Fractures

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Nichole Weaver
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Included In This Lesson

Study Tools For Fractures

Sprains and Strains – Nursing Care (Mnemonic)
Traction – Nursing Care (Mnemonic)
Fracture Management (Cheatsheet)
Compound Fracture Before and After Repair (Image)
Displaced Fracture with Dislocation (Image)
Skeletal Traction (Image)
Hip Fracture Presentation (Image)
Blisters from Compartment Syndrome (Image)
Facsciotomy to Relieve Compartment Syndrome (Image)
Hip Arthroplasty (Image)
Plaster Cast for Fracture (Image)
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Outline

Overview

  1. A fracture occurs when sufficient force is applied to a bone, causing it to break.

Nursing Points

General

  1. Types of fractures
    1. Closed – skin intact
    2. Open/Compound – bone pierces skin
    3. Transverse – broken straight across
    4. Spiral – fracture from twisting force
    5. Comminuted – multiple pieces of bone
    6. Impacted – from vertical force on long bone
    7. Greenstick – incomplete fracture, common in children
    8. Oblique – diagonal fracture
    9. Displaced – bones no longer aligned
  2. Strain – excessive stretching of muscle
  3. Sprain – excessive stretching of ligament
  4. Complications
    1. Fat Embolism
      1. Risk with  long-bone fractures
      2. Piece of fat from bone marrow moves through bloodstream to lungs
    2. Compartment Syndrome
      1. Increased pressure within compartment in extremity after fracture or crush injury
      2. Cuts off circulation to muscles and nerves

Assessment

  1. Fracture
    1. Assess distal circulation
      1. Pulses
      2. Skin temperature
      3. Color
    2. Assess distal nerve function
      1. Numbness
      2. Tingling
    3. May see obvious deformity
    4. May see ecchymosis over fractured area
  2. Fat Embolism
    1. Anxiety, restlessness
    2. Tachypnea, dyspnea
  3. Compartment Syndrome
    1. Pale skin
    2. Extreme swelling
    3. Loss of pulses or sensation distal to injury

Therapeutic Management

  1. Analgesics
  2. RICE – Rest, Ice, Compression, Elevation
  3. Cast
    1. Stabilization of bone for healing
    2. Monitor extremity for swelling, pain, discoloration, sensation, and circulation distal to cast
  4. Traction
    1. Force applied in opposite direction to realign and immobilize fracture
    2. Ensure proper alignment of body
    3. Buck’s Traction – force applied to splint
    4. Skeletal Traction – pin inserted through bone to hold traction force
      1. Meticulous pin care
    5. Weights should hang freely from bed
      1. Do not set them on the floor
      2. Do not remove weights without provider order
      3. Support weight when sliding up in bed
  5. Fat Embolism
    1. No specific treatment
    2. Support hemodynamics
    3. Corticosteroids
    4. Monitor in ICU
  6. Compartment Syndrome
    1. Emergent intervention required to prevent loss of limb
    2. Fasciotomy required to relieve pressure
      1. Once pressure goes down, can be closed or covered with skin graft

Nursing Concepts

  1. Mobility
  2. Perfusion
  3. Comfort

Patient Education

  1. Report cold, purple, or numb fingers when in a cast
  2. Proper body alignment and movement restrictions when in traction
  3. Purpose of Fasciotomy / Wound care
  4. Medication instructions for analgesics

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Transcript

Okay guys we’re going to finish up our musculoskeletal course by talking about fractures and some of the common issues we see with these patients.

First we want to be clear about the difference between a strain and a sprain and a fracture. A strain is an overstretched muscle while a sprain is an overstretched ligament. That’s really the only difference between the two, and neither one involves any damage to the phone. For strains and sprains we simply use the RICE method. RICE stands for rest, ice, compression, and elevation. that will help to ease any pain and swelling around those muscles or ligaments. A fracture happens when enough force is applied to the bone to actually break it. You may or may not see an obvious deformity or bruising around the area. But it’s also possible that a fracture could displace and put pressure on blood vessels or nerves, so we want to check circulation and sensation distal to the injury. We also want to ask the patient how the injury happened, because that will help us understand what type of fracture to expect.

