Today we are talkin’ what to do when your patient has Supraventricular Tachycardia. If you’ve ever had a patient with Supraventricular Tachycardia (SVT) you know it can be very worrisome, especially with how fast paced everything becomes after it’s diagnosis. Usually, you identify SVT through an extremely high heart rate and/or patient complaining of palpitations and a racing heart rate. Like all things that are new, unfamiliar and critical, experiencing this as a new nurse can be scary and feel like one of those moments when you might just *freeze* but don’t worry! We have all felt this way at one point or another and I am going to teach you what to do when your patient has Supraventricular Tachycardia, what you need to know to be prepared and avoid that instinct to flight. Let’s jump into it… What to know about SVT? Supraventricular Tachycardia (SVT) is an abnormal heart rhythm or arrhythmia defined by its severely increased heart rate. SVT can be symptomatic (where patient is showing s/s of distress) or asymptomatic (patient can be completely calm with no physical symptoms at all). What defines SVT? In infants, a heart rate >220 is defined as SVT while a heart rate >180 is definitive in children. Do not confuse Sinus Tachycardia and Supraventricular Tachycardia. These are two different rhythms that require different treatments and interventions. As mentioned above, SVT can be symptomatic or asymptomatic. Patient’s who are symptomatic may experience: Feelings of fluttering heart, palpitations, “racing heart” Lightheaded, dizziness, syncope, sweating Shortness of breath How does SVT look on an EKG? An SVT heart rhythm will appear as the image above. It is important to note that in an SVT rhythm you will have a missing or abnormal P wave. This is because the heart is beating SO fast that the EKG can barely even capture the P wave. Let’s look at a normal sinus rhythm (NSR) or normal heart rhythm compared to an SVT rhythm. As you can see, in our NSR you have your p wave, QRS complex, followed by a t wave. The p wave is completely missing or abnormal in our SVT rhythm. What to do? So, what do you do when your patient has supraventricular tachycardia? EKG. If a patient comes in complaining of chest pain, tightness in chest, heart palpitations, racing heart, dizziness or any cardiac related symptoms an EKG is most guaranteed. Once an EKG is complete you will be able to detect an SVT rhythm but what about when a child or infant is asymptomatic from obvious physical symptoms and cannot tell you what they feel? Two scenarios usually go down in this case — 1. A parent will tell you they feel their child’s heart racing through their chest or 2. You will immediately detect an abnormal heart rate through your intake vitals check. Usually this heart rate will read VERY high (as mentioned above, over 180). It will alarm you and you will want to recheck it. When you recheck, HR is still extremely elevated. You will immediately call the provider and an EKG will be ordered. If a patient is suspected of having SVT you will: Provide oxygen and ventilation as needed. If a patient is experiencing shortness of breath, dyspnea, or oxygen levels are affected you will provide oxygen. Even if SpO2 isn’t affected but the patient is having shortness of breath you will still provide supplemental oxygen to help the patient breathe easily and to lessen the workload of the heart. Remember, when your heart beats it is pumping oxygen filled blood to the rest of your body. If your heart is beating too quickly, it is working harder to oxygenate. Providing supplemental oxygen will give your heart the extra help it needs during an SVT arrhythmia. Place patient on a continuous cardiac monitor. A patient with any abnormal heart rhythm must be monitored closely and continuously. You want to make sure the patient does not worsen but also ensure the patient is responding to treatment. Obtain a PIV immediately and prepare to administer Adenosine. If possible, obtain an IV or IO immediately. This patient will likely need Adenosine. Adenosine is the medication that treats SVT by bringing down the heart rate. Because of its very short half life, it is critical to place a Peripheral IV (PIV) as close to the heart as possible. Therefore, your location of choice for a PIV would be the Antecubital fossa or AC. This is so the medication can reach the heart as fast as possible and actually have an effect (if you guys are interested, I can make a post all about Adenosine on our Medication Monday’s! Let me know in the comments below). Attempt vagal maneuvers if possible, but do not delay treatment if patient is hemodynamically unstable. Vagal maneuvers are techniques that help bring down heart rate naturally. These maneuvers include: Valsalva maneuver Bearing down as if you were having a bowel movement Blowing through a straw, a balloon, blowing out a “birthday candle” You can tell kids to pretend a piece of paper is a birthday candle and to blow it out as hard as they can. This helps keep it “fun” for them. Remember, this situation is already scary to begin with. As nurses, aside from acting quickly and responding adequately to this medical emergency, you also need to remember your patient is scared and you are there to calm them down and help them feel safe. We don’t want children to be traumatized by doctors or experiences. Applying an icepack to the face This is especially used for infants or children who cannot understand how to perform a vasovagal maneuver. Grab crash cart and prepare for cardioversion. A patient in SVT will more than likely require cardioversion. Yes, patients can get out of an SVT rhythm via the vasovagal maneuvers or adenosine but if not, you must cardiovert. As of 2020, Initial cardioversion: 0.5J – 1J/kgIf patient requires a second cardiovert, up dose to: 2J/kg Patient is usually sedated for this procedure as it can be painful. When cardioverting you are essentially jolting or shocking the heart at a very price moment during the rhythm and “snapping it out” of its current arrhythmia in hopes to bring it back to normal sinus (if you want a post on cardioversion, let me know in the comments below!). I hope this helped all of you newer nurses and future nurses on what to do when your patient is having Supraventricular Tachycardia. Always remember, try your best to stay calm and level-headed during an emergency situation. I know it’s easy to say and hard to do, especially in the beginning but I am a true believer that preparation is what helps you stay calm. If you study this you will feel comfortable (or at least calmer) in a situation like this because you will know what to do. When you know what to do, you feel like you have more control and feeling more in control helps you feel like you have a good grip on the situation. Have you experienced any emergency situation when you felt scared or nervous? How did you overcome it? Looking back now, have you grown from that experience? I bet you have! Comment below. ’till next time, The RN Educator Disclaimer: This post is not intended as medical advice and is only to be used as educational and informative content. If you are concerned of any medical issues, please consult your doctor.
