Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)

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Included In This Lesson

Study Tools For Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)

Bleeding Precautions (Mnemonic)
Blood Type O (Mnemonic)
Bleeding Complications (Minor) (Mnemonic)
DIC Pathochart (Cheatsheet)
Blood Compatibility Chart Cheatsheet (Cheatsheet)
Clotting Cascade Anticoagulants Cheatsheet (Cheatsheet)
Clotting Cascade (Image)
Subconjunctival Hemorrhage (Image)
Petichiae and Purpura (Image)
63 Must Know Lab Values (Book)
Disseminated Intravascular Coagulation (DIC) Assessment (Picmonic)
Disseminated Intravascular Coagulation (DIC) Interventions (Picmonic)
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Outline

Pathophysiology:

With DIC there is an overactivation in the clotting cascade. The body clots and bleeds, clots, and bleeds and eventually there are not enough clots left and severe bleeding occurs.

Overview

  1. Also known as “Consumption Coagulopathy”
  2. Widespread activation of the clotting cascade
    1. Results in the formation of blood clots in small blood vessels systemically
    2. Normal clotting is disrupted
    3. Clotting Factors are used up
    4. Severe bleeding and massive hemorrhage occurs

Nursing Points

General

  1. Risk Factors – anything that initiates the clotting cascade (it can overreact)
    1. Postpartum
    2. Recent Surgery or Traumatic Injury
    3. Sepsis or Septic Shock
    4. Liver Disease

Assessment

  1. Pallor
  2. Ecchymosis
    1. Petechiae
    2. Purpura
    3. Hematomas
  3. Bleeding
    1. Hemoptysis
    2. Hematemesis
    3. Melena
    4. Occult blood in stool
    5. Hematuria
  4. Abnormal Labs
    1. Prolonged aPTT, PT, and thrombin time
    2. ↓ Platelets
  5. Dyspnea
  6. Chest pain
  7. Anxiety
  8. Confusion

Therapeutic Management

  1. Determine and treat underlying cause immediately
  2. Replace clotting factors
    1. Fresh Frozen Plasma
    2. Vitamin K
    3. Factor VII
  3. Administer Heparin drip if excessive clotting
    1. Stop consumption of clotting factors
  4. Initiate bleeding precautions
  5. Monitor I&O

Nursing Concepts

  1. Clotting
    1. Bleeding precautions
    2. NO invasive procedures unless medically necessary
      1. IV starts, NG Tube, Foley
      2. Central Lines
    3. Assess all current lines for bleeding
    4. Monitor for signs of bleeding from ANYWHERE (eyes, ears, nose, gums, any wounds, etc.)
  2. Perfusion
    1. Monitor hemodynamics for possible hypovolemic shock

Patient Education

  1. Bleeding precautions
    1. No straight blade razors – electric only
    2. Soft-bristle toothbrush
    3. Report bleeding to provider
    4. Avoid injury/falls
  2. Do NOT take Aspirin or other anticoagulants without permission from primary care provider

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Transcript

Okay guys, we’re gonna talk about DIC, or disseminated intravascular coagulation. This is something that can be difficult to understand and isn’t explained well, but we’re gonna break it down and make it simple for you.

The best way I can help you understand DIC is to tell you the other name it goes by. It’s also called Consumption Coagulopathy. So right away you can see there’s a problem with clotting and something is being consumed, right? So what happens in DIC is that the clotting cascade gets activated, platelets clump together, clotting factors activate each other down the cascade until it activates fibrin and thrombin to form a clot. In DIC, this clotting cascade goes haywire and clots begin to form in small blood vessels throughout the body. It’s systemic and widespread. These little clots are everywhere. As that happens, the clotting factors get used up – or – consumed. It’s like the hot water heater running out of hot water. Once we’ve consumed our clotting factors, we are no longer able to form a clot and the patient will begin to bleed profusely and will have massive hemorrhage. Guys they will literally bleed out of every orifice in their body – like – every orifice. Eyes, ears, nose, urine, bowels, anywhere you stuck them. Everywhere. Risk factors for DIC – really anything that can initiate the clotting cascade. But the most common causes are things like postpartum patients – the separation of the placenta causes bleeding, which can stimulate the clotting cascade. Sepsis or septic shock can also cause this response, as well as any kind of surgery or traumatic injury. Also, patients with liver disease already have issues with clotting factors, so they’re more susceptible to DIC.