Let’s briefly review the types of fractures. A fracture is either closed or open. If the skin is intact, it’s closed. If the bone pierces the skin, then it’s considered an open or compound fracture. Transverse fractures are when the bone breaks straight across. Spiral fractures happen because of twisting. This is actually a common fracture to see in domestic or child abuse, because one person is holding the other person’s arm while they try to pull away, and it twists and breaks. Comminuted fractures have multiple pieces of bone within the broken area. Impacted fractures or when one piece of bone shoves into the other because of a vertical impact, like jumping off of a building. Greenstick fractures occur when the bone doesn’t break all the way through. This is common in children because their bones are still relatively flexible. And finally, oblique fractures are ones that break at an angle.

These oblique fractures are the most likely to displace. you can see how not only has this person’s ulna dislocated, but their radius has an oblique fracture that has displaced. That means it’s no longer in alignment. This is how we end up with cut off nerves and blood vessels. Before we do anything, the provider needs to reset this phone to be in alignment again. They can do that manually or they may have to take the patient to surgery to realign and insert screws to hold it in place.

We can use plaster casts like this one to help align and immobilize fractures. this will allow for proper and straight healing of the bone. I’m sure you or a friend or a family member has had one of these at some point in your life. And I’m sure someone signed your cast, so I will sign this one, for old time’s sake. When patients do have a cast, they could have swelling underneath the cast that could cause problems. So we want to assess for swelling, pain, circulation, and sensation distal to the cast to make sure that blood flow isn’t being restricted.

Another method we used to align and immobilize fractures is called traction. This is where we pull on the leg or arm away from the body to force it into alignment and force it to be immobile. There are two main types of traction we use. Bucks traction is when we apply a splint of some sort and then pull the splint away from the body, which pulls the extremity as well. Skeletal traction is when a pin is inserted through the bone, like you see here, and then the traction weight is applied to that PIN. We see this a lot with femur and hip fractures because of the force required for traction. Essentially, if this is the patient’s bed, and this is their leg, we insert the pin through the bone, then attach it to a device that has a pulley system and hang weights from that pulley. The orthopedic doctor will decide how much weight is required. The big thing that you need to know is that the weights need to hang freely off the bed. You should not allow them to hit the floor. now, as nurses we are not allowed to remove the weights without a provider order, however you will need to have someone to support the weights when you slide the patient up in bed, and consult the provider if you need to travel anywhere because the weights shouldn’t be swinging.

Now we just went to quickly review a couple of more severe complications of fractures. The first is fat embolism. this is a risk with any patient who has a long bone fracture. Essentially, fat moves from the bone marrow into the bloodstream, just like any other embolus and it can move to the lungs, heart, or brain. The reason this happens, as you see here if the fracture goes through the bone, then it exposes the bone marrow to the blood vessels. That is why some fat from the bone marrow could potentially get into the bloodstream. Usually fat emboli end up in the lungs, so you could see tachycardia, hypotension, restlessness, tachypnea, anxiety – very similar to a pulmonary embolism. Unfortunately there is no specific treatment, so we just want to support the patient’s hemodynamics, and possibly give corticosteroids to decrease the symptoms. Eventually, the patient’s body will dissolve the fat embolus.

The second major risk with fractures is called compartment syndrome. As with any injury, there will be an inflammatory response and swelling at the area. So if this is the patient’s bone, and this is the muscle, and skin around the bone. As swelling occurs, it increases pressure within this muscle compartment. Well, we know that there are also blood vessels and nerves in here, right? So, as the pressure increases, this blood supply can be cut off. Some of the signs we might see would be pale skin, cold skin, possibly blistering like you see here. And we may see a loss of pulses or sensation below the injury. This requires emergent intervention, otherwise the patient could lose that limb. We need to relieve the pressure within that muscle cavity so that we can restore circulation. The way that we do that is with a fasciotomy.

A fasciotomy is when the surgeon literally takes a scalpel and cuts through the skin, through the fascia, and to or even through the muscle. That allows the pressure to be relieved, so that circulation can be restored. We want to leave these open as long as it takes for the swelling to go down. Once the swelling goes down, we could potentially close the wound with staples or sutures, and sometimes even a wound vac. Or If the swelling doesn’t go down far enough, the patient could receive a skin graft to cover the area, like what you see here.

