Nursing Care Plan (NCP) for Spinal Cord Injury
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Study Tools For Nursing Care Plan (NCP) for Spinal Cord Injury
Spinal Cord Injury Pathochart (Cheatsheet)
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Outline
Lesson Objectives for Spinal Cord Injury (SCI)
- Understanding Spinal Cord Injury (SCI):
- Define and comprehend the anatomy and function of the spinal cord.
- Understand the different types and levels of spinal cord injuries, including complete and incomplete injuries.
- Recognizing Etiology and Risk Factors:
- Explore the common causes of spinal cord injuries, such as trauma (falls, accidents, sports injuries) and non-traumatic factors (tumors, infections).
- Identify risk factors that may contribute to the occurrence and severity of spinal cord injuries.
- Classifying Spinal Cord Injuries:
- Classify spinal cord injuries based on the American Spinal Injury Association (ASIA) impairment scale.
- Understand the significance of neurological assessment in determining the level and severity of injury.
- Complications and Impact on Function:
- Examine potential complications associated with spinal cord injuries, including neurogenic shock, respiratory compromise, and autonomic dysreflexia.
- Understand the impact of spinal cord injuries on motor, sensory, and autonomic functions.
- Multidisciplinary Care Approach:
- Emphasize the importance of a multidisciplinary approach to care, involving healthcare professionals such as neurologists, orthopedic surgeons, physical therapists, and occupational therapists.
- Recognize the role of rehabilitation and ongoing support in maximizing functional outcomes and enhancing quality of life for individuals with spinal cord injuries.
Pathophysiology of Spinal Cord Injury (SCI)
- Primary Injury:
- SCI results from a primary injury caused by mechanical trauma, often involving fractures, dislocations, or compression of the vertebral column.
- The initial injury disrupts the normal structure and function of the spinal cord.
- Secondary Injury:
- Secondary injury processes follow the primary injury and involve a cascade of events that exacerbate tissue damage.
- These processes include inflammation, edema, ischemia, and the release of neurotoxic substances, contributing to ongoing cellular damage.
- Axonal Damage:
- Axonal damage occurs due to the disruption of nerve fibers within the spinal cord.
- Axons may be directly injured by the primary trauma or undergo Wallerian degeneration in the aftermath of the injury.
- Loss of Blood Flow:
- The primary and secondary injuries can lead to a decrease in blood flow to the spinal cord, resulting in ischemia and further damage to neural tissue.
- Impaired blood flow contributes to the development of cysts and scar tissue within the injured area.
- Formation of Glial Scar:
- A glial scar forms at the site of injury, composed of astrocytes and fibrous tissue.
- While the scar acts as a barrier to prevent further damage, it also creates an inhibitory environment for axonal regeneration, limiting functional recovery.
Etiology of Spinal Cord Injury (SCI)
- Traumatic Causes:
- Motor vehicle accidents, falls, sports injuries, and acts of violence are common traumatic causes of SCI.
- High-impact forces can lead to fractures, dislocations, or compression of the spinal cord.
- Non-Traumatic Causes:
- Non-traumatic causes include tumors, infections (such as abscesses or meningitis), and vascular disorders affecting the spinal cord.
- These conditions can exert pressure on the spinal cord, leading to injury.
- Degenerative Conditions:
- Degenerative conditions like spinal stenosis or intervertebral disc herniation can contribute to the development of SCI.
- Chronic compression of the spinal cord over time may result in injury.
- Inflammatory Diseases:
- Conditions such as transverse myelitis or multiple sclerosis, characterized by inflammation of the spinal cord, can cause SCI.
- Inflammatory processes may damage neural tissue and disrupt normal spinal cord function.
- Congenital Abnormalities:
- Congenital anomalies, such as spina bifida or tethered spinal cord, can predispose individuals to spinal cord injuries.
- Anomalies in the development of the spinal column and cord may increase the risk of injury throughout life.
Desired Outcome in the Management of Spinal Cord Injury (SCI)
- Optimal Neurological Function:
- Preserve and improve neurological function to the highest extent possible.