This bundle includes 3 PDF digital items: 🫁 Respiratory and Ventilator Abbreviations Cheat Sheet 🫁 OXYGEN devices cheat sheet 🫁 Basic VENTILATOR modes and alarms cheat sheet ✔️Use on your device or print at home! These are great resources for those new to critical care or emergency room nursing. You can also use this cheat for studying for nursing program exams or NCLEX! 🖥 THIS IS A DIGITAL PRODUCT 🖥 *No physical product will be shipped* ✔️ Digital means its ready to download straight away after buying! No waiting, and no shipping fees. Purchase once and its yours forever! ✔️ You can use on your computer/device or print at home (unlimited printing!) ✔️ See instructions in product photos for how to download or click here: https://www.etsy.com/help/article/3949 IMPORTANT NOTE: Etsy doesn’t let you download items through their app. Therefore, you must access it through the Etsy website on your computer or iPad. By purchasing this product, you agree to the following terms and conditions: • These files are for the sole purchaser only and may not be resold, copied, distributed, altered, shared, or used for commercial use. All information provided in this file may only be used for personal purposes and is never to be shared with others online or in person. No right, title, or interest is conveyed to purchaser. Any unauthorized copying, alteration, distribution, transmission, display, or other use of the material is prohibited. It may be printed for personal use only. • The content of this file is for educational purposes only and is not medical advice. The content is targeted towards nurses in North America. While content may be applicable in other countries, information may differ. • Always consult and follow your facility's policy and guidelines. The information in this file is not to be used in substitution of your institution's policies, procedures, or guidelines. This file is a supplementary resource only. The Nurse Files co. is not responsible for any decisions or outcomes. • The Nurse Files co. does their best to ensure that all information in this file is complete, accurate, and current. Despite their efforts, however, information in the file may occasionally be inaccurate, incomplete, or out of date. © 2023 The Nurse Files Co.
Moroccan pure Cosmetic Argan Oil for hair, body and face. Argan Oil is the perfect recipe for healthy frizz free hair. It is the number one beauty secret for Moroccan Men and Women. It is a perfect gift for any important person in your life. Suitable for all hair types. Comes with an applicator bottle and a free Moroccan hair care cheat sheet, Gift and personalisation is available. Do NOT ingest Do NOT put in your eyes or ears please go to the emergency room if any of these happen.
Documents to help keep Student Information organized (contact info, IEP, related services, medical, data recording/storage, parent communication, and more). Suggested use would be to create a binder for each student with files and a copy of the students IEP and other important papers. Include a three ring punched folder to hold loose notes from parents/doctors/etc. This download comes as a word file so you have the choice to type in your information or print out the blank sheets and hand write in the information Included with download: --student information "cheat sheet" - Includes spaces to fill out contact and emergency info, medical (medication, allergies, additional [e.g. g-tube, vent), related services (add duration and therapist name), equipment and assistance needs (e.g. glasses, rifton chair, orthotics/braces) --Contact log -- Data collection sheet- Includes spaces to write in goal and then date, activity, and notes for each session. --IEP goals quick view sheet- write out classroom goals divided by domain for quick reference --Child information form to send home to parents- asks about nicknames, languages spoken at home, names of family members/important people, child's favorites, toilet training, and parents' goals for their child. --"First Day Fears" (a letter to send home to parents about easing the transition from home to school) --Blank Daily log (to send home each day with spaces for name, date, bathroom & eating details, daily activities and general notes --Special education lesson plan form (columns for IEP goals, type of activity, time, and core standards) --Annual Review Prep Sheet --IEP annual review meeting notes sheet -- Team meeting notes sheet
Blank walls suck, so bring some life to your dorm, bedroom, office, studio, wherever,Printed on 185gsm semi gloss poster paper,Custom cut - refer to size chart for finished measurements,Includes a 3/16 inch (5mm) white border to assist in framing
🫁 Ventilators majorly confused me when I was new to ICU! To make it more clear I created this simplified cheat sheet on basic ventilator modes and alarms. 🫁 This is a great resource for those new to critical care or emergency room nursing. You can also use this cheat for studying for nursing program exams, NCLEX or CCRN! This purchase includes: ✔️PDF download: Basic vent modes and alarms cheat sheet (2 pages) ✔️Use on your device or print at home! 🖥 THIS IS A DIGITAL PRODUCT 🖥 *No physical product will be shipped* ✔️ Digital means its ready to download straight away after buying! No waiting, and no shipping fees. Purchase once and its yours forever! ✔️ You can use on your computer/device or print at home (unlimited printing!) ✔️ See instructions in product photos for how to download or click here: https://www.etsy.com/help/article/3949 IMPORTANT NOTE: Etsy doesn’t let you download items through their app. Therefore, you must access it through the Etsy website on your computer or iPad. By purchasing this product, you agree to the following terms and conditions: • These files are for the sole purchaser only and may not be resold, copied, distributed, altered, shared, or used for commercial use. All information provided in this file may only be used for personal purposes and is never to be shared with others online or in person. No right, title, or interest is conveyed to purchaser. Any unauthorized copying, alteration, distribution, transmission, display, or other use of the material is prohibited. It may be printed for personal use only. • The content of this file is for educational purposes only and is not medical advice. The content is targeted towards nurses in North America. While content may be applicable in other countries, information may differ. • Always consult and follow your facility's policy and guidelines. The information in this file is not to be used in substitution of your institution's policies, procedures, or guidelines. This file is a supplementary resource only. The Nurse Files co. is not responsible for any decisions or outcomes. • The Nurse Files co. does their best to ensure that all information in this file is complete, accurate, and current. Despite their efforts, however, information in the file may occasionally be inaccurate, incomplete, or out of date. © 2023 The Nurse Files Co.
