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ACLS (Advanced cardiac life support) Drugs

ACLS (Advanced cardiac life support) Drugs

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Outline

Overview

  1. Priorities during cardiac arrest include CPR and early defibrillation.
  2. ACLS medications are used to improve survival chances.
  3. ACLS medications are administered during CPR for medication distribution.
  4. Without CPR, medications remain local.
  5. ACLS medications can be given ET/IV/IO.
  6. ACLS medications in stable patients are used to halt abnormal rhythms.

Nursing Points

General

  1. ACLS medications vary depending on EKG rhythm & patient symptoms:
    1. PEA / Asystole = Epinephrine
    2. VF / Pulseless VT = Epinephrine & Amiodarone
    3. Unstable Bradycardia = Atropine
    4. Stable Tachycardia = Adenosine & Amiodarone
  2. ACLS Algorithms
    1. Is the patient unresponsive? Check for a pulse 5-10 seconds
    2. Activate emergency response
    3. Start CPR & attach monitor/defibrillator
    4. Rhythm shockable?
      1. (YES) VF / Pulseless VT
      2. (NO) Asystole / PEA

Assessment

  1. Questions to ask during a code blue:
    1. What is the cardiac rhythm?
    2. Does the patient have a pulse?
    3. Is the patient stable or unstable?
      1. Stable: No hypotension, NO AMS, NO shock, NO CP, NO HF is present
      2. Unstable: Hypotension, AMS, shock, CP or HF are present

Therapeutic Management

  1. ACLS algorithms are AHA guidelines for managing cardiac emergencies
    1. These step-wise protocols follow certain sequences & steps
  2. VF / Pulseless VT
    1. Administer shock (biphasic 120-200 J, monophasic 360J)
    2. CPR 2 mins, epinephrine / consider advanced airway
    3. Admin shock (if still shockable rhythm), amiodarone 300 mg
  3. Asystole / PEA
    1. CPR 2 mins, epinephrine / consider advanced airway.
    2. Does unshockable rhythm remain? Continue CPR & epinephrine
  4. Bradycardia
    1. Stable Bradycardia = Monitor
    2. Unstable Bradycardia = Atropine
  5. Tachycardia
    1. Stable Tachycardia = Medications
      1. Wide QRS = Consider antiarrhythmic infusion (amiodarone) / expert consult
      2. Narrow QRS = Vagal maneuvers, adenosine, BB, CCB / expert consult
    2. Unstable Tachycardia = Cardioversion
  6. Epinephrine
    1. Drug class: Adrenergic Agonist
    2. Dose: 1 mg every 3 – 5 minutes
    3. Action: Stimulates alpha- & beta- adrenergic receptors
      1. Alpha1 = Increases in blood pressure
      2. Beta1 = Increases cardiac output
      3. beta2 = Bronchi opens up, helping airway
    4. Side Effects: Restlessness, tremors, angina, hypertension
    5. Will raise BP / HR, which can cause myocardial ischemia & angina
    6. Use can cause myocardial dysfunction after ROSC
  7.  Amiodarone
    1. Drug class: Antiarrhythmic
    2. Dose: 1st dose: 300 mg IV/IO bolus, 2nd dose: 150 mg IV/IO bolus
    3. Action: Blocks abnormal electrical activity to the heart
    4. Half-life lasts up to 40 days
    5. Side Effects: Pulmonary fibrosis, bradycardia, hypotension
    6. Rapid infusion may cause hypotension
    7. Do not administer other drugs that prolong QT interval
  8. Atropine
    1. Drug class: Anticholinergic
    2. Dose: 0.5 mg IV every 3 to 5 minutes (max 3 mg)
    3. Action: Blocks parasympathetic / Fight or flight
    4. Side Effects: Tachycardia, dry mouth, blurred vision, drowsiness
    5. Use with caution in myocardial ischemic patients
    6. Not effective with AV, type II HB & 3-degree CHBs
  9. Adenosine
    1. Drug class: Antiarrhythmic
    2. Dose: 6 mg rapid IVP, follow with NS / 2nd dose 12 mg
    3. Action: Interrupts pathways / Restore sinus rhythms
    4. Half-life is < 10 seconds
    5. Side Effects: Flushing, chest pain, a brief period of asystole/bradycardia
    6. Use with caution with patients with asthma (may cause bronchospasm)

Nursing Concepts

  1. EKG Rhythms
  2. Pharmacology

Patient Education

  1. When a patient has ROSC (return of spontaneous circulation), the following checklist should be completed:
    1. Optimize ventilation & oxygenation
    2. Maintain oxygen saturation > 94%
    3. Consider advanced airway / waveform capnography
    4. Do not hyperventilate
  2. Treat hypotension (SBP < 90 mm Hg)
    1. IV/IO bolus
    2. Vasopressor infusion
    3. Consider treatable causes
    4. 12-Lead EKG
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Transcript

Hello and welcome. Today we’re going to discuss ACLS medications and how they manage cardiovascular emergencies.

ACLS medications are used in cardiopulmonary arrest or other cardiac emergencies. Some situations cause temporary injury or insult, while other events cause permanent cellular death. Therefore, time is tissue.

ACLS medications are used to improve cardiac performance due to recent cardiac injury or defect. These medications are used to optimize cardiac output, improve blood pressure, and end lethal dysrhythmias (3 punch combo). When you think of ACLS medications I want you to think about four words, restart, restore, improve and support (RRIS). In nursing school, you were probably told that cardiac output equals stroke volume times heart rate. Well, disturbances to these elements will cause cardiovascular compromise. HR issues include bradycardia and tachycardia. Cardiac arrest has no heart rate so therefore, no cardiac output.

Before we get into ACLS medications, we must start with the most important question, what is the rhythm?  The rhythm and the patient’s symptoms will determine the type of ACLS medication used. So with that in mind, what is the rhythm being displayed here? Ventricular tachycardia, that is correct. Once we determine the rhythm, we must see if there is a pulse present. What you do is determined by rhythm & patient presentation (pulse vs no pulse – stable vs unstable).

