Nursing Care Plan (NCP) for Skull Fractures

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Study Tools For Nursing Care Plan (NCP) for Skull Fractures

Example Care Plan_Skull Fractures (Cheatsheet)
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Outline

Lesson Objectives for Skull Fractures

  • Understanding Skull Fractures:
    • Define and comprehend the concept of skull fractures, including the different types and mechanisms of injury.
    • Differentiate between linear and depressed fractures, basilar skull fractures, and open and closed fractures.
  • Recognizing Signs and Symptoms:
    • Identify and understand the clinical manifestations and signs associated with skull fractures.
    • Recognize the importance of prompt assessment and diagnosis based on observed symptoms, such as altered mental status, headache, and cranial nerve deficits.
  • Diagnostic Approaches:
    • Explore the diagnostic methods used in assessing skull fractures, including imaging techniques such as CT scans and X-rays.
    • Understand the role of diagnostic tools in confirming the presence, location, and severity of skull fractures.
  • Complications and Risk Factors:
    • Examine potential complications arising from skull fractures, such as intracranial hemorrhage, infection, and neurological deficits.
    • Identify risk factors, including age, mechanism of injury, and associated injuries, that may influence the course and outcomes of skull fractures.
  • Emergency Management and Nursing Interventions:
    • Learn the principles of emergency management for individuals with suspected or confirmed skull fractures.
    • Understand nursing interventions and care priorities, including monitoring neurological status, preventing complications, and providing patient and family education.

Pathophysiology of Skull Fractures

  • Mechanical Trauma:
    • Skull fractures result from direct mechanical trauma to the head, commonly due to blunt force or penetrating injuries.
    • The impact forces can cause fractures to occur at the site of impact (coup injury) or on the opposite side of impact (contrecoup injury).
  • Types of Fractures:
    • Linear fractures involve a break in the continuity of the skull without displacement of bone fragments.
    • Depressed fractures occur when a portion of the skull is pushed inward, towards the brain.
    • Basilar skull fractures affect the base of the skull and may involve the temporal, frontal, sphenoid, or ethmoid bones.
  • Potential Intracranial Injury:
    • Skull fractures can lead to intracranial injuries, including contusions, hematomas, and lacerations.
    • The risk of traumatic brain injury (TBI) is increased, especially if the fracture extends into or involves the cranial vault.
  • Cerebrospinal Fluid (CSF) Leak:
    • Fractures that extend through the base of the skull may result in a CSF leak.
    • CSF leakage can occur through the nose (rhinorrhea) or ears (otorrhea), increasing the risk of infection.
  • Complications:
    • Potential complications include infection of the meninges (meningitis) or brain (abscess), especially in cases of open fractures.
    • Neurological deficits, seizures, and long-term cognitive impairments may result from the initial trauma and associated injuries.

Etiology of Skull Fractures

 

  • Traumatic Injuries:
    • Motor vehicle accidents, falls, physical assaults, and sports-related injuries are common causes of skull fractures.
    • High-impact trauma, such as those sustained in severe accidents or violent incidents, increases the risk of fractures.
  • Occupational Hazards:
    • Individuals working in occupations with a higher risk of head injuries, such as construction workers or military personnel, may be exposed to skull fracture-inducing incidents.
  • Child Abuse:
    • Non-accidental trauma, including physical abuse or shaken baby syndrome, can lead to skull fractures in infants and young children.
    • Vigilance is crucial in identifying signs of abuse in pediatric patients.
  • Penetrating Injuries:
    • Gunshot wounds, stab wounds, or other penetrating injuries can directly impact the skull, resulting in fractures.
    • These injuries often carry a higher risk of complications due to the nature of the trauma.
  • Sports Injuries:
    • Participation in high-impact sports, especially those involving contact or collisions, can lead to skull fractures.
    • Proper protective gear and adherence to safety guidelines are essential in minimizing the risk of sports-related head injuries.

Desired Outcome in the Management of Skull Fractures

  • Stabilization and Neurological Preservation:
    • Stabilize the patient’s condition to prevent further injury and optimize neurological outcomes.
    • Preserve and monitor neurological function, aiming for the prevention of complications such as intracranial hemorrhage.
  • Prevention of Complications:
    • Minimize the risk of complications, including infection, intracranial pressure (ICP) elevation, and neurological deficits.
    • Implement interventions to prevent secondary injuries and optimize the healing process.
  • Effective Pain Management:
    • Provide effective pain management to enhance patient comfort and facilitate participation in therapeutic activities.
    • Monitor pain levels and adjust interventions accordingly to maintain optimal pain control.
  • Early Detection and Management of CSF Leak:
    • Early detection and management of cerebrospinal fluid (CSF) leaks, if present, to prevent complications such as infection.
    • Implement measures to reduce the risk of meningitis or other infections associated with CSF leakage.
  • Patient and Family Education:
    • Educate patients and their families on signs of worsening symptoms, potential complications, and the importance of follow-up care.
    • Promote understanding of restrictions, activity modifications, and necessary precautions during the recovery period.

