Nursing Care Plan (NCP) for Diabetes Insipidus
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Study Tools For Nursing Care Plan (NCP) for Diabetes Insipidus
Diabetes Insipidus Assessment (Picmonic)
Diabetes Insipidus Pathochart (Cheatsheet)
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Outline
Lesson Objective for Diabetes Insipidus (DI)
- Understanding of Diabetes Insipidus:
- Define Diabetes Insipidus, distinguishing it from other forms of diabetes.
- Explain the pathophysiology of DI, emphasizing the role of antidiuretic hormone (ADH) and its impact on fluid balance.
- Identification of Signs and Symptoms:
- Recognize the clinical manifestations of Diabetes Insipidus, including excessive thirst, polyuria, and potential electrolyte imbalances.
- Understand the importance of early detection and prompt intervention to prevent complications.
- Diagnostic Methods:
- Discuss the diagnostic procedures used to confirm Diabetes Insipidus, such as water deprivation tests and vasopressin challenge tests.
- Understand the significance of laboratory results, including urine osmolality and specific gravity.
- Management Strategies:
- Explore pharmacological interventions for DI, including the use of desmopressin and other medications.
- Discuss non-pharmacological measures, such as fluid management and lifestyle modifications, to control symptoms.
- Patient Education and Self-Care:
- Emphasize the importance of patient education in managing Diabetes Insipidus.
- Provide information on self-monitoring, medication adherence, and lifestyle adjustments to empower individuals with DI to actively participate in their care.
Pathophysiology of Diabetes Insipidus (DI)
- Role of Antidiuretic Hormone (ADH):
- Diabetes Insipidus is characterized by a deficiency or dysfunction of antidiuretic hormone (ADH), also known as vasopressin.
- ADH, produced by the hypothalamus and released by the pituitary gland, plays a crucial role in regulating water balance by controlling the reabsorption of water in the kidneys.
- Decreased ADH Secretion or Action:
- Central Diabetes Insipidus (CDI) results from insufficient production or release of ADH.
- Nephrogenic Diabetes Insipidus (NDI) occurs when the kidneys fail to respond to ADH, reducing their ability to concentrate urine.
- Effect on Renal Tubules:
- In the absence of adequate ADH, the renal tubules do not reabsorb enough water, leading to the excretion of large volumes of dilute urine.
- This results in polyuria (increased urine output) and polydipsia (excessive thirst) as the body attempts to compensate for fluid loss.
- Causes of ADH Dysfunction:
- CDI may be caused by trauma, tumors, or other conditions affecting the hypothalamus or pituitary gland.
- NDI can be congenital or acquired, often due to kidney disorders, medications, or electrolyte imbalances.
- Impact on Electrolyte Balance:
- Excessive loss of water in urine can disrupt electrolyte balance, potentially leading to hypernatremia (elevated sodium levels) and dehydration.
- Patients with DI may experience symptoms such as fatigue, weakness, and, in severe cases, neurological complications.
Etiology of Diabetes Insipidus (DI)
- Central Diabetes Insipidus (CDI):
- Trauma: Head injuries or surgical trauma to the hypothalamus or pituitary gland can disrupt ADH production or release.
- Tumors: Benign or malignant tumors in the hypothalamus or pituitary gland may affect ADH synthesis.
- Infections: Inflammatory conditions, infections, or autoimmune disorders may damage the structures involved in ADH regulation.
- Nephrogenic Diabetes Insipidus (NDI):
- Congenital Factors: NDI can be inherited genetically, leading to impaired responsiveness of the renal tubules to ADH.
- Acquired Causes: Certain medications (e.g., lithium, demeclocycline), electrolyte imbalances, or chronic kidney diseases can contribute to acquired NDI.
- Psychogenic Polydipsia:
- Excessive water intake, often due to psychological factors, can overwhelm the kidneys’ ability to concentrate urine, mimicking symptoms of DI.
- Gestational DI:
- Pregnancy-related factors, such as the production of vasopressinase by the placenta, can contribute to a transient form of DI during pregnancy.
