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Kaiser Ann Pajulas, USRN
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Hyperbilirubinemia (Jaundice)

Hyperbilirubinemia (Jaundice)

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Outline
ADPIE Related Lessons
Transcript
Additional Lessons

Study Tools For Hyperbilirubinemia (Jaundice)

Newborn Hyperbilirubinemia Pathochart (Cheatsheet)
Hyperbilirubinemia (Image)
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Outline

Overview

  1. Definition: an elevated total bilirubin compared to the newborns age in hours
    1. Graphed: Bilirubin level compared to hours of age

Nursing Points

General

  1. Bilirubin explanation
    1. Formed in the liver when old RBC’s are broken down (a natural, normal process) → excreted into bile and urine
    2. When it’s needed, it is released from the gallbladder and goes to the small intestines to get to work, helping digest fats
    3. We then excrete it in our feces and it is what makes feces brown
  2. Why is this commonly seen in newborns?
    1. In utero, the placenta removes the bilirubin from the baby’s body because they don’t excrete it in their feces until  after they are birth
    2. Some newborn’s will have a liver that is immature or takes longer to work efficiently
  3. Pathological vs. physiological
    1. Physiological jaundice- starts 2nd or 3rd day of life can be expected as this normal transition from placenta doing the work to the baby’s liver.  
      1. Breastfeeding
      2. Broken down RBCs (bruising)
      3. Prematurity
    2. Pathological:Jaundice that appears within the first 24 hours of life indicates that there is a pathological process going on. Something else other than this normal process, and requires further investigation/assessment.
      1. Blood incompatibility
      2. Problem with liver
  4. Concern
    1. Kernicterus-brain damage that can occur If hyperbilirubinemia is sustained

Assessment

  1. Jaundice
    1. Definition: Accumulation of bilirubin, resulting in yellowing of skin, sclera
    2. Assess skin in natural light
    3. Assess skin head to extremities, usually starts in forehead or face
    4. Jaundice in first 24 hours is a red flag for PATHOLOGICAL issues – notify MD!
  2. Elevated bilirubin levels
    1. Plotted on graph as low risk, high-intermediate risk, or high risk
      1. High risk needs phototherapy
    2. Some variant but a total level  of 12 at day 2 to 3 is usually high risk with critical being greater than 15 mg/dl

Therapeutic Management

  1. Frequent feeding→ hydration and nutrition
  2. Phototherapy

Nursing Concepts

  1. Human Development
  2. Gastrointestinal/Liver Metabolism
  3. Nutrition

Patient Education

  1. Feeding frequently
  2. Keeping them under the light
  3. Goggles
  4. Importance of phototherapy

[lesson-linker lesson=221500 background=”white”]

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Transcript

In this lesson I will talk about hyperbilirubinemia and your role in care of this patient.

So what is hyperbilirubinemia? It is high bilirubin. Ok what is bilirubin? Bilirubin is form in the liver from broken down red blood cells. The bilirubin is then excreted into the feces. Why is this a common problem in newborns? Well a few things, the newborns didn’t have to worry about doing this when they were in utero and now they sometimes have an immature liver that is trying to do its job. They might have bruising from delivery which means more broken down red blood cells. They might not be feeding great which means they aren’t stooling alot and excreting the bilirubin. There are two classifications, pathological and physiological jaundice to understand.

So our pathological versus physiological. Pathological jaundice appears within the first 24 hours of life and it indicates that there is a pathological process going on. This means something else other than this normal process. So this could be a blood incompatibility between mom and baby and blood mixture has occurred. If the baby has maternal blood that doesn’t match then he is going to work hard to break down those red blood cells which means there will be more broken down red blood cells. Another cause could be a diseased liver. It is working properly. So pathological jaundice will requires further investigation and assessment. Physiological jaundice starts the 2nd or 3rd day of life and can be expected as this normal transition from placenta doing the work to the baby’s liver. Causes of this are bruising from delivery. So bruising is broken down red blood cells so if we have extra of these it is adding to the work of the liver and the baby can not excrete it quick enough. Prematurity because the liver is just immature and not able to keep up. Breastfeeding is another cause because the baby isn’t getting enough to stool enough and get the bilirubin excreted. Our concern for anytime of jaundice is if it goes untreated and levels rise to dangerous levels then kernicterus could occur which is brain damage.

