Nursing Care Plan (NCP) for Anaphylaxis
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Outline
Lesson Objective for Anaphylaxis Nursing Care:
- Recognition of Anaphylactic Triggers:
- Identify and educate individuals at risk of anaphylaxis about common triggers, including food allergens, insect stings, medications, and latex, to facilitate early recognition and prevention.
- Emergency Response Preparedness:
- Equip healthcare providers, individuals at risk, and caregivers with the knowledge and skills necessary for prompt and effective emergency response to anaphylactic reactions, including the administration of epinephrine.
- Prevention and Allergen Avoidance:
- Implement strategies to prevent anaphylactic episodes by educating individuals on allergen avoidance, reading food labels, and ensuring the availability of auto-injectable epinephrine at all times.
- Individualized Anaphylaxis Action Plan:
- Collaborate with individuals at risk and their healthcare providers to develop individualized anaphylaxis action plans outlining specific steps to take in the event of an allergic reaction, including when to use epinephrine and when to seek emergency medical assistance.
- Community Education and Awareness:
- Raise awareness about anaphylaxis within the community by providing education on recognizing symptoms, administering epinephrine, and fostering a supportive environment for individuals at risk.
Pathophysiology of Anaphylaxis:
- Immediate Immune Response:
- Anaphylaxis is a rapid and severe allergic reaction triggered by the immune system’s exaggerated response to an allergen. It involves the activation of mast cells and basophils, leading to the release of histamine and other mediators.
- Histamine Release:
- Mast cells and basophils release histamine, prostaglandins, and other inflammatory substances. Histamine causes vasodilation, increased vascular permeability, and smooth muscle contraction, contributing to the characteristic symptoms of anaphylaxis.
- Systemic Vasodilation:
- The release of vasodilatory mediators results in widespread vasodilation, leading to a rapid drop in blood pressure (hypotension). This can cause inadequate perfusion of vital organs and tissues.
- Bronchoconstriction:
- Anaphylaxis often involves bronchoconstriction, causing respiratory symptoms such as wheezing, shortness of breath, and chest tightness. Severe bronchoconstriction can lead to respiratory failure.
- Multi-organ Involvement:
- Anaphylaxis can affect multiple organ systems, leading to symptoms ranging from skin manifestations (hives, itching) and gastrointestinal symptoms (nausea, vomiting) to cardiovascular collapse. The rapid progression of symptoms requires immediate intervention to prevent life-threatening complications.
Etiology of Anaphylaxis:
- Allergen Exposure:
- Anaphylaxis is primarily triggered by exposure to specific allergens that the individual’s immune system recognizes as harmful. Common allergens include certain foods (e.g., peanuts, shellfish), insect stings (e.g., bees, wasps), medications (e.g., antibiotics, NSAIDs), and latex.
- Previous Sensitization:
- Individuals who have previously been sensitized to an allergen through exposure may develop an exaggerated immune response upon subsequent exposure. Sensitization involves the production of specific antibodies, such as immunoglobulin E (IgE), in response to the allergen.
- Cross-Reactivity:
- Cross-reactivity can occur when proteins in different allergens share similar structures. For example, someone allergic to birch pollen may experience an allergic reaction to certain fruits due to cross-reactivity.
- Inherited Predisposition:
- Genetic factors may contribute to an individual’s predisposition to allergies and anaphylaxis. A family history of allergies or atopic conditions can increase the likelihood of developing an allergic response.
- Idiopathic Cases:
- In some cases, the cause of anaphylaxis may remain unknown (idiopathic). Idiopathic anaphylaxis occurs when an individual experiences severe allergic reactions without an identified trigger, making it challenging to predict and prevent.
Desired Outcome for Anaphylaxis Nursing Care:
- Rapid Symptom Resolution:
- The immediate and primary goal is the prompt resolution of anaphylactic symptoms, including respiratory distress, skin manifestations, and cardiovascular instability, through the administration of epinephrine and other appropriate interventions.
- Restoration of Hemodynamic Stability:
- Achieve and maintain hemodynamic stability by addressing hypotension and preventing cardiovascular collapse. Administer fluids and vasoactive medications as needed to restore adequate perfusion to vital organs.
- Prevention of Recurrence:
- Implement measures to prevent the recurrence of anaphylaxis by identifying and avoiding specific allergens, educating individuals at risk and their caregivers, and ensuring the availability and proper use of emergency medications, such as epinephrine auto-injectors.
- Optimal Respiratory Function:
- Ensure optimal respiratory function by alleviating bronchoconstriction and addressing any respiratory distress. Continuous monitoring and appropriate interventions, including bronchodilators, may be necessary to maintain clear airways.
- Psychosocial Support and Education:
- Provide psychosocial support and education to individuals at risk and their caregivers to reduce anxiety, improve quality of life, and enhance overall well-being. Education should focus on recognizing early symptoms, using emergency medications, and seeking prompt medical attention.