- Idiopathic DI:
- In some cases, the cause of DI may be unknown, and the condition is classified as idiopathic.
Desired Outcomes for Diabetes Insipidus (DI)
- Normalization of Urine Output:
- Achieve urine output within the normal range to prevent dehydration and maintain adequate fluid balance.
- Correction of Electrolyte Imbalances:
- Stabilize and maintain electrolyte levels, especially sodium, within the normal range to prevent complications such as hypernatremia.
- Symptom Relief:
- Alleviate symptoms associated with DI, including excessive thirst and polyuria, to improve the patient’s overall quality of life.
- Prevention of Dehydration:
- Implement measures to prevent dehydration by ensuring adequate fluid intake and monitoring urine output, especially during periods of increased fluid loss.
- Identification and Management of Underlying Causes:
- Address and manage any underlying conditions or causes of DI, such as trauma, tumors, or medications, to prevent recurrence and promote long-term stability.
Diabetes Insipidus Nursing Care Plan
Subjective Data:
- Excessive thirst
- Polyuria, excessive urination
- Headache
- Fatigue
- Nausea
- Dry mouth
- Loss of appetite
- Muscle cramps
- Confusion
Objective Data:
- Dry mucous membranes
- Tachycardia
- Weight loss
- Hypotension
- Hypernatremia
- Decreased skin elasticity
Nursing Assessment for Diabetes Insipidus (DI)
- Fluid Balance Assessment:
- Monitor fluid intake and output to identify imbalances, excessive urine output, and potential dehydration.
- Urine Characteristics:
- Assess urine volume, color, and concentration to detect signs of diluted urine, a characteristic feature of DI.
- Thirst and Oral Intake:
- Evaluate the patient’s thirst level and oral fluid intake to determine if excessive fluid loss is triggering compensatory increased intake.
- Vital Signs Monitoring:
- Regularly measure vital signs, including blood pressure, heart rate, and respiratory rate, to identify signs of dehydration or imbalances.
- Electrolyte Levels:
- Monitor serum electrolyte levels, especially sodium, to detect and address any imbalances resulting from increased urine output.
- Weight Changes:
- Track changes in the patient’s weight to assess for signs of fluid retention or loss.
- Neurological Assessment:
- Conduct a neurological assessment to identify symptoms such as confusion, irritability, or lethargy, which may indicate electrolyte imbalances.
- Patient History:
- Gather a comprehensive medical history, including any recent head trauma, surgery, medications, or underlying conditions, to identify potential causes of DI.
Implementation for Diabetes Insipidus (DI)
- Fluid Replacement:
- Administer prescribed fluids orally or intravenously to maintain adequate hydration and replace fluid losses.
- Medication Administration:
- Administer prescribed medications, such as desmopressin, to manage DI symptoms by promoting water reabsorption in the kidneys.
- Monitor Electrolytes:
- Regularly assess electrolyte levels, especially sodium, and administer electrolyte replacement therapy as directed to maintain balance.
- Patient Education:
- Educate the patient and caregivers on the importance of consistent fluid intake, medication adherence, and recognizing signs of dehydration.
- Safety Measures:
- Implement safety measures to prevent injury related to dehydration or electrolyte imbalances, such as falls or confusion.
Nursing Interventions and Rationales
- Monitor I & O, daily weights, and polydipsia
Weight loss will occur with excessive fluid loss. Thirst can be an indicator of fluid balance.
- Monitor for signs / symptoms of hypovolemia
Excess fluid loss results in decreased circulatory volume. Early detection and intervention can prevent hypovolemic shock from occurring.
- Monitor for signs of hypotension and provide education and assistance with ambulation
Dehydration and hypernatremia can cause the blood pressure to drop which may result in dizziness or weakness with position changes. Assist patient when standing or walking to prevent falls and injury. Educate patient to make slow changes in position.
- Encourage hydration and provide easy access to fluids; administer IV fluids if necessary
- Hypotonic- D5W or 0.45% sodium chloride
- Isotonic – NS (0.9% sodium chloride) if hemodynamically unstable
If the patient has intact thirst, offer plenty of fluids to prevent dehydration. If the patient cannot orally tolerate fluids, initiate IV fluids.