Skull Fractures Nursing Care Plan

 

Subjective Data:

  • Pain
  • Reported trauma

Objective Data:

  • Unstable midface
  • Racoon eyes
  • Battle’s sign
  • Obvious deformity or ecchymosis
  • Misaligned jaw
  • Bleeding from ears/nose

Nursing Assessment for Skull Fractures

 

  • Initial Trauma Assessment:
    • Perform a rapid trauma assessment, prioritizing airway, breathing, and circulation (ABCs).
    • Assess the mechanism of injury, including the type and force of trauma that may have led to the skull fracture.
  • Neurological Assessment:
    • Conduct a comprehensive neurological assessment, including Glasgow Coma Scale (GCS) scoring, pupillary response, and motor function evaluation.
    • Monitor for any signs of altered mental status, confusion, or neurological deficits.
  • Physical Examination of the Head:
    • Inspect the head for signs of trauma, such as bruising, swelling, lacerations, or deformities.
    • Palpate the skull for tenderness, crepitus, or abnormal depressions that may indicate a fracture.
  • Assessment for CSF Leak:
    • Assess for signs of cerebrospinal fluid (CSF) leakage, including clear fluid drainage from the nose (rhinorrhea) or ears (otorrhea).
    • Test any fluid for glucose content to confirm the presence of CSF.
  • Imaging Studies:
    • Facilitate diagnostic imaging studies, such as computed tomography (CT) scans or X-rays, to confirm the presence, location, and severity of the skull fracture.
    • Monitor for any associated intracranial injuries, such as hematomas or contusions.
  • Vital Signs Monitoring:
    • Monitor vital signs regularly, paying attention to changes in blood pressure, heart rate, and respiratory rate.
    • Assess for signs of increased intracranial pressure (ICP), such as hypertension or bradycardia.
  • Pain Assessment:
    • Assess and reassess pain levels using a numeric pain scale.
    • Evaluate the effectiveness of pain management interventions and adjust as needed.
  • Psychosocial Assessment:
    • Perform a psychosocial assessment to identify factors such as stressors, support systems, and coping mechanisms.
    • Consider the psychological impact of the injury on the patient and provide emotional support as needed.

 

Regular and thorough nursing assessments are crucial for early detection of complications, effective pain management, and overall patient well-being during the management of skull fractures.

 

Implementation for Skull Fractures

 

  • Neurological Monitoring:
    • Implement routine neurological monitoring to assess changes in level of consciousness, pupil reactions, and motor function.
    • Collaborate with the healthcare team to promptly address any signs of worsening neurological status.
  • Pain Management:
    • Administer prescribed pain medications as scheduled and assess the effectiveness of pain relief.
    • Utilize non-pharmacological pain management strategies, such as positioning and comfort measures, to enhance overall pain control.
  • Head Elevation:
    • Maintain the head of the bed in a slightly elevated position (30 degrees) to help reduce intracranial pressure.
    • Monitor for any signs of increased intracranial pressure, such as changes in vital signs or neurological status.
  • Prevention of Complications:
    • Implement measures to prevent complications, including infection control measures to reduce the risk of meningitis.
    • Educate the patient and family on signs of infection and the importance of seeking prompt medical attention if symptoms occur.
  • Patient and Family Education:
    • Provide education on activity restrictions, emphasizing the importance of avoiding activities that could worsen the fracture or increase intracranial pressure.
    • Instruct the patient and family on signs of deteriorating symptoms and the need for follow-up appointments.

Nursing Interventions and Rationales

 

  • Monitor airway and respiratory status

Swelling in the face or brain can cause compromised airway or breathing. Cranial nerve damage may also impair swallowing.

  • Assess drainage for CSF, avoid nose blowing

Halo’s sign (yellow ring around blood spot on gauze) indicates a CSF leak from nose/ears or through a fracture. Nose blowing can cause a CSF leak or bleed.

  • Assess cranial nerve function

Facial fractures and basilar skull fractures carry a high risk of cranial nerve damage, including sensation to the face and ability to swallow.

  • Assess LOC and ICP/CPP with frequent neuro checks. CPP = MAP – ICP (monitor hemodynamics)

Neurological changes related to increasing ICP may be subtle or may occur rapidly. Frequent detailed neuro checks allow changes to be recognized quickly so that interventions can be initiated.

  • Perform interventions to minimize ICP:
    • Maintain HOB 30-45°
    • Decrease stimuli
    • Avoid Valsalva maneuvers
  • Maintain HOB 30-45°
    • HOB < 30 = increased blood flow to brain → Increased ICP
    • HOB > 45 = increased intrathoracic pressure → decreased venous outflow from brain → increased ICP
  • Decrease stimuli
    • Agitation or stress can cause increased ICP
  • Avoid Valsalva maneuvers
    • Coughing or bearing down can cause increased ICP
  • Assess swallow before giving anything by mouth – involve Speech Therapy as appropriate

Due to muscle weakness, patients may experience difficulty swallowing. It may be appropriate to have ST assess for appropriate interventions to prevent aspiration.

