Positioning

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Chance Reaves
MSN-Ed,RN
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Outline

Nursing Points

General

  1. Select the ideal vein
    1. This impacts all other positions
      1. Ex: Selecting a leg vein will mean you have to elevate the bed versus being able to place the arm in a bedside table.
    2. Place the extremity or position in the ideal location
      1. Elevating a foot will decrease optimal vein filling
      2. Dangle arms to improve blood flow
        1. Pumping the fist can help increase blood flow
  2. Patient comfort
    1. Select a position comfortable for the patient
    2. If they are uncomfortable, they are less likely to cooperate
      1. Ex: Sitting a patient upright after abdominal surgery may be uncomfortable
    3. Be mindful of patient needs
  3. Nursing ergonomics
    1. Raise the bed to the real working height
      1. If you’re not comfortable, the process will become even more frustrating
    2. If you can’t raise the bed, then sit
      1. Pull up a bedside chair and place the patient’s hand or leg so you can access it comfortably

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Transcript

In this lesson we’re going to talk about patient positioning as it relates to your IV placement. What you want to do is think about three things whenever you’re looking at your patient’s position. The first one is ideal site location. The second one is patient comfort, and the last one is nursing ergonomics. So let’s take a look at the first one. The first one is an ideal site selection. So what that means is if we’re putting in maybe a foot Ivy, we want to make sure that we put the foot in the best position, the most proper position, and the most optimal position to get that IV started. If I raise that foot up really high, it’s actually going to cause that Venus draining, so your the veins are going to be flat, they’re not going to pop up like you want them to. It’s going to make it more complicated.

It also is uncomfortable for the patient, so always think, take that into consideration. The second thing is patient comfort. You never want to put your patient in a compromising position where it could affect them health wise or something that’s uncomfortable. If they’re uncomfortable, they’re not going to be compliant. They’re going to wiggle. You’re going to have a more difficult time getting that IV set. So always put your patient in a very comfortable position. And the last one is nursing or ergonomics. And when I say nursing ergonomics, I’m talking about your safety. I’m talking about making sure that you are comfortable and that you are really doing things in an optimal position and optimal comfort for you. The last thing you want to do is have the bed in the lowest position. You’re trying to get a foot Ivy, and then all of a sudden your back hurts.

And for the rest of the day, you’re just aching. And you don’t want to do that. So what you need to do is you need to raise that bet up to the real working height. I’m a tall guy, I’ve always told my patients every time I’m raising them up in the bed, Hey, you’re going for a little ride, because that’s important for them to know that they’re going to be really high up in the air. But it’s for my safety as well. The other thing is if that’s not going to work for you, you can also put the patient’s bed in the lowest position and then bring that bedside chair over and have them dangle that arm over and you can get that IV, but that way. So always take these things into consideration when you’re looking at your patient’s position. Now, I hope these tips have really helped you out. Now, like we always say, go out and be your best selves today, and as always, happy nursing.

 

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Basics of Pharm Study Plan

Concepts Covered:

  • Concepts of Pharmacology
  • Studying
  • Test Taking Strategies
  • Learning Pharmacology
  • Dosage Calculations
  • Medication Administration
  • Intraoperative Nursing
  • Microbiology
  • Disorders of Pancreas
  • Circulatory System
  • Upper GI Disorders
  • Fundamentals of Emergency Nursing
  • Understanding Society
  • Tissues and Glands
  • Adulthood Growth and Development
  • Newborn Care
  • Postoperative Nursing
  • Prenatal Concepts
  • Substance Abuse Disorders
  • Immunological Disorders
  • Adult
  • Emergency Care of the Cardiac Patient
  • Nervous System
  • Vascular Disorders
  • Cardiac Disorders
  • Anxiety Disorders
  • Depressive Disorders
  • Bipolar Disorders
  • Psychotic Disorders
  • Central Nervous System Disorders – Brain
  • Gastrointestinal Disorders
  • Neurological
  • Respiratory Disorders
  • Noninfectious Respiratory Disorder
  • Hematologic Disorders
  • Peripheral Nervous System Disorders
  • Pregnancy Risks
  • Postpartum Complications