After determining the cardiac rhythm,  it is now time to find out whether the patient is stable or unstable. Stable patients have normal blood pressures, no change in mentation, no displays of shock, no chest pain and no symptoms of heart failure. Unstable patients  have one or all signs of instability shown in the chart here. Most of the time, stable patients can be monitored or provided medication, while unstable patients require more aggressive treatments such as cardioversion or pacemaker.

Let’s look at the main meds used in each of the major algorithms. Then, we’ll dive into the actual meds themselves. Here, we have ventricular fibrillation and pulseless ventricular tachycardia. Ventricular fibrillation and pulseless ventricular tachycardia are rhythms where your patient will NOT have a pulse. The 2 ACLS medications used in this scenario is epinephrine and amiodarone.  I remember this by thinking, VF/VT = AE. Amiodarone, epinephrine.

Now, let move on to asystole/PEA situations. These rhythms lack a pulse, the patient is pulseless. Unlike ventricular fibrillation and pulseless ventricular tachycardia where the electrical activity is chaotic, here you might just see a line (like on TV) and no, shock isn’t required here. The focus here is epinephrine. No other ACLS drug is used besides epinephrine. Just think APE (Asystole/PEA/Epi = APE).

Bradycardia is a cardiac emergency has  2 tracks. First, you must first determine whether the patient is stable or unstable. If the patient is stable, we merely monitor and observe. My heart resting heart rate is 45 bpm. I show no signs of instability, so what would you do in my case? That is right, you would monitor and observe. Now, if the patient is unstable, like we mentioned, we would use ACLS medications. In this case, atropine first. Followed by infusions of dopamine or epinephrine. Again, symptoms will determine our action or inaction.

Now, tachycardia is another cardiac emergency that is managed based on patient symptoms. In the tachycardia, a stable patient has time for medications – chemical cardioversion. Depending on the width of the QRS interval, amiodarone or adenosine can be used. If the patient is unstable, we move right to synchronized “electrical” cardioversion. Remember CO = SV x HR? Elevated heart rate cause perfusion and blood flow issues d/t decreased filling times. The faster it beats, the less time there is to fill the tank. We are attempting to fix this.

Now let’s review the ACLS drug, epinephrine. This drug is an adrenergic agonist and stimulates both alpha and beta receptors. When alpha-1 receptors are stimulated, there is an increase in blood pressure. When alpha-2 receptors are stimulated, there is an increase in cardiac output. And lastly, when beta-2 receptors are stimulated, the bronchi of the lungs open up, helping breathing. When you think of epinephrine, think of adrenaline and the potential side effects of this drug entering your body. This drug is to be used with caution in patients with cardiovascular dysfunction as the receptor stimulation could cause further cardiac damage d/t patient’s already myocardial fragile state.

Now let’s review the ACLS drug, epinephrine. This drug is an adrenergic agonist and stimulates both alpha and beta receptors. When alpha-1 receptors are stimulated, there is an increase in blood pressure. When alpha-2 receptors are stimulated, there is an increase in cardiac output, for example, an increase in heart rate. And lastly, when beta-2 receptors are stimulated, the bronchi of the lungs open up, helping breathing. When you think of epinephrine, think of adrenaline and the potential side effects of this drug entering your body. This drug is to be used with caution in patients with cardiovascular dysfunction (such as AMI or heart failure) as the receptor stimulation could cause further cardiac damage d/t patient’s already myocardial fragile state.

Atropine is a drug used in unstable bradycardia with a pulse. This drug is an anticholinergic and blocks the parasympathetic system (rest & digest) and induces the flight-or-fight (stress) response. So when you think of atropine, think of the drug activating your fight-or-flight response, in an attempt to increase your heart rate. But due to its anticholinergic properties, it causes other issues such as dry mouth, blurred vision and drowsiness. This drug only works on lower tier heart blocks. Other aggressive heart blocks will require a pacemaker. Please check out our ECG course regarding heart blocks and how they vary.

Amiodarone is an antiarrhythmic which means that the drug is used to block abnormal cardiac electrical activity aka “chemical” cardioversion.  The goal of this drug is to convert the rhythm and restore NSR. In cardiac emergencies, amiodarone is given various doses, often resulting in a patient being on an intravenous drip. Amiodarone can cause bradycardia and hypotension in some patients. One unique thing about amiodarone is it’s very long half-life of up to 40 days. One key concept again with using amiodarone is its potential for bradycardia and hypotension.

Adenosine like amiodarone is an antiarrhythmic drug. Its goal is to block abnormal electrical activity and restore NSR. When you think of adenosine, think of restarting your computer. Your patient’s heart rate is going to slow way down. Let’s say from 150 to 50 to 30, the patient might complain of feeling weird. When you look at the monitor, you might even see asystole for a few brief seconds, followed by NSR. Antiarrhythmics are drugs used to “chemically” cardiovert dysrhythmias. The side effects of chest pain and flushing are due to the slowing down of the heart rate which alters cardiac output. This drug also has a side effect of bronchospasms, so this drug should be used with caution in patients with asthma.

So, you got your patient back, you have a blood pressure, you have a pulse and now it’s time to do your ROSC checklist. ROCS stands for return of spontaneous circulation. The goal with ROSC is to restore proper heart function & perfusion. Immediate post-cardiac arrest care includes optimizing ventilation, treating hypotension (maybe some of the drugs that we gave), and if your patient is unresponsive (induced hypothermia) or had a STEMI (cath lab). The heart has taken a hit from this acute event, now it’s time to find out the why and provide support.

Nursing concepts for ACLS medications include EKG rhythms and pharmacology.