This should be pretty obvious to you by now, with everything we’ve talked about. The priority nursing concepts for patient with fracture is mobility, or specifically alignment and immobility of the fracture. Perfusion, because of the risk for impaired circulation. And of course comfort, we do want to address any pain that the patient has.

Just to recap quickly. Fractures occur when significant force is applied to the Bone, causing it to break. We want to make sure the bone gets realigned because displaced bones can cut off blood supply or nerves, and it needs to be aligned in order to heal properly. We need to immobilize the fracture using a cast or traction. And we want to make sure we’re addressing circulation at all times, and watching for a fat embolus and the possible development of compartment syndrome. Remember even swelling within the cast could cause a problem with perfusion. And of course don’t forget to address the patient’s pain.

So that’s it for fractures, and our musculoskeletal course. 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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1st Degree AV Heart Block
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Absolute Neutrophil Count (ANC) Lab Values
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Acute Renal (Kidney) Module Intro
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AIDS Case Study (45 min)
Airway Suctioning
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Cardiac Labs – What and When to Use Them 2 – Live Tutoring Archive
Cardiac Stress Test
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
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Cardiovascular Disorders (CVD) Module Intro
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Causes of Pancreatitis Nursing Mnemonic (BAD HITS)
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Cerebral Perfusion Pressure CPP
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CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Chronic Kidney Disease (CKD) Case Study (45 min)
Chronic Obstructive Pulmonary Disease (COPD) Case Study (60 min)
Chronic Renal (Kidney) Module Intro
Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)
Cirrhosis Case Study (45 min)
Cirrhosis Complications Nursing Mnemonic (Please Bring Happy Energy)
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Gout Case Study (45 min)
Hb (Hepatitis) Vaccine
Head/Neck Assessment
Health Assessment Course Introduction
Hearing Loss
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Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Heart Failure – Live Tutoring Archive
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Failure 2 – Live Tutoring Archive
Heart Failure Case Study (45 min)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Hematology Module Intro
Hematology/Oncology/Immunology Course Introduction
Hemodialysis (Renal Dialysis)
Hemorrhagic Stroke Risk Factors Nursing Mnemonic (HATS)
Heparin (Hep-Lock) Nursing Considerations
Hepatitis B Virus (HBV) Lab Values
Hiatal Hernia
Hiatal Hernia Symptoms Nursing Mnemonic (Her Belly Really Hurts Following Dinner)
High Pressure Vent Alarms Nursing Mnemonic (Kings Eat Big Cakes)
Histamine 1 Receptor Blockers
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Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)
Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Hypertension (HTN) Concept Map
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypertensive Crisis Case Study (45 min)
Hyperthermia (Thermoregulation)
Hyperthyroidism Case Study (75 min)
Hypertonic Solutions (IV solutions)
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypoglycemia
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Hypoparathyroidism
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Hypotonic Solutions (IV solutions)
Hypoxia – Signs and Symptoms Nursing Mnemonic (RAT BED)
ICU Nurse Report to OR (Operating)Team
Immunology Module Intro
Impulse Transmission
Inflammatory Bowel Disease Case Study (45 min)
Informed Consent
Inserting a Foley (Urinary Catheter) – Male
Inserting an NG (Nasogastric) Tube
Insulin