Want to be an expert in your next emergency situation as a nurse? Learn these 11 crash cart meds, when to use them and what to look out for.
The following are antidotes that should be familiarized by the nurse to respond to this emergency situation quickly.
Hello, hello friends! Jackie here bringing you some great information today. If you are anything like me as a new nurse you probably dreeeeaddd the thought of an IV order. Yes? No? Or was I the only one? Man! Every time I would see an IV order I would start freaking out, overthink and have an internal anxiety attack. IV’s are actually one of THE hardest skills for a nurse to acquire and this is simply because in order to master it you must PRACTICE. Without practice, you cannot possibly learn how to insert an IV. I know what you’re thinking “But why should I try to prick a patient, probably multiple times because I’m not that great at IV’s, if someone else can get it on their first try?” Ahhhh… good point! But do you always want to depend on other nurses to get your IV’s? What if your patient is deteriorating and the doctor is looking at you wondering why you still haven’t gotten that IV? Or why you are waiting around for IV team? Or how the fact you have to wait for someone else to have free time to put in your patient’s IV is just backing you up in your nursing tasks? You can give back by becoming the nurse that HELPS put in an IV. YOU can become the resource. How great would that feel? To get to that point that other nurses ask YOU for help. That’s always the goal as a new nurse. Grow and improve… Learn as much as possible to not only give our patients the best care possible but also be a resource and pass on the what we have learned to other new nurses. The truth is, IV’s don’t need to be so scary and to prepare you for them I am sharing 5 AMAZING IV Insertion Tips every nurse should know. Let’s jump right into it. 1. Location is KEY. Location is so underestimated when looking for an IV, especially with patients who have fragile, small veins like in pediatrics. This is such a game-changing IV Insertion tip every nurse should know. When inspecting and palpating for an IV site make it a HABIT to look at all 4 extremities, even if you found an AWESOME vein in the first extremity. You might ask, “but if I found my site why continue looking for another location?” Well, I cannot tell you the amount of times I have seen people go for a vein that seemed great, only to have a vein in another location look SO MUCH BETTER. That is why, take your time and inspect and palpate all areas to ensure you are using the best vein. This will totally increase your chances of getting that IV on that first try! Trust me, don’t skip this step. You will thank me later. What to say when parents or patients look at you like you like you don’t know what you are doing or looking for? Simple. Beat them to the punch and explain BEFORE doing anything what you are going to do. In this case, “I will be looking at both hands and feet (for pediatrics) to make sure I choose the best possible vein.” Works like a charm and they immediately feel like 1.You are experienced and know what your doing and 2. Have their best interest in mind. 2. Plump up those veins. Another IV insertion tip every nurse should know is to plump those veins! There will be times where you can see a vein but can’t necessarily “feel it”. Honestly, if you can ever FEEL a vein but can’t see it, trust me, these are blessings in disguise. You may not visualize the vein but they are usually PIPES and what I mean by that is they are usually big, plump veins. Just make sure you aren’t confusing it for a tendon. A good way to do this is palpate the “invisible vein” while the tourniquet is on. Keep your fingers on it and remove the tourniquet if you can no longer palpate it, it most likely is a vein. If you can still palpate it then it could be a tendon. Now, how do we plump up small, fragile or skinny veins? Apply heat You might have heard this trick before but one of the best ways to dilate veins is by applying heat to the area. You can use a warm compress, or warm towel and have the patient hold it over the area while you prep your IV station. By the time you look and feel your vein again it should appear much larger due to vasodilation. Let’s say you are stuck between two possible sites, if you still haven’t decided apply warm compresses to both locations and see which one dilates more at time of IV start. Remember, you want to go for the best veins to increase your chances of successful insertion! Always keep in mind, warm compress should not be too hot or should be placed over a thin barrier to avoid burns. Gravity Gravity is your friend. If warm compresses are not working or not available use gravity to increase blood flow to the area. If you are starting an IV on the hand or arm just dangle the patient’s arm off the side of the bed. This will cause blood flow to pool in the lower arm/hand causing vasodilation. Gently tapping the vein Notice how I said… Gently. Now, don’t go out there and start slapping and flicking veins. This is an old habit that is now discouraged. However, lightly tapping on a vein can cause vasodilation. I have seen it with my own eyes!! Double tourniquets Finally, another great way to plump up veins is to double tourniquet. Keep in mind though, you should not double tourniquet a patient who has fragile skin. By applying two tourniquets about an inch or two apart you are ensuring there is enough pressure in the vein. This increased pressure will engorge the veins making it easier to succeed in IV insertion. Remember, you don’t want to leave the tourniquet on for too long or it will actually have the opposite effect (vasoconstriction). In this case you need to loosen the tourniquet and let the extremity refill again. 3. Use your resources Don’t forget there are other resources you can use to visualize the vein. In pediatric patients or patients with small, thin veins you can definitely benefit from an IV light. Most hospitals have an IV light where you shine a translucent light over the selected area and it will show you the veins in that area. If your hospital doesn’t have an IV light or if you find it doesn’t really help, you can also use a bright light (like an otoscope light or small flashlight) underneath the hand (this works great for infants) or on the side of the skin. The light will shine through the skin giving it a red appearance (imagine using a flashlight on your hand … it’s pretty much that same red color it gives). While your skin is shining red you will be able to see all the veins in that area. Try it at home with a flashlight! Also, keep in mind other resources such as pain relief measures. There are lidocaine sprays or creams that certain hospitals may carry that help ease pain of IV insertions. The less pain the patient feels, the less anxious and tense they become leading to better outcomes! 