  • Administer analgesics as ordered

Severe pain can cause increased ICP, among other complications. Give pain medications as ordered and as needed.

Evaluation for Skull Fractures

 

  • Neurological Status:
    • Regularly evaluate neurological status, comparing current assessments to baseline values.
    • Assess for improvements or deterioration in consciousness, pupil reactivity, and motor responses.
  • Pain Control:
    • Evaluate the effectiveness of pain management interventions, assessing the patient’s pain levels and response to medications.
    • Adjust pain management strategies as needed to maintain optimal pain control.
  • Complication Prevention:
    • Monitor for signs of complications, including infection or increased intracranial pressure.
    • Evaluate the success of infection control measures and interventions aimed at preventing complications.
  • Adherence to Activity Restrictions:
    • Assess the patient’s adherence to prescribed activity restrictions and precautions.
    • Identify any challenges or concerns related to activity restrictions and address them accordingly.
  • Patient and Family Understanding:
    • Evaluate the patient and family’s understanding of the injury, treatment plan, and signs of potential complications.
    • Address any questions or misconceptions and provide additional education as necessary.

Regular evaluation is essential to ensure the effectiveness of interventions, prevent complications, and promote optimal recovery for individuals with skull fractures. Adjustments to the care plan should be made based on the ongoing assessment and individual patient needs.


References

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Transcript

Today we are diving into skull fractures. The patho behind skull fractures. Skull fractures, or any fracture that includes the cranium, the face, or the base of the skull. These fractures are dangerous because they can be superficial, but they can also penetrate pretty deep into the cranial cavity. Some of the nursing considerations that we want to think about is we want to assess for CSF or cerebral spinal fluid. We want to assess drainage. We also want to do frequent neuro tracks and we want to assess for the battle signs or raccoon eyes. The battle sign is just the bruising over the mastoid process. And then the raccoon eyes, is the darkening around your eyes. We also want to assess for, and manage the pain. One of the desired outcomes is that we want to prevent long-term neurological damage. 

This is affecting the skull, which is protecting your brain. We just want to protect from any long-term damage. And then we want to protect the airway and preserve the patient’s functional abilities. So with any fracture, but especially a skull fracture, when someone tells you that there is a reported trauma, car accident, or anything like that, you want to think about skull fractures. If they complain of pain, you also want to immediately go there. Some of the things that we’re going to see is, that we’re going to see an unstable mid-face, raccoon eyes, and battle’s sign. We’re going to also see any type of just obvious deformity.  We’ll see some ecchymosis and then we will also see a misaligned jaw. And that’s just from the impact of the trauma that caused the fracture. We may see bleeding from the nose or the ears, and then we will also possibly see clear drainage from the ears or the nose. 

That’s the cerebral spinal fluid. We’re going to be very mindful of that. Some nursing interventions that you want to think of. Number one, remember ABC. We want to monitor that airway and that respiratory status because swelling can occur in the face. It can cause a compromised airway, and we do not want that cranial nerve damage to also impair swallowing. So the patients are also at risk for aspiration. So we want to assess CSF fluid. So CSF cerebral, spinal fluid, the way that we do that is by looking for what we call a halo sign and pretty much a halo sign is you take a piece of gauze, put it under the clear drainage that’s coming from the nose and it’ll create like a ring or a halo around of blood. And so if you see that nine times out of 10, it is a cerebral spinal fluid. 

You want to make sure that you tell the patient not to blow their nose, because that can exacerbate the injury. Like I said, frequent neuro checks. We want to do neuro checks one to two hours or more. The reason why is because they can have changes in their level of consciousness. We also want to do an ICP intracranial pressure or cerebral perfusion pressure, with those neuro checks and those would be ordered by the provider. Finally, we want to make sure that we minimize ICP. We want to keep that intracranial pressure low. So the way we do that, keep the head of the bed up 30 to 45 degrees. So head of the bed 35 degrees, I mean, 30 to 45 degrees. That’s going to keep the drainage down. We also want to decrease stimuli. We don’t want the patient agitated, and we want to avoid that bearing down. That again, it’s just going to keep that pressure away from the head and decrease the incidence of draining the CSF. 

Quick overview on the key points, fractures of the skull are a no-no they’re bad. Okay. Some of the things that the patient’s going to report is pain. They’re going to report the actual trauma. Uh, we are going to be looking for objective data as nurses. And we’re going to look for the raccoon eyes, which is the darkness around the eyes, the battle sign, which is the mastoid process here. And if we have any type of bleeding or drainage from the nose or the ears, CSF drain is very important. CSF drainage. That’s the clear liquid from the nose or ears. In addition to the halo sign, you can also test it for glucose. If it tests positive for glucose, then that means it is CSF and not mucus. The risk for infection is something else we want to be considerate of. If the is testing for CSF, also minimize the ICP, head of the bed up, decrease the stimuli, avoid the solver maneuvers. We love you guys; go out and be your best self today. And, as always, happy nursing.

 

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Hyperthyroidism Case Study (75 min)
Hypertonic Solutions (IV solutions)
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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)