So like I said, they begin to bleed from basically everywhere. They’ll be pale and weak, and of course they’re at risk for hypovolemic shock if they lose too much blood. We’ll see abnormal labs like prolonged clotting times and decreased platelets. They may be dyspneic, have chest pain, anxiety, or even be confused because of the loss of blood or the clots. And we will see signs of bleeding – and lots of it. They may just have ecchymoses like petechiae, purpura, or hematomas. Or they could have frank bleeding – like I said – from every orifice in their body. Any time you see hemat or hemo, think blood. So hemoptysis is coughing up blood, hematemesis is vomiting blood. They could have melena which is bloody stools, or it could even be occult blood where you can’t see it, so we have to test for it. Or they could have hematuria which is blood in their urine. They’ll also ooze from every IV site, every skin tear, anywhere with open skin will start to ooze. It’s legitimately some horror movie stuff – it’s crazy.

So what do we do for them? Well first and foremost we always want to identify and treat the underlying cause. Ultimately remember they’re using up all of their clotting factors, so the first thing we want to do is replace them. That might be through Fresh Frozen Plasma or FFP or with actual factors like Factor 7. But – now, hang with me because this part is confusing – we also want to start them on Heparin, especially if they’re having a lot of clotting. This seems counterintuitive in a patient who’s bleeding, but our goal is to STOP the clotting cascade – because we want them to STOP using up their clotting factors. If we can get them to stop using them up, and replace the ones they’ve lost, then we can hopefully stop this overactive cascade and the patient will have enough factors to be able to clot again. Then, we’ll wean them off the heparin. And, of course, we will replace any blood they’ve lost to keep them hemodynamically stable. From a nursing perspective we want to monitor for bleeding in our at-risk patients, monitor I&O and hemodynamics, because they’re at risk for hypovolemic shock, and we want to initiate bleeding precautions – this means absolutely NO invasive procedures unless they’re absolutely medically necessary. No Peripheral IV’s, no venipuncture, no NG tubes, no foleys, and especially no central lines or arterial lines until the DIC is under control. Now – use your nursing judgment here – if they don’t have sufficient IV access for blood transfusions or fluids, of course we need to make sure we have them, but if your lines are working, use them – don’t add more.

So, this is probably pretty obvious, but out priority nursing concepts for a patient with DIC are clotting and perfusion – we want to replace their clotting factors and stop the clotting cascade, and to keep them hemodynamically stable while we sort out the cause.

So, I know DIC can be complicated, so let’s recap. Disseminated Intravascular Coagulation or DIC happens when the clotting cascade is stimulated and overreacts sending microclots throughout the system. This process consumes the patient’s clotting factors so they can’t clot anymore and we begin to see massive hemorrhage. They bleed from everywhere. We want to identify and treat the cause and replace their clotting factors and red blood cells. We’ll also give them heparin to stop the overactive clotting process. All the while, we’re monitoring and controlling bleeding, monitoring I&O, and supporting their hemodynamics to prevent hypovolemic shock.

So those are the basics of Disseminated Intravascular Coagulation, or DIC – I hope we made it simple to understand. Let us know if you have any questions. Now, go out and be your best selves today. And, as always, happy nursing!