Let’s recap & review the rhythm and their corresponding drugs… VF / Pulseless VT? Epi and amiodarone (think adrenaline & antiarrhythmic = AA). Asystole / PEA? Epi all day. It rhymes (a little). Symptomatic bradycardia? Atropine. And lastly, Stable tachycardia? Adenosine and amiodarone (Double AA). If there is no pulse, what med would you pull out of the code cart? That is right! Epi all day!

Here are some key points to take away from the ACLS meds presentation: 

1. We must know the EKG rhythm. Does your patient have a pulse? 2. Is your patient stable or unstable?  Will you monitor or will medications be needed? 3. If ACLS medications are needed,  what are the doses / types of drugs needed? 4. Responses –  What is the expected outcome of you administering these drugs? Lastly, the evaluation. If your patient who had a cardiac arrest event and is now in ROSC, what happens next. The goal isn’t simply to memorize these drugs, the goal is to understand the sequence of events that are needed, why they’re needed and how they affect your patient. It’s a few drugs and few rhythms, don’t overthink it. You can do this!

Don’t forget to check our the lecture on parasympathetic vs sympathetic pathways, along with the ECG lessons to further understand the drug actions mentioned in this presentation. Now, go out and be your best self today and as always, Happy Nursing!

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Prostaglandins in Pregnancy
Protein (PROT) Lab Values
Retinopathy of Prematurity (ROP)
Rh Immune Globulin (Rhogam)
Rh Immune Globulin in Pregnancy
Signs of Pregnancy – Live Tutoring Archive
Signs of Pregnancy (Presumptive, Probable, Positive)
Spironolactone (Aldactone) Nursing Considerations
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
Subinvolution
Terbutaline (Brethine) Nursing Considerations
Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)
Tips & Advice for Newborns (Neonatal IV Insertion)
Tocolytics
Tocolytics
Top 5 Misunderstood OB Concepts – Live Tutoring Archive
Transient Tachypnea of Newborn
Umbilical Cord Vasculature Nursing Mnemonic (2A1V)
Uterine Stimulants (Oxytocin, Pitocin)
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)
What the Heck is Antepartum Testing? – Live Tutoring Archive
Abortion in Nursing: Spontaneous, Induced, and Missed
05.03 Jaundice for CCRN Review
ADLs (Activity of Daily Living) Nursing Mnemonic (BATTED)
Behavioral Genetics
Brain and Behavior
Defense Mechanisms
Emotions and Motivation
Energy Balance and Weight Control
Exercise Guidelines Nursing Mnemonic (FIT)
Growth & Development Theories
Health & Stress
IADLS (Instrumental Activities of Daily Living) Nursing Mnemonic (SCUM)
Intelligence and Language
Intro to Psychology Course Introduction
Learning & Behavior,Memory
Maslow’s Hierarchy of Needs in Nursing
Not Settling
Psychological Disorders
Self Care & Avoiding Nursing Burnout
Sensation & Perception
State of Consciousness
Stress and Crisis
Types of Exercise
01.01 CCRN Test Overview for CCRN Review
12 Points to Answering Pharmacology Questions
5 Rules for Powerpoint
5 Things You Never Knew About The NCLEX – Live Tutoring Archive
9 Easy Steps to Passing Every Nursing School Test | With Jon Haws, BSN, RN, Founder of NURSING.com
Absolute Words
Acute vs Chronic
Addiction – Behavioral Problems Nursing Mnemonic (The 5 D’s)
ADLs (Activity of Daily Living) Nursing Mnemonic (BATTED)
Advanced Critical Thinking
Alcoholism – Outcomes Nursing Mnemonic (BAD)
Alkalosis and Acidosis Nursing Mnemonic (Kick Up, Drop Down)
Anatomy of an NCLEX Question
Anticholinergics – Side Effects Nursing Mnemonic (4 Can’ts)
Arterial Blood Gases Nursing Mnemonic (ROME)
Ask Questions
Avoiding Alarm Fatigue
Backwards and Forwards
Be a Mix Tape (Rewind and Fast-Forward)
Beta 1 and Beta 2 Nursing Mnemonic (1 Heart, 2 Lungs)
Bloom’s Taxonomy
C – Content
Can You Draw It
Care Plan Review (Addresses Patient Considerations) for Certified Perioperative Nurse (CNOR)
Caring Licensed Practical Nurse Nursing Mnemonic (CLPN)
Caring Practices for Progressive Care Certified Nurse (PCCN)
Causes of Poor Gas Exchange Nursing Mnemonic (All People Can Value Lungs)
Chance’s Story on His Personal Journey
Cheatsheets
Child Abuse/Neglect – Warning Signs Nursing Mnemonic (CHILD ABUSE)
CHO, CHO, CHON Nursing Mnemonic (CHO, CHO, CHON)
Cholinergic Crisis – Signs and Symptoms Nursing Mnemonic (SLUDGE)
Clinical Inquiry for Progressive Care Certified Nurse (PCCN)
Community Health Tool Nursing Mnemonic (MAP-IT)
Concept Map Course Introduction
Connections
Course Introduction to Nursing School Preparation
Critical Thinking
Critical Thinking
Degree Restrictions in Career Growth
Denying Feelings
Dig for the Why
Diploma vs ADN vs BSN vs Bridge
Drawing Pictures
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Drugs for Bradycardia & Low Blood Pressure Nursing Mnemonic (IDEA)
Duplicate Facts
E – Engagement
Electrolytes – Location in Body Nursing Mnemonic (PISO)
Emergency Drugs Nursing Mnemonic (LEAN)
Environmental Health Assessment Nursing Mnemonic (I PREPARE)
