births, preterm births, abortions, or miscarriages

⭐️The only instance where multiple infants count individually is in the number of living children

- SIDS DO’s & DON’Ts -

DO
✅Position the infant on their back to sleep
✅Keep the crib empty of toys, blankets, and pillows
✅Dress the infant in lightweight, comfortable clothing
✅Have the infant sleep alone in their crib

DON’T
❌Position the infant on the stomach or side to sleep
❌Place soft bedding or toys in the crib
❌Over-bundle or overdress the infant
❌Co-sleep with the infant

What else do you think of when it comes to SIDS?

10 am skill💤💯


Central lines, PICC lines, and Midlines…oh my! 🩸Let’s break them down:

–Central Venous Catheter (CVC) –
Inserted into a large vein in the neck (internal jugular vein) or chest (subclavian vein)
Long-term therapy for those with poor peripheral access or frequent/constant administration of fluids & medications
Leads to large central veins near the heart
Typically stays in place for up to 6 weeks (varies depending on the case)
Increased risk of infection

– Peripherally Inserted Central Catheter (PICC Line) –
Inserted into a peripheral vein in the arm, basilic vein
Long-term therapy for those with poor IV access or frequent/constant administration of fluids & medications
Leads to large central veins near the heart, making it a central line
May remain in place for up to 6 weeks (varies depending on the case)
Increased risk of infection

CVCs & PICC lines are both central access devices, with the main difference being the insertion site: neck/chest vs. arm!

– Midline Catheter–
Inserted peripherally into a peripheral vein in the arm; basilic vein
Extends MIDWAY from insertion site to the heart → Midline think Midway!
Remains in for therapies extending 5-28 days (varies depending on the case)
LOWER risk of infection; doesn’t extend into central veins

Have you seen or used these in clinical practice yet? 👩‍⚕️

*8:30 AM NURSING COMPETENCE*
You are caring for a patient with a history of heart failure. Over the past 72 hours the patient has gained 1 Kilogram, has become increasing short of breath, JVD is noted and 3+ pitting edema. The heart rate is sitting at 57. The 0900 medications are due. They include digoxin, spironolactone, an ACE inhibitor and furosemide. What should you do first?
A-Hold the furosemide and contact the provider.
B-Administer all of the above medications as ordered and document the findings.
C-Hold the digoxin and give the rest of the medications.
D-Apply 2L/NC and hold all medications at this time.


Picture on the right is an extreme case of JVD. The left picture is what you are more apt to see