Nothing is more important to the patient’s outcome than properly performed chest compressions.
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Continuing Education
Approximately 34 million people in the United States have diabetes; 90% to 95% of them have type 2 diabetes. Insulin saves lives and helps people with both type…
Although most Americans voice concern about climate change (climate breakdown), many remain unaware that they’re experiencing its effects today. In fact, those born in the 1980s or later…
When you arrive for your afternoon shift, you receive report from the day-shift nurse. He states he just admitted Marc Stevens, age 78, after a colostomy takedown. He…
The renal system comprises the kidneys, ureters, and urethra, which maintain homeostasis via filtration and excretion of waste products, participate in acidbase balance, produce renin for maintaining hemodynamics,…
Suffering—it’s a powerful word that evokes a visceral response. Actually, patient means “one who suffers” in Latin. To reduce patient suffering, we need to consider the experience of nurses and other caregivers, because patient…
Millions of adults in the United States have or are at risk for developing chronic kidney disease (CKD); incidence continues to rise and CKD impacts many aspects of…
Learn what steps you can take to help patients avoid drug contamination and cope with drug shortages.
As the U.S. population ages, the risk for age-related illnesses such as Alzheimer’s disease and other types of dementia increases. According to Lang and colleagues, about 50% of…
Arrhythmogenic cardiomyopathy (ACM) is a description given to various rare conditions that can lead to life-threatening arrhythmias in the absence of ischemic, hypertensive, or valvular heart disease.
Understand the basics so you can effectively manage your patients. Takeaways: Neuraxial anesthesia is the administration of medication into the subarachnoid or epidural space to produce anesthesia and…
Anxiety disorders commonly present in primary care settings, and advanced practice RNs (APRNs) will benefit from understanding treatment options that promote positive outcomes. Several effective nonpharmacologic options exist…
Scientists are learning more about this baffling disorder, but a cure is a long way off.
A study by Wax and colleagues found that each year in the United States over 500,000 healthcare-associated bloodstream infections are attributed to I.V. catheters, including central and peripheral…
All segments of the international population are living longer, and many will experience dementia. Policymakers are focused on the cost estimates of caring for elders with cognitive impairment.…
Asthma is not curable, but it is controllable, and requires disease knowledge and understanding, which is gained through proper education.
Atrial fibrillation is a complex medical diagnosis requiring a holistic and interprofessional approach to minimize symptoms, prevent adverse outcomes, and improve the patient’s quality of life. The treatment…
Beth T, age 42, is a Caucasian female with a 32-year history of type 1 diabetes and a 15-year history of Crohn’s disease. For the last 12 years, she has…
Learning objectives 1. State how breast cancer is diagnosed and evaluated. 2. Identify the implications of genetics for patients with breast cancer. 3. Discuss targeted therapy for breast…
The number of new breast cancer cases is relatively stable (breast cancer represents 15% of all new cancer cases diagnosed in the United States each year), but improvements…
Review of immune checkpoint inhibitor and CAR T-cell therapy adverse effects and treatments. Takeaways: The U.S. Food and Drug Administration has approved several immunotherapy agents to treat cancer,…
Delays in seeking treatment frequently lead to poor health outcomes. Especially with regard to symptoms associated with cancer, early detection and treatment can improve survival rates and quality…
Cardiac resynchronization therapy (CRT) can help reduce readmissions in patients with heart failure (HF). It uses an implanted cardiac device to boost the heart’s efficiency and improve blood…
CS/PC strategies enhance the three essential skills of home health nursing: building a caring-trusting relationship with the patient, holistic and advanced assessment and care planning skills, and effective…
Nurses play a pivotal role in ensuring optimal care. Takeaways: Sickle cell disease is an inherited chronic condition that affects nearly every system in the body. Early recognition…
Opioid use disorder in the United States is a public health emergency not only for adults, but also for newborns. Infants exposed to opioids in utero and who…
For many years, surgical aortic valve replacement (SAVR) was the gold-standard treatment for severe, symptomatic aortic stenosis (AS). For eligible patients, this procedure can improve symptoms and extend…
Respiratory failure is one of the most common reasons for admission to the intensive care unit (ICU) and a common comorbidity in patients admitted for acute care. What’s…
After shock is recognized and I.V. fluid resuscitation is initiated, vasopressors and inotropes are used as supportive therapies in critical care settings. Safe and effective titration of these…
Nearly 6 million Americans suffer from heart failure (HF). The American Heart Association predicts that the number of individuals diagnosed with HF will increase 46% by 2030. HF can’t be…
A precursor to serious complications, this dangerous condition is on the rise among Americans.