Insulin – Intermediate Acting (NPH) Nursing Considerations
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Insulin – Mixtures (70/30)
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Insulin Mnemonic (Ready, Set, Inject, Love)
Intake and Output (I&O)
Integumentary (Skin) Course Introduction
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Interventional Radiology
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Intracranial Pressure ICP
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Intrarenal Causes of Acute Kidney Injury Nursing Mnemonic (TONIC)
Intro to Health Assessment
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Iron (Fe) Lab Values
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Kidney Cancer
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Lactic Acid
Leukemia
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Leukemia Case Study (60 min)
Levels of consciousness Nursing Mnemonic (Never Carry Dirty Socks Or Smelly Clothes)
Levofloxacin (Levaquin) Nursing Considerations
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Lidocaine Toxicity – Signs and Symptoms Nursing Mnemonic (SAMS)
Linen Change
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Live Bedside Report Medsurg (Medical surgical)
Liver Cancer
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Local Anesthesia
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Losartan (Cozaar) Nursing Considerations
Low Pressure Vent Alarms Nursing Mnemonic (Cake Everyday)
Lower Gastrointestinal (GI) Module Intro
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Lung Diseases Module Intro
Lymphatic Assessment
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Macular Degeneration
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Medications to Prevent Seizures Nursing Mnemonic (Pretty Little Liars Forever)
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Musculoskeletal Assessment
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Myocardial Infarction (MI) Case Study (45 min)
Myocardial Infarction Nursing Mnemonic (MONATAS)
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Nephrotic Syndrome Case Study (Peds) (45 min)
Neuro A&P Module Intro
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Neuro Trauma Module Intro
Neurological Fractures
NG (Nasogastric)Tube Management
Nitro Compounds
Nitroglycerin (Nitrostat) Nursing Considerations
Nitroprusside (Nitropress) Nursing Considerations
Norepinephrine (Levophed) Nursing Considerations
NRSNG Live | So You Want to be a Surgical Nurse?
Nuclear Medicine
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Chlamydia (STI)
Nursing Care and Pathophysiology for Cholecystitis
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 Crohn’s Disease
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Epididymitis
Nursing Care and Pathophysiology for Gonorrhea (STI)
Nursing Care and Pathophysiology for Gout
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology for Hemorrhoids
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Herpes Simplex (HSV, STI)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology for Human Papilloma Virus (HPV STI)
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Nursing Care and Pathophysiology for Lyme Disease
Nursing Care and Pathophysiology for Male Infertility
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Osteomyelitis
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Parkinsons
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Polycystic Ovarian Syndrome (PCOS)
Nursing Care and Pathophysiology for Psoriasis
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Pulmonary Embolism
Nursing Care and Pathophysiology for Rhabdomyolysis
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology for Scleroderma
Nursing Care and Pathophysiology for Seizure
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology for Testicular Torsion
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology of Pneumonia
Nursing Care and Pathophysiology of Renal Calculi (Kidney Stones)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care Plan (NCP) for Abdominal Pain
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Activity Intolerance
