Nursing Care Plan (NCP) for Aspiration
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Outline
Lesson Objectives for Aspiration
- Definition and Recognition:
- Define aspiration as the inhalation of foreign material (such as food, liquids, or gastric contents) into the airways, leading to potential respiratory complications.
- Risk Factors:
- Identify common risk factors for aspiration, including impaired swallowing function, altered consciousness, neurological disorders, and conditions affecting upper airway protection.
- Clinical Manifestations:
- Recognize the clinical manifestations associated with aspiration, such as coughing, choking, wheezing, dyspnea, and potential complications like pneumonia.
- Prevention Strategies:
- Understand preventive measures to minimize the risk of aspiration, including proper positioning during meals, modified diets, and interventions to improve swallowing safety.
- Immediate Response:
- Learn the immediate nursing response to aspiration events, including assessment, initiation of emergency protocols, and collaboration with the healthcare team to ensure prompt and appropriate interventions.
Pathophysiology of Aspiration
- Inhalation of Foreign Material:
- Aspiration occurs when foreign material, such as food particles, liquids, or gastric contents, is inhaled into the airways instead of being directed into the digestive system.
- Bronchial Entry:
- Aspirated material can enter the bronchi and lungs, leading to potential obstruction, inflammation, and infection in the respiratory system.
- Airway Irritation:
- Aspirated substances can irritate the delicate tissues of the airways, triggering a local inflammatory response. This irritation can contribute to coughing and increased secretions.
Etiology of Aspiration
- Impaired Swallowing Function:
- Conditions that affect swallowing function, such as dysphagia due to neurological disorders, stroke, or structural abnormalities, increase the risk of aspiration.
- Altered Consciousness:
- Individuals with altered levels of consciousness, such as those under the influence of sedatives, anesthetics, or alcohol, are more prone to aspiration due to reduced protective reflexes.
- Neurological Disorders:
- Neurological conditions, including Parkinson’s disease, dementia, and conditions affecting the cranial nerves or brainstem, can impair the coordination of swallowing and increase the risk of aspiration.
- Gastroesophageal Reflux Disease (GERD):
- GERD can contribute to aspiration by allowing gastric contents to flow back into the esophagus, increasing the likelihood of aspiration into the respiratory tract.
- Upper Airway Obstruction:
- Conditions that cause upper airway obstruction, such as tumors, foreign bodies, or anatomical abnormalities, can lead to difficulty in managing secretions and increase the risk of aspiration.
Desired Outcome for Aspiration
- Respiratory Stability:
- Maintain respiratory stability with clear breath sounds, absence of wheezing or stridor, and adequate oxygenation to prevent complications such as pneumonia.
- Effective Airway Clearance:
- Promote effective airway clearance to minimize the risk of respiratory distress, coughing, or further aspiration events.
- Improved Swallowing Safety:
- Enhance swallowing safety through interventions and strategies to reduce the risk of aspiration, especially in individuals with impaired swallowing function.
- Prevention of Complications:
- Prevent complications associated with aspiration, such as pneumonia or chronic respiratory conditions, through vigilant monitoring and prompt intervention.
- Patient Education:
- Educate the patient and caregivers on strategies to reduce the risk of aspiration, recognize early signs, and seek prompt medical attention when needed.
Nursing Care Plan (NCP) for Aspiration
Subjective Data:
- Shortness of breath
- Difficulty breathing
- Chest pain
Objective Data:
- Coughing
- Low oxygen saturation
- Tachypnea/dyspnea
- Blue lips/fingers
- Lung sounds (crackles and/or diminished
- Frothy sputum
Nursing Assessment for Aspiration
- Swallowing Assessment:
- Conduct a thorough swallowing assessment, including observation of the patient during meals, assessing the coordination of swallowing, and identifying any signs of difficulty or discomfort.
- Neurological Assessment:
- Perform a neurological assessment to identify conditions or impairments affecting consciousness, cranial nerves, and coordination, which may contribute to aspiration risk.
- Respiratory Assessment:
- Monitor respiratory status, including breath sounds, respiratory rate, and oxygen saturation, to detect signs of respiratory distress or compromise.
- Gastrointestinal Assessment:
- Assess for conditions such as GERD that may increase the risk of gastric contents entering the esophagus, contributing to aspiration risk.
- Cough Assessment:
- Evaluate the presence and characteristics of cough, as persistent or ineffective coughing may indicate a potential aspiration event.