Key takeways Early diagnosis of rheumatoid arthritis is important to manage symptoms. A combination of biologics and non-drug management of rheumatoid arthritis can slow progression of joint damage…
Spinal Cord Injuries (SCIs) are a significant cause of disability, with profound—and in many cases devastating— consequences. According to recent data, about 12,000 SCIs occur annually in the United States, and up to 250,000 Americans are living…
Many patients face prolonged recovery and permanent disability after a traumatic brain injury. This article reviews appropriate assessment and intervention and highlights family care.
Central lines can save lives. But dangerous complications can occur unless caregivers know how to identify, prevent, and solve potential problems.
APPROXIMATELY 5 million central vascular access devices (CVADs) are inserted into U.S. patients every year, and at least 85% of hospitalized patients receive some form of I.V. therapy.…
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder associated with repetitive head injuries.
Addressing climate change through corporate social responsibility is urgent and timely in the COVID-19 disaster recovery period for the nursing profession.
Ongoing research shows a decline in new graduate nurses’ clinical judgment. Effective mentorship plays a crucial role in ensuring patient safety while new nurses develop clinical judgment skills.…
Community-acquired Pneumonia (CAP) is exactly what it sounds like—a lung infection acquired while out and about in the world. The cause may be a virus, bacteria, or fungus.…
What do you think when you have a patient with pneumonia and a history of mental illness? Before even meeting the patient, do you assume you’ll face difficulty…
Concussion, a subset of mild traumatic brain injury, can lead to long-term effects, including chronic traumatic encephalopathy. (See Concussion’s impact.) The Centers for Disease Control and Prevention (CDC)…
Blood glucose self-monitoring helps patients with diabetes understand the interrelationships among food, activity, and medication to achieve their glycemic targets. It also aids treatment effectiveness assessment. Patients continue…
“I believe we can change the world if we start listening to one another again. Simple, honest, human conversation…a chance to speak, feel heard, and [where] we each…
Mrs. Glenn, a 72-year-old female on a medical-surgical floor, was hospitalized 3 days ago for pneumonia. Since her admission, she has been on continuous pulse oximetry and is…
MAJOR depressive disorder (MDD) affects more than 16 million adults in the United States each year and is a leading cause of disability for individuals ages 15 to…
Eugene Jones, age 66, has a 10-year history of type 2 diabetes mellitus; 1 year ago, he suffered a myocardial infarction (MI). During today’s routine clinic appointment, his…
When large volumes of insulin are injected subcutaneously, inadequate absorption, poor adherence, insulin leaking at the site of injection, and increased drug and supply costs can occur. Concentrated…
Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are endocrine emergencies. Hospitalizations for diabetes and DKA are rising, possibly because of increased diabetes prevalence and higher insulin costs.
Nurses are critical to recognizing and managing this life-threatening condition. Learning Objectives Identify the pathophysiology of differentiation syndrome (DS). Compare DS with tumor lysis syndrome. Discuss DS management.…
Early mobilization involves the early application and intensification of physical therapy within the first 2 to 5 days of a critical illness.
ETCO2 monitoring, a tool once used almost exclusively in patients receiving anesthesia, has proven useful in various settings, including the emergency department, medical–surgical units, critical care, ambulatory care,…
Enteral feedings deliver nourishment through a tube directly into the GI tract. They’re ordered for patients with a functioning GI tract who can’t ingest enough nutrition orally to meet their…
EPILEPSY is one of the most common disorders of the central nervous system, affecting 65 million people worldwide—3.4 million in the United States. It can occur with or…
Osteoarthritis is a chronic disorder of the joints that is painful, prevalent, costly, and a leading cause of disability.· Management of osteoarthritis is multifaceted and includes nonpharmacologic, pharmacologic,…
CHEST thoracotomy tubes (CTTs) have been around for centuries, but not until the late 1950s did they become standard of care for treating empyema, pneumothorax, hemothorax, hemopneumothorax, and…
Post-intensive care syndrome (PICS) is defined as new or increased physical, cognitive, or mental health impairment in a patient after hospitalization in a critical care unit. Similarly, post-intensive…
Nurses can serve as leaders as they help patients and families through a difficult time. Takeaways: All nurses must be competent in providing palliative and end-of-life care. Nursing…
The more resource options available for day-to-day surge events, the more effectively hospital operations can withstand imbalances in supply and demand. Proactively addressing the financial impact of surge…
This article explains basic genetic terminology and processes and describes assessment steps to help clinical nurses care for and manage patients at risk for inherited adult-onset diseases.