Anaphylaxis Nursing Care Plan
Subjective Data:
- Chest tightness
- Difficulty swallowing
- Stomach cramping
- Shortness of breath
- Dizziness
- The feeling of impending doom
Objective Data:
- Rash, hives (usually itchy)
- Weak, rapid pulse
- Hypotension
- Swollen throat
- Hoarse voice
- Coughing
- Vomiting
- Diarrhea
- Pale or red color to the face and body
Nursing Assessment for Anaphylaxis:
- Initial Assessment:
- Conduct a rapid and comprehensive initial assessment, including airway, breathing, and circulation (ABCs). Prioritize interventions based on the severity of symptoms and potential life-threatening complications.
- Identify Triggers and Allergens:
- Gather information about the individual’s medical history and known allergens. Identify potential triggers, including specific foods, insect stings, medications, or environmental factors.
- Assess Respiratory Status:
- Monitor respiratory status closely for signs of bronchoconstriction, wheezing, shortness of breath, or respiratory distress. Evaluate lung sounds and oxygen saturation.
- Evaluate Cardiovascular Function:
- Assess cardiovascular status, including blood pressure, heart rate, and peripheral perfusion. Identify signs of hypotension, tachycardia, or other cardiovascular instability.
- Skin Examination:
- Examine the skin for allergic reactions, including hives (urticaria), redness, swelling (angioedema), and itching. Document the distribution and progression of skin manifestations.
- Neurological Assessment:
- Conduct a neurological assessment to detect any changes in consciousness, confusion, or neurological deficits. These may indicate inadequate perfusion to the brain.
- Gastrointestinal Assessment:
- Assess the gastrointestinal system for symptoms such as nausea, vomiting, abdominal pain, or diarrhea, which may indicate systemic involvement.
- Psychosocial Assessment:
- Consider the psychosocial impact of anaphylaxis, including anxiety and fear associated with future allergic reactions. Evaluate the individual’s and caregivers’ understanding of the condition and their ability to manage emergency situations.
- Follow-Up Assessment:
- Perform ongoing assessments to monitor the individual’s response to interventions, identify any delayed or recurrent symptoms, and address evolving needs during recovery.
Implementation for Anaphylaxis Nursing Care:
- Administer Epinephrine Promptly:
- Administer epinephrine intramuscularly as the first-line treatment for anaphylaxis. Ensure proper dosage based on the individual’s weight and severity of symptoms. Repeat as necessary, following established protocols.
- Establish and Maintain Airway:
- Ensure a patent airway by positioning the individual appropriately and, if necessary, providing airway support with interventions such as chin lift, jaw thrust, or the insertion of an oropharyngeal or nasopharyngeal airway.
- Provide Oxygen Support:
- Administer supplemental oxygen to maintain adequate oxygen saturation levels. Monitor respiratory status continuously and be prepared to escalate interventions, including advanced airway management.
- Initiate Intravenous Access:
- Establish intravenous (IV) access to administer fluids and medications. Administer isotonic crystalloid solutions to address hypotension and improve perfusion to vital organs.
- Administer Additional Medications:
- Depending on the severity of symptoms, antihistamines for skin manifestations, bronchodilators for bronchoconstriction, and corticosteroids to address inflammation may be indicated. Continuously monitor vital signs and response to interventions.
- Educate Patient on Preventing Future Episodes:
- Collaborate with the healthcare team to determine trigger for anaphylaxis. Referral to an allergist may be necessary. Educate the patient on avoiding triggers and how to self-administer epinephrine, if prescribed.
Nursing Interventions and Rationales
- Administer epinephrine or EpiPen autoinjector if available
Antihistamines are not adequate to treat true anaphylaxis. Administer epinephrine or EpiPen immediately.
- Remove antigen/causative allergen
If medication is the trigger, discontinue the medication immediately; remove, but do not squeeze the stinger of an insect
- Initiate IV access and maintain patency
Medications and fluids will need to be given quickly. IV access allows uniform and quick dosing.
- Monitor airway and oxygenation status; prepare for intubation or tracheostomy if necessary to maintain airway
The swelling of the throat may be caused by acute inflammation. Airway obstruction is the most common manifestation of anaphylaxis and can be fatal. Monitor ABG and oxygen saturation.
- Perform CPR if necessary
Anaphylaxis may occur quickly and result in cardiac or respiratory arrest. Provide CPR or rescue breathing as necessary
- Position patient upright in high-Fowler’s position if conscious
Positioning is to lessen airway obstruction and encourage optimal gas exchange by promoting maximum chest expansion.
- Monitor vital signs; assess for signs of shock
A drop in blood pressure and elevation of heart rate are signs of shock.