Nursing Care Plan (NCP) for Acute Bronchitis
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Acute Pain
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Anemia
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Aortic Aneurysm
Nursing Care Plan (NCP) for Arterial Disorders
Nursing Care Plan (NCP) for Aspiration
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Bell’s Palsy
Nursing Care Plan (NCP) for Benign Prostatic Hyperplasia (BPH)
Nursing Care Plan (NCP) for Bladder Cancer
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Bone Cancer (Osteosarcoma, Chondrosarcoma, and Ewing Sarcoma)
Nursing Care Plan (NCP) for Bowel Obstruction
Nursing Care Plan (NCP) for Brain Tumors
Nursing Care Plan (NCP) for Breast Cancer
Nursing Care Plan (NCP) for Bronchoscopy (Procedure)
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Cellulitis
Nursing Care Plan (NCP) for Cervical Cancer
Nursing Care Plan (NCP) for Cholecystitis
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Chronic Obstructive Pulmonary Disease (COPD)
Nursing Care Plan (NCP) for Colorectal Cancer (Colon Cancer)
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Dementia
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis
Nursing Care Plan (NCP) for Emphysema
Nursing Care Plan (NCP) for Encephalopathy
Nursing Care Plan (NCP) for Endocarditis
Nursing Care Plan (NCP) for Enuresis / Bedwetting
Nursing Care Plan (NCP) for Epididymitis
Nursing Care Plan (NCP) for Gastroesophageal Reflux Disease (GERD)
Nursing Care Plan (NCP) for GI (Gastrointestinal) Bleed
Nursing Care Plan (NCP) for Glaucoma
Nursing Care Plan (NCP) for Glomerulonephritis
Nursing Care Plan (NCP) for Gout / Gouty Arthritis
Nursing Care Plan (NCP) for Guillain-Barre
Nursing Care Plan (NCP) for Hashimoto’s Thyroiditis
Nursing Care Plan (NCP) for Heart Valve Disorders
Nursing Care Plan (NCP) for Hepatitis
Nursing Care Plan (NCP) for Herpes Zoster – Shingles
Nursing Care Plan (NCP) for Hydrocephalus
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Care Plan (NCP) for Hyperparathyroidism
Nursing Care Plan (NCP) for Hyperthermia (Thermoregulation)
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Hypoglycemia
Nursing Care Plan (NCP) for Hypoparathyroidism
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Impetigo
Nursing Care Plan (NCP) for Inflammatory Bowel Disease (Ulcerative Colitis / Crohn’s Disease)
Nursing Care Plan (NCP) for Kidney Cancer
Nursing Care Plan (NCP) for Leukemia
Nursing Care Plan (NCP) for Lung Cancer
Nursing Care Plan (NCP) for Lyme Disease
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Nursing Care Plan (NCP) for Meniere’s Disease
Nursing Care Plan (NCP) for Multiple Sclerosis (MS)
Nursing Care Plan (NCP) for Mumps
Nursing Care Plan (NCP) for Myasthenia Gravis (MG)
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Nephrotic Syndrome
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan (NCP) for Nutrition Imbalance
Nursing Care Plan (NCP) for Osteoarthritis (OA), Degenerative Joint Disease
Nursing Care Plan (NCP) for Osteoporosis
Nursing Care Plan (NCP) for Ovarian Cancer
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Parkinson’s Disease
Nursing Care Plan (NCP) for Peptic Ulcer Disease (PUD)
Nursing Care Plan (NCP) for Pericarditis
Nursing Care Plan (NCP) for Pneumonia
Nursing Care Plan (NCP) for Pneumothorax/Hemothorax
Nursing Care Plan (NCP) for Polycystic Ovarian Syndrome (PCOS)
Nursing Care Plan (NCP) for Pressure Ulcer / Decubitus Ulcer (Pressure Injury)
Nursing Care Plan (NCP) for Prostate Cancer
Nursing Care Plan (NCP) for Psoriasis
Nursing Care Plan (NCP) for Pulmonary Embolism
Nursing Care Plan (NCP) for Renal Calculi
Nursing Care Plan (NCP) for Respiratory Failure
Nursing Care Plan (NCP) for Restrictive Lung Diseases
Nursing Care Plan (NCP) for Rhabdomyolysis
Nursing Care Plan (NCP) for Rheumatoid Arthritis (RA)
Nursing Care Plan (NCP) for Risk for Fall
Nursing Care Plan (NCP) for Rubeola – Measles
Nursing Care Plan (NCP) for Seizures
Nursing Care Plan (NCP) for Sepsis
Nursing Care Plan (NCP) for Skin cancer – Melanoma, Basal Cell Carcinoma, Squamous Cell Carcinoma