4. Choose the proper IV catheter This is a crucial IV insertion tip every nurse should know and makes a huge difference when having successful IV placements. The IV catheter you choose must be one that is dependent on the size of your vein (width & length) AND the reason for placement. You must be thinking “what does that matter? an IV is an IV no matter what!” Well, yes this is true BUT having the correct IV catheter will save you much trouble in the next few hours or days. Let’s talk size of vein. It is very important to consider the size of the vein you will be using. Is it a large, plump vein that is straight? If so, consider using a bigger gauge such as a 22-20ga. In pediatrics you generally do not go larger than a 20 ga. unless you will be transfusing blood or infusing large amounts of fluids quickly (this is when reason for placement comes into play… we will talk about that in a second). This is because veins are usually not that big as an adults. A 20-22 ga. IV catheter has a more stable catheter since it is bigger and longer therefore, when it’s time to thread it will thread like butter! Literally. Such an easy and smooth thread for a gauge that size. However, you want to make sure you have a long enough vein when using these catheters. How to know if your vein is long enough? You can measure the vein next to the catheter and make sure the tip of the catheter will land at least 1/2 an inch – an inch (rough estimate) before the vein ends. You don’t want it to land right when the vein ends because then the fluid will be crashing against the vein wall and won’t be able to properly infuse (and let’s not forget that annoying IV pump that will constantly be beeping “distal occlusion” Ugh!) If your vein is short and ends quickly consider using a 24 gauge. This is usually used for children. The majority of adults get 22 gauges and larger. The 24 gauge catheter is shorter so you won’t need such a “long” straight vein. In other words, this is ideal for a patient who has a vein that is straight for a little bit and quickly curves to the side. These catheters are smaller and flimsier so threading is a little more tricky. Just take your time and make sure a good amount of needle is in before threading. If you don’t insert enough of the needle you might have difficulty threading. Reason for placement is very important and will determine the size of the catheter you will be using. If this patient is going into surgery you should be looking at bigger gauges since this patient may require large fluids during surgery or a blood transfusion if things don’t go well. A dehydrated patient ideally would need a larger bore but because those veins are so dehydrated, thin and constricted you might have to place a smaller bore. 5. Prep your IV station Prep your IV station BEFORE IV insertion guys. I cannot tell you how many close misses I have seen because stations weren’t ready to go. So now you have this patient screaming and fighting about the IV while you are holding down the IV trying your hardest not to lose your line and trying even harder to cut a piece of tape to tape that IV down. Sounds like a SUPER hectic scenario right? CHAOS! Don’t let this happen to you. Always have all your supplies on standby and ready to go and never forget to set up your tape prior to insertion. Have your strips of tape ready to tape down and stabilize your IV line incase your patient starts moving (it’s almost inevitable for this to happen with kids). Here’s a list of the most common supplies needed when starting an IV That’s all for today friends. These are the TOP 5 IV Insertion tips every nurse should know. Let me know if you have any other tips and share them below! Would love to hear more from you guys… ’till next time, The RN Educator
Albuterol, a short-acting bronchodilator, does just what the name suggests. It helps relax & dilate (open up) your bronchioles in the lungs & allows for air to move freely. Because of it’s short-acting effect it is considered a rescue medication. 🩺 𝐖𝐡𝐞𝐧 𝐝𝐨 𝐲𝐨𝐮 𝐮𝐬𝐞 𝐚𝐥𝐛𝐮𝐭𝐞𝐫𝐨𝐥?Albuterol is used when a patient is experiencing bronchospasm that is manifested through shortness of breath, chest tightness, difficulty breathing or wheezing. Asthma (most common in children), anaphylaxis (a severe allergic reaction) and COPD (seen in adults) are known conditions that can cause these symptoms. ✨Although albuterol acts quickly to alleviate respiratory distress, there are also side effects that may occur & are important to look out for. 🔎 𝐑𝐞𝐦𝐞𝐦𝐛𝐞𝐫: any medication that dilates the bronchioles will have an inverse effect on the cardiac system. This means when albuterol causes bronchodilation it will inversely cause vasoconstriction. 🩺 𝐖𝐡𝐚𝐭 𝐭𝐨 𝐦𝐨𝐧𝐢𝐭𝐨𝐫 𝐰𝐡𝐞𝐧 𝐠𝐢𝐯𝐢𝐧𝐠 𝐚𝐥𝐛𝐮𝐭𝐞𝐫𝐨𝐥:𝙃𝙚𝙖𝙧𝙩 𝙧𝙖𝙩𝙚 — due to vasoconstriction, albuterol will cause HR and BP to increase. Monitoring this is essential in ensuring your patient does not have an arrythmia. Patients with a Hx of HTN or cardiac issues must be monitored closely. At times, providers will prescribe Levalbuterol (Xopenex), a bronchodilator with milder systemic side effects, for those with cardiac history. 𝙎𝙥𝙊2 — You should see an increase in oxygen levels after albuterol administration. This is because the dilation of your bronchioles allows more oxygen to get through & perfuse the lungs. 𝙇𝙪𝙣𝙜 𝙨𝙤𝙪𝙣𝙙𝙨 — always assess your patient BEFORE administering albuterol and AFTER. In order to know if there was an improvement, there must be a pre & post assessment for comparison. After albuterol, lung sounds should improve. If a patient was experiencing tightness where little to no air was heard prior to albuterol you may hear mild to mod. wheezing after albuterol. This signifies that this patient was probably very tight before the tx and now the albuterol is finally helping some air squeeze through. These pt’s would definitely require further treatment. Have any of you ever had a treatment before? What side effects did you experience? Did it help you feel and breathe better? Share below!
