#nursing practice

To clarify, I would not be diagnosing- someone would come to me with a diagnosis of, say, hypertension, which most docs don’t have time to fully explain beyond “now you have to take this pill” and I could allow time to answer questions, explain how the illness worked in a way they could understand, and coach them on potential lifestyle changes they may want to make. This is covered under #4 of the nurse practice act in my state, pictured below:

What are your assessments? What are your interventions? Whatever you do for the patient make sure you record in their documentation.

In an inpatient setting, monitor their vitals every 4 hours or more if it becomes unstable or if anything changes temperature heart rate respiratory rate blood pressure.

If there are any changes in the things mentioned above, notify the physician, and document that you notified them.

Check your patient's pulse ox, vital signs, ABGS. Did the doctor order oxygen rate, time started, delivery device all need to be documented.

It's important to monitor fluid balance record intake and output q 4 hours if any significant imbalances occur notify the physician and what you were doing in the meantime to help the patient.

Try to markdown times of specimen collections and when antibiotics start obviously with drug names dosage ECT.

Remember if it is a new IV antibiotic record if the patient has an allergic reaction or no signs of allergic reaction.

What are you doing to help with clearing secretions are you elevating the head of the bed and couraging frequent coughing and deep breathing, recommend chest pt...?

Patients may be too weak to eat without help and may require assistance at mealtimes from dietary and aides to get the best nutrition to aid healing.

Encourage activity. Can you at least get them up sitting or up into a chair?

I know I have been MIA for a while now. It was taking a break to finish my Doctorate of Nursing Practice with a specialization in Adult Geriatric Primary Care. I graduated!!! This special tumblr has been with me from the beginning- before I applied to grad school.  This community that has followed this blog has been such a blessing.  I am forever grateful to each and every one of you guys for the support and love.  Onward to studying for boards and hopefully more posts! <3

Nurse on!!!

Without also charting what you did about it. did you give prn meds? Did you offer a massage? did you offer a warm washcloth for a compress? did you offer distraction...?

A nurse is:

1. An accountable professional; (you are responsible for your actions and inactions.)

2. Promots health and prevents ill health; ( speak up, speak to your patients, ask questions and educate.)

3. Assesses needs and plans care; (everyday, every patient....brain sheets help.)

4. Provides and evaluates care; (exactly this plus document and then some more.)

5. Leads, manages care and works in teams; (....we work with people)

6. Improves safety and quality of care; (CEs plus trying to bring better practice to where we work )

7. Coordinates care.(phone calls all-day)

Here is one(1) of six (6) pacemaker therapy nursing diagnosis and nursing care plans:

Also known as: what you're looking for, and how to help your patient with this issue

Ineffective Tissue Perfusion:Decreased in the oxygen resulting in the failure to nourish the tissues at the capillary level.

EVB:Decreased blood pressure,Decreased heart rate, Decreased cardiac output, stroke volume, Increased peripheral vascular resistance, Changes in level of consciousness, Mental changes, Cold clammy skin, Cardiopulmonary arrest, Inappropriate pacing or sensing

NI: what the nurse can do:

1. Monitor the ECG for any changes in rate and rhythm. Treat and or notify as necessary.

2. Obtain and go over rhythm strip at least every 4 hours. notify DR of abnormalities.

3. After surgery monitor vitals every 15 minutes then increase to 2 hours etc according to hospital policy you're checking for adequate perfusion and output.

4. Monitor for failure to sense.

5. Monitor for muscle twitching this may indicate a dislodgement.

6. Monitor for sudden heart pain. Listen to heart watch for muffled sounds and friction rubs.

7. Monitor for patient complains of weakness, edema, and dizziness. This could be a malfunction with the pacemaker causing decreased perfusion.

8. Teach and limit patient movement after surgery to decrease chance of disconnection.

Other things to watch for.....

Impaired Skin Integrity

Risk for Injury

Risk for Infection

Impaired Physical Mobility