- Nutritional Status:
- Assess the patient’s nutritional status and ability to tolerate oral intake, considering factors such as weight loss, dehydration, or signs of malnutrition.
- Speech and Language Assessment:
- Collaborate with speech and language therapists to assess speech and language function, as impairments in these areas may contribute to swallowing difficulties.
- Medication Review:
- Review the patient’s medication list to identify drugs that may affect consciousness, coordination, or increase the risk of aspiration.
Implementation for Aspiration
- Positioning:
- Position the patient upright during and after meals to facilitate gravity-assisted swallowing and reduce the risk of aspiration. Consider the use of specialized seating or positioning devices as needed.
- Modified Diet:
- Implement a modified diet based on the individual’s swallowing capabilities, including texture modifications (e.g., pureed, soft) and fluid consistency adjustments. Collaborate with a dietitian for personalized dietary plans.
- Swallowing Rehabilitation:
- Initiate swallowing rehabilitation exercises, working closely with speech and language therapists to improve swallowing coordination and strength. Encourage adherence to recommended exercises.
- Respiratory Support:
- Provide respiratory support as needed, including oxygen therapy and nebulization, to maintain adequate oxygenation and address respiratory symptoms. Monitor respiratory status closely.
- Education and Caregiver Training:
- Educate the patient and caregivers on strategies to reduce the risk of aspiration, proper swallowing techniques, and the importance of adhering to dietary modifications. Provide training on recognizing signs of aspiration and when to seek medical attention.
Nursing Interventions and Rationales
| Nursing Intervention (ADPIE) | Rationale |
| Assess respiratory function -lung sounds, O2 Sats, skin color, chest symmetry | will assess baseline for patient and whether their respiratory function is getting better or worse with interventions |
| maintain patent airway- NPO, HOB>30 Degrees, oral hygiene, suction equipment in room, O2 in case | Keep the airway protected. Maintain proper ventilation/oxygenation |
| Perform a swallow screen test | should be performed with thin liquids at bedside (if not NPO status) checks patients swallowing ability. If fails, patient goes to NPO status, and notify physician
Note: swallow study is done in radiology if they fail the screening test |
| Acquire a chest x-ray | this will see if a patient has aspirated, whether they have acquired pneumonia or not |
| Lab testing/ABG/sputum-blood cultures | blood gas- monitors PaCO2/PCO2 & PaO2/PO2
CBC- Monitors WBC count Sputum/Blood Cultures-may be needed an able to make sure the patient is receiving the right antibiotic therapy if needed |
| Antibiotic therapy-
Clindamycin & Metronidazole |
may be prophylaxis, or because patient developed pneumonia. Clindamycin is most commonly used for aspiration pneumonia. Metronidazole can be used in conjunction with Clindamycin for further coverage |
Evaluation for Aspiration
- Airway Patency:
- Evaluate airway patency by assessing breath sounds, monitoring for signs of airway obstruction, and ensuring effective coughing and airway clearance.
- Swallowing Function:
- Assess improvements in swallowing function through regular swallowing assessments, observing the patient’s ability to manage oral intake and identifying any ongoing difficulties.
- Respiratory Status:
- Monitor respiratory status for improvements or stabilization, including the absence of respiratory distress, decreased coughing, and improved oxygen saturation levels.
- Dietary Tolerance:
- Evaluate the patient’s tolerance of modified diets and adjustments, assessing weight stability, nutritional intake, and signs of dehydration or malnutrition.
- Patient and Caregiver Adherence:
- Assess patient and caregiver adherence to prescribed interventions, dietary modifications, and rehabilitation exercises. Identify any challenges or barriers to compliance and provide additional support or education as needed.
References
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/dysphagia-what-happens-during-a-bedside-swallow-exam
https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/aspiration-pneumonia
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Transcript
Hey everyone. Today, we are going to be putting together a nursing care plan for aspiration. So, let’s get started. So we’re going to go over the pathophysiology. So aspiration occurs when something enters into the lungs that is not air. If this ventilation progresses to infection, aspiration pneumonia can develop. Some nursing considerations. We want to make sure we’re doing a full respiratory assessment, maintaining a patent airway, performing a swallow screen test, doing some labs, ABGs, and administering medications. Desired outcomes. We want to make sure that the patient has a patent airway, oxygenation maintenance, and prevention of further complications, such as pneumonia.