- Administer medications as appropriate
- Epinephrine
- Diphenhydramine
- Albuterol
Medications are given for vasoconstriction and to reverse the effects of histamine. Albuterol may be given to reverse histamine-induced bronchospasm.
- Educate patient regarding avoidance of allergens; how to use EpiPen
Teach patient to read nutrition labels and the importance of wearing a Medic Alert bracelet to prevent future anaphylactic reactions. Patients should have EpiPen available and be aware of how to use it.
Evaluation for Anaphylaxis Nursing Care:
- Assess Symptom Resolution:
- Evaluate the resolution of anaphylactic symptoms, including improvement in respiratory distress, relief from skin manifestations, and stabilization of cardiovascular parameters. Monitor for any residual or recurrent symptoms.
- Monitor Vital Signs:
- Continuously monitor vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation. Evaluate for any signs of instability or recurrence of symptoms, particularly within the first few hours after initial treatment.
- Evaluate Response to Medications:
- Assess the individual’s response to medications administered during the acute phase, such as epinephrine, antihistamines, bronchodilators, and corticosteroids. Ensure that these interventions effectively contributed to symptom relief.
- Assess Psychosocial Impact:
- Consider the psychosocial impact of the anaphylactic event on the individual and their caregivers. Evaluate anxiety levels, concerns about future exposures, and the understanding of emergency management strategies.
- Review Follow-Up Plan:
- Discuss and review the individual’s follow-up plan, including the need for allergen identification, avoidance strategies, and education on the proper use of epinephrine auto-injectors. Provide resources for ongoing support and education.
References
- https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468
- https://www.aaaai.org/conditions-and-treatments/allergies/anaphylaxis
- https://www.webmd.com/allergies/video/most-common-triggers
- https://online.epocrates.com/diseases/50124/Anaphylaxis/Etiology
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Transcript
All right, today, we are going to be talking about anaphylaxis. Anaphylaxis, what’s happening? Anaphylaxis, the pathophysiology behind it is it’s just an allergic reaction, but it’s an extreme allergic reaction once a person is exposed to an allergen. Some nursing considerations that we want to consider are all tied to the airway and maintaining the airway. So, we want to maintain the airway. We want to monitor the vital signs. We want to administer the EpiPen. We want to get an ABG. We want to get any other medications and administer them as ordered. And then, we want to also remove the causative factors. So whatever’s causing the allergy reaction, we want to get it as far away as possible. A more desired outcome is to restore an effective breathing pattern, and we want to improve that ventilation and just maintain that hemodynamics. Okay?
Some things that a patient would tell you when they are feeling the effects of anaphylaxis is they’re going to complain of some chest tightness. They’re going to have some difficulty swallowing. They are going to complain of some stomach cramping, and they are going to complain of dizziness. And as with most respiratory conditions, they’re going to have this unknown feeling of impending doom. And it’s just because of that lack of oxygen. Some things that we’re going to observe as nurses, some objective data, we’re going to see some rash, hives. Usually, the hives are itchy. We’re going to see some low BP, some hypotension. We’re going to see a swollen throat. We’re going to be able to assess that. We’re going to hear a hoarse voice, coughing. There might be some vomiting, some diarrhea. And then we’re going to also see a pale or reddish color to the face and the body.
First things first. Remember this, if you don’t remember anything else. When it comes to anaphylaxis, we’re going to get that EpiPen, and we are going to give it. Okay? We are going to give EpiPen. Okay? So EpiPen, EpiPen is short for epinephrine, and that’s just going to immediately start to release those muscles that are contracted from the anaphylaxis.
Next up, we’re going to monitor the oxygenation, and we’re going to monitor the airway status. So airway, remember ABCs, airway, breathing, and circulation? We’re on our A now. We’re going to focus on the airway. We are going to want to intubate or have an emergent, a trach, if necessary, but most important is we want to monitor to make sure that they are getting properly oxygenated. Okay? Next thing is we are going to be ready for CPR. Oftentimes with respiratory conditions, the heart will give… We want to be ready to give rescue breaths or compressions as necessary. Okay?
Next we’re going to monitor those vital signs. Primarily, we’re going to focus on signs of shock. A patient with anaphylaxis can go into shock, which means their BP’s going to drop. They’re going to have a heart rate increase. So they’re going to be tachycardic. These are signs of shock that we want to be aware of. Finally, we want to make sure that we give the patient the best chance of oxygenating. So we’re going to sit them up in high Fowler’s, as high as possible that they would tolerate, so anything 90 degrees or better is the best. And the reason why we’re doing this is we are positioning them to lessen the airway obstruction and also improve and optimize gas exchange.