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Wound Care – Assessment
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Wound Bleeding (Uncontrolled External Hemorrhage) for Certified Emergency Nursing (CEN)
Who Needs Dialysis Nursing Mnemonic (AEIOU)
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Urine Culture and Sensitivity Lab Values
Upper Gastrointestinal (GI) Module Intro
Understanding Blood Pressure Meds! – Live Tutoring Archive
Ulcerative Colitis – Assessment Nursing Mnemonic (MADE 10)
Types of Anemia Nursing Mnemonic (Always Introduce Special Patients)
Tuberculosis for Certified Emergency Nursing (CEN)
Tuberculosis (TB) Case Study (60 min)
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Transient Ischemic Attack (TIA) for Certified Emergency Nursing (CEN)
Traction – Nursing Care Nursing Mnemonic (TRACTION)
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To Clot or Not To Clot – Anticoagulants! – Live Tutoring Archive
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Thrombocytopenia
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Symptoms of Nephrotic Syndrome Nursing Mnemonic (NAPHROTIC)
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Sterile Field
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Sprains and Strains – Nursing Care Nursing Mnemonic (RICE)
Spinal Cord Injury Case Study (60 min)
Spinal Cord Injury
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Specialty Diets (Nutrition)
Sinus Tachycardia
Sinus Bradycardia
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Shock Module Intro
Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Shock
Septic Shock (Sepsis) Case Study (45 min)
Sepsis Labs
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Rheumatoid Arthritis Assessment Nursing Mnemonic (RHEUMATOID)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Restrictive Lung Disease Causes Nursing Mnemonic (PAINT)
Respiratory Trauma Module Intro
Respiratory Trauma for Certified Emergency Nursing (CEN)
Respiratory Procedures Module Intro
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Ranitidine (Zantac) Nursing Considerations
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Plant Alkaloids Topoisomerase and Mitotic Inhibitors
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Nursing Care Plan (NCP) for Thrombocytopenia
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Nursing Care Plan (NCP) for Rheumatoid Arthritis (RA)
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Nursing Care Plan (NCP) for Respiratory Failure
Nursing Care Plan (NCP) for Pulmonary Embolism
Nursing Care Plan (NCP) for Psoriasis
Nursing Care Plan (NCP) for Pressure Ulcer / Decubitus Ulcer (Pressure Injury)
Nursing Care Plan (NCP) for Pneumothorax/Hemothorax
Nursing Care Plan (NCP) for Pneumonia
Nursing Care Plan (NCP) for Pericarditis
Nursing Care Plan (NCP) for Parkinson’s Disease
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Osteoporosis
Nursing Care Plan (NCP) for Osteoarthritis (OA), Degenerative Joint Disease
Nursing Care Plan (NCP) for Nutrition Imbalance
Nursing Care Plan (NCP) for Neutropenia
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Nursing Care Plan (NCP) for Myasthenia Gravis (MG)
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Nursing Care Plan (NCP) for Meniere’s Disease
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Nursing Care Plan (NCP) for Inflammatory Bowel Disease (Ulcerative Colitis / Crohn’s Disease)
Nursing Care Plan (NCP) for Impetigo
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hypoparathyroidism
Nursing Care Plan (NCP) for Hypoglycemia
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Hyperthermia (Thermoregulation)
Nursing Care Plan (NCP) for Hyperparathyroidism
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Nursing Care Plan (NCP) for Encephalopathy
Nursing Care Plan (NCP) for Emphysema
Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Diabetes
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Nursing Care Plan (NCP) for Benign Prostatic Hyperplasia (BPH)
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Nursing Care Plan (NCP) for Aspiration
Nursing Care Plan (NCP) for Angina
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Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Acute Pain