So we’re going to go ahead and get started on the care plan. We’re going to have some subjective data and we’re going to have some objective data. So what are we going to see with the patients that are aspirating? They may have some shortness of breath and they may have some chest pain. Some objective data: coughing, maybe blue lips if they’re aspirating or some frothy sputum. Some other things: they may have difficulty breathing, some low oxygen saturation, adventitious lung sounds. You might hear some crackles or some diminished sounds.
So with our interventions, we’re going to assess their respiratory function. We’re going to look for their skin color. Is it blue? Is it pink? Are they oxygenating enough? You’re going to be looking for chest symmetry. So you want to make sure we’re assessing the entirety of the respiratory function. See what their baseline is. See when we do some interventions, if it’s improving or not. Another intervention we’re going to be doing is to make sure we’re maintaining their airway. So maintaining the patient’s airway. So we’re going to keep them NPO. Make sure they’re doing oral hygiene. Make sure we have suction equipment in the room. Always, always make sure we have suction equipment because you never know if you’re going to need it to help try to clear their airway if the patient’s not able to clear it themself. Also, any O2, in case you may need O2 for your patient. Another intervention we’re going to be doing, we’re going to perform a swallow screen test. Now the swallow screen test is done at the bedside. So this is going to be performed with thin liquids at the bedside. We’re going to check the patient’s swallowing ability. If the patient fails this test, the patient will go to NPO status and you’ll notify the physician. I do want to note a swallow study is done in radiology if they fail the screening test. Another intervention we’re going to be doing is acquiring a chest X-ray to see if the patient may have aspirated and whether they have acquired any sort of pneumonia. Another intervention we’re going to be doing are labs, ABGs, or sputum culture. So the blood gases, we’re going to monitor the PaCO2 and PaO2 levels. For the labs, we’re going to be looking for CBC, which is going to monitor their white blood cell counts. And for the sputum, we’re going to be checking to see if there’s any sort of pneumonias, the type of bacteria that we’re going to be treating, and making sure that the patient’s going to be on the right antibiotic therapy. So then we’re also going to be given the patient medication. So antibiotic therapy, such as clindamycin and metronidazole. So it may be prophylactic measures, or if the patient had developed pneumonia, clindamycin is commonly used for aspiration pneumonia, and metronidazole can be used in conjunction with the clindamycin for any further coverage that the patient needs.
Alright, so now we’re going to look at some of the key points for the care plan. So aspiration occurs when something enters into the lungs, that’s not air likely caused by someone losing their gag reflex, or the inability to clear secretions on their own. Some subjective and objective data. They’ll have some shortness of breath, chest pain, difficulty breathing, some coughing, low oxygen saturation, blue lips, or fingers, frothy sputum. You want to do a full respiratory assessment and perform a swallow screen test bedside. We’re going to give meds. We’re going to do labs. Make sure they have a patent airway. So we’ll be giving those meds, doing the labs, checking the white blood cells and ABGs. X-ray just to see if they have pneumonia. And once again, maintaining that airway is very, very important.
Alright, you guys did awesome. We love you guys out. Be your best self today, and as always happy nursing.
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Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Acute Pain
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Acute Bronchitis
Nursing Care Plan (NCP) for Activity Intolerance
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Abdominal Pain
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care and Pathophysiology of Pneumonia