Gestational diabetes mellitus (GDM) refers to any degree of glucose intolerance that starts or is first recognized during pregnancy. Frequently, GDM represents pre-existing hyperglycemia and indicates underlying β-cell…
The more you know about menopause, the more you can help patients understand and cope with symptoms.
Our skin, scalp, mucous membranes, teeth, and digestive system are covered with symbiotic microorganisms we need for health. Some researchers describe the microbes in our digestive system (the…
Heart failure (HF), a clinical syndrome that results from changes in the cardiac structure, leads to impaired ventricular filling or reduced blood ejected with each heartbeat. Primary prevention…
Home care is unique, placing nurses and other healthcare professionals in patients’ homes and personal space, and doesn’t include typical healthcare organization requirements.
Feeding tubes are used for various indications in patients with either acute or long-term needs. Critical care, acute care, long-term, and home care nurses provide nutrition and hydration…
According to the 2021 Heart Disease and Stroke Statistics, hypertension (HTN) affects nearly one in two (46%) adults in the United States. More men than women have HTN up until…
Take a strategic approach to translating research into practice. Implementation is a major step in the evidence-based practice (EBP) process that’s often underappreciated and under-resourced, resulting in delays…
Key takeways Bladder conditions are common, costly, and hidden. With adequate information, individuals can participate in self-care for treatment and prevention. Nurses serve important roles in their professional…
Understanding these rapidly evolving treatments will help you advocate for patients and manage side effects. By Beth Boseki, MSN, RN, OCN, CCRP; Lauren FInaldi, BSN, RN, OCN; Samantha Siegel,…
The word arthritis denotes inflammation of the joint and the surrounding tissues. Initially considered a noninflammatory condition, knee osteoarthritis (KOA) results in joint structure alteration that points to…
Patients who arrive in the emergency department (ED) because of a fall or with a medical condition or after an accident that resulted in a fall, require prevention…
Living donor liver transplant has helped overcome the global shortage of donor organs. Live liver donors who electively undergo major abdominal surgery require specific care and expertise to…
A healthy 4-month-old baby boy of Eurasian descent is exclusively breastfed. This morning, his mother changes him and finds crusty, red oozing blisters covering his back. She calls…
Jill Smith, a 58-year-old waitress in a local bar, comes to the clinic complaining of shortness of breath and a persistent cough for the last month. She reports…
Key takeways Patients may experience cancer pain even after their cancer has been adequately treated and is in remission or cured. Proper assessment is key to pain management…
Lawrence Jeffries, age 78, is admitted to the hospital for an arthroplasty of the left hip. A retired roofer, he lives with his wife and son in a…
Managing pain in any older adult poses unique challenges. But older adults who are frail are more likely to experience chronic pain, acute pain, or both. What’s more, they stand a greater chance that…
Nurses frequently care for patients who use or are considering using medical cannabis. In 2018, the National Council of State Boards of Nursing (NCSBN) released guidelines for nurses…
Bridging the gap requires nurse intervention. Individuals within underserved populations face many hurdles to healthcare. They lack access, experience disparities in health literacy, and must consider how they…
Nurses work to ensure the safe delivery of medications, so they should remain current and knowledgeable about medication updates, side-effects, allergic reactions, drug–drug interactions, and changes in guideline…
The limited pool of qualified nursing staff readily available to provide safe, quality care taxes the human capital management of healthcare organizations worldwide. To maintain an adequate workforce…
Melanoma, which was once thought to be uncommon, is the most serious type of skin cancer. It accounts for 75% of deaths associated with cutaneous cancers.