- Enhance motor and sensory capabilities based on the level and severity of the spinal cord injury.
- Prevention of Complications:
- Minimize the risk of complications, including respiratory infections, pressure ulcers, and contractures.
- Implement preventive measures to address potential issues associated with immobility and neurogenic dysfunction.
- Pain Management:
- Provide effective pain management to enhance patient comfort and improve overall quality of life.
- Tailor pain interventions to address neuropathic pain and musculoskeletal discomfort associated with the injury.
- Achievement of Independence:
- Facilitate the patient’s ability to perform activities of daily living (ADLs) independently, considering assistive devices and adaptive techniques.
- Promote self-care and independence to enhance the patient’s overall well-being.
- Psychosocial Adjustment and Support:
- Support the patient in adjusting to the emotional and psychosocial challenges associated with SCI.
- Promote mental well-being, coping mechanisms, and a positive outlook on life post-injury.
Spinal Cord Injury Nursing Care Plan
Subjective Data:
- Loss of sensory function below the level of the injury
Autonomic Dysreflexia
- Blurry vision
- Feeling hot
- Restless/anxious
Objective Data:
- Loss of motor function below the level of the injury
- Respiratory distress if high-level injury (C3-C5)
Autonomic Dysreflexia
- Severe hypertension
- Bradycardia
- Increased temp
- Flushed skin
- Seizures
Neurogenic Shock
- Hypotension
- Bradycardia
- Increased temp
- Flushed skin
Nursing Assessment for Spinal Cord Injury (SCI)
- Neurological Assessment:
- Conduct a thorough neurological assessment, including the level and completeness of the spinal cord injury based on the ASIA impairment scale.
- Monitor for changes in motor and sensory function, reflexes, and signs of neurogenic shock.
- Respiratory Assessment:
- Assess respiratory status, including respiratory rate, depth, and signs of respiratory distress.
- Monitor for any respiratory complications, such as pneumonia or atelectasis, and intervene promptly.
- Skin Integrity Assessment:
- Perform regular skin assessments to identify areas at risk for pressure ulcers.
- Implement preventive measures, such as turning schedules, pressure-relieving devices, and meticulous skin care.
- Musculoskeletal Assessment:
- Evaluate muscle strength, tone, and joint range of motion.
- Monitor for signs of contractures and implement measures to prevent joint immobility.
- Bowel and Bladder Function Assessment:
- Assess bowel and bladder function, implementing a bowel and bladder management program as appropriate.
- Monitor for complications such as urinary tract infections or bowel impaction.
- Pain Assessment:
- Assess and reassess pain levels, including both neuropathic and musculoskeletal pain.
- Collaborate with the healthcare team to develop a comprehensive pain management plan.
- Psychosocial Assessment:
- Conduct a psychosocial assessment to identify emotional responses, coping mechanisms, and support systems.
- Address mental health concerns and provide emotional support as needed.
- Functional Independence Assessment:
- Evaluate the patient’s ability to perform ADLs independently.
- Identify areas of impairment and collaborate with occupational therapists to develop strategies for enhancing independence.
Implementation for Spinal Cord Injury (SCI)
- Neurological Monitoring:
- Implement routine neurological monitoring to assess changes in motor and sensory function.
- Utilize standardized assessments, such as the ASIA impairment scale, to track neurological status over time.
- Respiratory Management:
- Provide respiratory care, including chest physiotherapy, deep breathing exercises, and assisted coughing techniques.
- Ensure proper positioning and use of respiratory aids to prevent complications like pneumonia.
- Pressure Ulcer Prevention:
- Implement a structured pressure ulcer prevention program, including regular turning schedules, the use of pressure-relieving devices, and skin inspections.
- Educate the patient and caregivers on the importance of skin care and early detection of potential issues.
- Pain Management:
- Administer pain medications as prescribed, considering both neuropathic and musculoskeletal pain.
- Collaborate with the healthcare team to explore non-pharmacological pain management strategies, such as physical therapy or relaxation techniques.
- Mobility and Independence Promotion:
- Collaborate with physical and occupational therapists to develop a personalized rehabilitation plan.