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care and Pathophysiology of Myocarditis
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology for Pulmonary Embolism
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Psoriasis
Nursing Care and Pathophysiology for Polycystic Ovarian Syndrome (PCOS)
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Parkinsons
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Human Papilloma Virus (HPV STI)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Crohn’s Disease
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology for Compartment Syndrome
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nuclear Medicine
Norepinephrine (Levophed) Nursing Considerations
Noncardiac Pulmonary Edema for Certified Emergency Nursing (CEN)
Nitroprusside (Nitropress) Nursing Considerations
Nitroglycerin (Nitrostat) Nursing Considerations
Nitro Compounds
NG (Nasogastric)Tube Management
Neurological Fractures
Neurological Disorders (Multiple Sclerosis, Myasthenia Gravis, Guillain-Barré Syndrome) for Certified Emergency Nursing (CEN)
Neurogenic Shock for Certified Emergency Nursing (CEN)
Neostigmine (Prostigmin) Nursing Considerations
Naproxen (Aleve) Nursing Considerations
Myocardial Infarction Nursing Mnemonic (MONATAS)
Myocardial Infarction (MI) Case Study (45 min)
Musculoskeletal Course Introduction
Musculoskeletal Assessment
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)
Morphine (MS Contin) Nursing Considerations
Moderate Sedation
Mobility & Assistive Devices
Miscellaneous Nerve Disorders
Minimally-Invasive Thoracic Surgery (VATS) for Progressive Care Certified Nurse (PCCN)
Migraines
MI Surgical Intervention
Metronidazole (Flagyl) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Methylprednisolone (Solu-Medrol) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Metabolic/Endocrine Course Introduction
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic & Endocrine Module Intro
Meropenem (Merrem) Nursing Considerations
Meperidine (Demerol) Nursing Considerations
Meningitis for Certified Emergency Nursing (CEN)
Meniere’s Disease
Medication Classess for IBD Nursing Mnemonic (Sometimes I Can’t Answer)
Mechanical Aids
Management of Pressure Ulcers (Pressure Injuries) Nursing Mnemonic (SKIN)
Malignant Hyperthermia (MH) Nursing Interventions for Certified Perioperative Nurse (CNOR)
Malignant Hyperthermia
Magnetic Resonance Imaging (MRI)
Macular Degeneration
Lymphoma – Signs and Symptoms Nursing Mnemonic (NURSE For Pete’s Sake)
Lymphoma
Lymphatic Assessment
Lung Diseases Module Intro
Lower Gastrointestinal (GI) Module Intro
Low Pressure Vent Alarms Nursing Mnemonic (Cake Everyday)
Losartan (Cozaar) Nursing Considerations
Loperamide (Imodium) Nursing Considerations
Local Anesthetic Systemic Toxicity (LAST) Nursing Interventions for Certified Perioperative Nurse (CNOR)
Local Anesthesia
Liver/Gallbladder Module Intro
Live Bedside Report Medsurg (Medical surgical)
Lisinopril (Prinivil) Nursing Considerations
Lipase Lab Values
Linen Change
Lidocaine Toxicity – Signs and Symptoms Nursing Mnemonic (SAMS)
Lidocaine (Xylocaine) Nursing Considerations
Levothyroxine (Synthroid)
Levofloxacin (Levaquin) Nursing Considerations
Levels of consciousness Nursing Mnemonic (Never Carry Dirty Socks Or Smelly Clothes)
Lactic Acid
Lactate Dehydrogenase (LDH) Lab Values
Lacerations for Certified Emergency Nursing (CEN)
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Isoniazid (Niazid) Nursing Considerations
Ischemic Bowel for Progressive Care Certified Nurse (PCCN)
Ischemic (CVA) Stroke Labs
Iron (Fe) Lab Values
Ionized Calcium Lab Values
Iodine Nursing Considerations
Intubation in the OR
Introduction to Health Assessment
Intro to Health Assessment
Intrarenal Causes of Acute Kidney Injury Nursing Mnemonic (TONIC)
Intraoperative Positioning
Intraoperative Nursing Priorities
Intraoperative (Intraop) Complications
Intracranial Pressure ICP
Interventions for Aphasia Nursing Mnemonic (PROP)
Interdisciplinary Team Participation for Certified Perioperative Nurse (CNOR)
Interdisciplinary Team Member Functions for Certified Perioperative Nurse (CNOR)