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Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Abdominal Pain
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care and Pathophysiology of Pneumonia
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care and Pathophysiology of Myocarditis
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology for Pulmonary Embolism
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Psoriasis
Nursing Care and Pathophysiology for Polycystic Ovarian Syndrome (PCOS)
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Parkinsons
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Human Papilloma Virus (HPV STI)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Crohn’s Disease
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology for Compartment Syndrome
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nuclear Medicine
Norepinephrine (Levophed) Nursing Considerations
Noncardiac Pulmonary Edema for Certified Emergency Nursing (CEN)
Nitroprusside (Nitropress) Nursing Considerations
Nitroglycerin (Nitrostat) Nursing Considerations
Nitro Compounds
NG (Nasogastric)Tube Management
Neurological Fractures
Neurological Disorders (Multiple Sclerosis, Myasthenia Gravis, Guillain-Barré Syndrome) for Certified Emergency Nursing (CEN)
Neurogenic Shock for Certified Emergency Nursing (CEN)
Neostigmine (Prostigmin) Nursing Considerations
Naproxen (Aleve) Nursing Considerations
Myocardial Infarction Nursing Mnemonic (MONATAS)
Myocardial Infarction (MI) Case Study (45 min)
Musculoskeletal Course Introduction
Musculoskeletal Assessment
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)
Morphine (MS Contin) Nursing Considerations
Moderate Sedation
Mobility & Assistive Devices
Miscellaneous Nerve Disorders
Minimally-Invasive Thoracic Surgery (VATS) for Progressive Care Certified Nurse (PCCN)
Migraines
MI Surgical Intervention
Metronidazole (Flagyl) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Methylprednisolone (Solu-Medrol) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Metabolic/Endocrine Course Introduction
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic & Endocrine Module Intro
Meropenem (Merrem) Nursing Considerations
Meperidine (Demerol) Nursing Considerations
Meningitis for Certified Emergency Nursing (CEN)
Meniere’s Disease
Medication Classess for IBD Nursing Mnemonic (Sometimes I Can’t Answer)
Mechanical Aids
Management of Pressure Ulcers (Pressure Injuries) Nursing Mnemonic (SKIN)
Malignant Hyperthermia (MH) Nursing Interventions for Certified Perioperative Nurse (CNOR)
Malignant Hyperthermia
Magnetic Resonance Imaging (MRI)
Macular Degeneration
Lymphoma – Signs and Symptoms Nursing Mnemonic (NURSE For Pete’s Sake)
Lymphoma
Lymphatic Assessment
Lung Diseases Module Intro
Lower Gastrointestinal (GI) Module Intro
Low Pressure Vent Alarms Nursing Mnemonic (Cake Everyday)
Losartan (Cozaar) Nursing Considerations
Loperamide (Imodium) Nursing Considerations
Local Anesthetic Systemic Toxicity (LAST) Nursing Interventions for Certified Perioperative Nurse (CNOR)
Local Anesthesia
Liver/Gallbladder Module Intro
Live Bedside Report Medsurg (Medical surgical)
Lisinopril (Prinivil) Nursing Considerations
Lipase Lab Values
Linen Change
Lidocaine Toxicity – Signs and Symptoms Nursing Mnemonic (SAMS)
Lidocaine (Xylocaine) Nursing Considerations
Levothyroxine (Synthroid)
Levofloxacin (Levaquin) Nursing Considerations
Levels of consciousness Nursing Mnemonic (Never Carry Dirty Socks Or Smelly Clothes)
Lactic Acid
Lactate Dehydrogenase (LDH) Lab Values
Lacerations for Certified Emergency Nursing (CEN)
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Isoniazid (Niazid) Nursing Considerations
Ischemic Bowel for Progressive Care Certified Nurse (PCCN)
Ischemic (CVA) Stroke Labs
Iron (Fe) Lab Values
Ionized Calcium Lab Values
Iodine Nursing Considerations
Intubation in the OR
Introduction to Health Assessment
Intro to Health Assessment
Intrarenal Causes of Acute Kidney Injury Nursing Mnemonic (TONIC)
Intraoperative Positioning
Intraoperative Nursing Priorities
Intraoperative (Intraop) Complications
Intracranial Pressure ICP
Interventions for Aphasia Nursing Mnemonic (PROP)
