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Nursing Care Plan (NCP) for Respiratory Failure

Nursing Care Plan (NCP) for Respiratory Failure

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Study Tools For Nursing Care Plan (NCP) for Respiratory Failure

Respiratory Anatomy (Picmonic)
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Outline

Lesson Objectives for Respiratory Failure

  • Understanding Respiratory Failure:
    • Define respiratory failure as a condition in which the respiratory system is unable to maintain adequate gas exchange, leading to a mismatch between oxygen supply and demand and impaired removal of carbon dioxide.
  • Types and Causes of Respiratory Failure:
    • Differentiate between hypoxemic and hypercapnic respiratory failure and identify common causes, including lung diseases, neuromuscular disorders, chest wall abnormalities, and central nervous system dysfunction.
  • Clinical Manifestations:
    • Recognize the signs and symptoms of respiratory failure, such as dyspnea, tachypnea, altered mental status, cyanosis, and respiratory distress. Understand the importance of early identification for prompt intervention.
  • Diagnostic Approaches:
    • Explore diagnostic methods for assessing respiratory failure, including arterial blood gas analysis, chest imaging (X-ray, CT scan), pulmonary function tests, and other relevant laboratory tests. Understand the significance of these assessments in determining the underlying cause.
  • Management and Nursing Interventions:
    • Learn about the principles of managing respiratory failure, including oxygen therapy, mechanical ventilation, bronchodilator therapy, and supportive care. Understand the role of nursing interventions in monitoring respiratory status and providing comprehensive care to patients.

Pathophysiology of Respiratory Failure

 

  • Impaired Oxygenation:
    • Respiratory failure involves a disruption in the exchange of oxygen and carbon dioxide in the lungs. In hypoxemic respiratory failure, there is inadequate oxygenation of the blood, leading to decreased oxygen levels in arterial blood.
  • Ventilation-Perfusion Mismatch:
    • Hypoxemic respiratory failure often results from a ventilation-perfusion mismatch, where the airflow to certain lung areas does not match the blood flow, impairing the exchange of gases. This can occur in conditions such as pneumonia or acute respiratory distress syndrome (ARDS).
  • Alveolar Hypoventilation:
    • Hypercapnic respiratory failure is characterized by inadequate removal of carbon dioxide. This may occur due to conditions that affect the respiratory centers in the brain, neuromuscular disorders, or conditions leading to increased airway resistance.
  • Alveolar Collapse and Atelectasis:
    • In some cases, respiratory failure may involve alveolar collapse and atelectasis, reducing the surface area available for gas exchange. This can occur in conditions such as acute lung injury or after surgery.

Etiology of Respiratory Failure

  • Pulmonary Conditions:
    • Chronic obstructive pulmonary disease (COPD), asthma, pneumonia, and acute respiratory distress syndrome (ARDS) are common pulmonary conditions that can lead to respiratory failure.
  • Neuromuscular Disorders:
    • Conditions affecting the neuromuscular system, such as Guillain-Barré syndrome, myasthenia gravis, or amyotrophic lateral sclerosis (ALS), can impair the muscles involved in breathing, contributing to respiratory failure.
  • Chest Wall Abnormalities:
    • Chest wall deformities or injuries that restrict lung expansion, such as kyphoscoliosis or severe trauma, can lead to respiratory failure by limiting the ability of the lungs to inflate.
  • Central Nervous System Dysfunction:
    • Disorders affecting the central nervous system, including brainstem injuries, strokes, or drug overdose, can disrupt the normal control of breathing, leading to respiratory failure.
  • Environmental Factors:
    • Exposure to toxins, smoke inhalation, or near-drowning incidents can result in acute respiratory failure. Inhalation of harmful substances can damage lung tissue and compromise respiratory function.

Desired Outcome for Respiratory Failure

  • Improved Oxygenation:
    • Achieve and maintain adequate oxygenation, as evidenced by normal or improved arterial blood gas values and relief of hypoxia-related symptoms.
  • Effective Ventilation:
    • Ensure effective removal of carbon dioxide, demonstrating normalized or improved levels of partial pressure of carbon dioxide (PaCO2) and resolution of hypercapnia-related symptoms.
  • Stabilized Respiratory Status:
    • Attain respiratory stability with a reduction in respiratory rate, improved lung sounds, and absence of signs of respiratory distress.
  • Enhanced Mobility and Function:
    • Promote increased activity tolerance and mobility, indicating improved respiratory function and reduced fatigue.
  • Patient and Family Education:
    • Provide education to the patient and their family regarding respiratory management, including medication adherence, recognizing early signs of respiratory distress, and when to seek medical attention.