Interdisciplinary Healthcare Team Collaboration for Certified Perioperative Nurse (CNOR)
Integumentary (Skin) Important Points
Integumentary (Skin) Module Intro
Integumentary (Skin) Course Introduction
Intake and Output (I&O)
Insulin Mnemonic (Ready, Set, Inject, Love)
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin
Inserting an NG (Nasogastric) Tube
Inserting a Foley (Urinary Catheter) – Male
Informed Consent
Influenza for Certified Emergency Nursing (CEN)
Inflammatory Bowel Disease Case Study (45 min)
Infectious Diseases: Influenza for Progressive Care Certified Nurse (PCCN)
Individualized Physical Assessments for Certified Perioperative Nurse (CNOR)
Increased Intraocular Pressure for Certified Emergency Nursing (CEN)
Impulse Transmission
Implant Verification and Availability for Certified Perioperative Nurse (CNOR)
Implant Records and Tracking for Certified Perioperative Nurse (CNOR)
Implant Preparation for Certified Perioperative Nurse (CNOR)
Impaired or Disruptive Behavior Reporting (Interdisciplinary Healthcare Team) for Certified Perioperative Nurse (CNOR)
Immunology Module Intro
Immunocompromise (HIV and AIDS, Oncology and Chemotherapy, Transplant Patient) for Certified Emergency Nursing (CEN)
Hypoxia – Signs and Symptoms Nursing Mnemonic (RAT BED)
Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)
Hypotonic Solutions (IV solutions)
Hypothermia (Thermoregulation)
Hypoparathyroidism
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)
Hypoglycemia for Progressive Care Certified Nurse (PCCN)
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Hypoglycemia
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypertonic Solutions (IV solutions)
Hyperthyroidism Case Study (75 min)
Hyperthermia (Thermoregulation)
Hypertensive Crisis Case Study (45 min)
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypertension (HTN) Concept Map
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (FRIED)
Hyperglycemia for Progressive Care Certified Nurse (PCCN)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Hypercalcemia – Signs and Symptoms Nursing Mnemonic (GROANS, MOANS, BONES, STONES, OVERTONES)
Hygiene
Hydralazine
HMG-CoA Reductase Inhibitors (Statins)
Histamine 2 Receptor Blockers
Histamine 1 Receptor Blockers
High Pressure Vent Alarms Nursing Mnemonic (Kings Eat Big Cakes)
Hepatitis for Certified Emergency Nursing (CEN)
Hepatitis B Virus (HBV) Lab Values
Hepatic Disorders (Cirrhosis, Hepatitis, Portal Hypertension) for Progressive Care Certified Nurse (PCCN)
Heparin (Hep-Lock) Nursing Considerations
Hemorrhagic Stroke Risk Factors Nursing Mnemonic (HATS)
Hemorrhagic Fevers for Certified Emergency Nursing (CEN)
Hemorrhage Nursing Interventions for Certified Perioperative Nurse (CNOR)
Hemodialysis (Renal Dialysis)
Hematology/Oncology/Immunology Course Introduction
Hematology Module Intro
Hematologic Disorders for Certified Emergency Nursing (CEN)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Heat Temperature-related Emergencies for Certified Emergency Nursing (CEN)
Heart Failure for Certified Emergency Nursing (CEN)
Heart Failure Case Study (45 min)
Heart Failure 2 – Live Tutoring Archive
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Heart (Cardiac) Sound Locations and Auscultation
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) and Great Vessels Assessment
Healthcare-Acquired Infections: Surgical Site Infections (SSI) for Progressive Care Certified Nurse (PCCN)
Hearing Loss
Healthcare-Acquired Infections: Catheter-Associated Bloodstream Infections (CAUTI) for Progressive Care Certified Nurse (PCCN)
Healthcare Team Member Supervision and Education for Certified Perioperative Nurse (CNOR)
Health Assessment Course Introduction
Head/Neck Assessment
Hb (Hepatitis) Vaccine
Hazardous Material Handling and Disposition (Chemo, Radioactive) for Certified Perioperative Nurse (CNOR)
Hand Hygiene Guideline Adherence for Certified Perioperative Nurse (CNOR)
Glucagon (GlucaGen) Nursing Considerations
Glipizide (Glucotrol) Nursing Considerations
Glaucoma
GI Infections (C. difficile) for Progressive Care Certified Nurse (PCCN)
GI Bleed (Upper, Lower) for Progressive Care Certified Nurse (PCCN)