Evaluating Patient Response to Plan of Care for Certified Perioperative Nurse (CNOR)
Exercise Guidelines Nursing Mnemonic (FIT)
Explaining the “Why”
Exporting and Uploading to Frame.io
Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fire Safety 1 Nursing Mnemonic (PASS)
Fire Safety 2 Nursing Mnemonic (RACE)
Getting Access to frame.io
Getting Started with Tech
Gluten Free Diet Nursing Mnemonic (BROW)
Goal Setting
HESI® Prep Course Introduction
High Risk Behavior Nursing Mnemonic (HEADSS)
How to Write a Nursing Care Plan
Hyperkalemia – Causes Nursing Mnemonic (MACHINE)
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypernatremia – Causes Nursing Mnemonic (MODEL)
IADLS (Instrumental Activities of Daily Living) Nursing Mnemonic (SCUM)
Identifying Interventions per Nursing Diagnoses for Certified Perioperative Nurse (CNOR)
Identifying Measurable Patient Outcomes for Certified Perioperative Nurse (CNOR)
Increase MAP Nursing Mnemonic (VAK)
Inflammation- Signs and Symptoms Nursing Mnemonic (HIPER)
Interviewing for Nursing School
Introduction to CCMM
Jon’s Story on His Personal Journey
Keep it Short
Lesson Elements
MAO Inhibitors Nursing Mnemonic (TIPS)
Marie’s Story on Her Personal Nursing Journey
Miriam’s Story on Her Personal Journey
Mnemonic for Organ Systems (MR DICE RUNS)
MSN (Masters) vs. DNP (Doctorate)
NCLEX Question Traps! – Live Tutoring Archive
NCLEX® Question Traps
Need Help Making A Study Plan? – Live Tutoring Archive
NRSNG | Closing Thoughts
NRSNG Live | 5 Things You Never Knew About NCLEX Questions
NRSNG Live | AMA (Ask Me Anything) Nursing Success Roundtable
NRSNG Live | AMA Student Panel – How I Survive (Barely) Nursing School
NRSNG Live | How I Went From Nursing School Dropout to Passing NCLEX in 75 and Teaching 18 Million Nurses
NRSNG Live | How to Get the Most out of NRSNG
NRSNG Live | How to Pass Any Nursing School Test
NRSNG Live | My Super Secret Note Taking Method
NRSNG Live | The Core Content Mastery Method and How to Use it Throughout Your Nursing Journey
NRSNG Live | The Successful State of Mind
NRSNG Live | What Your Nursing Professors Want to Tell You But Can’t
Nursing Care Plans Course Introduction
Nursing Case Study Introduction
Nursing Process
Nursing Process – Assess
Nursing Process – Diagnose
Nursing Process – Evaluate
Nursing Process – Implement
Nursing Process – Plan
Nursing School Application Essay
NURSING.com Assessment & Skills Checks
NURSING.com Introduction
O – Origins
OLD CARTS Mnemonic (OLD CARTS)
Online vs Brick-and-Mortar
Opposite or the Same – Live Tutoring Archive
Opposites
Our Goals for Teaching
Our Mission
Outline Question Method (Note taking)
Overview of the Nursing Process
Paying for Nursing School
Pharmacokinetics Nursing Mnemonic (ADME)
Pictures
Plan of Care Updates for Certified Perioperative Nurse (CNOR)
Planning Community Health Interventions Nursing Mnemonic (PRECEDE-PROCEED)
Post-Partum Assessment Nursing Mnemonic (BUBBLE)
Prioritization
Prioritizing Assessments
Priority
Purpose of Nursing Care Plans
Questions To Ask Before Applying To A Nursing Program
R – Real-Life
Real Life
Real-Life Experiences
Recording
Repeating Words
Resources for Lesson Creation
RN to MSN
Safety Check Nursing Mnemonic (MADLE)
Same
SATA
SATA like a BOSS – Live Tutoring Archive
SATA like a BOSS 2 – Live Tutoring Archive
SBAR Communication Nursing Mnemonic (SBAR)
Screencastify Setup
Share the Wealth
SSRI’s Nursing Mnemonic (Effective For Sadness, Panic, and Compulsions)
Start and End with the Linchpin
Steps in the Nursing Process 1 Nursing Mnemonic (ADPIE)
Steps in the Nursing Process 2 Nursing Mnemonic (AAPIE)
Steps In The Nursing Process 3 Nursing Mnemonic (SOAPIE)
Study Setting
Study Tips for Success
Systems Thinking for Progressive Care Certified Nurse (PCCN)
TEAS® Prep Course Introduction
Tenet 1 Filet Mignon
Tenet 2 Linchpins & Connections
Tenet 3 Why Behind the What
Tenet 4 Learner-Centered Talkabouts
Test Taking Course Introduction
The Academy
The CARPET Methods of Teaching
The Nurse Routine
The Nursing Process Pro Tips for Test Taking – Live Tutoring Archive
The Outline is the Foundation
Thinking Like a Nurse
Time Management
Time Management
To The Point
Tracheal Esophageal Fistula – Sign and Symptoms Nursing Mnemonic (The 3 C’s)
Trauma – Complications Nursing Mnemonic (TRAUMATIC)
Trauma Surgery – Medical History Nursing Mnemonic (AMPLE)
Triage Nursing Mnemonic (START)
Trusting your Gut
Two pathways of the peripheral nervous system Nursing Mnemonic (SAME)
Using Nursing Care Plans in Clinicals
Vasospasm Therapy Nursing Mnemonic (Triple H Therapy)
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)
Vitamins – Fat Soluble Nursing Mnemonic (All Dogs Eat Kibble)
Vitamins – Water Soluble Nursing Mnemonic (Birth Control)
Walkers Nursing Mnemonic (Wandering Wilma Always Late)
Welcome to NURSING.com
Welcome to NURSING.com
What Are the Absolutes
What are the NCLEX Categories? – Live Tutoring Archive
What do you want me to know?
What is CCMM?
What is Pedagogy
What is the NCLEX?
What Should They Learn
What to Expect In Clinical
Where To Start
Why NURSING.com?
Working night shift
Your Role
