Nursing Care Plan (NCP) for Emphysema

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Study Tools For Nursing Care Plan (NCP) for Emphysema

COPD Pathochart (Cheatsheet)
Restrictive vs. Obstructive Lung Diseases (Picmonic)
Example Care Plan_Emphysema (Cheatsheet)
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Outline

Lesson Objectives for Emphysema

  • Definition and Understanding:
    • Define emphysema as a chronic obstructive pulmonary disease (COPD) characterized by the irreversible enlargement of airspaces in the lungs, leading to decreased elasticity and impaired airflow.
  • Pathophysiology:
    • Understand the underlying pathophysiology of emphysema, including the destruction of alveolar walls, loss of lung elasticity, and airflow limitation, resulting in air trapping and difficulty exhaling.
  • Risk Factors:
    • Identify and comprehend the common risk factors for emphysema, such as cigarette smoking, environmental exposures, and genetic predisposition, to recognize individuals at higher risk for developing the condition.
  • Clinical Manifestations:
    • Recognize the clinical manifestations of emphysema, including progressive dyspnea, chronic cough, barrel chest, and decreased exercise tolerance, to facilitate early diagnosis and intervention.
  • Management Strategies:
    • Learn about the management strategies for emphysema, encompassing pharmacological interventions, pulmonary rehabilitation, lifestyle modifications, and oxygen therapy, to optimize respiratory function and enhance quality of life.

Pathophysiology of Emphysema

 

  • Alveolar Wall Destruction:
    • Emphysema is characterized by the gradual destruction of the alveolar walls, leading to enlarged airspaces and a reduction in the surface area available for gas exchange.
  • Loss of Elasticity:
    • The destruction of elastic fibers in the lung tissue results in decreased lung elasticity, making it difficult for the airways to recoil during exhalation. This loss of elasticity contributes to air trapping.
  • Air Trapping:
    • Air becomes trapped in the enlarged alveoli and airways during exhalation, causing hyperinflation of the lungs. This hyperinflation leads to increased residual volume and decreased expiratory airflow.
  • Impaired Gas Exchange:
    • The combination of alveolar destruction and air trapping impairs gas exchange, leading to a decreased surface area for oxygen and carbon dioxide exchange, resulting in hypoxemia and hypercapnia.
  • Chronic Inflammation:
    • Chronic exposure to irritants, most notably cigarette smoke, triggers inflammation in the airways. The inflammatory response contributes to the destruction of lung tissue and further obstructs airflow.

Etiology of Emphysema

  • Cigarette Smoking:
    • The primary cause of emphysema is long-term exposure to cigarette smoke. The harmful chemicals in tobacco smoke induce chronic inflammation and damage to lung tissue.
  • Environmental Exposures:
    • Prolonged exposure to environmental pollutants, such as air pollution, occupational dust, and fumes, can contribute to the development of emphysema.
  • Genetic Factors:
    • Genetic predisposition plays a role in some cases of emphysema. Alpha-1 antitrypsin deficiency, an inherited condition, can lead to early-onset emphysema, especially in nonsmokers.
  • Aging:
    • Aging is a risk factor for emphysema, as the natural aging process contributes to changes in lung tissue and function.
  • Respiratory Infections:
    • Recurrent respiratory infections, especially during childhood, may contribute to the development of emphysema by causing chronic inflammation and lung damage.

Desired Outcome for Emphysema

  • Improved Respiratory Function:
    • Enhance respiratory function to optimize oxygenation and reduce the symptoms of dyspnea, leading to improved overall quality of life.
  • Effective Airway Clearance:
    • Facilitate effective airway clearance to minimize air trapping, reduce the risk of respiratory infections, and enhance the patient’s ability to breathe more comfortably.
  • Enhanced Exercise Tolerance:
    • Improve exercise tolerance and endurance to support physical activity and reduce the impact of respiratory limitations on daily activities.
  • Minimized Respiratory Distress:
    • Minimize respiratory distress by managing symptoms such as chronic cough and breathlessness, contributing to a more comfortable and stable respiratory status.
  • Patient Education and Self-Management:
    • Provide comprehensive education on the disease process, medications, breathing techniques, and lifestyle modifications to empower the patient in self-management and foster adherence to the treatment plan.

Emphysema Nursing Care Plan

 

Subjective Data:

  • Chronic cough
  • Difficulty breathing 
  • Notice avoiding certain activities 
  • Chest tightness/pain

Objective Data:

  • Wheezing
  • SOB- especially upon exertion 
  • Oxygenation saturation decrease 
  • Blue/grey lips or fingernails 
  • Inability to speak full sentences 
  • Swelling/edema 
  • Tachycardia 
  • Barrel chest 
  • “Pink puffers” (difficulty catching their breath, face redden while gasping for air)

Nursing Assessment for Emphysema

 