GERD causes Nursing Mnemonic (Reflux Is Probably Mean)
GERD (Gastroesophageal Reflux Disease)
Genitourinary Infections for Certified Emergency Nursing (CEN)
Genitourinary Course Introduction
Genitourinary Trauma for Certified Emergency Nursing (CEN)
Genitourinary (GU) Assessment
General Assessment (Physical assessment)
General Anesthesia
Gastrointestinal (GI) Bleed Concept Map
Gastritis
Gabapentin (Neurontin) Nursing Considerations
Fundamentals Course Introduction
Functional Issues (Immobility, Falls, Gait Disorders) for Progressive Care Certified Nurse (PCCN)
Functional GI Disorders (Obstruction, Ileus, Diabetic Gastroparesis, Gastroesophageal Reflux, Irritable Bowel Syndrome) for Progressive Care Certified Nurse (PCCN)
Free T4 (Thyroxine) Lab Values
Fluid Volume Overload
Fibromyalgia
Fibrinogen Lab Values
Fibrin Degradation Products (FDP) Lab Values
Ferrous Sulfate (Iron) Nursing Considerations
Fentanyl (Duragesic) Nursing Considerations
Explant Preparation (Final Disposition) for Certified Perioperative Nurse (CNOR)
Ethical and Professional Standards for Certified Perioperative Nurse (CNOR)
Essential NCLEX Meds by Class
Esophageal Varices for Certified Emergency Nursing (CEN)
Erythromycin (Erythrocin) Nursing Considerations
Erythrocyte Sedimentation Rate (ESR) Lab Values
Equipment Utilization (Manufacturers Recommendations) for Certified Perioperative Nurse (CNOR)
Epoetin Alfa
Epoetin (Epogen) Nursing Considerations
Epinephrine (EpiPen) Nursing Considerations
Environmental Stewardship (Waste Minimization) for Certified Perioperative Nurse (CNOR)
Environmental Factor Control for Certified Perioperative Nurse (CNOR)
Environmental Cleaning (Spills, Room Turnover, Terminal Cleaning) for Certified Perioperative Nurse (CNOR)
Envenomation Emergencies for Certified Emergency Nursing (CEN)
Enteral & Parenteral Nutrition (Diet, TPN)
Enoxaparin (Lovenox) Nursing Considerations
Endoscopy & EGD
End-Stage Renal Disease (ESRD) for Progressive Care Certified Nurse (PCCN)
Encephalopathy (Hypoxic-ischemic, Metabolic, Infectious, Hepatic) for Progressive Care Certified Nurse (PCCN)
Encephalopathies
Enalapril (Vasotec) Nursing Considerations
Emergency Situation Identification for Certified Perioperative Nurse (CNOR)
EENT Medications
EENT Course Introduction
Echocardiogram (Cardiac Echo)
Dysrhythmias Labs
Dysrhythmias for Certified Emergency Nursing (CEN)
Drugs that Cause SJS Nursing Mnemonic (I C NASA)
Dopamine (Inotropin) Nursing Considerations
Dobutamine (Dobutrex) Nursing Considerations
DKA Treatment Nursing Mnemonic (KING UFC)
Diverticulitis for Certified Emergency Nursing (CEN)
Diverticulitis Complications Nursing Mnemonic (Please Fix His Abscess SOon)
Disseminated Intravascular Coagulation Case Study (60 min)
Disease Specific Medications
Discharge Planning for Certified Emergency Nursing (CEN)
Discharge (DC) Teaching After Surgery
Different Dressings
Diltiazem (Cardizem) Nursing Considerations
Dialysis & Other Renal Points
Diagnostic Criteria for Lupus Nursing Mnemonic (SOAP BRAIN MD)
Diabetic Ketoacidosis for Progressive Care Certified Nurse (PCCN)
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Diabetes Mellitus for Progressive Care Certified Nurse (PCCN)
Diabetes Mellitus & Those Dang Blood Sugars! – Live Tutoring Archive
Diabetes Mellitus Case Study (45 min)
Diabetes Mellitus (DM) Module Intro
Diabetes Management
Diabetes Insipidus Nursing Mnemonic (DDD)
Diabetes Insipidus Case Study (60 min)
Dementia and Alzheimers
Delegation and Personnel Management for Certified Perioperative Nurse (CNOR)
Decrease ICP Nursing Mnemonic (Craniums Excite Me)
Day in the Life of a Med-surg Nurse
D-Dimer (DDI) Lab Values
Cyclosporine (Sandimmune) Nursing Considerations
Cyclic Citrullinated Peptide (CCP) Lab Values
Cushings Assessment Nursing Mnemonic (STRESSED)
Cushing’s Syndrome Case Study (60 min)
Cultures
CT & MR Angiography
Crohn’s Morphology and Symptoms Nursing Mnemonic (CHRISTMAS)
Critical Thinking to Facilitate Patient Care for Certified Perioperative Nurse (CNOR)
Creatinine Clearance Lab Values
Creatine Phosphokinase (CPK) Lab Values
Cranial Nerve Mnemonic 02 Nursing Mnemonic (Oh Oh Oh To Touch And Feel Very Good Velvet AH!)