Citations
Evidence Based Research
Nurse Educator
Page Sections, Footnotes & Headers
Page Set-Up
Research Nurse
Title Page
Why CEs (Continuing education) matter
Aging and Socialization
Crime in Society
Dark Skin: IV Insertion
Gender Equity (Inclusion, Gender Transition) for Certified Emergency Nursing (CEN)
Gender Inequality
Global Inequalities
High-Risk Behaviors
Human Trafficking for Certified Emergency Nursing (CEN)
Introduction to Sociology
Lab Panels
Lab Panels – The Basics and What YOU Need to Know – Live Tutoring Archive
Lab Panels – The Basics and What YOU Need to Know 2 – Live Tutoring Archive
Lab Panels – The Basics and What YOU Need to Know 3 – Live Tutoring Archive
Lab Values Course Introduction
Race, Ethnicity, and Migration in Society
Shorthand Lab Values
Social Effects on Health, Illness, and Disability
Social Groups
Social Interactions in Life
Sociological Perspectives
Sociology and Culture
Sociology and Education
Sociology Course Introduction
Sociology Research
Citations
Evidence Based Research
Nurse Educator
Page Sections, Footnotes & Headers
Page Set-Up
Research Nurse
Title Page
Why CEs (Continuing education) matter
01.01 CCRN Test Overview for CCRN Review
12 Points to Answering Pharmacology Questions
5 Rules for Powerpoint
5 Things You Never Knew About The NCLEX – Live Tutoring Archive
9 Easy Steps to Passing Every Nursing School Test | With Jon Haws, BSN, RN, Founder of NURSING.com
Absolute Words
Acute vs Chronic
Addiction – Behavioral Problems Nursing Mnemonic (The 5 D’s)
ADLs (Activity of Daily Living) Nursing Mnemonic (BATTED)
Advanced Critical Thinking
Alcoholism – Outcomes Nursing Mnemonic (BAD)
Alkalosis and Acidosis Nursing Mnemonic (Kick Up, Drop Down)
Anatomy of an NCLEX Question
Anticholinergics – Side Effects Nursing Mnemonic (4 Can’ts)
Arterial Blood Gases Nursing Mnemonic (ROME)
Ask Questions
Avoiding Alarm Fatigue
Backwards and Forwards
Be a Mix Tape (Rewind and Fast-Forward)
Beta 1 and Beta 2 Nursing Mnemonic (1 Heart, 2 Lungs)
Bloom’s Taxonomy
C – Content
Can You Draw It
Care Plan Review (Addresses Patient Considerations) for Certified Perioperative Nurse (CNOR)
Caring Licensed Practical Nurse Nursing Mnemonic (CLPN)
Caring Practices for Progressive Care Certified Nurse (PCCN)
Causes of Poor Gas Exchange Nursing Mnemonic (All People Can Value Lungs)
Chance’s Story on His Personal Journey
Cheatsheets
Child Abuse/Neglect – Warning Signs Nursing Mnemonic (CHILD ABUSE)
CHO, CHO, CHON Nursing Mnemonic (CHO, CHO, CHON)
Cholinergic Crisis – Signs and Symptoms Nursing Mnemonic (SLUDGE)
Clinical Inquiry for Progressive Care Certified Nurse (PCCN)
Community Health Tool Nursing Mnemonic (MAP-IT)
Concept Map Course Introduction
Connections
Course Introduction to Nursing School Preparation
Critical Thinking
Critical Thinking
Degree Restrictions in Career Growth
Denying Feelings
Dig for the Why
Diploma vs ADN vs BSN vs Bridge
Drawing Pictures
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Drugs for Bradycardia & Low Blood Pressure Nursing Mnemonic (IDEA)
Duplicate Facts
E – Engagement
Electrolytes – Location in Body Nursing Mnemonic (PISO)
Emergency Drugs Nursing Mnemonic (LEAN)
Environmental Health Assessment Nursing Mnemonic (I PREPARE)
Evaluating Patient Response to Plan of Care for Certified Perioperative Nurse (CNOR)
Exercise Guidelines Nursing Mnemonic (FIT)
Explaining the “Why”
Exporting and Uploading to Frame.io
Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fire Safety 1 Nursing Mnemonic (PASS)
Fire Safety 2 Nursing Mnemonic (RACE)
Getting Access to frame.io
Getting Started with Tech
Gluten Free Diet Nursing Mnemonic (BROW)
Goal Setting
HESI® Prep Course Introduction
High Risk Behavior Nursing Mnemonic (HEADSS)
How to Write a Nursing Care Plan
Hyperkalemia – Causes Nursing Mnemonic (MACHINE)
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypernatremia – Causes Nursing Mnemonic (MODEL)
IADLS (Instrumental Activities of Daily Living) Nursing Mnemonic (SCUM)
Identifying Interventions per Nursing Diagnoses for Certified Perioperative Nurse (CNOR)
Identifying Measurable Patient Outcomes for Certified Perioperative Nurse (CNOR)
Increase MAP Nursing Mnemonic (VAK)
Inflammation- Signs and Symptoms Nursing Mnemonic (HIPER)
Interviewing for Nursing School
Introduction to CCMM
Jon’s Story on His Personal Journey
Keep it Short
Lesson Elements
MAO Inhibitors Nursing Mnemonic (TIPS)
Marie’s Story on Her Personal Nursing Journey
Miriam’s Story on Her Personal Journey
Mnemonic for Organ Systems (MR DICE RUNS)
MSN (Masters) vs. DNP (Doctorate)
NCLEX Question Traps! – Live Tutoring Archive
NCLEX® Question Traps
Need Help Making A Study Plan? – Live Tutoring Archive
NRSNG | Closing Thoughts
NRSNG Live | 5 Things You Never Knew About NCLEX Questions
NRSNG Live | AMA (Ask Me Anything) Nursing Success Roundtable
NRSNG Live | AMA Student Panel – How I Survive (Barely) Nursing School
NRSNG Live | How I Went From Nursing School Dropout to Passing NCLEX in 75 and Teaching 18 Million Nurses
NRSNG Live | How to Get the Most out of NRSNG
NRSNG Live | How to Pass Any Nursing School Test