Interdisciplinary Team Participation for Certified Perioperative Nurse (CNOR)
Interdisciplinary Team Member Functions for Certified Perioperative Nurse (CNOR)
Interdisciplinary Healthcare Team Collaboration for Certified Perioperative Nurse (CNOR)
Integumentary (Skin) Important Points
Integumentary (Skin) Module Intro
Integumentary (Skin) Course Introduction
Intake and Output (I&O)
Insulin Mnemonic (Ready, Set, Inject, Love)
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin
Inserting an NG (Nasogastric) Tube
Inserting a Foley (Urinary Catheter) – Male
Informed Consent
Influenza for Certified Emergency Nursing (CEN)
Inflammatory Bowel Disease Case Study (45 min)
Infectious Diseases: Influenza for Progressive Care Certified Nurse (PCCN)
Individualized Physical Assessments for Certified Perioperative Nurse (CNOR)
Increased Intraocular Pressure for Certified Emergency Nursing (CEN)
Impulse Transmission
Implant Verification and Availability for Certified Perioperative Nurse (CNOR)
Implant Records and Tracking for Certified Perioperative Nurse (CNOR)
Implant Preparation for Certified Perioperative Nurse (CNOR)
Impaired or Disruptive Behavior Reporting (Interdisciplinary Healthcare Team) for Certified Perioperative Nurse (CNOR)
Immunology Module Intro
Immunocompromise (HIV and AIDS, Oncology and Chemotherapy, Transplant Patient) for Certified Emergency Nursing (CEN)
Hypoxia – Signs and Symptoms Nursing Mnemonic (RAT BED)
Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)
Hypotonic Solutions (IV solutions)
Hypothermia (Thermoregulation)
Hypoparathyroidism
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)
Hypoglycemia for Progressive Care Certified Nurse (PCCN)
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Hypoglycemia
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypertonic Solutions (IV solutions)
Hyperthyroidism Case Study (75 min)
Hyperthermia (Thermoregulation)
Hypertensive Crisis Case Study (45 min)
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypertension (HTN) Concept Map
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (FRIED)
Hyperglycemia for Progressive Care Certified Nurse (PCCN)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Hypercalcemia – Signs and Symptoms Nursing Mnemonic (GROANS, MOANS, BONES, STONES, OVERTONES)
Hygiene
Hydralazine
HMG-CoA Reductase Inhibitors (Statins)
Histamine 2 Receptor Blockers
Histamine 1 Receptor Blockers
High Pressure Vent Alarms Nursing Mnemonic (Kings Eat Big Cakes)
Hepatitis for Certified Emergency Nursing (CEN)
Hepatitis B Virus (HBV) Lab Values
Hepatic Disorders (Cirrhosis, Hepatitis, Portal Hypertension) for Progressive Care Certified Nurse (PCCN)
Heparin (Hep-Lock) Nursing Considerations
Hemorrhagic Stroke Risk Factors Nursing Mnemonic (HATS)
Hemorrhagic Fevers for Certified Emergency Nursing (CEN)
Hemorrhage Nursing Interventions for Certified Perioperative Nurse (CNOR)
Hemodialysis (Renal Dialysis)
Hematology/Oncology/Immunology Course Introduction
Hematology Module Intro
Hematologic Disorders for Certified Emergency Nursing (CEN)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Heat Temperature-related Emergencies for Certified Emergency Nursing (CEN)
Heart Failure for Certified Emergency Nursing (CEN)
Heart Failure Case Study (45 min)
Heart Failure 2 – Live Tutoring Archive
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Heart (Cardiac) Sound Locations and Auscultation
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) and Great Vessels Assessment
Healthcare-Acquired Infections: Surgical Site Infections (SSI) for Progressive Care Certified Nurse (PCCN)
Hearing Loss
Healthcare-Acquired Infections: Catheter-Associated Bloodstream Infections (CAUTI) for Progressive Care Certified Nurse (PCCN)
Healthcare Team Member Supervision and Education for Certified Perioperative Nurse (CNOR)
Health Assessment Course Introduction
Head/Neck Assessment
Hb (Hepatitis) Vaccine
Hazardous Material Handling and Disposition (Chemo, Radioactive) for Certified Perioperative Nurse (CNOR)
Hand Hygiene Guideline Adherence for Certified Perioperative Nurse (CNOR)
Glucagon (GlucaGen) Nursing Considerations
Glipizide (Glucotrol) Nursing Considerations
Glaucoma
GI Infections (C. difficile) for Progressive Care Certified Nurse (PCCN)