This newborn is going to be assessed like normal with the head to toe assessment but you will observe jaundice on a patient with hyperbilirubinemia. So yellowing of the skin and sclera. This starts at the head usually and as it builds the yellow color spreads from head to extremities. So they might be a touch yellow on face and then as you see it move down to the diaper area it is rising. You need to have good lighting and really assess the skin. If jaundice coloring happens in first 24 hours it is a red flag that we have pathological problems so notify the doctor to draw a bilirubin. Once you have your bilirubin level from the lab you can graph it. This is how you will assess if phototherapy is needed. So let me draw this graph for you. On one side we have the bilirubin level on the other it is the hours of life. And you plot your number and it will either fall in the low risk, ow intermediate, high-intermediate, or high risk. High risk levels needs phototherapy. You do need a physician order for phototherapy but at least you will know to expect that we need to light the kid up. There is some variant based on different labs or if it is a pathological issue but a total level of 12 mg/dl at day 2 to 3 is usually high risk with critical being greater than 15 mg/dl.

Management is going to be frequent feeding. We need the baby to stay hydrated and get enough volume so that the baby will stool more. The more they eat the more they excrete, right? We will initiate phototherapy treatment if levels are high enough. Education is important if the lights are started. The baby needs to wear protective goggles over their eyes and stay under the light. So you can see in this image the goggles on the eyes. I just wanted you to have an idea of what that was and have a visual. The googles protect their eyes from the light and it is funny because when you take them out from the light to assess them or draw labs you remove the goggles and can see a yellow ring around their eyes like a racoon. That is always a good sign that the bilirubin is coming down. The babies hate being under this light because they have no clothes on, they are un-swaddled and can’t be held. So it can be quite miserable for them and the parents. But if they don’t stay under this light it will get worse.

Human development is a concept because if this is pathological then it is related to development, liver metabolism because it is working to excrete the bilirubin and nutrition because we need the baby well fed and hydrated to excrete the bilirubin.
So on to the important facts. Remember these and you will have a good grasp of what this is. We have high bilirubin levels in the blood. The bilirubin comes from broken down red blood cells. It is secreted by the liver so if we have anything that causes a lot of broken down red blood cells like bruising or blood incompatibility and an immature liver then the bilirubin can’t be excreted fast enough. This will cause jaundice to occur and our treatment is phototherapy to reduce the bilirubin.

Make sure you check out the resources attached to this lesson and review the differences between physiological and pathological. Now, go out and be your best selves today. And, as always, happy nursing.

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Kaiser Ann Pajulas, USRN

Concepts Covered:

  • Basics of Sociology
  • Statistics
  • Communication
  • Fundamentals of Emergency Nursing
  • Musculoskeletal Disorders
  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Medication Administration
  • Gastrointestinal Disorders
  • Pregnancy Risks
  • Labor Complications
  • Factors Influencing Community Health
  • Respiratory Disorders
  • Emergency Care of the Neurological Patient
  • EENT Disorders
  • Newborn Complications
  • Documentation and Communication
  • Preoperative Nursing
  • Legal and Ethical Issues
  • Adult
  • Substance Abuse Disorders
  • Hematologic Disorders
  • Musculoskeletal Trauma
  • Intraoperative Nursing
  • Microbiology
  • Disorders of Pancreas
  • Oncology Disorders
  • Anxiety Disorders
  • Neurologic and Cognitive Disorders
  • Personality Disorders
  • Basics of NCLEX
  • Studying
  • Newborn Care
  • Basics of Mathematics
  • Note Taking
  • Integumentary Disorders
  • Emergency Care of the Trauma Patient
  • Respiratory Emergencies
  • Developmental Considerations
  • Digestive System
  • Lower GI Disorders
  • Central Nervous System Disorders – Brain
  • Postpartum Care
  • Basic
  • Infectious Respiratory Disorder
  • Integumentary Disorders
  • Eating Disorders
  • Circulatory System
  • Cardiovascular Disorders
  • Test Taking Strategies
  • Musculoskeletal Disorders
  • EENT Disorders
  • Postoperative Nursing
  • Neurological Emergencies
  • Cognitive Disorders
  • Concepts of Population Health
  • Community Health Overview
  • Noninfectious Respiratory Disorder
  • Delegation
  • Depressive Disorders
  • Terminology
  • Postpartum Complications
  • Vascular Disorders
  • Nervous System
  • Upper GI Disorders
  • Renal and Urinary Disorders
  • Developmental Theories
  • Fetal Development
  • Endocrine and Metabolic Disorders
  • Prenatal Concepts
  • Trauma-Stress Disorders
  • Psychological Emergencies
  • Adulthood Growth and Development
  • Childhood Growth and Development
  • Prenatal and Neonatal Growth and Development
  • Renal Disorders
  • Hematologic Disorders
  • Liver & Gallbladder Disorders
  • Tissues and Glands
  • Disorders of Thermoregulation
  • Urinary Disorders
  • Urinary System
  • Shock
  • Labor and Delivery
  • Oncologic Disorders
  • Emotions and Motivation
  • Peripheral Nervous System Disorders
  • Bipolar Disorders
  • Infectious Disease Disorders
  • Immunological Disorders
  • Sexually Transmitted Infections
  • Disorders of the Thyroid & Parathyroid Glands
  • Male Reproductive Disorders
  • Central Nervous System Disorders – Spinal Cord
  • Female Reproductive Disorders
  • Acute & Chronic Renal Disorders
  • Prioritization
  • Somatoform Disorders
  • Pediatric
  • Perioperative Nursing Roles
  • Concepts of Pharmacology
  • Psychotic Disorders
  • Concepts of Mental Health
  • Neurological Trauma
  • Health & Stress
  • Respiratory System