NRSNG Live | My Super Secret Note Taking Method
NRSNG Live | The Core Content Mastery Method and How to Use it Throughout Your Nursing Journey
NRSNG Live | The Successful State of Mind
NRSNG Live | What Your Nursing Professors Want to Tell You But Can’t
Nursing Care Plans Course Introduction
Nursing Case Study Introduction
Nursing Process
Nursing Process – Assess
Nursing Process – Diagnose
Nursing Process – Evaluate
Nursing Process – Implement
Nursing Process – Plan
Nursing School Application Essay
NURSING.com Assessment & Skills Checks
NURSING.com Introduction
O – Origins
OLD CARTS Mnemonic (OLD CARTS)
Online vs Brick-and-Mortar
Opposite or the Same – Live Tutoring Archive
Opposites
Our Goals for Teaching
Our Mission
Outline Question Method (Note taking)
Overview of the Nursing Process
Paying for Nursing School
Pharmacokinetics Nursing Mnemonic (ADME)
Pictures
Plan of Care Updates for Certified Perioperative Nurse (CNOR)
Planning Community Health Interventions Nursing Mnemonic (PRECEDE-PROCEED)
Post-Partum Assessment Nursing Mnemonic (BUBBLE)
Prioritization
Prioritizing Assessments
Priority
Purpose of Nursing Care Plans
Questions To Ask Before Applying To A Nursing Program
R – Real-Life
Real Life
Real-Life Experiences
Recording
Repeating Words
Resources for Lesson Creation
RN to MSN
Safety Check Nursing Mnemonic (MADLE)
Same
SATA
SATA like a BOSS – Live Tutoring Archive
SATA like a BOSS 2 – Live Tutoring Archive
SBAR Communication Nursing Mnemonic (SBAR)
Screencastify Setup
Share the Wealth
SSRI’s Nursing Mnemonic (Effective For Sadness, Panic, and Compulsions)
Start and End with the Linchpin
Steps in the Nursing Process 1 Nursing Mnemonic (ADPIE)
Steps in the Nursing Process 2 Nursing Mnemonic (AAPIE)
Steps In The Nursing Process 3 Nursing Mnemonic (SOAPIE)
Study Setting
Study Tips for Success
Systems Thinking for Progressive Care Certified Nurse (PCCN)
TEAS® Prep Course Introduction
Tenet 1 Filet Mignon
Tenet 2 Linchpins & Connections
Tenet 3 Why Behind the What
Tenet 4 Learner-Centered Talkabouts
Test Taking Course Introduction
The Academy
The CARPET Methods of Teaching
The Nurse Routine
The Nursing Process Pro Tips for Test Taking – Live Tutoring Archive
The Outline is the Foundation
Thinking Like a Nurse
Time Management
Time Management
To The Point
Tracheal Esophageal Fistula – Sign and Symptoms Nursing Mnemonic (The 3 C’s)
Trauma – Complications Nursing Mnemonic (TRAUMATIC)
Trauma Surgery – Medical History Nursing Mnemonic (AMPLE)
Triage Nursing Mnemonic (START)
Trusting your Gut
Two pathways of the peripheral nervous system Nursing Mnemonic (SAME)
Using Nursing Care Plans in Clinicals
Vasospasm Therapy Nursing Mnemonic (Triple H Therapy)
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)
Vitamins – Fat Soluble Nursing Mnemonic (All Dogs Eat Kibble)
Vitamins – Water Soluble Nursing Mnemonic (Birth Control)
Walkers Nursing Mnemonic (Wandering Wilma Always Late)
Welcome to NURSING.com
Welcome to NURSING.com
What Are the Absolutes
What are the NCLEX Categories? – Live Tutoring Archive
What do you want me to know?
What is CCMM?
What is Pedagogy
What is the NCLEX?
What Should They Learn
What to Expect In Clinical
Where To Start
Why NURSING.com?
Working night shift
Your Role
08.01 Psychological Review for CCRN Review
Addiction – Behavioral Problems Nursing Mnemonic (The 5 D’s)
Albumin Lab Values
Alcohol Withdrawal (Addiction)
Alcohol Withdrawal Case Study (45 min)
Alcoholism – Outcomes Nursing Mnemonic (BAD)
Alprazolam (Xanax) Nursing Considerations
Alzheimer – Diagnosis Nursing Mnemonic (The 5 A’s)
Ammonia (NH3) Lab Values
Anorexia – Signs and Symptoms Nursing Mnemonic (ANOREXIA)
Antianxiety Meds
Antianxiety Meds
Antidepressants
Antidepressants
Antipsychotics
Antipsychotics
Anxiety
Anxiety Disorders (PTSD, Anxiety, Panic Attack) for Certified Emergency Nursing (CEN)
Atypical Antipsychotics
Benzodiazepines
Benzodiazepines Nursing Mnemonic (Donuts and TLC)
Blood Urea Nitrogen (BUN) Lab Values
Bulimia – Signs and Symptoms 1 Nursing Mnemonic (BULIMIA)
Bulimia – Signs and Symptoms 2 Nursing Mnemonic (WASHED)
Buspirone (Buspar) Nursing Considerations
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Carbamazepine (Tegretol) Nursing Considerations
Chloride-Cl (Hyperchloremia, Hypochloremia)
Chlorpromazine (Thorazine) Nursing Considerations
Cholesterol (Chol) Lab Values
Cognitive Impairment Disorders
Creatinine (Cr) Lab Values
Day in the Life of a Hospice, Palliative Care Nurse
Day in the Life of a Mental Health Nurse
Defense Mechanisms
Defense Mechanisms
Dementia Nursing Mnemonic (DEMENTIA)
Depression
Depression Assessment Nursing Mnemonic (SIGNS)
Depression Concept Map
Diazepam (Valium) Nursing Considerations
Disruptive Behaviors, Aggression, Violence for Progressive Care Certified Nurse (PCCN)
Dissociative Disorders
Divalproex (Depakote) Nursing Considerations
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Encephalopathy Case Study (45 min)
End of Life for Progressive Care Certified Nurse (PCCN)