Nursing Care Plan (NCP) for Skull Fractures
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Stomach Cancer (Gastric Cancer)
Nursing Care Plan (NCP) for Stroke (CVA)
Nursing Care Plan (NCP) for Syncope (Fainting)
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Care Plan (NCP) for Testicular Cancer
Nursing Care Plan (NCP) for Thoracentesis (Procedure)
Nursing Care Plan (NCP) for Thrombocytopenia
Nursing Care Plan (NCP) for Thrombophlebitis / Deep Vein Thrombosis (DVT)
Nursing Care Plan (NCP) for Thyroid Cancer
Nursing Care Plan (NCP) for Tuberculosis
Nursing Care Plan (NCP) for Urinary Tract Infection (UTI)
Nursing Care Plan (NCP) for West Nile Virus
Nursing Care Plan for (NCP) Trigeminal Neuralgia
Nursing Care Plan for Amputation
Nursing Care Plan for Chlamydia (STI)
Nursing Care Plan for Cirrhosis (Liver)
Nursing Care Plan for Compartment Syndrome
Nursing Care Plan for Coronary Artery Disease (CAD)
Nursing Care Plan for Distributive Shock
Nursing Care Plan for Endometriosis
Nursing Care Plan for Fibromyalgia
Nursing Care Plan for Fractures
Nursing Care Plan for Gastritis
Nursing Care Plan for Gonorrhea (STI)
Nursing Care Plan for Hemorrhoids
Nursing Care Plan for Herpes Simplex (HSV, STI)
Nursing Care Plan for Hiatal Hernia
Nursing Care Plan for Liver Cancer
Nursing Care Plan for Macular Degeneration
Nursing Care Plan for Myocarditis
Nursing Care Plan for Nasal Disorders
Nursing Care Plan for Osteomyelitis
Nursing Care Plan for Pelvic Inflammatory Disease (PID)
Nursing Care Plan for Pulmonary Edema
Nursing Care Plan for Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care Plan for Scleroderma
Nursing Care Plan for Syphilis (STI)
Nursing Care Plan for Testicular Torsion
Nursing Case Study for Acute Kidney Injury
Nursing Case Study for Breast Cancer
Nursing Case Study for Cardiogenic Shock
Nursing Case Study for Colon Cancer
Nursing Case Study for Diabetic Foot Ulcer
Nursing Case Study for Hepatitis
Nursing Case Study for Pneumonia
Nursing Case Study for Rheumatic Heart Disease
Nursing Case Study for Rheumatoid Arthritis
Nursing Case Study for Type 1 Diabetes
Nursing Skills Course Introduction
Nutrition (Diet) in Disease
Nutrition-related Diseases
Omeprazole (Prilosec) Nursing Considerations
Oncology Important Points
Oncology Module Intro
Oncology nurse
Ondansetron (Zofran) Nursing Considerations
Opioids
Osteosarcoma
Ovarian Cancer
Oxygen Delivery Module Intro
Pacemakers
Pain and Nonpharmacological Comfort Measures
Pain Assessment Questions Nursing Mnemonic (OPQRST)
Pain Assessments for Certified Perioperative Nurse (CNOR)
Pantoprazole (Protonix) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Patient Positioning
Patients with Communication Difficulties
Pentobarbital (Nembutal) Nursing Considerations
Peptic Ulcer Disease Case Study (60 min)
Performing Cardiac (Heart) Monitoring
Perioperative Nursing Course Introduction
Perioperative Nursing Roles
Peripheral Vascular Assessment
Peritoneal Dialysis (PD)
Phenazopyridine (Pyridium) Nursing Considerations
Phenobarbital (Luminal) Nursing Considerations
Phosphorus (PO4) Blood Test Lab Values
Pituitary Adenoma
Plant Alkaloids Topoisomerase and Mitotic Inhibitors
Pneumonia Concept Map
Pneumonia Labs
Pneumonia Risk Factors Nursing Mnemonic (VENTS)
Pneumothorax Signs and Symptoms Nursing Mnemonic (P-THORAX)
Positioning
Post-Anesthesia Recovery
Postoperative (Postop) Complications
PPE Donning & Doffing
Premature Atrial Contraction (PAC)
Premature Ventricular Contraction (PVC)
Preoperative (Preop) Education
Preoperative (Preop) Nursing Priorities
Preoperative (Preop)Assessment
Pressure Line Management
Pressure Ulcers/Pressure injuries (Braden scale)
Procalcitonin (PCT) Lab Values
Propofol (Diprivan) Nursing Considerations
Propranolol (Inderal) Nursing Considerations
Propylthiouracil (PTU) Nursing Considerations
Prostate Cancer
Prostate Nursing Mnemonic (FUN)
Prostate Specific Antigen (PSA) Lab Values
Protein in Urine Lab Values
Proton Pump Inhibitors
Pulmonary edema treatment Nursing Mnemonic (MAD DOG)
Pupil Reactions Nursing Mnemonic (PERRLA)
Radiation Cancer Treatment
Ranitidine (Zantac) Nursing Considerations
Reactivation of Herpes Zoster Nursing Mnemonic (FICA)