Cortisone (Cortone) Nursing Considerations
Cortisol Lab Vales
Coronavirus (COVID-19) Nursing Care and General Information
Coronary Circulation
Coronary Artery Disease Concept Map
Coronary Arteries – Location Nursing Mnemonic (I have a RIGHT to CAMP if you LEFT off the AC)
Cor Pulmonale – Signs & Symptoms Nursing Mnemonic (Please Read His Text)
COPD management Nursing Mnemonic (COPD)
COPD Exacerbation for Progressive Care Certified Nurse (PCCN)
COPD Concept Map
COPD (Chronic Obstructive Pulmonary Disease) Labs
Congestive Heart Failure Concept Map
Confirming Patient Identity (Patient Identifiers) for Certified Perioperative Nurse (CNOR)
Confirmation of Correct Procedure (Operative Site, Side, Site Marking) for Certified Perioperative Nurse (CNOR)
Complications of Thoracentesis Nursing Mnemonic (Patients Sometimes Bleed Internally)
Complications of Immobility
Compartment Syndrome for Certified Emergency Nursing (CEN)
Communication of Patient Outcomes (Continuum of Care) for Certified Perioperative Nurse (CNOR)
Common Signs of Parkinson’s Nursing Mnemonic (SMART)
Comfort Provisions (Behavioral Response to Procedure) for Certified Perioperative Nurse (CNOR)
Colonoscopy
Cold Temperature-related Emergencies for Certified Emergency Nursing (CEN)
Coagulopathies, Medication-Induced (Coumadin, Platelet Inhibitors, Heparin, HIT) for Progressive Care Certified Nurse (PCCN)
Coagulation Studies (PT, PTT, INR)
Clopidogrel (Plavix) Nursing Considerations
Cirrhosis Complications Nursing Mnemonic (Please Bring Happy Energy)
Cirrhosis for Certified Emergency Nursing (CEN)
Cirrhosis Case Study (45 min)
Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)
Chronic Obstructive Pulmonary Disease (COPD) for Certified Emergency Nursing (CEN)
Chronic Renal (Kidney) Module Intro
Chronic Kidney Disease (CKD) Case Study (45 min)
CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Chest Tube Management Case Study (60 min)
Chest Tube Management
Chest Tube Management
Chest Tube Assessment Nursing Mnemonic (Two AA’s)
Cerebral Perfusion Pressure CPP
Cerebral Perfusion Pressure Case Study (60 min)
Cephalexin (Keflex) Nursing Considerations
Central Line Dressing Change
Celecoxib (Celebrex) Nursing Considerations
Causes of Dyspnea Nursing Mnemonic (The 6 P’s)
Causes of Pancreatitis Nursing Mnemonic (BAD HITS)
Causes of Anaphylaxis Nursing Mnemonic (Many Boys Love Food)
Cataracts
Cardiovascular Disorders (CVD) Module Intro
Cardiovascular Angiography
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiac Stress Test
Cardiac Labs – What and When to Use Them 2 – Live Tutoring Archive
Cardiac Labs – What and When to Use Them – Live Tutoring Archive
Cardiac Course Introduction
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Cardiac Anatomy
Cardiac A&P Module Intro
Cardiac (Heart) Enzymes
Carbon Dioxide (Co2) Lab Values
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Captopril (Capoten) Nursing Considerations
Canes Nursing Mnemonic (COAL)
Calcium Channel Blockers
Calcium Carbonate (Tums) Nursing Considerations
Calcium Acetate (PhosLo) Nursing Considerations
C. Difficile for Certified Emergency Nursing (CEN)
C-Reactive Protein (CRP) Lab Values
Burns for Certified Emergency Nursing (CEN)
Burn Injuries
Brain Natriuretic Peptide (BNP) Lab Values
Brain Death v. Comatose
BPH Symptoms Nursing Mnemonic (FUN WISE)
Bowel Perforation for Certified Emergency Nursing (CEN)
Bowel Obstruction Concept Map
Body Mechanics (Utilization) for Certified Perioperative Nurse (CNOR)
Blunt Chest Trauma
Blood Salvage Transfusion Anticipation for Certified Perioperative Nurse (CNOR)
Blood Flow Through The Heart
Bleeding Precautions Nursing Mnemonic (RANDI)
Bleeding for Certified Emergency Nursing (CEN)
Bleeding Complications (Minor) Nursing Mnemonic (BEEP)
Bismuth Subsalicylate (Pepto-Bismol) Nursing Considerations
Biopsy
Biohazard Material Handling and Disposition (Blood, Microbiology, Creutzfeldt-Jakob Disease) for Certified Perioperative Nurse (CNOR)
Beta Hydroxy (BHB) Lab Values
Benztropine (Cogentin) Nursing Considerations
Bed Bath
Barriers to Health Assessment
Barrier Material Selection (Procedure-Specific) for Certified Perioperative Nurse (CNOR)
Bariatric: IV Insertion
Bariatric Surgeries
Barbiturates
Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)