GI Bleed (Upper, Lower) for Progressive Care Certified Nurse (PCCN)
GERD causes Nursing Mnemonic (Reflux Is Probably Mean)
GERD (Gastroesophageal Reflux Disease)
Genitourinary Infections for Certified Emergency Nursing (CEN)
Genitourinary Course Introduction
Genitourinary Trauma for Certified Emergency Nursing (CEN)
Genitourinary (GU) Assessment
General Assessment (Physical assessment)
General Anesthesia
Gastrointestinal (GI) Bleed Concept Map
Gastritis
Gabapentin (Neurontin) Nursing Considerations
Fundamentals Course Introduction
Functional Issues (Immobility, Falls, Gait Disorders) for Progressive Care Certified Nurse (PCCN)
Functional GI Disorders (Obstruction, Ileus, Diabetic Gastroparesis, Gastroesophageal Reflux, Irritable Bowel Syndrome) for Progressive Care Certified Nurse (PCCN)
Free T4 (Thyroxine) Lab Values
Fluid Volume Overload
Fibromyalgia
Fibrinogen Lab Values
Fibrin Degradation Products (FDP) Lab Values
Ferrous Sulfate (Iron) Nursing Considerations
Fentanyl (Duragesic) Nursing Considerations
Explant Preparation (Final Disposition) for Certified Perioperative Nurse (CNOR)
Ethical and Professional Standards for Certified Perioperative Nurse (CNOR)
Essential NCLEX Meds by Class
Esophageal Varices for Certified Emergency Nursing (CEN)
Erythromycin (Erythrocin) Nursing Considerations
Erythrocyte Sedimentation Rate (ESR) Lab Values
Equipment Utilization (Manufacturers Recommendations) for Certified Perioperative Nurse (CNOR)
Epoetin Alfa
Epoetin (Epogen) Nursing Considerations
Epinephrine (EpiPen) Nursing Considerations
Environmental Stewardship (Waste Minimization) for Certified Perioperative Nurse (CNOR)
Environmental Factor Control for Certified Perioperative Nurse (CNOR)
Environmental Cleaning (Spills, Room Turnover, Terminal Cleaning) for Certified Perioperative Nurse (CNOR)
Envenomation Emergencies for Certified Emergency Nursing (CEN)
Enteral & Parenteral Nutrition (Diet, TPN)
Enoxaparin (Lovenox) Nursing Considerations
Endoscopy & EGD
End-Stage Renal Disease (ESRD) for Progressive Care Certified Nurse (PCCN)
Encephalopathy (Hypoxic-ischemic, Metabolic, Infectious, Hepatic) for Progressive Care Certified Nurse (PCCN)
Encephalopathies
Enalapril (Vasotec) Nursing Considerations
Emergency Situation Identification for Certified Perioperative Nurse (CNOR)
EENT Medications
EENT Course Introduction
Echocardiogram (Cardiac Echo)
Dysrhythmias Labs
Dysrhythmias for Certified Emergency Nursing (CEN)
Drugs that Cause SJS Nursing Mnemonic (I C NASA)
Dopamine (Inotropin) Nursing Considerations
Dobutamine (Dobutrex) Nursing Considerations
DKA Treatment Nursing Mnemonic (KING UFC)
Diverticulitis for Certified Emergency Nursing (CEN)
Diverticulitis Complications Nursing Mnemonic (Please Fix His Abscess SOon)
Disseminated Intravascular Coagulation Case Study (60 min)
Disease Specific Medications
Discharge Planning for Certified Emergency Nursing (CEN)
Discharge (DC) Teaching After Surgery
Different Dressings
Diltiazem (Cardizem) Nursing Considerations
Dialysis & Other Renal Points
Diagnostic Criteria for Lupus Nursing Mnemonic (SOAP BRAIN MD)
Diabetic Ketoacidosis for Progressive Care Certified Nurse (PCCN)
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Diabetes Mellitus for Progressive Care Certified Nurse (PCCN)
Diabetes Mellitus & Those Dang Blood Sugars! – Live Tutoring Archive
Diabetes Mellitus Case Study (45 min)
Diabetes Mellitus (DM) Module Intro
Diabetes Management
Diabetes Insipidus Nursing Mnemonic (DDD)
Diabetes Insipidus Case Study (60 min)
Dementia and Alzheimers
Delegation and Personnel Management for Certified Perioperative Nurse (CNOR)
Decrease ICP Nursing Mnemonic (Craniums Excite Me)
Day in the Life of a Med-surg Nurse
D-Dimer (DDI) Lab Values
Cyclosporine (Sandimmune) Nursing Considerations
Cyclic Citrullinated Peptide (CCP) Lab Values
Cushings Assessment Nursing Mnemonic (STRESSED)
Cushing’s Syndrome Case Study (60 min)
Cultures
CT & MR Angiography
Crohn’s Morphology and Symptoms Nursing Mnemonic (CHRISTMAS)
Critical Thinking to Facilitate Patient Care for Certified Perioperative Nurse (CNOR)
Creatinine Clearance Lab Values
Creatine Phosphokinase (CPK) Lab Values
Cranial Nerve Mnemonic 02 Nursing Mnemonic (Oh Oh Oh To Touch And Feel Very Good Velvet AH!)