  • Respiratory Status:
    • Monitor respiratory rate, rhythm, and effort, assessing for signs of increased work of breathing, dyspnea, or use of accessory muscles during respiration.
  • Oxygenation Levels:
    • Assess oxygen saturation levels through pulse oximetry to determine the effectiveness of gas exchange and the need for supplemental oxygen therapy.
  • Cough and Sputum Production:
    • Evaluate the frequency and characteristics of cough, including the presence of sputum. Monitor for changes that may indicate infection or worsening lung function.
  • Activity Tolerance:
    • Assess the patient’s ability to engage in activities of daily living and exercise. Identify limitations and evaluate changes in exercise tolerance over time.
  • Nutritional Status:
    • Evaluate the patient’s nutritional status, as malnutrition can impact respiratory muscle function. Collaborate with dietitians to develop strategies for maintaining or improving nutritional status.
  • Medication Adherence:
    • Assess the patient’s adherence to prescribed medications, including bronchodilators, anti-inflammatory agents, and supplemental oxygen. Identify any barriers to adherence and provide education as needed.
  • Psychosocial Assessment:
    • Perform a psychosocial assessment to identify emotional well-being, coping mechanisms, and potential anxiety or depression related to the chronic nature of the disease.
  • Home Environment:
    • Assess the home environment for potential respiratory irritants or pollutants. Provide guidance on creating a lung-friendly home environment.

 

Implementation for Emphysema

 

  • Pharmacological Management:
    • Administer bronchodilators and anti-inflammatory medications as prescribed to improve airway function and reduce inflammation. Educate the patient on proper inhaler techniques and the importance of medication adherence.
  • Oxygen Therapy:
    • Administer supplemental oxygen therapy as prescribed to maintain adequate oxygenation. Monitor oxygen saturation levels and adjust the flow rate to achieve target levels. Educate the patient on the proper use of oxygen equipment.
  • Pulmonary Rehabilitation:
    • Facilitate enrollment in pulmonary rehabilitation programs to enhance exercise tolerance, provide education on breathing techniques, and improve overall respiratory function. Collaborate with rehabilitation specialists to tailor the program to the patient’s needs.
  • Lifestyle Modifications:
    • Encourage and support lifestyle modifications, including smoking cessation, regular exercise, a healthy diet, and avoidance of environmental pollutants. Provide resources and referrals to smoking cessation programs if applicable.
  • Patient Education:
    • Provide comprehensive education on the nature of emphysema, self-management strategies, symptom recognition, and the importance of regular follow-up appointments. Empower the patient to actively participate in their care and make informed decisions.

Nursing Interventions and Rationales

 

Auscultate lung sounds If wheezy they may need a breathing treatment If you hear crackles, they may have pneumonia and potentially could use suctioning.
Monitor ABGs Blood gases help to determine if the patient is in respiratory acidosis.
Encourage a healthy weight Early stages of emphysema: overweight Late stages of emphysema: underweight Having excess weight on the patient decreases the space for the lungs to expand. In later stages of emphysema, the patient can be very thin (barrel-chested) and it is important to make sure they are getting the proper nutrition, so their body is at the optimal performance (for that patient).
Monitor Oxygen saturation ****Give oxygen as ordered and needed. Be careful about turning their drive to breath off by giving too much O2, as a general rule, emphysema patients should be kept around 88%-92%. ****
Breathing treatments and medications- Beta-Agonists: Such as albuterol work as bronchodilators

Anticholinergics: Such as Ipratropium work to relax bronchospasms

Corticosteroids: Such as Fluticasone work as an anti-inflammatory

Assess for/Administer influenza vaccine and pneumococcal vaccine Preventing complications such as influenza or pneumonia is important because the lungs are already working harder to keep the body balanced with oxygen and CO2, an increased risk of infection only complicates the patient’s ability to breathe.

Evaluation for Emphysema

 

  • Respiratory Function:
    • Monitor improvements in respiratory function, including changes in respiratory rate, oxygen saturation levels, and ease of breathing. Evaluate the impact of interventions on reducing dyspnea and respiratory distress.
  • Exercise Tolerance:
    • Assess changes in exercise tolerance and endurance through standardized exercise testing or functional assessments. Document improvements and adjust rehabilitation programs as needed.
  • Medication Adherence:
    • Evaluate the patient’s adherence to prescribed medications. Monitor for any side effects or complications and address barriers to adherence through patient education and support.
  • Quality of Life:
    • Measure changes in the patient’s overall quality of life, considering factors such as physical function, emotional well-being, and social participation. Assess for improvements in daily activities and independence.
  • Prevention of Complications:
    • Evaluate the prevention of complications such as respiratory infections and exacerbations. Monitor for signs of infection and assess the effectiveness of preventive measures implemented in the care plan.