How many times has your game died because of a bad cue ball control choice? (Actually, do you really want to remember how many times that happened?) This has been a big personal problem in the decades that I've played the Green Game. There are so many speeds to hit the cue ball and so many ways to make it spin. That means even dead-easy shots become very complicated when you have to get shape for the next shot. There are literally hundreds of options. I'm not a \"feel\" player, able to intuitively shoot by instinct. I'm a \"scientific\" player, who likes to figure what, how, and why a shot can work (and way too often, not work). Finally, I got tired of guessing the correct cue ball speed and spin, and decided to apply some intelligence to this weakness in my game. (Of course, I have no objection to winning because someone else does something foolish.) I mapped out several hundred common shooting situations, with the cue ball, 1 ball, and 2 ball. Then I shot each layout, over and over, trying out different speeds and spins. Everything was tested and retested - and then repeated over and over. The table layouts in this book are the results from those months and months of testing with tens of thousands of shots. This is why these are \"Cheat Sheets\". Basically - I've done all the suffering for you. You need to add some reality to these shots. First, try the shot with what you think works. Then use the provided cheat tip. Once successful, repeat again. Then setup on the shot and shoot it with your eyes closed. Once you realize you can dial in the speed and spin to get consistent results, the learning curve goes much faster. All it takes is some dedicated practice time to prove you can do it - and that is when you start winning more games. What you learn in this book will not stop all of your bad shooting decisions. It WILL reduce the number of mistakes. That is why, after you buy this book that I provide an email connection in the book. I am very interested that you get good value.
Learn how to master that IV by gathering the supplies you need for an IV start ahead of time and ensuring IV success every time!
Are you looking for the BEST NCLEX prep book to study for the NCLEX? Discover the TOP 8 NCLEX Prep Books to help pass your exam!
Safety Plan template, therapy tool designed to help prioritized coping strategies and sources of support counseling clients can use during or preceding a crisis. This safety worksheet is a suicide prevention therapy resource tool to formalize a plan for client safety. Great tool therapist office, social workers, school psychologists, school counselors, community mental health providers. ✦ INCLUDED ✦> Safety Plan - template with spaces for: stressors/triggers, making environment safe, warning signs, what other can do to help, coping strategies, distraction strategies, reasons to live, and support system name and phone number. > Crisis Contacts - template with a number of national crisis contacts and room to add ones local emergency contacts. ✦ FEATURES ✦➔Printable - just print and start writing➔Computer/Laptop/Tablet - Tablet: reMarkable, iPad, etc. - Apps: GoodNotes, Notability etc. - Fillable PDF: get FREE Adobe Acrobat Reader https://get.adobe.com/reader/ ➔Editable PDF - Upon purchase, you'll receive a PDF with links to a free online PDF editing tools for small text changes and logo addition. Complex format edits require Adobe professional software (not included).➔Size - US Letter 8.5x11 & A4 8.27x11.69 ✦IMPORTANT✦✧This is a digital item. No physical product will be shipped.✧Colors may vary due to different monitors & printers.✧Due to the digital nature of this item, it is impossible to return. Therefore, I'm unable to offer cancellations, refunds, or exchanges.✧For personal use ONLY. Products cannot be resold for any reason.✧‼️ If you would like to redistribute (make multiple copies) and handout to therapeutic groups, clients or interns please purchase our redistribution Commercial License. Purchase only ONE time and it’s good for all past and future purchases at CC Digital Studios ➔LINK: https://bit.ly/3sRdVzS ✦LETS CONNECT✦FREE Anxiety Journal Tips & Prompts: CLICK HEREPinterest: CLICK HEREEmail me if you have any questions! [email protected] © 2023 CC Digital Studios, LLC All rights reserved.
