A case of acute chest syndrome
Quick thinking and anticipating treatment results in a good outcome. Takeaways: Patients with sickle cell disease are at high risk…
Rapid Response
A case of obstetrical sepsis
Quick action results in a positive outcome. By Debra A. Hrelic, PhD, RNC Takeaways: In sepsis, tachycardia and tachypnea are a…
A complicated case of adenovirus
Immunocompromised patients are at risk for serious complications. Takeaways: Adenovirus, which typically presents as a febrile respiratory illness for 1…
A stubborn case of supraventricular tachycardia
JAKE KARCHNER, age 65, is admitted for treatment of acute myeloid leukemia. Because of his history of supraventricular tachycardia (SVT),…
Acute hypopituitarism
Your recognition of troubling signs and symptoms results in prompt diagnosis and treatment. Takeaways: Hypopituitarism is the deficient secretion of…
Anaphylaxis in the school setting
Quick action results in positive outcome. Takeaways: School mealtimes are important for socialization and nutrition, but food allergies can be…
Asthma exacerbation
An accurate history reduces risk. By Fidelindo Lim, DNP, CCRN, and Nick Deuz, BSN, RN Yi Rong Huang, a 55-year-old…
Atrial fibrillation
Patient history, new symptoms, and assessment findings prompt a call for the rapid response team Takeaways: Atrial fibrillation results from…
Atypical presentation of myocardial infarction
Quickly recognizing unusual symptoms can save lives. Takeaways Cardiovascular disease remains the leading cause of death in women, but it’s…
Bacterial meningitis
Rapid recognition prevents patient harm. Takeaways: Early recognition of bacterial meningitis decreases morbidity and mortality. Photophobia, nuchal rigidity (stiff neck),…
Barely breathing
After cleft palate repair, 16-month-old Nicholas* is admitted to the general care unit in a children’s hospital for postoperative monitoring. Because of…
Bradykinin-induced angioedema
Quick treatment results in a good outcome. Takeaways: Angiotensin-converting enzyme inhibitors can increase the release of bradykinin, which can increase…
Catching cauda equina in time
Michael Smith, age 45, is admitted for lumbar laminectomy revision and fusion surgery. Despite his operative blood loss of an…
Cerebral vasospasm
Prompt recognition of subtle signs saves patient’s life. Key Points: Patients who experience an aneurysmal subarachnoid hemorrhage (aSAH) require frequent…
Danger of respiratory syncytial virus
Education may help avoid decompensation and escalation. Takeaways: Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis in…
Early detection of acute compartment syndrome
Quick action prevents serious harm. Takeaways: Acute compartment syndrome (ACS) is a surgical emergency that requires early identification to avoid…
Esophageal varices
Quick action prevents a negative outcome. Takeaways: Cirrhosis of the liver causes scaring, shrinking, and hardening. Complications of cirrhosis include…
Fat embolism syndrome
Early identification prevents negative outcomes. Takeaways: Fat embolism syndrome is a rare complication that can occur after traumatic orthopedic injuries.…
Hyponatremia signals acute adrenal insufficiency
Maryann Ward, age 56, is admitted to the chest pain unit. Sara, her nurse, finds her alert and oriented. Mrs. Ward tells Sara…
Isopropyl alcohol poisoning
Quick action puts a patient on the path to recovery. Takeaways: Isopropyl alcohol poisoning is uncommon and resembles ethanol intoxication…
Malignant hyperthermia
This potentially lethal condition calls for quick action. Takeaways: Malignant hyperthermia is a genetic life-threatening disease that results in an…
Opioid overdose
When Tom Smith* finds his mother Mary, age 59, extremely sleepy and difficult to awaken, he calls 911. The emergency…
Patient on the precipice
Richard Hamilton, age 67, is admitted to the telemetry unit from the emergency department (ED) with new-onset chest pain. In the…
Prolonged QT syndrome: An unexpected pause
Knowing what to assess and when can prevent a dangerous complication for older adults. Takeaways: Older adults are often prescribed…
Pulmonary atelectasis and retained secretions
Critical thinking averts serious consequences. Takeaways: Atelectasis is a serious postoperative pulmonary complication. Risk factors include advanced age, obesity, upper…
Rapid response team in a psychiatric hospital
A twist on the RRT positions nurses as leaders in responding to non-life-threatening situations. Takeaways Medical emergencies occur in many…
Rapid Response: Fat embolism threatens a patient’s life
Jorge Valencia, age 27, is admitted to the medical-surgical unit after surgical reduction and fixation of a displaced, compound right…
Rapid Response: Hypoglycemia and chronic kidney disease
Insulin administration requires close monitoring. Takeaways: When administering insulin, closely monitor food intake and potential side effects including hypoglycemia. Chronic…
Re-expansion pulmonary edema
An uncommon complication with serious consequences Takeaways: Re-expansion pulmonary edema is a rare complication of pleural drainage with potentially fatal…
Recognizing complications in the oncology patient
Quick response includes paying attention to the details. Takeaways: Rapid assessment is key to identifying early complications in the oncology…
Recognizing risk for increased intracranial pressure
Mary Meyer, a 20-year-old college student, is admitted to the medical unit with flulike symptoms including nausea, vomiting, headache, and…
Seizing the moment
Horace Gunner,* a 65-year-old man with hypertension and type 2 diabetes, is admitted to the hospital after a fall at…
Sepsis protocol in action
A nurse’s quick action prevents progression to septic shock. Takeaways: Rapid and accurate identification of sepsis improves patient outcomes. The…
Sickle cell crisis in the ED
Following the pain pathway leads to a good outcome. Takeaways: Quick action and critical thinking leads to optimal pain control…
Small bowel obstruction
Early identification results in a positive outcome. Takeaways: Abdominal pain, bloating and distension, vomiting, and obstipation are warning signs of…
Stroke alert
Quick identification of stroke in a postpartum patient yields positive result. Anna Connor, a 30-year-old woman, is admitted to the…
Sulfonylurea-induced hypoglycemia in an elderly patient
Myrna Klein, age 82, is admitted to the medical-surgical unit from the emergency department (ED) at 9 pm for an…
Supraventricular tachycardia
Quick action reverses SVT and prevents a disastrous outcome. Takeaways: Atrial fibrillation and atrial flutter are the most common subtypes…
Transurethral resection of the prostate
Quick response to postsurgical complication. Takeaways: Benign prostatic hypertrophy, if left untreated, may lead to chronic urinary retention. Medical…
Tube feeding aspiration
What would you do in this situation? Takeaways: Acute aspiration of tube feeding can result in a respiratory emergency Know…
When all signs point to tension pneumothorax
Key takeaways Initial presentation of tension pneumothorax in patients with unassisted breathing is slower and more subtle than in patients…