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Transcript

Hey everyone. Today, we are going to be creating a nursing care plan for emphysema. So, let’s get started. First, we’re going to go over the pathophysiology. So, emphysema is when the air sacs of the lungs or the alveoli are damaged over time; the inner walls are weakened, and they lose their elasticity and rupture, which creates larger air sacs. This will reduce the surface area of the lungs and cause CO2 to stay in the alveoli and not be exhaled out of the body; this makes it harder for the O2 to enter into the alveoli. Some nursing considerations: you want to do a full respiratory assessment, monitor ABGs, O2 saturation, maintain a healthy weight, administer medications, and administer the influenza and the pneumococcal vaccine. Some desired outcomes: you’re going to have clear, even, non-labor breathing while maintaining optimal oxygenation and optimal ventilation for the patient. 

So, we’re going to go ahead and create our care plan. We’re going to have some subjective data and we’re going to have some objective data that we’re going to be writing down. So, we’re going to see what we are, are we going to see with our patients? So, with our patients, some of the subjective data you’re going to have is a chronic cough and difficulty breathing. These patients have a very hard time breathing. Some objective data: you guys probably have heard it before – they are the pink puffers. And what does that mean? Pink puffers. Basically, they’re having difficulty catching their breath. So, they’re red in the face while they’re gasping for that air. You’ll also notice with these patients, they may have some wheezing and tachycardia, or an increased heart rate. Some other things they’ll notice is avoiding certain activities because they won’t be able to breathe as easily, some chest tightness and pain, some shortness of breath, especially upon exertion, and decreased O2 saturation. You might see some blue gray lips or clubbing on the fingernails and an inability to speak full sentences. Swelling, edema, and barrel chest are pretty common with these patients. 

So, some interventions: we want to make sure that we’re going to auscultate those lung sounds. So, we’re going to listen to those lungs. If they’re wheezy, they may need a breathing treatment. If you hear any crackles, they may have pneumonia, and that could be potentially in need of some use of suctioning. Some other interventions: we’re going to be monitoring the ABGs; blood gases are going to help determine if they are in any sort of respiratory acidosis. We want to encourage a healthy weight, especially early stages of emphysema – they are overweight, and in late stages of emphysema, they’re underweight. So, they’re going to monitor their weight. Having excess weight on a patient decreases the space for the lungs to be able to expand. In the later stages of emphysema, the patient can be very thin or barrel chested. And it’s very important to make sure that they’re getting enough proper nutrition so that their body is at the optimal performance for that patient. We also want to monitor their O2 sats. We want to give oxygen as ordered as needed, but you want to be careful about turning their drive to breathe off by giving them too much. So, as a general rule and a super, super important thing that I want you guys to know is that any emphysema patient should be kept around 88 to 92%. Very, very important. Another invention for these patients is going to be giving them any sort of breathing treatments and medication. So certain medications we would give are beta agonists. There’s also long-acting bronchodilators and corticosteroids. So, with the beta agonist, such as albuterol, they work as bronchodilators. They’re going to help open up the airway for the patients. Long-acting bronchodilators, such as spiriva, work to relax any sort of bronchospasms, and corticosteroids, such as fluticasone, work as anti-inflammatory. So, these are great medications for the patient. Another intervention we want to do, we want to assess and or administer the influenza vaccine and the pneumococcal vaccine. So, the influenza and the pneumococcal. So, we want to prevent any sort of complications such as influenza or pneumonia, which is important because the lungs are already working harder to keep the body balanced with the oxygen and the CO2. So, an increased risk of infection only complicates the patient’s ability to breathe. 

So, we’ve got our completed care plan. We’re going to go ahead and go through some key points. So, pathophysiology etiology emphysema is when the air sacs and the lungs where the alveoli are damaged over time, the inner walls of the sacs weaken, losing their elasticity and rupturing can be caused by exposure to irritants in the air, such as smoking chemicals, and air pollutants. Some subjective and objective data: You’ll see with the patient, they’ll have a chronic cough, difficulty breathing, and wheezing. It’s those pink puffers, right? Tachycardia decreased O2 saturation, inability to speak in full sentence, blue, gray lips, and barrel chested. We want to make sure we’re doing a respiratory assessment. So, we want to make sure we’re monitoring their ABGs, monitoring their O2 sats, encouraging a healthy weight, giving medications and vaccines. So, we want to make sure that we’re educating them on these meds and also educating the importance of the influenza and the pneumococcal vaccines to prevent any further complications. All right, we are completed with this care plan. 

You guys did amazing. We love you guys. Go out, be your best self today and as always happy nursing.

 

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Nursing Care Plan (NCP) for Glomerulonephritis
Nursing Care Plan (NCP) for Glaucoma
Nursing Care Plan (NCP) for GI (Gastrointestinal) Bleed
Nursing Care Plan (NCP) for Gastroesophageal Reflux Disease (GERD)
Nursing Care Plan (NCP) for Enuresis / Bedwetting
Nursing Care Plan (NCP) for Encephalopathy
Nursing Care Plan (NCP) for Emphysema
Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Dementia
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Chronic Obstructive Pulmonary Disease (COPD)
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Cellulitis
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Bowel Obstruction
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Benign Prostatic Hyperplasia (BPH)
Nursing Care Plan (NCP) for Bell’s Palsy
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Aspiration
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Anemia
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
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