Happy 𝐌𝐞𝐝𝐢𝐜𝐚𝐭𝐢𝐨𝐧 𝐌𝐨𝐧𝐝𝐚𝐲 friends! 💉💊 Meet 𝐃𝐞𝐱𝐚𝐦𝐞𝐭𝐡𝐚𝐬𝐨𝐧𝐞! A corticosteroid, also referred to as Decadron, that serves as an anti-inflammatory agent for certain conditions. Let’s go over it. 𝐖𝐡𝐞𝐧 𝐢𝐬 𝐢𝐭 𝐮𝐬𝐞𝐝?✨Croup✨Asthma✨Anaphylaxis✨Cerebral edema🔎Many of you have probably heard about it being used for Covid patient’s as well. Among other conditions, dexamethasone is commonly given to children with croup in an outpatient or ER setting. It works to reduce inflammation in the upper airway. Often times, only a single dose is needed to ease symptoms of croup. However, if respiratory symptoms worsen further evaluation and treatment is necessary. 𝐒𝐢𝐝𝐞 𝐞𝐟𝐟𝐞𝐜𝐭𝐬:⚡️Upset stomach⚡️Headache⚡️Insomnia⚡️Dizziness⚡️Anxiety⚡️Hypertension, hyperglycemia &⚡️Hypokalemia 𝐖𝐡𝐚𝐭 𝐭𝐨 𝐦𝐨𝐧𝐢𝐭𝐨𝐫:🔎 Blood Pressure🔎 Electrolytes🔎 Weight 𝐏𝐫𝐞𝐜𝐚𝐮𝐭𝐢𝐨𝐧𝐬:🔸May decrease immune system and mask signs of infection🔸Contraindicated in patients with systemic fungal infections❌ Do not give with live vaccines 💡𝐐𝐮𝐞𝐬𝐭𝐢𝐨𝐧 » What other conditions is Dexamethasone used for? Answer below! ⚠️ The information in this post or comments is not intended as medical advice. It is only for educational purposes. ⚠️
Download the best FREE Nursing Report Sheet templates (by Nursejanx)! SBAR and nurse brain sheet templates for Med Surg, ICU, and Tele!
Hello hello, future nurses! I hope everyone has been having an amazing summer. With Fall semester right around the corner, I thought I would share with you some amazing cheat sheets for documentation I have found. I WANTED SO BADLY TO UPLOAD MY CUSTOM DOC, but for some reason, it needs to be converted before attaching? *face palm*. So, once that is figured out, it WILL be shared with you all. Instead of uploading my version of a "clinical cheat sheet", I have shared with you all the ones found
This bundle includes 3 PDF digital items: 🫁 Respiratory and Ventilator Abbreviations Cheat Sheet 🫁 OXYGEN devices cheat sheet 🫁 Basic VENTILATOR modes and alarms cheat sheet ✔️Use on your device or print at home! These are great resources for those new to critical care or emergency room nursing. You can also use this cheat for studying for nursing program exams or NCLEX! 🖥 THIS IS A DIGITAL PRODUCT 🖥 *No physical product will be shipped* ✔️ Digital means its ready to download straight away after buying! No waiting, and no shipping fees. Purchase once and its yours forever! ✔️ You can use on your computer/device or print at home (unlimited printing!) ✔️ See instructions in product photos for how to download or click here: https://www.etsy.com/help/article/3949 IMPORTANT NOTE: Etsy doesn’t let you download items through their app. Therefore, you must access it through the Etsy website on your computer or iPad. By purchasing this product, you agree to the following terms and conditions: • These files are for the sole purchaser only and may not be resold, copied, distributed, altered, shared, or used for commercial use. All information provided in this file may only be used for personal purposes and is never to be shared with others online or in person. No right, title, or interest is conveyed to purchaser. Any unauthorized copying, alteration, distribution, transmission, display, or other use of the material is prohibited. It may be printed for personal use only. • The content of this file is for educational purposes only and is not medical advice. The content is targeted towards nurses in North America. While content may be applicable in other countries, information may differ. • Always consult and follow your facility's policy and guidelines. The information in this file is not to be used in substitution of your institution's policies, procedures, or guidelines. This file is a supplementary resource only. The Nurse Files co. is not responsible for any decisions or outcomes. • The Nurse Files co. does their best to ensure that all information in this file is complete, accurate, and current. Despite their efforts, however, information in the file may occasionally be inaccurate, incomplete, or out of date. © 2023 The Nurse Files Co.
Get the complete picture of your patient's health with this comprehensive head-to-toe physical assessment guide.