Study Plan Lessons

Lab Panels – The Basics and What YOU Need to Know 2 – Live Tutoring Archive
Fundamentals Course Introduction
Legal & Ethical Issues in ER
Nursing Care and Pathophysiology of Osteoporosis
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
6 Rights of Medication Administration
Abdomen (Abdominal) Assessment
Abortion in Nursing: Spontaneous, Induced, and Missed
Abruptio Placentae (Placental abruption)
Abuse
Access to Care
ACE (angiotensin-converting enzyme) Inhibitors
Acute Bronchitis
Acute Confusion
Acute Otitis Media (AOM)
Addicted Newborn
Admissions, Discharges, and Transfers
Advance Directives
Advanced Cardiovascular Life Support (ACLS)
Aggressive & Violent Patients
Airway Suctioning
Albumin Lab Values
Alcohol Withdrawal (Addiction)
Alkylating Agents
Alveoli & Atelectasis
Ammonia (NH3) Lab Values
Amputation
Amputation Concept Map
Anemia in Pregnancy
Anesthetic Agents
Aneurysm & Dissection
Angiotensin Receptor Blockers
Antepartum Testing
Anti Tumor Antibiotics
Anti-Infective – Aminoglycosides
Anti-Infective – Antifungals
Anti-Infective – Penicillins and Cephalosporins
Antidiabetic Agents
Antimetabolites
Antineoplastics
Anxiety
Appendicitis
Applying for Jobs
Artificial Airways
Asthma
Asthma Concept Map
Attention Deficit Hyperactivity Disorder (ADHD)
Atypical Antipsychotics
Autism Spectrum Disorders
Avoiding Alarm Fatigue
Babies by Term
Barriers to Health Assessment
Base Excess & Deficit
Basic Operations
Be a Mix Tape (Rewind and Fast-Forward)
Bed Bath
Benzodiazepines
Betamethasone and Dexamethasone
Betamethasone and Dexamethasone in Pregnancy
Bladder Cancer
Blood Cultures
Blood Transfusions (Administration)
Blunt Abdominal Trauma
Blunt Chest Trauma
Blunt Thoracic Trauma
Body Image Changes Throughout Development
Body System Assessments
Bone Cancer (Osteosarcoma, Chondrosarcoma, and Ewing Sarcoma)
Bowel Elimination
Bowel Obstruction Concept Map
Brain Death v. Comatose
Brain Tumors
Breast Cancer
Breast Cancer Concept Map
Breastfeeding
Brief CPR (Cardiopulmonary Resuscitation) Overview
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Bronchoscopy
Burn Injuries
Burn Injuries
C – Content
Calcium Channel Blockers
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Calculating Heart Rate
Can You Draw It
Cardiac (Heart) Enzymes
Cardiac Anatomy
Cardiac Glycosides
Cardiopulmonary Arrest
Cardiovascular Angiography
Care Plan Review (Addresses Patient Considerations) for Certified Perioperative Nurse (CNOR)
Casting & Splinting
Cataracts
Central Line Dressing Change
Cerebral Angiography
Cerebral Palsy (CP)
Cervical Cancer
Chemotherapy Patients
Chest Tube Management
Chloride-Cl (Hyperchloremia, Hypochloremia)
Cholesterol (Chol) Lab Values
Cleft Lip and Palate
Clubfoot
Cognitive Impairment Disorders
Communicating With Other nurses
Communicating With Pharmacy, RT, OT, PT
Communicating With Providers
Community Aggregates
Community Health Course Introduction
Community Health Nursing Theories
Congenital Heart Defects (CHD)
Congestive Heart Failure Concept Map
Conjunctivitis
Connections
Constipation and Encopresis (Incontinence)
Continuous Renal Replacement Therapy (CRRT, dialysis)
COPD Concept Map
Coronary Artery Disease Concept Map
Corticosteroids
Crash Cart
Critical Incident Management
Critical Thinking
CRNA
Crush Injuries
CT & MR Angiography
Cultural Awareness and Influences on Development
Cystic Fibrosis (CF)
Daily Charting
Day in the Life of a Labor Nurse
Day in the Life of a Med-surg Nurse
Day in the Life of a NICU Nurse
Day in the Life of a Postpartum Nurse
Day in the Life of an Operating Room Nurse