Cortisone (Cortone) Nursing Considerations
Cortisol Lab Vales
Coronavirus (COVID-19) Nursing Care and General Information
Coronary Circulation
Coronary Artery Disease Concept Map
Coronary Arteries – Location Nursing Mnemonic (I have a RIGHT to CAMP if you LEFT off the AC)
Cor Pulmonale – Signs & Symptoms Nursing Mnemonic (Please Read His Text)
COPD management Nursing Mnemonic (COPD)
COPD Exacerbation for Progressive Care Certified Nurse (PCCN)
COPD Concept Map
COPD (Chronic Obstructive Pulmonary Disease) Labs
Congestive Heart Failure Concept Map
Confirming Patient Identity (Patient Identifiers) for Certified Perioperative Nurse (CNOR)
Confirmation of Correct Procedure (Operative Site, Side, Site Marking) for Certified Perioperative Nurse (CNOR)
Complications of Thoracentesis Nursing Mnemonic (Patients Sometimes Bleed Internally)
Complications of Immobility
Compartment Syndrome for Certified Emergency Nursing (CEN)
Communication of Patient Outcomes (Continuum of Care) for Certified Perioperative Nurse (CNOR)
Common Signs of Parkinson’s Nursing Mnemonic (SMART)
Comfort Provisions (Behavioral Response to Procedure) for Certified Perioperative Nurse (CNOR)
Colonoscopy
Cold Temperature-related Emergencies for Certified Emergency Nursing (CEN)
Coagulopathies, Medication-Induced (Coumadin, Platelet Inhibitors, Heparin, HIT) for Progressive Care Certified Nurse (PCCN)
Coagulation Studies (PT, PTT, INR)
Clopidogrel (Plavix) Nursing Considerations
Cirrhosis Complications Nursing Mnemonic (Please Bring Happy Energy)
Cirrhosis for Certified Emergency Nursing (CEN)
Cirrhosis Case Study (45 min)
Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)
Chronic Obstructive Pulmonary Disease (COPD) for Certified Emergency Nursing (CEN)
Chronic Renal (Kidney) Module Intro
Chronic Kidney Disease (CKD) Case Study (45 min)
CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Chest Tube Management Case Study (60 min)
Chest Tube Management
Chest Tube Management
Chest Tube Assessment Nursing Mnemonic (Two AA’s)
Cerebral Perfusion Pressure CPP
Cerebral Perfusion Pressure Case Study (60 min)
Cephalexin (Keflex) Nursing Considerations
Central Line Dressing Change
Celecoxib (Celebrex) Nursing Considerations
Causes of Dyspnea Nursing Mnemonic (The 6 P’s)
Causes of Pancreatitis Nursing Mnemonic (BAD HITS)
Causes of Anaphylaxis Nursing Mnemonic (Many Boys Love Food)
Cataracts
Cardiovascular Disorders (CVD) Module Intro
Cardiovascular Angiography
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiac Stress Test
Cardiac Labs – What and When to Use Them 2 – Live Tutoring Archive
Cardiac Labs – What and When to Use Them – Live Tutoring Archive
Cardiac Course Introduction
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Cardiac Anatomy
Cardiac A&P Module Intro
Cardiac (Heart) Enzymes
Carbon Dioxide (Co2) Lab Values
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Captopril (Capoten) Nursing Considerations
Canes Nursing Mnemonic (COAL)
Calcium Channel Blockers
Calcium Carbonate (Tums) Nursing Considerations
Calcium Acetate (PhosLo) Nursing Considerations
C. Difficile for Certified Emergency Nursing (CEN)
C-Reactive Protein (CRP) Lab Values
Burns for Certified Emergency Nursing (CEN)
Burn Injuries
Brain Natriuretic Peptide (BNP) Lab Values
Brain Death v. Comatose
BPH Symptoms Nursing Mnemonic (FUN WISE)
Bowel Perforation for Certified Emergency Nursing (CEN)
Bowel Obstruction Concept Map
Body Mechanics (Utilization) for Certified Perioperative Nurse (CNOR)
Blunt Chest Trauma
Blood Salvage Transfusion Anticipation for Certified Perioperative Nurse (CNOR)
Blood Flow Through The Heart
Bleeding Precautions Nursing Mnemonic (RANDI)
Bleeding for Certified Emergency Nursing (CEN)
Bleeding Complications (Minor) Nursing Mnemonic (BEEP)
Bismuth Subsalicylate (Pepto-Bismol) Nursing Considerations
Biopsy
Biohazard Material Handling and Disposition (Blood, Microbiology, Creutzfeldt-Jakob Disease) for Certified Perioperative Nurse (CNOR)
Beta Hydroxy (BHB) Lab Values
Benztropine (Cogentin) Nursing Considerations
Bed Bath
Barriers to Health Assessment
Barrier Material Selection (Procedure-Specific) for Certified Perioperative Nurse (CNOR)
Bariatric: IV Insertion
Bariatric Surgeries
Barbiturates
Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)