Respiratory Failure Nursing Care Plan

 

Subjective Data:

  • Feeling SOB
  • Respiratory distress
  • Confusion
  • Lethargy

Objective Data:

  • Hypoxia
  • Hypercapnia
  • Blue skin, lips, nail beds, etc.
  • Arrhythmias
  • Increased RR
  • Decreased RR
  • Increased breathing workload
  • Low Sp02
  • Decreasing the level of consciousness

Nursing Assessment for Respiratory Failure

 

  • Respiratory Rate and Pattern:
    • Monitor respiratory rate, depth, and pattern regularly, noting any signs of increased work of breathing, use of accessory muscles, or irregularities.
  • Oxygen Saturation:
    • Continuously assess oxygen saturation levels through pulse oximetry, ensuring they remain within the target range and adjusting oxygen therapy as needed.
  • Breath Sounds:
    • Auscultate lung sounds to identify any adventitious sounds, changes in breath sounds, or the presence of wheezing, crackles, or diminished breath sounds.
  • Neurological Status:
    • Evaluate neurological status, including level of consciousness, orientation, and response to stimuli, as respiratory failure can impact cerebral oxygenation.
  • Hemodynamic Parameters:
    • Monitor vital signs, especially blood pressure and heart rate, to assess cardiovascular stability and the impact of respiratory failure on overall hemodynamics.
  • Fluid Balance:
    • Assess fluid balance by monitoring input and output, as well as signs of fluid retention or dehydration, which can affect respiratory function.
  • Chest X-ray and Imaging:
    • Collaborate with the healthcare team to obtain and interpret chest X-rays or other imaging studies to assess lung parenchyma, identify consolidations, or rule out complications like pneumothorax.
  • Psychosocial Assessment:
    • Evaluate the patient’s psychosocial well-being and assess for signs of anxiety or emotional distress related to respiratory compromise. Offer emotional support and involve the patient in decision-making regarding their care.

 

Implementation for Respiratory Failure

 

  • Oxygen Therapy:
    • Administer supplemental oxygen as prescribed to maintain target oxygen saturation levels. Monitor and adjust oxygen flow rates or delivery devices based on frequent assessments of the patient’s respiratory status.
  • Mechanical Ventilation:
    • Collaborate with the respiratory therapy team and assist in the management of mechanical ventilation if indicated. Monitor ventilator settings, respiratory mechanics, and collaborate with the healthcare team to optimize ventilatory support.
  • Positioning and Mobilization:
    • Encourage and assist with proper patient positioning to optimize lung expansion. Promote early mobilization to prevent complications related to immobility, enhance lung function, and improve overall patient outcomes.
  • Medication Administration:
    • Administer prescribed medications such as bronchodilators, corticosteroids, or neuromuscular blocking agents as directed. Monitor for therapeutic effects and potential side effects, adjusting doses as needed.
  • Fluid and Nutritional Support:
    • Collaborate with the healthcare team to provide appropriate fluid and nutritional support. Monitor fluid balance, administer intravenous fluids as prescribed, and ensure adequate nutrition to support respiratory function and overall recovery.

Nursing Interventions and Rationales

 

  • Maintain patent airway
  • Some patients with trauma or neurological injury may require frequent suctioning and/or oropharyngeal airway/nasopharyngeal airway/intubation to ensure adequate oxygen delivery
  • Obtain and evaluate labs (ABG)
  • This will reveal the level of decompensation as well as if interventions are effective
  • Complete a full respiratory assessment to detect changes or further decompensation as early as possible, and notify MD as indicated
  • Enables quicker interventions and may change them (for example, wheezing noted on auscultation would potentially indicate steroids and a breathing treatment, while crackles could require suctioning, repositioning, and potential fluid restriction)
  • Provide supplemental oxygen as appropriate
  • Supplemental oxygen will ideally increase their oxygen levels. (Use caution with COPD patients, as they cannot breathe out the CO2 adequately, so over-oxygenation is a concern, and they also may have a lower baseline SpO2 level)
  • Ensure patient is in the optimal position to decrease work of breathing
  • Sitting up in bed to enable appropriate lung expansion allows for adequate inspiration and expiration, which facilitates better gas exchange (if clinically appropriate to be sitting up)
  • Prepare for rapid sequence intubation, if necessary
  • Helpful to be prepared, as this can progress quickly. Know where the necessary meds and equipment are and how to get ahold of assistive personnel.
  • Remove any negative/distracting stimuli: turn the TV off, encourage family members to be calm
  • When patients are anxious or cannot focus it can increase their work of breathing and exacerbate the issue. Promote a calming environment so all the patient has to worry about is breathing.
  • Prevent ventilator acquired pneumonia (VAP) if the patient is intubated
  • If the patient becomes intubated, prevent this major further complication
  • Provide oral care
  If a patient is intubated or receiving oxygen via nasal cannula/face mask or tent, or other methods of delivery, oral care is essential to protect the mucous membrane and prevent infection
  • Cluster care
  • Decreases oxygen demands if the patient’s rest can be maximized
  • Promote appropriate nutrition
  • Malnourishment is common with chronic lung disease, and appropriate nutrition provides the patient support for healing
  • Assist to treat underlying causes. If the patient has pneumonia, administering antibiotics is essential to healing, if the patient has a PE, administer appropriate blood thinners, if the patient has asthma, you’re auscultating lungs sounds before and after to evaluate effectiveness.
  • The underlying cause must be treated and routinely reevaluated for the patient to progress.
  • Monitor for conditions that can increase the oxygen demands (fever, anemia)
  • Frequently other things are going on, so make sure you’re being diligent in addressing them to give the patient the best opportunity to maximize their gas exchange (treat the fever, administer blood products, etc.)
  • Prevent aspiration pneumonia in patients who cannot maintain their airway
  Hypoxia can cause lethargy and a decreasing LOC; should they aspirate on their secretions this will put them at a significantly increased risk for aspiration pneumonia, which would further impair gas exchange and respiratory failure
  • Manage secretions
  • Tough to allow appropriate gas exchange in a patient if they cannot handle their secretions and are using effort to cough/clear their airway, or if it is getting down into their trachea.
  • Assess ability to swallow safely post-intubation
  • Vocal cords may be irritated and have edema if a patient has been intubated and if give oral intake too quickly too early, patients can easily aspirate. Many facilities require patients to wait for 12-24 hrs post-intubation to resume regular oral intake as well as a swallow evaluation.