Decimals & Percentages
Defects of Decreased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Degree Restrictions in Career Growth
Delegation
Depression
Depression Concept Map
Developmental Considerations for the Hospitalized Individual
Diabetes Management
Different Dressings
Digestive Terminology
Diploma vs ADN vs BSN vs Bridge
Discharge (DC) Teaching After Surgery
Disseminated Intravascular Coagulation (DIC)
Dissociative Disorders
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Documentation Basics
Drawing Blood
Drawing Pictures
Dysrhythmia Emergencies
Dysrhythmias Labs
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Echocardiogram (Cardiac Echo)
Ectopic Pregnancy
EENT Assessment
EENT Medications
EKG (ECG) Waveforms
Electromyography (EMG)
EMTALA & Transfers
Endoscopy & EGD
Enteral & Parenteral Nutrition (Diet, TPN)
Environmental and Genetic Influences on Growth & Development
Environmental Health
Epiglottitis
Epispadias and Hypospadias
Epoetin Alfa
Erikson’s Theory of Psychosocial Development
Erythroblastosis Fetalis
Fall and Injury Prevention
Family Structure and Impact on Development
Fertilization and Implantation
Fetal Alcohol Syndrome (FAS)
Fetal Development
Fetal Environment
Fetal Heart Monitoring (FHM)
Fever
Fluid Shifts (Ascites) (Pleural Effusion)
Forensic Nurse
Fundal Height Assessment for Nurses
Gastritis
Gastrointestinal (GI) Bleed Concept Map
General Anesthesia
General Assessment (Physical assessment)
Generalized Anxiety Disorder
Genitourinary (GU) Assessment
GERD (Gastroesophageal Reflux Disease)
Gestational HTN (Hypertension)
Glaucoma
Glomerular Filtration Rate (GFR)
Gravidity and Parity (G&Ps, GTPAL)
Grief and Loss
Grief and Loss
Growth & Development – Toddlers
Growth & Development – Early Adulthood
Growth & Development – Infants
Growth & Development – Late Adulthood
Growth & Development – Middle Adulthood
Growth & Development – School Age- Adolescent
Growth & Development – Toddlers
Growth & Development -Transitioning to Adult Care
Growth and Development – Prenatal
Handling Job Rejection
Handoff Report
Hanging an IV Piggyback
Head Trauma & Traumatic Brain Injury
Head/Neck Assessment
Health Promotion & Disease Prevention
Health Promotion Assessments
Heart (Cardiac) and Great Vessels Assessment
Hematocrit (Hct) Lab Values
Hemodialysis (Renal Dialysis)
Hemoglobin (Hbg) Lab Values
Hemophilia
Hiatal Hernia
HIPAA
Histamine 1 Receptor Blockers
How to Write a Nursing Care Plan
Human Growth & Development Course Introduction
Hydatidiform Mole (Molar pregnancy)
Hydrocephalus
Hygiene
Hyperbilirubinemia (Jaundice)
Hyperemesis Gravidarum
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Hypertensive Emergency
Hyperthermia (Thermoregulation)
Hypertonic Solutions (IV solutions)
Hypothermia (Thermoregulation)
IM Injections
Impetigo
Infections in Pregnancy
Initial Care of the Newborn (APGAR)
Inserting a Foley (Urinary Catheter) – Female
Inserting a Foley (Urinary Catheter) – Male
Inserting an NG (Nasogastric) Tube
Insulin
Insulin Drips
Intake and Output (I&O)
Integumentary (Skin) Assessment
Interventional Radiology
Intracranial Hemorrhage
Intraoperative Positioning
Introduction to CCMM
Intubation in the OR
Iron Deficiency Anemia
Isolation Precaution Types (PPE)
IV Push Medications
Kidney Cancer
Lab Panels
Lactic Acid
Legal & Ethical Issues in ER
Legalities of Charting
Leopold Maneuvers
Leukemia
Leukemia
Levels of Consciousness (LOC)
Linen Change
Liver Cancer
Liver Function Tests
Local Anesthesia
Lung Cancer
Lung Sounds
Lymphatic Assessment
Lymphoma
Macular Degeneration
Magnesium Sulfate