Today we are talkin’ what to do when your patient has Supraventricular Tachycardia. If you’ve ever had a patient with Supraventricular Tachycardia (SVT) you know it can be very worrisome, especially with how fast paced everything becomes after it’s diagnosis. Usually, you identify SVT through an extremely high heart rate and/or patient complaining of palpitations and a racing heart rate. Like all things that are new, unfamiliar and critical, experiencing this as a new nurse can be scary and feel like one of those moments when you might just *freeze* but don’t worry! We have all felt this way at one point or another and I am going to teach you what to do when your patient has Supraventricular Tachycardia, what you need to know to be prepared and avoid that instinct to flight. Let’s jump into it… What to know about SVT? Supraventricular Tachycardia (SVT) is an abnormal heart rhythm or arrhythmia defined by its severely increased heart rate. SVT can be symptomatic (where patient is showing s/s of distress) or asymptomatic (patient can be completely calm with no physical symptoms at all). What defines SVT? In infants, a heart rate >220 is defined as SVT while a heart rate >180 is definitive in children. Do not confuse Sinus Tachycardia and Supraventricular Tachycardia. These are two different rhythms that require different treatments and interventions. As mentioned above, SVT can be symptomatic or asymptomatic. Patient’s who are symptomatic may experience: Feelings of fluttering heart, palpitations, “racing heart” Lightheaded, dizziness, syncope, sweating Shortness of breath How does SVT look on an EKG? An SVT heart rhythm will appear as the image above. It is important to note that in an SVT rhythm you will have a missing or abnormal P wave. This is because the heart is beating SO fast that the EKG can barely even capture the P wave. Let’s look at a normal sinus rhythm (NSR) or normal heart rhythm compared to an SVT rhythm. As you can see, in our NSR you have your p wave, QRS complex, followed by a t wave. The p wave is completely missing or abnormal in our SVT rhythm. What to do? So, what do you do when your patient has supraventricular tachycardia? EKG. If a patient comes in complaining of chest pain, tightness in chest, heart palpitations, racing heart, dizziness or any cardiac related symptoms an EKG is most guaranteed. Once an EKG is complete you will be able to detect an SVT rhythm but what about when a child or infant is asymptomatic from obvious physical symptoms and cannot tell you what they feel? Two scenarios usually go down in this case — 1. A parent will tell you they feel their child’s heart racing through their chest or 2. You will immediately detect an abnormal heart rate through your intake vitals check. Usually this heart rate will read VERY high (as mentioned above, over 180). It will alarm you and you will want to recheck it. When you recheck, HR is still extremely elevated. You will immediately call the provider and an EKG will be ordered. If a patient is suspected of having SVT you will: Provide oxygen and ventilation as needed. If a patient is experiencing shortness of breath, dyspnea, or oxygen levels are affected you will provide oxygen. Even if SpO2 isn’t affected but the patient is having shortness of breath you will still provide supplemental oxygen to help the patient breathe easily and to lessen the workload of the heart. Remember, when your heart beats it is pumping oxygen filled blood to the rest of your body. If your heart is beating too quickly, it is working harder to oxygenate. Providing supplemental oxygen will give your heart the extra help it needs during an SVT arrhythmia. Place patient on a continuous cardiac monitor. A patient with any abnormal heart rhythm must be monitored closely and continuously. You want to make sure the patient does not worsen but also ensure the patient is responding to treatment. Obtain a PIV immediately and prepare to administer Adenosine. If possible, obtain an IV or IO immediately. This patient will likely need Adenosine. Adenosine is the medication that treats SVT by bringing down the heart rate. Because of its very short half life, it is critical to place a Peripheral IV (PIV) as close to the heart as possible. Therefore, your location of choice for a PIV would be the Antecubital fossa or AC. This is so the medication can reach the heart as fast as possible and actually have an effect (if you guys are interested, I can make a post all about Adenosine on our Medication Monday’s! Let me know in the comments below). Attempt vagal maneuvers if possible, but do not delay treatment if patient is hemodynamically unstable. Vagal maneuvers are techniques that help bring down heart rate naturally. These maneuvers include: Valsalva maneuver Bearing down as if you were having a bowel movement Blowing through a straw, a balloon, blowing out a “birthday candle” You can tell kids to pretend a piece of paper is a birthday candle and to blow it out as hard as they can. This helps keep it “fun” for them. Remember, this situation is already scary to begin with. As nurses, aside from acting quickly and responding adequately to this medical emergency, you also need to remember your patient is scared and you are there to calm them down and help them feel safe. We don’t want children to be traumatized by doctors or experiences. Applying an icepack to the face This is especially used for infants or children who cannot understand how to perform a vasovagal maneuver. Grab crash cart and prepare for cardioversion. A patient in SVT will more than likely require cardioversion. Yes, patients can get out of an SVT rhythm via the vasovagal maneuvers or adenosine but if not, you must cardiovert. As of 2020, Initial cardioversion: 0.5J – 1J/kgIf patient requires a second cardiovert, up dose to: 2J/kg Patient is usually sedated for this procedure as it can be painful. When cardioverting you are essentially jolting or shocking the heart at a very price moment during the rhythm and “snapping it out” of its current arrhythmia in hopes to bring it back to normal sinus (if you want a post on cardioversion, let me know in the comments below!). I hope this helped all of you newer nurses and future nurses on what to do when your patient is having Supraventricular Tachycardia. Always remember, try your best to stay calm and level-headed during an emergency situation. I know it’s easy to say and hard to do, especially in the beginning but I am a true believer that preparation is what helps you stay calm. If you study this you will feel comfortable (or at least calmer) in a situation like this because you will know what to do. When you know what to do, you feel like you have more control and feeling more in control helps you feel like you have a good grip on the situation. Have you experienced any emergency situation when you felt scared or nervous? How did you overcome it? Looking back now, have you grown from that experience? I bet you have! Comment below. ’till next time, The RN Educator Disclaimer: This post is not intended as medical advice and is only to be used as educational and informative content. If you are concerned of any medical issues, please consult your doctor.