End-of-Life and Palliative Care (Organ and Tissue Donation, Advance Directives, Care Withholding, Family Presence) for Certified Emergency Nursing (CEN)
Escitalopram (Lexapro) Nursing Considerations
Fluoxetine (Prozac) Nursing Considerations
Generalized Anxiety Disorder
Glomerular Filtration Rate (GFR)
Grief and Loss
Grief and Loss
Haloperidol (Haldol) Nursing Considerations
Handling Death and Dying
Head to Toe Nursing Assessment (Physical Exam)
Homicidal and Suicidal Ideation for Certified Emergency Nursing (CEN)
Hypochondriasis (Hypochondriac)
Lamotrigine (Lamictal) Nursing Considerations
Lithium (Lithonate) Nursing Considerations
Lithium Lab Values
Liver Function Tests
Lorazepam (Ativan) Nursing Considerations
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Manic Attack – Signs and Symptoms Nursing Mnemonic (DIG FAST)
MAO Inhibitors Nursing Mnemonic (TIPS)
MAOIs
Meds for Alzheimers
Mental Health Course Introduction
Metabolic Alkalosis
Methadone (Methadose) Nursing Considerations
Midazolam (Versed) Nursing Considerations
Mood Disorders (Bipolar, Depression) for Certified Emergency Nursing (CEN)
Mood Disorders (Bipolar)
Mood Stabilizers
Mood Stabilizers
Nurse-Patient Relationship
Nursing Care Plan (NCP) for Alcohol Withdrawal Syndrome / Delirium Tremens
Nursing Care Plan (NCP) for Alzheimer’s Disease
Nursing Care Plan (NCP) for Anxiety
Nursing Care Plan (NCP) for Depression
Nursing Care Plan (NCP) for Dissociative Disorders
Nursing Care Plan (NCP) for Eating Disorders (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder)
Nursing Care Plan (NCP) for Mood Disorders (Major Depressive Disorder, Bipolar Disorder)
Nursing Care Plan (NCP) for Paranoid Disorders
Nursing Care Plan (NCP) for Personality Disorders
Nursing Care Plan (NCP) for Post-Traumatic Stress Disorder (PTSD)
Nursing Care Plan (NCP) for Schizophrenia
Nursing Care Plan (NCP) for Somatic Symptom Disorder (SSD)
Nursing Care Plan (NCP) for Suicidal Behavior Disorder
Nursing Case Study for (PTSD) Post Traumatic Stress Disorder
Nursing Case Study for Bipolar Disorder
Nursing Case Study for Mania (Manic Syndrome)
Olanzapine (Zyprexa) Nursing Considerations
Oxycodone (OxyContin) Nursing Considerations
Palliative Care for Progressive Care Certified Nurse (PCCN)
Paranoid Disorders
Paroxetine (Paxil) Nursing Considerations
Personality Disorders
Phases of Nurse-Client Relationship
Phosphorus-Phos
Post-Traumatic Stress Disorder (PTSD)
Postmortem Care
Potassium-K (Hyperkalemia, Hypokalemia)
Psychological Disorders (Anxiety, Depression) for Progressive Care Certified Nurse (PCCN)
Quetiapine (Seroquel) Nursing Considerations
Schizophrenia
Schizophrenia Case Study (45 min)
Self Concept
Senile Dementia – Assess for Changes Nursing Mnemonic (JAMCO)
Sertraline (Zoloft) Nursing Considerations
Sodium-Na (Hypernatremia, Hyponatremia)
Somatoform
Somatoform Disorder Case Study (30 min)
SSRI’s Nursing Mnemonic (Effective For Sadness, Panic, and Compulsions)
SSRIs
Substance Abuse (Alcohol, Drug Withdrawal) for Progressive Care Certified Nurse (PCCN)
Substance Abuse (Chronic Alcohol Abuse, Chronic Drug Abuse) for Progressive Care Certified Nurse (PCCN)
Substance Abuse (Drug-Seeking Behavior) for Progressive Care Certified Nurse (PCCN)
Suicidal Behavior
TCAs
Therapeutic Communication
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Thought Disorders (Psychosis, Schizophrenia) for Certified Emergency Nursing (CEN)
Total Bilirubin (T. Billi) Lab Values
Types of Schizophrenia
Urinalysis (UA)
Vitamin B12 Lab Values
Assessment for Myasthenic Crisis Nursing Mnemonic (BRISH)
Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)
Canes Nursing Mnemonic (COAL)
Causes of Dyspnea Nursing Mnemonic (The 6 P’s)
CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Common Signs of Parkinson’s Nursing Mnemonic (SMART)
Complications of Thoracentesis Nursing Mnemonic (Patients Sometimes Bleed Internally)
Cor Pulmonale – Signs & Symptoms Nursing Mnemonic (Please Read His Text)
Critical Thinking to Facilitate Patient Care for Certified Perioperative Nurse (CNOR)
Evaluation of Irregular Moles Nursing Mnemonic (ABCDE)
Formulating Nursing Diagnoses for Certified Perioperative Nurse (CNOR)
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Interventions for Aphasia Nursing Mnemonic (PROP)
Lidocaine Toxicity – Signs and Symptoms Nursing Mnemonic (SAMS)
Management of Pressure Ulcers (Pressure Injuries) Nursing Mnemonic (SKIN)
Medications to Prevent Seizures Nursing Mnemonic (Pretty Little Liars Forever)
Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)
Personal Growth Resources for Certified Perioperative Nurse (CNOR)
Seizure Causes Nursing Mnemonic (VITAMIN)
Seizure Documentation Nursing Mnemonic (TDOC)
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
06.04 Differentiating Ectopy and Aberrancy for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
Age and Culturally Appropriate Health Assessment Techniques for Certified Perioperative Nurse (CNOR)
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Aneurysm and Dissection for Certified Emergency Nursing (CEN)
Aspiration for Certified Emergency Nursing (CEN)