Study Plan Lessons

Pharmacology Course Introduction
Pharmacokinetics
Pharmacokinetics Nursing Mnemonic (ADME)
12 Points to Answering Pharmacology Questions
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
The SOCK Method of Pharmacology 1 – Live Tutoring Archive
The SOCK Method of Pharmacology 2 – Live Tutoring Archive
The SOCK Method of Pharmacology 3 – Live Tutoring Archive
Basics of Calculations
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Complex Calculations (Dosage Calculations/Med Math)
Pediatric Dosage Calculations
Struggling with Dimensional Analysis? – Live Tutoring Archive
Medication Errors
6 Rights of Medication Administration
Using Aseptic Technique
Supplies Needed
Needle Safety
Drawing Up Meds
Medications in Ampules
Oral Medications
SubQ Injections
IM Injections
Injectable Medications
Pill Crushing & Cutting
Positioning
Tips & Tricks
Insulin
Insulin Mixing
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin Drips
Glipizide (Glucotrol) Nursing Considerations
IV Insertion Course Introduction
Selecting THE vein
IV Catheter Selection (gauge, color)
IV Insertion Angle
Starting an IV
IV Placement Start To Finish (How to Start an IV)
Bariatric: IV Insertion
Combative: IV Insertion
Dark Skin: IV Insertion
Tattoos IV Insertion
Geriatric: IV Insertion
Tips & Advice for Pediatric IV
Tips & Advice for Newborns (Neonatal IV Insertion)
How to Secure an IV (chevron, transparent dressing)
Maintenance of the IV
How to Remove (discontinue) an IV
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Understanding All The IV Set Ports
Spiking & Priming IV Bags
IV Infusions (Solutions)
Hanging an IV Piggyback
Giving Medication Through An IV Set Port
IV Push Medications
IV Pump Management
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
Drawing Blood from the IV
NG Tube Medication Administration
NG Tube Med Administration (Nasogastric)
Interactive Practice Drip Calculations
Pain Management Meds – Live Tutoring Archive
Pain Management for the Older Adult – Live Tutoring Archive
Opioid Analgesics in Pregnancy
Patient Controlled Analgesia (PCA)
Codeine (Paveral) Nursing Considerations
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hydromorphone (Dilaudid) Nursing Considerations
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Fentanyl (Duragesic) Nursing Considerations
Oxycodone (OxyContin) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Ketorolac (Toradol) Nursing Considerations
ACLS (Advanced cardiac life support) Drugs
Adenosine (Adenocard) Nursing Considerations
Amiodarone (Pacerone) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Atenolol (Tenormin) Nursing Considerations
Hydralazine
Lidocaine (Xylocaine) Nursing Considerations
Procainamide (Pronestyl) Nursing Considerations
Nitro Compounds
Verapamil (Calan) Nursing Considerations
Streptokinase (Streptase) Nursing Considerations
Anti-Platelet Aggregate
Antianxiety Meds
Antidepressants
TCAs
MAOIs
Mood Stabilizers
Olanzapine (Zyprexa) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Buspirone (Buspar) Nursing Considerations
Barbiturates
Sedatives-Hypnotics
Sedatives-Hypnotics
Pentobarbital (Nembutal) Nursing Considerations
Phenobarbital (Luminal) Nursing Considerations
Benztropine (Cogentin) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Parasympathomimetics (Cholinergics) Nursing Considerations
Anti-Infective – Antifungals
Nystatin (Mycostatin) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Cyclosporine (Sandimmune) Nursing Considerations
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Bisacodyl (Dulcolax) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Mannitol (Osmitrol) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Epoetin Alfa
Neostigmine (Prostigmin) Nursing Considerations
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Meds for Postpartum Hemorrhage (PPH)
Methylergonovine (Methergine) Nursing Considerations
Rh Immune Globulin in Pregnancy
Eye Prophylaxis for Newborn
Phytonadione (Vitamin K) for Newborn
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Anesthetic Agents
Propofol (Diprivan) Nursing Considerations
Nalbuphine (Nubain) Nursing Considerations
Interactive Pharmacology Practice