Azithromycin (Zithromax) Nursing Considerations
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Flutter
Atrial Fibrillation (A Fib)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atorvastatin (Lipitor) Nursing Considerations
Atenolol (Tenormin) Nursing Considerations
Asthma for Certified Emergency Nursing (CEN)
Asthma (Severe) for Progressive Care Certified Nurse (PCCN)
Assessment of Guillain-Barre Syndrome Nursing Mnemonic (GBS=PAID)
Assessment for Myasthenic Crisis Nursing Mnemonic (BRISH)
ASA (Aspirin) Nursing Considerations
Artificial Airways
ARDS causes Nursing Mnemonic (GUT PASS)
ARDS Case Study (60 min)
Aortic Stenosis Symptoms Nursing Mnemonic (SAD)
Aortic Aneurysm – Thoracic signs Nursing Mnemonic (PEE BADS)
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
Antinuclear Antibody Lab Values
Antineoplastics
Antimetabolites
Antidiabetic Agents
Anticonvulsants
Anti-Platelet Aggregate
Anti-Infective – Antitubercular
Anti-Infective – Tetracyclines
Anti-Infective – Sulfonamides
Anti-Infective – Glycopeptide
Anti-Infective – Carbapenems
Anti Tumor Antibiotics
Anion Gap Acidosis 1 Nursing Mnemonic (KULT)
Anion Gap Acidosis 2 Nursing Mnemonic (MUDPILES)
Anion Gap
Angiotensin Receptor Blockers
Aneurysm and Dissection for Certified Emergency Nursing (CEN)
Anesthetic Agents
Anesthetic Agents
Aneurysm (Dissecting, Repair) for Progressive Care Certified Nurse (PCCN)
Anesthesia Management Assistance for Certified Perioperative Nurse (CNOR)
Anemia for Progressive Care Certified Nurse (PCCN)
Amputation for Certified Emergency Nursing (CEN)
Anaphylaxis Nursing Interventions for Certified Perioperative Nurse (CNOR)
Amputation Concept Map
Amputation
Amlodipine (Norvasc) Nursing Considerations
Amitriptyline (Elavil) Nursing Considerations
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Alteplase (tPA, Activase) Nursing Considerations
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Alkylating Agents
Alkaline Phosphatase (ALK PHOS) Lab Values
Alendronate (Fosamax) Nursing Considerations
Alanine Aminotransferase (ALT) Lab Values
Airway Suctioning
AIDS Case Study (45 min)
Age and Culturally Appropriate Health Assessment Techniques for Certified Perioperative Nurse (CNOR)
Advanced Directive and DNR Status Confirmation for Certified Perioperative Nurse (CNOR)
Advance Directives
Adrenal Gland Hormones Nursing Mnemonic (The 3 S’s)
Adrenal and Thyroid Disorder Emergencies for Certified Emergency Nursing (CEN)
Admissions, Discharges, and Transfers
Adjunct Neuro Assessments
Addisons Disease
Addisons Assessment Nursing Mnemonic (STEROID)
Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)
Acute Renal (Kidney) Module Intro
Acute Kidney Injury Case Study (60 min)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)
Acute Abdomen for Certified Emergency Nursing (CEN)
ACE (angiotensin-converting enzyme) Inhibitors
Accountability and Assistance for Personal Limitations for Certified Perioperative Nurse (CNOR)
Absolute Reticulocyte Count (ARC) Lab Values
Absolute Neutrophil Count (ANC) Lab Values
3rd Degree AV Heart Block (Complete Heart Block)
2nd Degree AV Heart Block Type 2 (Mobitz II)
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
1st Degree AV Heart Block
10.04 Pulmonary Question Review for CCRN Review
07.10 Neurologic Review questions for CCRN Review
07.09 Meningitis for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
06.04 Differentiating Ectopy and Aberrancy for CCRN Review
05.05 GI Practice Questions for CCRN Review
05.02 Liver Overview and Disease for CCRN Review
05.01 Pancreatitis and Large Bowel Obstruction for CCRN Review
03.04 DKA vs HHNK for CCRN Review
03.05 Endocrine Practice Questions for CCRN Review
03.03 Hypoglycemia for CCRN Review
03.02 Diabetes Insipidus for CCRN Review
03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review
02.18 Cardiovascular Practice Questions for CCRN Review
02.17 Septic Shock for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.15 Hypovolemic Shock for CCRN Review
02.14 Shock Stages for CCRN Review
02.13 Myocardial Infarction – Anterior Septal Wall for CCRN Review
02.02 Cardiomyopathy for CCRN Review
02.06 Heart Murmurs for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.12 Myocardial Infarction- Inferior Wall for CCRN Review