Moisture-associated skin damage (MASD), inflammation and erosion of the skin, results from prolonged exposure to different sources of moisture such as feces or urine, sweat, saliva, wound exudate,…
Knowledge can help reduce stigmatization and improve access to care. Takeaways: Cases of human Mpox had been considered rare, but current data show rapid spread from human-to-human transmission.…
The growth of human trafficking increases the odds that you’ll encounter a patient who’s a victim. We can’t afford to miss any opportunity to provide aid to this…
Long COVID, a stigmatized and somewhat controversial condition, has begun to gain the public’s attention as some who previously had acute COVID-19 began reporting a unique constellation of…
New treatment modalities for lung cancer, including targeted therapy and immunotherapy, have contributed to improved patient survival rates. However, these treatments come with unique adverse effects. The nurse’s…
Combine medication and counseling with shared decision-making to treat addiction. Takeaways: Medication-assisted treatment (MAT), an evidence-based intervention for opioid use disorder and withdrawal symptom management, combines medication with counseling…
The body’s systemic response to an infection, sepsis can progress to severe sepsis and, in some cases, to septic shock. More than 1 million Americans suffer from severe sepsis annually. This number may grow in the…
Through shared governance, nurses are encouraged to participate in organizational decision-making to satisfy professional obligations. Incorporating ethical competence and professional development into everyday nursing practice is imperative to…
Marcy Taylor*, a 48-year-old woman, visits her nurse practitioner, Bryan Thomas, to discuss weight loss management. Marcy is 62 inches tall, weighs 182 lbs, and has a body…
Understanding how and why anesthesia providers select analgesic agents. Takeaways: Many options exist for managing intraoperative and postoperative surgical pain. Medications used for pain management can be broken…
Evidence-based recommendations. Takeaways: Inadequate postoperative pain relief can increase length of stay, delay discharge, increase readmission rates, and delay ambulation. Exploring the postoperative challenges faced by patients with…
Stay-up-to-date to avoid complications and achieve the best treatment for patients. Takeaways: This article discusses the use of oral anticoagulants. Indications, side effects and dosing of oral anticoagulants. …
Fran, a triage nurse in a busy primary care office, receives a call from Marla Rodriguez, whose mother is a long-time patient. Marla says her mother has an intense red rash over most of her…
Controlling symptoms and preventing exacerbations are the key to patient quality of life. Takeaways: Nurses must be able to identify patients with chronic obstructive pulmonary disease (COPD) early…
Accurately assessing and detecting acute or chronic pain in older adults (65 years and older) is challenging, especially if they have difficulty recognizing, interpreting, and communicating their pain…
Application of genetics and genomic science to health care is emerging in full force and having a powerful effect on nursing practice. Genomic medicine—using an individual’s genomic information to…
A bacterial or viral infection of the middle ear, acute otitis media (AOM) is the most common childhood infection in the United States for which antibiotics are prescribed. It’s…
An individualized, multimodal, and interprofessional approach is key for success. Takeaways: Many pediatric patients experience unnecessary pain because of undertreatment and inadequate pain management after surgery. Barriers to…
According to the American Congress of Obstetricians and Gynecologists, about 6,000 women in the United States enter menopause every day. During menopause (which is defined as the cessation…
Your patient has heart failure exacerbation, hypertension, type 2 diabetes, peripheral vascular disease, chronic renal failure, and depression. She says that she feels lightheaded and anxious. She also…
The Centers for Medicare and Medicaid Services report that pressure injuries (PIs) affect millions of patients each year, with incidence rates ranging from 2.2% to 23.9% in long-term…
Fall prevention “bundles” applied to all patients are ineffective; fall prevention interventions must be tailored to each individual patient’s fall risk factors.
Mistakes involving medications are among the most common healthcare errors. Medication errors lengthen hospital stays, increase inpatient expenses, and lead to more than 7,000 deaths annually in the…
Hospital-acquired pneumonia (HAP) is a serious complication of an acute care admission, particularly for patients noted to be at risk. HAP can be reduced when infection prevention measures…
Preventable medication errors cost the U.S. healthcare system more than $21 billion annually, according to the National Priorities Partnership and National Quality Forum. This number has risen significantly…
Confused about central catheters? Here’s what you need to know.