- Monitor labs / electrolyte balance
- Serum and urine osmolality
- Serum and urine sodium levels
- Serum potassium
Excess fluid loss results in the body excreting potassium and retaining sodium. This results in too much sodium and too little potassium in the blood.
- Administer medications appropriately
- Chlorpropamide or carbamazepine – stimulates the release of vasopressin (ADH)
- Hydrochlorothiazide- may be used for nephrogenic DI
- Aqueous vasopressin – used for short term DI
- Pitressin tannate is a long-acting vasopressin
Depending on the type of diabetes insipidus, medications may be given to stimulate the production of vasopressin, or it may be given as a supplement. When giving medications, monitor for effectiveness and changes in blood pressure due to changes in fluid balance.
- Provide easy access to bathroom
Frequent urination can be frustrating for the patient. Provide easy access for voiding including urinal or bedside commode as appropriate.
- Prevent injury and initiate fall precautions
Frequent trips to the bathroom can increase the risk of falls. Provide assistance as needed with ambulation, especially if patient has confusion, muscle cramps or muscle weakness from electrolyte imbalance.
- Assess for skin integrity, apply skin barriers as needed
Polyuria may lead to bouts of incontinence and increase the risk of skin breakdown. Apply barriers and precautions as necessary to avoid redness or excoriation.
Evaluation for Diabetes Insipidus (DI)
- Fluid Balance:
- Monitor and assess the patient’s fluid balance, ensuring that urine output has stabilized and that the patient is adequately hydrated.
- Symptom Improvement:
- Evaluate the reduction or resolution of DI symptoms, such as excessive thirst, polyuria, and nocturia.
- Electrolyte Levels:
- Review electrolyte levels, especially sodium, to ensure they are within the normal range, indicating appropriate management of water and electrolyte balance.
- Medication Effectiveness:
- Assess the effectiveness of prescribed medications, such as desmopressin, in controlling DI symptoms without causing adverse effects.
- Patient and Caregiver Understanding:
- Evaluate the patient and caregiver’s understanding of self-care measures, including fluid management, medication administration, and recognizing signs of dehydration.
References
- https://www.mayoclinic.org/diseases-conditions/diabetes-insipidus/symptoms-causes/syc-20351269
- https://www.niddk.nih.gov/health-information/kidney-disease/diabetes-insipidus
- https://www.webmd.com/diabetes/guide/what-is-diabetes-insipidus#1
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Transcript
Hey guys, in this care plan, we are going to be discussing diabetes insipidus. What we’re going to look at here is a description of diabetes insipidus. We’re going to look at subjective and objective data associated with it and then we’re going to look at nursing interventions and rationales.
Alright, so diabetes insipidus is a condition where the kidneys are not able to retain water in the way that they should. This means that the kidneys are creating extremely large amounts of dilute and even odorless urine actually, they can have up to 20 quarts a day. So, we’re looking at a very extreme, increased urine output. Normal urine output is about one to two quarts per day and like I said, you can have up to 20 with diabetes insipidus because of this excess urine production. The patient becomes really dehydrated and feels very thirsty and you can get some really abnormal electrolytes.
Okay, so let’s think a little bit about how this actually may happen. So, the hypothalamus in the brain is actually what secretes a hormone called vasopressin, which is an antidiuretic hormone. So, this antidiuretic hormone is actually what tells the kidneys how much fluid they need to absorb. So, usually vasopressin is released from the hypothalamus when the body needs to retain fluid for some reason. So maybe, they’ve lost blood but for some reason, the body needs more fluid. Now, if the hypothalamus isn’t able to release vasopressin because it’s been damaged, you get something called central diabetes insipidus or CDI. If the kidneys aren’t able to respond to vasopressin that is in the body, you get something called nephrogenic diabetes, insipidus or NDI. So, those are the two different types of diabetes insipidus to be aware of. Either way, what happens is that the kidneys won’t know when to stop removing fluid from the body and the patient is going to have excess urine production. When you have this, you may see diabetes insipidus.