Hello friends. You know what day it is… Happy Medication Monday! Today we are discussing Digoxin and what to monitor when your patient is taking digoxin, a known and widely used cardiac medication. I know some of you have been wanting to hear more about cardiac and cardiac medications specifically since this system tends to be one of the more difficult subjects in nursing (totally agree, btw!) so let’s jump right into it. What is Digoxin? Digoxin, classified as an anti-arrhythmic, is used to control blood pressure and arrhythmias. You may also hear it referred to as a digitalis preparation (which means it is a medication used to treat heart failure). In congestive heart failure, Digoxin is usually the preferred drug in pediatric patients due to its rapid action and shorter half life. Digoxin’s purpose is to slow and strengthen myocardial contraction (in other words, strengthens the heart beat). Think about this — in heart failure, your heart is having problems pumping out blood, it is weak and usually there are certain problems that interfere with your hearts ability to effectively pump and supply enough blood to the rest of your body. In children, these problems are usually congenital but in adults, they can be caused by a number of other things. Digoxin will help improve your cardiac output by improving the hearts ability to pump. It does this by strengthening the contractility of your heart muscle while slowing down your heart rate, reducing strain on the heart. Dosage forms Digoxin comes in two forms: PO IV — Slow IV push is critical, over 5 to 10 minutes. An IV administration that is not pushed slowly can cause serious adverse effects including arrhythmias, which is something you want to monitor when your patient is taking digoxin. IV is usually started in the hospital setting and later transitioned to PO. IM — If IM Digoxin is given in older children make sure you give in a large muscle, as this form can be painful and cause tissue damage. Contraindications These contraindications are key in what to monitor when your patient is taking digoxin. If there is anything you take away from Digoxin please let it be that you hold the medication if apical heart rate is below these numbers. HOLD if resting apical pulse of infant is <90bpm HOLD if resting apical pulse of older child is <70bpm HOLD if resting pulse for adult is <60bpm This is critical due to the ability of Digoxin to lower the HR. Pediatric pulse rates vary with each child and because of this you must always ensure the following: Take apical pulse for 1 full minute before administering — Use a stethoscope to properly obtain the heart rate especially since infants tend to cry or move around a lot. Ensure you have a specific physician order on when to hold digoxin (at what heart rate) but use the above guidelines as a rule of thumb. If you hold Digoxin, always notify the physician. What is Digitalis Toxicity? Digitalis toxicity is a very serious adverse effect of digoxin intake. It can occur when there are high levels of digoxin circulating the blood or after long-term therapy. This can be caused by too much medication, high doses, or lower tolerance to the drug. Checking serum levels during digoxin therapy is such an important step in what to monitor when your patient is taking digoxin. Note: * Serum digoxin concentration can be within therapeutic range and digitalis toxicity can still occur* It is very important to always assess your patient for the following digitalis toxicity symptoms, hold medication if noted and report to physician immediately. Nausea, vomiting, fatigue Irregularities in heart rate and rhythm Decreased BP, pallor Neurological changes – confusion, lethargic, visual disturbances, seizures Anorexia, diarrhea What can put your patient at risk for Digitalis Toxicity: Review medication compatibility when administering Digoxin — including complimentary alternative medicines (CAM) as they can have severe interactions with digoxin. Dehydration Hypokalemia, hypomagnesium, hypercalcemia — These are electrolytes to pay attention to Renal conditions — due to the kidneys not being able to eliminate waste + medications These are important risk factors to look at when identifying what to monitor when your patient is taking digoxin. Patient Education Always make sure to educate your patients and their caretaker. In nursing, it is so important to focus on EDUCATION. Without education, it is very likely your patient can get worse or be non-compliant with care. Take the extra time to teach parents how to properly check an apical pulse, when to withhold medication and s/s of digitalis toxicity. Hope you guys enjoyed this lesson. I’ve included some NCLEX Practice Questions to help recap on what to monitor when your patient is taking digoxin. Challenge yourself and comment below your answers. Also, feel free to share any experiences you’ve had with digoxin and what symptoms did your patient experience? Keep in mind, HIPPA! Disclaimer: This post is not intended to be used as medical advice and is only intended for educational purposes. NCLEX Practice Question 1: Your patient, who is 7 years old is due to take her Digoxin dose. What patient finding would prompt you to hold the upcoming Digoxin dose and notify the physician immediately? A. Digoxin level of 1.2 ng/mlB. Potassium level of 2.8mEq/LC. Heart rate of 74bpmD. Blood glucose level of 82 NCLEX Practice Question 2: An infant is being discharged home on Digoxin. Which statement below, verbalized by the infant’s mother, demonstrates proper understanding of patient education? Select all that apply* A. “I will limit my baby’s intake of foods high in potassium.”B. “I will not give my baby this medication and notify the physician if his heart rate is less than 90 bpm.”C. “I will measure my baby’s pulse rate before every dose I take.”D. “It is important that I immediately report any neurological or GI changes he may experience while taking this medication.” NCLEX Practice Question 3: An infant is ordered a scheduled dose of Digoxin. The patient’s apical pulse rate is 78 bpm. The nurse would: A. Administer the dose as orderedB. Hold the dose and reassess the apical pulse rate in 1 hourC. Skip this dose but administer the next scheduled doseD. Hold the dose and notify the physician NCLEX Questions Source: RegisteredNurseRN.com Post your answers below! Will be posting answers in comments section. ’till next time, The RN Educator
What is the best survival gear? It’s one of the top questions we get. While our answer usually includes some variation of the knowledge is king mantra, we
33 Free Downloadable Nursing Report Sheet templates. Stay organized on the clinical floor with our easy to use nursing report sheets.
Our recommended, must have parenting book that is written by two pediatric nurse moms with over 20 years of experience and eight children between them (including two sets of twins). Who says that babies don't come with instructions? They do now! Everything that modern parents need to know about caring for babies in the first six months, including: • Step by step guidelines for getting babies on a routine• Hour by hour schedules at a glance• Feeding instructions for breast, bottle or both! • What symptoms warrant a trip to the emergency room• How to get your baby to sleep all night so you can too! Plus, much more! Advice from two pediatric nurse moms with eight children between them has moms all over the globe hailing this as, "The absolute best baby book ever."
Get the complete picture of your patient's health with this comprehensive head-to-toe physical assessment guide.
If you have asthma or a lung condition, your doctor may prescribe a nebulizer machine as treatment, or breathing therapy.
