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Rapid Response

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…
case obstetrical sepsis

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…
complicated adenovirus

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…
Acute hypopituitarism, healthcare, registered nurse, nursing, nursing journal

Acute hypopituitarism

Your recognition of troubling signs and symptoms results in prompt diagnosis and treatment. Takeaways: Hypopituitarism is the deficient secretion of…

Adult intussusception

Quick action ensures prompt diagnosis and treatment. Takeaways: Metformin-associated induced lactic acidosis (MALA) is a life-threatening condition that requires prompt,…
Anaphylasxis_schoolnurse

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 ant

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

Atrial fibrillation

Patient history, new symptoms, and assessment findings prompt a call for the rapid response team Takeaways: Atrial fibrillation results from…
Atypical myocardial infarction

Atypical myocardial infarction

Clinical judgment leads to swift action.   Takeaways: Myocardial infarctions may present differently in women than men. Not all cardiac emergencies…

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

Bradykinin-induced angioedema

Quick treatment results in a good outcome. Takeaways: Angiotensin-converting enzyme inhibitors can increase the release of bradykinin, which can increase…
cauda equina

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

Cerebral vasospasm

Prompt recognition of subtle signs saves patient’s life. Key Points: Patients who experience an aneurysmal subarachnoid hemorrhage (aSAH) require frequent…
danger respiratory syncytial virus

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…

Ectopic pregnancy

Courtney Thomas*, a 30-year-old patient, is 6 weeks pregnant with occasional mild lower abdominal pain and vaginal spotting. While in the outpatient lab, she experiences a diaphoretic episode and can’t void. She arrives in the ED several hours later with increased lower abdominal pain (2/10 when lying flat but 5/10 with movement) and nausea. The ED nurse takes her vital signs: temperature 98.2° F (36.7° C), HR 92 bpm, RR 20 breaths per minute, BP 118/70 mmHg. Ms. Thomas is transferred to the OB/GYN unit for observation while waiting for the lab results and for a transvaginal ultrasound.

esophageal

Esophageal varices

Quick action prevents a negative outcome.     Takeaways: Cirrhosis of the liver causes scaring, shrinking, and hardening. Complications of cirrhosis include…
FES

Fat embolism syndrome

Early identification prevents negative outcomes.    Takeaways: Fat embolism syndrome is a rare complication that can occur after traumatic orthopedic injuries.…
isopropyl alcohol poisoning ant

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

Malignant hyperthermia

This potentially lethal condition calls for quick action.  Takeaways: Malignant hyperthermia is a genetic life-threatening disease that results in an…

Metformin-associated lactic acidosis

Early recognition prevents negative outcome. Takeaways: Metformin-associated lactic acidosis is associated with a high mortality rate when treatment is delayed…

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…
RaDonda Vaught, healthcare, nursing journal, nursing

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…
pulmonary edema

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…

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 action ant

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

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…
bowel-obstruction

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 ant

Stroke alert

Quick identification of stroke in a postpartum patient yields positive result. Anna Connor, a 30-year-old woman, is admitted to the…

Supraventricular tachycardia

Quick action reverses SVT and prevents a disastrous outcome. Takeaways: Atrial fibrillation and atrial flutter are the most common subtypes…
TURP

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

Tube feeding aspiration

What would you do in this situation? Takeaways: Acute aspiration of tube feeding can result in a respiratory emergency Know…

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