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Magnetic Resonance Imaging (MRI)
MAOIs
Marfan Syndrome
Maslow’s Hierarchy of Needs in Nursing
Mastitis
Maternal Risk Factors
Mechanical Aids
Mechanisms of Labor
Meconium Aspiration
Medications in Ampules
Meds for Postpartum Hemorrhage (PPH)
Meds for PPH (postpartum hemorrhage)
Melanoma
Menstrual Cycle
Metabolic Alkalosis
Miscellaneous Nerve Disorders
Mixed (Cardiac) Heart Defects
Mobility & Assistive Devices
Moderate Sedation
Mood Disorders (Bipolar)
Multiple Myeloma
Mumps
Musculoskeletal Assessment
Nasal Disorders
Nephroblastoma
Nephrotic Syndrome
Neuro Assessment
Newborn Physical Exam
Newborn Reflexes
NG (Nasogastric)Tube Management
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Normal Sinus Rhythm
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 Appendicitis
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Asthma
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 Crohn’s Disease
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 Gonorrhea (STI)
Nursing Care and Pathophysiology for Gout
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Nursing Care and Pathophysiology for Hemorrhoids
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 Hypothyroidism
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Influenza (Flu)
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 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 Pulmonary Embolism
Nursing Care and Pathophysiology for Rhabdomyolysis
Nursing Care and Pathophysiology for Scleroderma
Nursing Care and Pathophysiology for Seizure
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology for Testicular Torsion
Nursing Care and Pathophysiology for Tuberculosis (TB)
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 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 Glomerulonephritis
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology of Renal Calculi (Kidney Stones)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care Delivery Models
Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage
Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Anxiety
Nursing Care Plan (NCP) for Appendicitis
Nursing Care Plan (NCP) for Decreased Cardiac Output
Nursing Care Plan (NCP) for Gastroesophageal Reflux Disease (GERD)
Nursing Care Plan (NCP) for Glaucoma
Nursing Care Plan (NCP) for Hepatitis
Nursing Care Plan (NCP) for Herpes Zoster – Shingles
Nursing Care Plan (NCP) for Influenza
Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan (NCP) for Pediculosis Capitis / Head Lice
Nursing Care Plan (NCP) for Pericarditis
Nursing Care Plan (NCP) for Pneumonia
Nursing Care Plan (NCP) for Skull Fractures
Nursing Care Plan (NCP) for Somatic Symptom Disorder (SSD)
Nursing Care Plan (NCP) for Urinary Tract Infection (UTI)
Nursing Care Plan for (NCP) Autism Spectrum Disorder
Nursing Process – Assess
Nursing Process – Diagnose
Nursing Process – Evaluate
Nutrition (Diet) in Disease
Nutrition Assessments
Nutrition in Pregnancy
Obstetrical Procedures
Obstructive Heart (Cardiac) Defects
Omphalocele
Oncology Important Points
Opioid Analgesics
Opioid Analgesics in Pregnancy
Order of Lab Draws
Osteosarcoma
Outline Question Method (Note taking)
Ovarian Cancer
Pain and Nonpharmacological Comfort Measures
Paranoid Disorders
Parasympatholytics (Anticholinergics) Nursing Considerations
Patient Positioning
Pediatric Advanced Life Support (PALS)
Pediatric Gastrointestinal Dysfunction – Diarrhea
Pediatric Oncology Basics
Pediculosis Capitis
Penetrating Abdominal Trauma