Reasons for a Bronchoscopy Nursing Mnemonic (Please Assess His Weird Bronchoscopy Results)
Reasons for Chest Tube Nursing Mnemonic (Don’t Ever Fail)
Red Cell Distribution Width (RDW) Lab Values
Renal (Kidney) Failure Labs
Respiratory A&P Module Intro
Respiratory Alkalosis
Respiratory Course Introduction
Respiratory Infections Module Intro
Respiratory Procedures Module Intro
Respiratory Trauma Module Intro
Restrictive Lung Disease Causes Nursing Mnemonic (PAINT)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Rheumatoid Arthritis Assessment Nursing Mnemonic (RHEUMATOID)
Rifampin (Rifadin) Nursing Considerations
Risk Factors for Cholelithiasis Nursing Mnemonic (5-F’s)
Risk Factors for Osteoporosis Nursing Mnemonic (ACCESS)
Routine Neuro Assessments
Science of Nutrition
Scleroderma Symptoms Nursing Mnemonic (CREST)
Sedatives-Hypnotics
Sedatives-Hypnotics
Seizure Assessment
Seizure Causes (Epilepsy, Generalized)
Seizure Causes Nursing Mnemonic (VITAMIN)
Seizure Therapeutic Management
Seizures Case Study (45 min)
Seizures Module Intro
Sepsis Concept Map
Sepsis Labs
Septic Shock (Sepsis) Case Study (45 min)
Shock
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Shock Module Intro
Signs of Osteoarthritis Nursing Mnemonic (OSTEO)
Sinus Bradycardia
Sinus Tachycardia
Skin Cancer
Specialty Diets (Nutrition)
Spinal Cord Injury
Spinal Cord Injury Case Study (60 min)
Spinal Precautions & Log Rolling
Sprains and Strains – Nursing Care Nursing Mnemonic (RICE)
Stages of Hepatitis Nursing Mnemonic (PIP)
Sterile Field
Sterile Gloves
Stoke Assessments Nursing Mnemonic (FAST)
Stomach Cancer (Gastric Cancer)
Strabismus
Streptokinase (Streptase) Nursing Considerations
Stroke (CVA) Module Intro
Stroke Assessment (CVA)
Stroke Case Study (45 min)
Stroke Concept Map
Stroke Nursing Care (CVA)
Stroke Therapeutic Management (CVA)
Sucralfate (Carafate) Nursing Considerations
Supraventricular Tachycardia (SVT)
Surgical Incisions & Drain Sites
Surgical Prep
Sympatholytics (Alpha & Beta Blockers)
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Symptoms of Nephrotic Syndrome Nursing Mnemonic (NAPHROTIC)
Symptoms of Wernicke’s Encephalopathy Nursing Mnemonic (COAT)
Systemic Lupus Erythematosus (SLE)
TB Drugs Nursing Mnemonic (RIPE)
Tension and Cluster Headaches
Testicular Cancer
Tetracycline (Panmycin) Nursing Considerations
The 5-Minute Assessment (Physical assessment)
The Medical Team
Thoracentesis
Thrombin Inhibitors
Thrombocytopenia
Thrombolytics
Thyroid Cancer
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroxine (T4) Lab Values
To Clot or Not To Clot – Anticoagulants! – Live Tutoring Archive
Total Iron Binding Capacity (TIBC) Lab Values
Toxicity Sepsis- Signs and Symptoms Nursing Mnemonic (The 6 T’s)
Trach Care
Trach Suctioning
Traction – Nursing Care Nursing Mnemonic (TRACTION)
Trauma – Assessment (Emergency) Nursing Mnemonic (ABCDEFGHI)
Triiodothyronine (T3) Lab Values
Trimethoprim-Sulfamethoxazole (Bactrim) Nursing Considerations
Troponin I (cTNL) Lab Values
Tuberculosis (TB) Case Study (60 min)
Types of Anemia Nursing Mnemonic (Always Introduce Special Patients)
Types of Hemorrhoids Nursing Mnemonic (Pie)
Ulcerative Colitis – Assessment Nursing Mnemonic (MADE 10)
Ultrasound
Understanding Blood Pressure Meds! – Live Tutoring Archive
Upper Gastrointestinal (GI) Module Intro
Urinary Elimination
Urinary Tract Infection Case Study (45 min)
Urine Culture and Sensitivity Lab Values
Using Aseptic Technique
Vancomycin (Vancocin) Nursing Considerations
Varicocele
Vascular Disease – Deep Vein Thrombosis Nursing Mnemonic (HIS Leg Might Fall off)
Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)
Vasopressin
Vasopressin (Pitressin) Nursing Considerations
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Vent Alarms
Ventilator Settings
Ventricular Fibrillation (V Fib)
Ventricular Tachycardia (V-tach)
Vessels & Fluid
Vitamin D Lab Values
Warfarin (Coumadin) Nursing Considerations
Who Needs Dialysis Nursing Mnemonic (AEIOU)
Wound Care – Assessment
Wound Care – Dressing Change
Wound Care – Selecting a Dressing
Wound Care – Wound Drains
Seizure Documentation Nursing Mnemonic (TDOC)