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Nursing Pearls of Wisdom: 19 (More) Things That Every New Nurse & Student Needs to Know (Part 2)

Nursing Pearls of Wisdom: 19 (More) Things That Every New Nurse & Student Needs to Know (Part 2)

PART 2 OF 2 (SEE PART ONE FOR MORE NURSING PEARLS)

  1. Normal ejection fraction 55-60%, but someone can still have a normal EF and have hx heart failure
  2. Best place for absorption of insulin is in abdomen (but make sure to rotate sites)
  3. It is ideal that a patient is NPO for an abdomen ultrasound
  4. Metformin needs to be held if contrast is given (for 48 hrs after)
  5. Fluoroquinolones (levofloxacin, ciprofloxacin,) are antibiotics often given in hospitals. It is important to watch for muscle pain & aches, as this may be a sign of the black box warning of tendon rupture. This adverse reaction is more common in patients >55 years old
  6. Do not be afraid to clarify an order..it is your license!
  7. Stress tests: patient should not smoke the day of the test. The patient should not have any caffeine 24 hrs before the test. Patients should not take beta blockers, nitroglycerin, and certain other heart medications on day of the test (nurse should clarify with cardiology as indicated)
  8. Blood should be transfused within 4 hours (no longer). In general, PRBCs ย should be transfused under 2 hours for most patients. Exceptions include CHF & ESRD..both have to be ran closer to the 4 hrs mark, due to risk of pulmonary edema
  9. Sickle cell crisis pain is REAL and can be SEVERE!
  10. If a patient begins to have confusion, in addition to a neurological exam, a glucose should also be checked
  11. Often the better report you receive, the better shift you will have, (not always, but more likely). So the point is, ask questions, get details, and clarify!
  12. Chest pain: If a myocardial infarction is suspected, common orders include: STAT- EKG, cardiac enzymes, EKG, CBC, BMP, dimer, CXR, morphine, oxygen administration, nitroglycerin, aspirin (these are just a few-there are more)
  13. Blood cultures should ideally be drawn before antibiotic administration
  14. If a patient suddenly develops newย severe headache or abdomen pain let the on call provider know this!! Imaging may be needed. If it is truly severe, further investigation is likely needed to determine the cause of these severe symptoms
  15. Many hospitals require a second nurse to verify insulin dosage before administration
  16. CHF and Renal patients need to have accurate intake and output, along with daily weights
  17. Consider asking for a catheter if there is a strong risk for skin breakdown and or a current concern of breakdown
  18. If suspect urine retentionโ€“ bladder scan before calling on call provider
  19. If a patient seemsย lethargic and or not as responsive, always think about the pain medications that they may have had. Especially if they are a renal patient. Narcotics can quickly build up in their system and cause respiratory depression thus leading to altered mental status. This is missed more than you would think! Narcan may likely be just what is needed.

This information is part 1 of 2 for Nursing Pearls. See Part 1 for more important nursing pearl

NOTE: The above info is not intended to be medical advice. This is for educational purposes only. This is intended for medical professionals and students only. You should check with your primary care provider with any questions that they may have regarding your health. Medical professionals should call their on call provider if any clarifications are needed. State and hospital protocols should always be followed accordingly. This information should not be used to direct or guide any medical decisions. This information should not replace clinical judgement. Med Made Ez (MME) disclaims any liability for the decisions you make based on this information.

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