Evaluation for Respiratory Failure

 

  • Respiratory Status:
    • Regularly assess and document changes in respiratory rate, depth, and pattern. Evaluate the effectiveness of interventions in improving oxygenation and ventilation.
  • Oxygen Saturation:
    • Monitor and evaluate oxygen saturation levels to ensure they remain within the target range. Adjust oxygen therapy as needed based on ongoing assessments.
  • Ventilator Parameters:
    • Evaluate and document ventilator parameters for patients on mechanical ventilation. Assess the patient’s response to ventilation and collaborate with the respiratory therapy team to optimize settings.
  • Patient Mobility:
    • Assess improvements in patient mobility and tolerance to activity. Document increased activity levels and collaborate with physical therapy for ongoing mobility support.
  • Patient and Family Education:
    • Evaluate the patient and family’s understanding of respiratory management, including medication adherence, recognition of respiratory distress signs, and strategies for managing the patient’s condition at home. Reinforce education as needed.

References

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Transcript

Let’s talk about respiratory failure and how to put this into a nursing care plan. First, we have to collect our information. This is all about that assessment piece and gathering our data. Our subjective data for somebody in respiratory failure, this is, remember what the client is reporting with that patient’s feeling. Maybe they’re telling you they feel short of breath, they’re confused, really tired or lethargic. That’s our subjective data that the patient reports. 

 

Objective data is going to be what we see. This would be things like hypoxia occurring, maybe on the pulse-ox, whatever it may be. They’re hypoxic. Maybe they’re a little cyanotic, a little blue. Maybe they have an increased CO2, they’re hypercapnia, so all that increased respiratory rate, or maybe even because they’re in respiratory failure, they could have a decrease in respiratory rate, so those things. Increased breathing workload, that work of breathing, decreasing level of consciousness, things that we are observing on the patient. 

 

So let’s take that data we’ve collected and now we’re going to analyze it. We’re going to diagnose and prioritize. So what’s the problem? Well, the lungs they’re not working right. Not working the way that they should, and that is our problem. The patient is in respiratory failure. So, let’s say our client, our problem here is that we have work of breathing and our O2 Sat is 80% or less. So, what needs to be improved? Well, we need to improve that oxygen saturation, right? We want to fix the hypoxia so we could give some oxygen to help. Then the priority, our priority is going to be oxygenation for this patient.

 

Now, ask your how, so this is going to help us to plan, implement and evaluate. So, how did we know it was a problem? Well, this is where we link that data all together, so that we know how it was a problem, whatever the symptoms are that the patient reported, or whatever we saw on the patient. And remember, this is a hypothetical patient, so for us with this patient, I was saying the low O2 Sat is going to be how we knew it was a problem, of 80%, and maybe that work of breathing, whatever it was, that’s how we knew. How are we going to address it? Well, we have to assess the hypoxia, so we’re going to be doing assessments, right? We’ll address it in that form. We’ll give oxygen, perhaps prepare stuff for intubation. Although we won’t be the ones, we can help prepare everything needed just in case. We will be doing a full respiratory assessment of this client. Now, how would I know if it gets better? Well, if we’re doing this stuff, we’re going to know it gets better because the hypoxia is going to be improved, right, or we should say, maybe that the O2 Sat would be within normal limits. Now, this might take a little bit of time, but that’s what we’re going for. Maybe the ABG would show improvement. That’d be another way, it’s going to show better gas, and then the respiratory status within normal limits, all things that would help us to know things had gotten better. 