Azithromycin (Zithromax) Nursing Considerations
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Flutter
Atrial Fibrillation (A Fib)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atorvastatin (Lipitor) Nursing Considerations
Atenolol (Tenormin) Nursing Considerations
Asthma for Certified Emergency Nursing (CEN)
Asthma (Severe) for Progressive Care Certified Nurse (PCCN)
Assessment of Guillain-Barre Syndrome Nursing Mnemonic (GBS=PAID)
Assessment for Myasthenic Crisis Nursing Mnemonic (BRISH)
ASA (Aspirin) Nursing Considerations
Artificial Airways
ARDS causes Nursing Mnemonic (GUT PASS)
ARDS Case Study (60 min)
Aortic Stenosis Symptoms Nursing Mnemonic (SAD)
Aortic Aneurysm – Thoracic signs Nursing Mnemonic (PEE BADS)
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
Antinuclear Antibody Lab Values
Antineoplastics
Antimetabolites
Antidiabetic Agents
Anticonvulsants
Anti-Platelet Aggregate
Anti-Infective – Antitubercular
Anti-Infective – Tetracyclines
Anti-Infective – Sulfonamides
Anti-Infective – Glycopeptide
Anti-Infective – Carbapenems
Anti Tumor Antibiotics
Anion Gap Acidosis 1 Nursing Mnemonic (KULT)
Anion Gap Acidosis 2 Nursing Mnemonic (MUDPILES)
Anion Gap
Angiotensin Receptor Blockers
Aneurysm and Dissection for Certified Emergency Nursing (CEN)
Anesthetic Agents
Anesthetic Agents
Aneurysm (Dissecting, Repair) for Progressive Care Certified Nurse (PCCN)
Anesthesia Management Assistance for Certified Perioperative Nurse (CNOR)
Anemia for Progressive Care Certified Nurse (PCCN)
Amputation for Certified Emergency Nursing (CEN)
Anaphylaxis Nursing Interventions for Certified Perioperative Nurse (CNOR)
Amputation Concept Map
Amputation
Amlodipine (Norvasc) Nursing Considerations
Amitriptyline (Elavil) Nursing Considerations
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Alteplase (tPA, Activase) Nursing Considerations
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Alkylating Agents
Alkaline Phosphatase (ALK PHOS) Lab Values
Alendronate (Fosamax) Nursing Considerations
Alanine Aminotransferase (ALT) Lab Values
Airway Suctioning
AIDS Case Study (45 min)
Age and Culturally Appropriate Health Assessment Techniques for Certified Perioperative Nurse (CNOR)
Advanced Directive and DNR Status Confirmation for Certified Perioperative Nurse (CNOR)
Advance Directives
Adrenal Gland Hormones Nursing Mnemonic (The 3 S’s)
Adrenal and Thyroid Disorder Emergencies for Certified Emergency Nursing (CEN)
Admissions, Discharges, and Transfers
Adjunct Neuro Assessments
Addisons Disease
Addisons Assessment Nursing Mnemonic (STEROID)
Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)
Acute Renal (Kidney) Module Intro
Acute Kidney Injury Case Study (60 min)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)
Acute Abdomen for Certified Emergency Nursing (CEN)
ACE (angiotensin-converting enzyme) Inhibitors
Accountability and Assistance for Personal Limitations for Certified Perioperative Nurse (CNOR)
Absolute Reticulocyte Count (ARC) Lab Values
Absolute Neutrophil Count (ANC) Lab Values
3rd Degree AV Heart Block (Complete Heart Block)
2nd Degree AV Heart Block Type 2 (Mobitz II)
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
1st Degree AV Heart Block
10.04 Pulmonary Question Review for CCRN Review
07.10 Neurologic Review questions for CCRN Review
07.09 Meningitis for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
06.04 Differentiating Ectopy and Aberrancy for CCRN Review
05.05 GI Practice Questions for CCRN Review
05.02 Liver Overview and Disease for CCRN Review
05.01 Pancreatitis and Large Bowel Obstruction for CCRN Review
03.04 DKA vs HHNK for CCRN Review
03.05 Endocrine Practice Questions for CCRN Review
03.03 Hypoglycemia for CCRN Review
03.02 Diabetes Insipidus for CCRN Review
03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review
02.18 Cardiovascular Practice Questions for CCRN Review
02.17 Septic Shock for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.15 Hypovolemic Shock for CCRN Review
02.14 Shock Stages for CCRN Review
02.13 Myocardial Infarction – Anterior Septal Wall for CCRN Review
02.02 Cardiomyopathy for CCRN Review
02.06 Heart Murmurs for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.12 Myocardial Infarction- Inferior Wall for CCRN Review