- Facilitate the use of assistive devices and adaptive techniques to promote independence in activities of daily living.
Nursing Interventions and Rationales
- Immobilize initially with C-collar and spinal precautions (log-roll)
Maintain full spinal precautions until cleared by a neurosurgeon. This involves a c-collar to immobilize the neck, keeping the HOB flat, and using a strict log-roll technique for turning. Any twist or bend of the spine could cause further damage to the spinal cord.
- Manage and maintain Halo brace, including pin care twice daily
Halo brace is used to immobilize the cervical spine with unstable vertebral fractures. Four pins are inserted into the skull – pin care should be done twice daily to prevent infection at the pin sites. A wrench should be kept at bedside to remove the vest in the case that chest compressions are needed.
- Administer medications
- Analgesics
- Muscle Relaxants
Patients may experience pain from the initial trauma as well as neuropathic pain due to the nerve injuries. Muscle relaxants like cyclobenzaprine and gabapentin can also help ease any muscle spasms or nerve pain.
- Encourage PT/OT, passive and active ROM
PT and OT can help the patient to maintain whatever functional ability they have. ROM exercises help to prevent atrophy and contractures.
- Monitor hemodynamics for signs of Autonomic Dysreflexia or Neurogenic Shock
Neurogenic shock is a risk within the first 24-72 hours, autonomic dysreflexia is a risk any time. Both show warm, flushed skin and an elevated temperature. Neurogenic shock shows hypotension and bradycardia, while autonomic dysreflexia shows hypertension and bradycardia. Find and treat cause of A.D. as soon as possible.
- Monitor for and provide interventions to prevent complications of immobility:
- Chest expansion exercises
- DVT prophylaxis
- Pad bony prominences, turn q2h
Immobility can lead to pneumonia, DVT/thrombophlebitis, and pressure ulcers. Monitor for signs and intervene to prevent them. Assess skin with every turn, monitoring for developing pressure ulcers (they can develop in as little as 2 hours).
- Provide resources for community support, refer to social worker for home care resources
Spinal cord injury patients often require many resources in the community and in their home for care, including wheelchairs, assistive devices, shower chairs, hospital beds, etc. The social worker can help to set these things up for the patient.
Evaluation for Spinal Cord Injury (SCI)
- Neurological Status:
- Regularly assess and document changes in neurological status, including improvements or deterioration in motor and sensory function.
- Use standardized assessments to quantify progress and inform adjustments to the care plan.
- Respiratory Function:
- Evaluate respiratory function through ongoing monitoring and assessment of respiratory status.
- Assess the effectiveness of respiratory interventions and adjust strategies as needed.
- Skin Integrity:
- Monitor skin integrity regularly, assessing for the development of pressure ulcers.
- Evaluate the success of pressure ulcer prevention measures and intervene promptly if any issues arise.
- Pain Control:
- Assess the effectiveness of pain management interventions, considering both pharmacological and non-pharmacological approaches.
- Adjust the pain management plan based on the patient’s reported pain levels and overall well-being.
- Functional Independence:
- Evaluate the patient’s progress in achieving functional independence and performing ADLs.
- Collaborate with the rehabilitation team to assess improvements in mobility, strength, and overall functional outcomes.
Regular evaluation is essential to ensure the effectiveness of interventions, monitor patient progress, and make necessary adjustments to optimize outcomes for individuals with spinal cord injuries. The collaborative effort of the healthcare team is crucial in achieving positive results and enhancing the overall quality of life for the patient.
References
- https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/symptoms-causes/syc-20377890
- http://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Cord-Injury
- https://medlineplus.gov/spinalcordinjuries.html
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Transcript
Hey guys, today, we’re going to take a look at the care plan for a spinal cord injury. In this lesson, we’ll briefly take a look at the pathophysiology and etiology of a spinal cord injury. We’ll also take a look at additional things like subjective and objective data that your patient with this issue may present with, and also any nursing interventions and the rationale for those interventions.