The desired outcome for a patient who has this diagnosis is to prevent dehydration, manage symptoms and prevent complications. Often the complications are about those abnormal electrolytes that I mentioned. Okay, so let’s get into the care plan.
The subjective data that you’re going to see with diabetes insipidus are excessive thirst, polyuria, excessive urination, headache, fatigue, nausea, dry mouth, loss of appetite, muscle cramps and confusion.
The objective data that you will see with this diagnosis are again, dry mucous membranes, tachycardia, weight loss, hypotension, hypernatremia and decreased skin elasticity. Also, you can see how with both of these, they’re directly linked to fluid abnormalities and electrical abnormalities.
Your first nursing intervention here is to keep a super close eye on the patient’s eyes, nose, weight and their level of thirst. Now, it’s important, so important that we know exactly what the patient is taking in. So, their intake and what their output is. We need to know every time they go to the bathroom and we need to know exactly how much they’re urinating. Also, remember that weight loss can occur with excessive fluid loss, and extreme thirst may be a clue that the patient’s fluid loss has actually worsened in extreme cases. If the dehydration becomes severe enough, the patient may actually show signs and symptoms of hypovolemia and possibly even shock in really severe cases. So, if this happens, you’re going to notice changes in vital signs. So, you’re going to notice an increased heart rate. You’re going to notice tachypnea as well, so increased respiratory rate and a decrease in blood pressure. So, we just mentioned that you might see a drop in blood pressure. If they’ve got low volume, if this happens, it’s really important to provide education and assistance with ambulation. You want to be looking for signs like dizziness and then really, you want to educate patients on how to make sure that we can avoid falls as much as possible, and then they may need assistance with their ambulation.
Okay, this next innovation intervention is super important. These patients are going to need fluids. So, we’ve got to encourage hydration and make sure that patients have access to fluids. Sometimes IV fluids are going to be necessary if they become hemodynamically unstable. Alright, so we’ve been talking about fluid balance a lot, but next we need to pay really close attention to the patient’s electrolyte balance. The way that we keep a close eye on this is to check urine and serum osmolality as well as our sodium and potassium levels. When the body is losing an excess amount of fluid, you’re going to see potassium excreted excessively as well. So, you’re going to end up with hypokalemia, but the opposite of that is going to happen with your sodium because your body’s going to retain the sodium and you’re going to end up with hypernatremia. So, when you’re looking at these electrolytes, you want to look for hypernatremia and hypokalemia.
The next thing we may need to do is actually to give medications. I’ve listed the really important ones here for you to see. So, the chlorpropamide may be given to stimulate the release of vasopressin. Hydrochlorothiazide may be given to treat nephrogenic diabetes insipidus, which again, remember is when the kidneys can’t respond to the vasopressin that’s already circulating in the body. Aqueous vasopressin may be given to treat short-term diabetes insipidus and the Pitressin tannate is a long-acting vasopressin. Now, remember, anytime you give your medication, it’s really important to monitor for the effectiveness of that medication. So, we want to be looking for changes in blood pressure and changes in fluid balance okay? Remember, these patients are at risk for hypotension, dizziness and electrolyte imbalances. So, it’s really important to include this in your nursing intervention, how to prevent injury and reduce the risk of falls. This means providing assistance to the bathroom and easy, easy access to the bathroom as well. Lastly, here, because of the frequent urination, some patients may actually experience incontinence. If that happens, they’re at increased risk for skin breakdown, therefore it’s essential that we continually assess skin integrity and apply skin barriers as needed.
Alright, that’s it for our lesson on diabetes insipidus. We love you guys. Now, go out and be your very best self today and as always, happy nursing!
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Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Hypertension (HTN) Concept Map
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypertensive Crisis Case Study (45 min)
Hyperthermia (Thermoregulation)
Hyperthyroidism Case Study (75 min)
Hypertonic Solutions (IV solutions)
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypoglycemia
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Hypoparathyroidism
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)