Assessment for Myasthenic Crisis Nursing Mnemonic (BRISH)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Atrial Flutter
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)
Bleeding for Certified Emergency Nursing (CEN)
Canes Nursing Mnemonic (COAL)
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Causes of Dyspnea Nursing Mnemonic (The 6 P’s)
CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Common Signs of Parkinson’s Nursing Mnemonic (SMART)
Complications of Thoracentesis Nursing Mnemonic (Patients Sometimes Bleed Internally)
Cor Pulmonale – Signs & Symptoms Nursing Mnemonic (Please Read His Text)
Critical Thinking to Facilitate Patient Care for Certified Perioperative Nurse (CNOR)
Discharge Planning for Certified Emergency Nursing (CEN)
Dysrhythmias for Certified Emergency Nursing (CEN)
Environmental Cleaning (Spills, Room Turnover, Terminal Cleaning) for Certified Perioperative Nurse (CNOR)
Environmental Stewardship (Waste Minimization) for Certified Perioperative Nurse (CNOR)
Evaluation of Irregular Moles Nursing Mnemonic (ABCDE)
Formulating Nursing Diagnoses for Certified Perioperative Nurse (CNOR)
Fundamentals Course Introduction
Head and Spinal Cord Trauma for Certified Emergency Nursing (CEN)
Hypertension (HTN) Concept Map
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypertension for Certified Emergency Nursing (CEN)
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Interventions for Aphasia Nursing Mnemonic (PROP)
Ischemic (CVA) Stroke Labs
Lacerations for Certified Emergency Nursing (CEN)
Lidocaine Toxicity – Signs and Symptoms Nursing Mnemonic (SAMS)
Management of Pressure Ulcers (Pressure Injuries) Nursing Mnemonic (SKIN)
Maxillofacial Trauma for Certified Emergency Nursing (CEN)
Medications to Prevent Seizures Nursing Mnemonic (Pretty Little Liars Forever)
Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Seizures
Patient and Healthcare Team Safety (Disasters, Environmental Hazards) for Certified Perioperative Nurse (CNOR)
Personal Growth Resources for Certified Perioperative Nurse (CNOR)
Premature Atrial Contraction (PAC)
Premature Ventricular Contraction (PVC)
Pulmonary Embolus for Certified Emergency Nursing (CEN)
Respiratory Distress Syndrome for Certified Emergency Nursing (CEN)
Respiratory Trauma for Certified Emergency Nursing (CEN)
Seizure Assessment
Seizure Causes (Epilepsy, Generalized)
Seizure Causes Nursing Mnemonic (VITAMIN)
Seizure Documentation Nursing Mnemonic (TDOC)
Seizure Therapeutic Management
Seizures Case Study (45 min)
Seizures Module Intro
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Sinus Bradycardia
Sinus Tachycardia
Stroke (CVA) Module Intro
Stroke Case Study (45 min)
Supraventricular Tachycardia (SVT)
Trauma Nursing Interventions for Certified Perioperative Nurse (CNOR)
Ventricular Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Ventricular Fibrillation (V Fib)
Ventricular Tachycardia (V-tach)
Wound Bleeding (Uncontrolled External Hemorrhage) for Certified Emergency Nursing (CEN)
54 Common Medication Prefixes and Suffixes
Alpha-fetoprotein (AFP) Lab Values
Carboxyhemoglobin Lab Values
Cardiac Terminology
Diagnostic Testing Course Introduction
Diagnostics Terminology
Digestive Terminology
Gamma Glutamyl Transferase (GGT) Lab Values
Growth Hormone (GH) Lab Values
Hematology Oncology & Immunology Terminology
Integumentary (Skin) Terminology
Mean Corpuscular Volume (MCV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Medical Terminology Course Introduction
MedTerm Basic Word Structure
MedTerm Body as a Whole
MedTerm Prefixes
MedTerm Suffixes
Metabolic & Endocrine Terminology
Methemoglobin (MHGB) Lab Values
Musculoskeletal Terminology
Myoglobin (MB) Lab Values
Neuro Terminology
Pharmacology Terminology
Prealbumin (PAB) Lab Values
Procedural Terminology
Psychiatry Terminology
Reproductive Terminology
Respiratory Terminology
Sensory Terminology
Urinary Terminology
Basic Algebra
Basic Geometry
Basic Operations
Basic Statistics
Common Stat tests
Covariance and Causality
Decimals & Percentages
Distributions
Gamma Glutamyl Transferase (GGT) Lab Values
Graphing Equations
Growth Hormone (GH) Lab Values
Interpreting Trends
Lab Panels
Lab Panels – The Basics and What YOU Need to Know – Live Tutoring Archive
Lab Panels – The Basics and What YOU Need to Know 2 – Live Tutoring Archive
Lab Panels – The Basics and What YOU Need to Know 3 – Live Tutoring Archive
Lab Values Course Introduction
Mathematics Course Introduction
Mean Corpuscular Volume (MCV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Measure of Spread
Normal distribution curve
Prealbumin (PAB) Lab Values
Ratios & Proportions
Response Variable vs. Explanatory variable
Shorthand Lab Values
Working with Fractions
ACLS (Advanced cardiac life support) Drugs
Advanced Cardiovascular Life Support (ACLS)
Brief CPR (Cardiopulmonary Resuscitation) Overview
CPR-BLS (Basic Life Support)
Life Support Review Course Introduction
Neonatal Resuscitation Program (NRP)
Pediatric Advanced Life Support (PALS)
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values