Let’s jump in. The spinal cord is a bundle of nerves that come off of the brainstem. They run down through the vertebral column and innervate the entire body. Basically when there is an injury to the spinal cord, nerve impulses below the point of injury will no longer be scent. This includes motor and sensory impulses. Spinal cord injuries are most commonly caused by trauma, like a motor vehicle accident or a fall, but they also can be caused by a penetrating trauma, like a stabbing or even a gunshot wound, so anything that penetrates the spinal column. The goal or desired outcome is to preserve and maintain optimal function and minimize any complications of the injury.
Let’s take a look at some of the subjective data that your patient with a spinal cord injury may present with. Remember, subjective data are going to be things that are based on your patient’s opinions or feelings. These things might include loss of sensory function below the level of the injury. Also, autonomic dysreflexia symptoms, which are common with spinal cord injuries include blurry vision, feeling hot, or being restless or anxious.
Objective or measurable data, which you may see in this patient includes loss of motor function below the level of the injury. Also respiratory distress, especially if the injury is high between C3 and C5, and autonomic dysreflexia. Other objective data includes severe hypertension, bradycardia, increased temp, flush skin, and even seizures. Neurogenic shock could also occur and with this, we would see hypotension, bradycardia, increased temp, and flushed skin.
Let’s take a look at some of the nursing interventions necessary when caring for a patient with a spinal cord injury. Immobilizing the patient and maintaining full spinal precautions until the patient is cleared by a neurosurgeon is critical. This includes placing a C-collar to immobilize the neck, keeping the head of the bed flat and using a strict log roll technique for any turning, because any twist or bend of the spine could create further damage. A halo brace is used to immobilize the cervical spine with unstable or tibial fractures. With this, four pins are inserted into the skull and Pin care must be completed twice daily to prevent or protect from infections at the pin site. Also guys, a wrench should be kept at the bedside in case the halo vest needs to be removed for chest compressions.
So as far as medication administration is concerned, analgesics and muscle relaxants are common to be used because of the pain that the patient experiences from the initial trauma, as well as from any neuropathic pain due to nerve injuries. Muscle relaxants like cyclobenzaprine and also Gabapentin can also help to ease any muscle spasms or nerve pain. PT and OT can help to maintain whatever functionality remains, and also passive and active range of motion can help prevent atrophy and even contractures. Monitoring hemodynamics is important to recognize signs of autonomic dysreflexia or neurogenic shock. Neurogenic shock is a risk that we see within the first 24 to 72 hours, but autonomic dysreflexia can actually occur at any time. Both of these complications show warm/ flush skin and an elevated temperature. However, neurogenic shock shows hypotension and bradycardia, while autonomic dysreflexia shows hypertension and bradycardia. We must monitor and provide for any interventions to prevent complications of immobility, which can lead to pneumonia, DVT, or thrombophlebitis and pressure ulcers. You’re going to want to assess the skin with every turn, monitoring for developing pressure ulcers, which can develop in as little as two hours. That’s super important. Spinal cord injury patients often require resources within the community and also in their home. For care, these things could include wheelchairs, assisted devices, shower chairs, hospital beds, anything like that. We want to include the social worker to set these things up for the patient.
Okay guys, here is a look at the completed care plans for spinal cord injuries. Alright, let’s do a quick review. The spinal cord contains a bundle of nerves, which come off of the brainstem and innervate the body. When an injury occurs to the spinal cord, impulses will not be sent below the level of injury, including sensory and motor impulses. Subjective data includes loss of sensory function, autonomic dysreflexia, there’ll be blurry vision, they’ll be hot and restless. Objective data includes loss of motor function with autonomic dysreflexia, severe hypertension and bradycardia, but with neurogenic shock hypotension and bradycardia. Analgesics and muscle relaxants will be administered, and PT and OT should be encouraged. Monitor hemodynamics closely for signs of autonomic dysreflexia or neurogenic shock. Prevent complications of immobility like contractures and pressure ulcers. Prevent further damage with the use of a C-collar, keeping the head of the bed flat and log rolling the patients, and also providing necessary community resources and services.
That’s it for this lesson on the care plan for spinal cord injuries. We love you guys. Now, go out and be your best self today and as always, happy nursing!
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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)