So, let’s go over some of the key points. The pathophysiology, anaphylaxis is just an overreaction. Think about your body is just overreacting to an allergen. Some of the subjective and objective things that we’re going to focus on remember the patient’s going to complain of some chest tightness, some difficulty in breathing, some dizziness. They’re going to have that sense of impending doom. What we’re going to see is we’re going to assess rash, hives, cough, low BP, and an increased heart rate.
We’re going to focus on airway protection because airway obstruction is the most common with anaphylaxis. We’re going to prepare for intubation, if necessary, and have the necessary tools at the bedside. And then, we are going to focus on stopping anaphylaxis. Do you see? Stopping anaphylaxis, and that’s going to include administering EpiPens. We may want to follow up with some steroids, some Benadryl, and albuterol. But the number one after EpiPen is removing that causative allergen, so whatever’s causing that allergic reaction.
We love you guys. Go out, be your best self today. And as always, Happy Nursing.
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Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Hypoparathyroidism
Hypothermia (Thermoregulation)
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
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Insulin Mnemonic (Ready, Set, Inject, Love)
Intake and Output (I&O)
Integumentary (Skin) Course Introduction
Integumentary (Skin) Important Points
Integumentary (Skin) Module Intro
Interventional Radiology
Interventions for Aphasia Nursing Mnemonic (PROP)
Intracranial Pressure ICP
Intraoperative (Intraop) Complications
Intraoperative Nursing Priorities
Intraoperative Positioning
Intrarenal Causes of Acute Kidney Injury Nursing Mnemonic (TONIC)
Intro to Health Assessment
Introduction to Health Assessment
Intubation in the OR
Iodine Nursing Considerations
Ionized Calcium Lab Values
Iron (Fe) Lab Values
Ischemic (CVA) Stroke Labs
Isoniazid (Niazid) Nursing Considerations
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Kidney Cancer
Lactate Dehydrogenase (LDH) Lab Values
Lactic Acid
Leukemia
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Leukemia Case Study (60 min)
Levels of consciousness Nursing Mnemonic (Never Carry Dirty Socks Or Smelly Clothes)
Levofloxacin (Levaquin) Nursing Considerations
Levothyroxine (Synthroid)
Lidocaine (Xylocaine) Nursing Considerations
Lidocaine Toxicity – Signs and Symptoms Nursing Mnemonic (SAMS)
Linen Change
Lipase Lab Values
Lisinopril (Prinivil) Nursing Considerations
Live Bedside Report Medsurg (Medical surgical)
Liver Cancer
Liver/Gallbladder Module Intro
Local Anesthesia
Loperamide (Imodium) Nursing Considerations
Losartan (Cozaar) Nursing Considerations
Low Pressure Vent Alarms Nursing Mnemonic (Cake Everyday)
Lower Gastrointestinal (GI) Module Intro
Lung Cancer
Lung Diseases Module Intro
Lymphatic Assessment
Lymphoma
Lymphoma – Signs and Symptoms Nursing Mnemonic (NURSE For Pete’s Sake)
Macular Degeneration
Magnetic Resonance Imaging (MRI)
Malignant Hyperthermia
Mammogram
Management of Glomerulonephritis Nursing Mnemonic (Please Help Deliver Diuretics)
Management of Lyme Disease Nursing Mnemonic (BAR)
Management of Pressure Ulcers (Pressure Injuries) Nursing Mnemonic (SKIN)
Mechanical Aids
Medication Classess for IBD Nursing Mnemonic (Sometimes I Can’t Answer)
Medications for Pancreatitis Nursing Mnemonic (Please Make Tummy Better)
Medications to Prevent Seizures Nursing Mnemonic (Pretty Little Liars Forever)
Melanoma
Meniere’s Disease
Meperidine (Demerol) Nursing Considerations
Meropenem (Merrem) Nursing Considerations
Metabolic & Endocrine Module Intro
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic/Endocrine Course Introduction
Metformin (Glucophage) Nursing Considerations
Methylprednisolone (Solu-Medrol) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Metronidazole (Flagyl) Nursing Considerations
MI Surgical Intervention
Migraines
Miscellaneous Nerve Disorders
Mobility & Assistive Devices
Moderate Sedation
Montelukast (Singulair) Nursing Considerations
Morphine (MS Contin) Nursing Considerations
Multiple Myeloma
Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Musculoskeletal Assessment
Musculoskeletal Course Introduction
Musculoskeletal Module Intro
Myocardial Infarction (MI) Case Study (45 min)
Myocardial Infarction Nursing Mnemonic (MONATAS)
Naproxen (Aleve) Nursing Considerations
Nasal Disorders
Neostigmine (Prostigmin) Nursing Considerations
Nephrotic Syndrome Case Study (Peds) (45 min)
Neuro A&P Module Intro
Neuro Anatomy
Neuro Assessment Module Intro
Neuro Course Introduction
Neuro Disorders Module Intro
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)