Penetrating Thoracic Trauma
Perioperative Nursing Roles
Peripheral Vascular Assessment
Peritoneal Dialysis (PD)
Personality Disorders
Pertussis – Whooping Cough
Pharmacology Course Introduction
Phenylketonuria
Phosphorus-Phos
Piaget’s Theory of Cognitive Development
Pill Crushing & Cutting
Pituitary Adenoma
Placenta Previa
Platelets (PLT) Lab Values
Pneumonia
Postpartum Discomforts
Postpartum Hematoma
Postpartum Hemorrhage (PPH)
Postpartum Physiological Maternal Changes
Potassium-K (Hyperkalemia, Hypokalemia)
PPE Donning & Doffing
Practice Settings
Precipitous Labor
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Preoperative (Preop) Nursing Priorities
Preoperative (Preop)Assessment
Pressure Line Management
Pressure Ulcers/Pressure injuries (Braden scale)
Preterm Labor
Prioritization
Prioritizing Assessments
Procedural Terminology
Process of Labor
Prostaglandins
Prostaglandins in Pregnancy
Provider Phone Calls
Psychiatry Terminology
Pulmonary Function Test
R – Real-Life
Radiation Cancer Treatment
Real-Life Experiences
Red Blood Cell (RBC) Lab Values
Renal (Kidney) Failure Labs
Reproductive Terminology
Resources for Lesson Creation
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Restraints
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Rh Immune Globulin (Rhogam)
Rh Immune Globulin in Pregnancy
Routine Neuro Assessments
Rubeola – Measles
Safety Checks
SBAR Communication
Schizophrenia
Scoliosis
Seizure Management in the ER
Selecting THE vein
Self Concept
Sensory Terminology
Sepsis Concept Map
Shift change and Patient handoff
Sickle Cell Anemia
Signs of Pregnancy (Presumptive, Probable, Positive)
Sinus Bradycardia
Sinus Tachycardia
Sodium-Na (Hypernatremia, Hyponatremia)
Somatoform
Spiking & Priming IV Bags
Spina Bifida – Neural Tube Defect (NTD)
Spinal Cord Injury
Spinal Precautions & Log Rolling
Start and End with the Linchpin
Sterile Gloves
Stoma Care (Colostomy bag)
Stomach Cancer (Gastric Cancer)
Stress and Crisis
Stroke (CVA) Management in the ER
Stroke Concept Map
Stroke Nursing Care (CVA)
Subinvolution
SubQ Injections
Sudden Infant Death Syndrome (SIDS)
Suicidal Behavior
Surgical Incisions & Drain Sites
Surgical Prep
Surgical Wound Classification Documentation for Certified Perioperative Nurse (CNOR)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Systemic Lupus Erythematosus (SLE)
Tenet 2 Linchpins & Connections
Tenet 3 Why Behind the What
Tenet 4 Learner-Centered Talkabouts
Tension and Cluster Headaches
Testicular Cancer
The 5-Minute Assessment (Physical assessment)
The EKG (ECG) Graph
The Medical Team
Thinking Like a Nurse
Thoracentesis
Thorax and Lungs Assessment
Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)
Thrombocytopenia
Thyroid Cancer
Time Management
Tocolytics
Tocolytics
Tonsillitis
Topical Medications
Total Bilirubin (T. Billi) Lab Values
Trach Care
Trach Suctioning
Transient Tachypnea of Newborn
Transition To Practice
Transition to Practice Course Introduction
Trauma Survey
Triage in the ER
Troponin I (cTNL) Lab Values
Types of Exercise
Types of Schizophrenia
Umbilical Hernia
Urinary Elimination
Using Aseptic Technique
Uterine Stimulants (Oxytocin, Pitocin)
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
Varicella – Chickenpox
Varicocele
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Vent Alarms
Vitals (VS) and Assessment
Vomiting
What Guides Nurses Practice
What is CCMM?
White Blood Cell (WBC) Lab Values
Working night shift
Working with a Preceptor
Wound Care – Assessment
Wound Care – Dressing Change
Wound Care – Selecting a Dressing
Wound Care – Wound Drains