 

Now, we have to translate and be concise with our nursing concepts. So for us, with this patient, oxygenation, coping, and comfort, because it never feels good when you can’t breathe, right, that’s uncomfortable, so we need to help the patient feel more comfortable with that and gas exchange. They kind of overlap a little bit with oxygenation, but those will be our concepts. 

 

Now, we’re going to transcribe it. So, you are going to take your problems and your priorities that we just came up with and put your data pieces in about your patient, whatever interventions you will do, and why are you doing it, the rationale, and then our expected outcomes. What do we hope that this intervention will cause to happen?

 

Here we have our priorities. Now we’re putting in our data. So, oxygenation, while the data that showed us that the oxygenation was a problem, was the patient was cyanotic, hypoxia, and maybe a poor ABG. So, what are we going to do? Well, we have got to intervene? We can give some supplemental oxygen, we can help maintain a patent airway, always important. And the reason why, our rationale, so it’s going to provide oxygen to the lungs and the body, which is going to help with oxygenation, right? Giving that supplemental option, maintaining a patent  airway is of course, also going to help bring oxygen into the body and our expected outcomes. So, I would hope that for our patient, we would have an improved ABG and no cyanosis. Our comfort and coping. So, this patient’s restless, which a lot of that can be because their O2 Sats are down and they’re uncomfortable, right, fearful, it’s scary. Not being able to breathe is awful, so we are going to offer support. We can also sit the client upright, right? That’s going to help with that lung expansion. There’s more room. If they’re sitting upright and can help with breathing.  

 

Our rationale. So kind of just said, why it’s going to, they’re going to feel more comfortable. They are going to feel comfortable, allow better line expansion, and just making them overall comfortable, which is going to help with our coping and our comfort. So, for this patient, we would expect our outcomes for them to be more relaxed if they felt that support, and have better ease of breathing. Specifically if we’re sitting them upright, that work of breathing should hopefully get a little bit easier, and that is going to help them. 

 

Alright, our gas exchange. So in our data here, we had a poor ABG, so a bad ABG came back.  So, that’s some of our data that is showing us that we don’t have good gas exchange happening. We are going to have to assist with intubation, of course,if needed, so that will help with our gas exchange. If the patient gets a good airway, we have intubation and that is allowing for good ventilation. And then our rationale, well, why, so it will allow for proper ventilation. Our expected outcome is going to be an improved ABG, right? We went from that to improved or within normal limits, whatever it may be, but that’s going to show us that we have achieved good gas exchange. 

 

Let’s look at our key points. We want to collect information. That’s our data, our subjective and objective data. We want to analyze that information, which is going to allow us to diagnose and prioritize what is important. We are going to ask how, and that’s going to help us to plan, implement, evaluate.  And then translate. So, just those concise terms, and then how are we going to transcribe it? Whatever form you prefer, just transcribe and link all of your data together. How you’re going to intervene and how you will evaluate. 

 

Alright, check out all the care plans that we have available to help you on NURSING.com. Now, go out and be your best selves today and as always, happy nursing!

 

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Genitourinary Course Introduction
GERD (Gastroesophageal Reflux Disease)
GERD causes Nursing Mnemonic (Reflux Is Probably Mean)
Glaucoma
Glipizide (Glucotrol) Nursing Considerations
Global Symptoms for Brain Tumors Nursing Mnemonic (HAS)
Glucagon (GlucaGen) Nursing Considerations
Gout Case Study (45 min)
Hb (Hepatitis) Vaccine
Head/Neck Assessment
Health Assessment Course Introduction
Hearing Loss
Heart (Cardiac) and Great Vessels Assessment
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Heart Failure – Live Tutoring Archive
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Failure 2 – Live Tutoring Archive
Heart Failure Case Study (45 min)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Hematology Module Intro
Hematology/Oncology/Immunology Course Introduction
Hemodialysis (Renal Dialysis)
Hemorrhagic Stroke Risk Factors Nursing Mnemonic (HATS)
Heparin (Hep-Lock) Nursing Considerations
Hepatitis B Virus (HBV) Lab Values
Hiatal Hernia
Hiatal Hernia Symptoms Nursing Mnemonic (Her Belly Really Hurts Following Dinner)
High Pressure Vent Alarms Nursing Mnemonic (Kings Eat Big Cakes)
Histamine 1 Receptor Blockers
Histamine 2 Receptor Blockers
HMG-CoA Reductase Inhibitors (Statins)
Hydralazine
Hygiene
Hypercalcemia – Signs and Symptoms Nursing Mnemonic (GROANS, MOANS, BONES, STONES, OVERTONES)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (FRIED)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)
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)