Adults with psychiatric conditions who are admitted as inpatients need to be assessed carefully to ensure they receive the best possible care. Although staff nurses don’t make the diagnosis, your assessment can help the psychiatrist…
Pulmonary embolism (PE) occurs when a clot (thrombus) that formed somewhere in the body dislodges, travels through the right side of the heart to the lungs and blocks…
About every 40 seconds in the United States, someone experiences an acute myocardial infarction (AMI)—that adds up to about 600,000 AMIs every year. This potentially debilitating condition, which…
Click here to download the PDF. Despite life-sustaining medical management for patients with critically worsening symptoms, heart failure (HF) prevalence continues to rise. An estimated 5.7 adult Americans…
The American Cancer Society estimates that in 2023 over 1.9 million individuals will receive a diagnosis of some form of cancer. Many will seek care for oncologic emergencies…
Traumatic brain injury (TBI) refers to blunt or penetrating head injury that disrupts normal brain functioning, causing impaired thinking and memory, personality changes, and possible sensory and motor changes. Some people recover completely with no cognitive deficits;…
Is your practice up-to-date? This article will discuss current research, steps for improving the verification process, reducing nasogastric tube misplacement.
A preventable and treatable lung disorder of adults, chronic obstructive pulmonary disease (COPD) is one of the most common causes of hospitalizations and readmissions. It affects 15 million Americans; nearly one in five hospital patients older than age…
Stroke readmissions are multifaceted and complex. In addition to recognizing risk factors for recurrent stroke, nurses should focus on impacting potentially preventable readmission complications such as medication adherence…
An interdisciplinary sepsis initiative eases the sepsis burden on patients, families, and the healthcare system.
Right-sided heart failure (HF) doesn’t get the attention that left-sided HF receives, but it’s an important factor in HF symptom severity and mortality. Right-sided HF, which can cause…
Every 40 seconds, a stroke occurs in the United States. This translates to approximately 795,000 strokes annually; of these, about 25% are recurrent strokes. Although stroke has declined…
A 42-year-old man arrives in the ED. He reports not feeling like himself. Three days ago he stepped on a nail, which punctured his foot. He removed the…
The nurse’s role at point of care Takeaways: Short peripheral and midline catheters can be essential to accomplishing patient therapeutic regimens. Nurses must be competent to recognize signs…
Kennedy terminal ulcer. Kennedy lesion. Skin failure. Skin changes at life’s end. Terminal ulcers. Trombley-Brennan terminal tissue injury. End-stage skin. Skin changes associated with dying. Decubitus ominosus. Unavoidable…
The glymphatic system, a glial-dependent waste clearance pathway in the brain, drains away soluble waste proteins and metabolic products, much like the lymphatic system in the rest of…
Since the discovery of multidrug-resistant infections, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci, concern has grown regarding antibiotic resistance among sexually transmitted infections (STIs). This concern is…
When celebrities die by suicide, discussion of this stigmatized topic makes its way into the headlines and conversations at work and home. That was true this year when…
Continuing Nursing Education Learning objectives 1. Differentiate between enteral and parenteral nutrition. 2. Discuss how to manage hypoglycemia and hyperglycemia in patients with diabetes who are receiving supplemental…
It’s your worst nightmare: At 8 A.M., you walk into the room of Laura M, a 35-year-old patient who had surgery yesterday, for your morning assessment. She’s unresponsive. The…
Cooling the temperature can protect the patient’s neurologic function and increase the chance for survival.
According to the American Heart Association (AHA), more than 795,000 Americans experience a stroke each year, and first-time strokes account for over three-quarters of them. An acute stroke,…
Avoidable hospital admissions are a key patient safety and quality concern. A significant cause of preventable readmissions is poor communication and coordination of care during transitions. Transitions between…
Nurses can help avoid negative effects of opioids while ensuring patient pain is managed. Takeaways: Pain management can be complicated by individual patients’ previous pain experiences, genetics, ability…
While relaxing at home at about 4 PM, Alan Sarangelo, a retired 62-year-old respiratory therapist, feels the left side of his face growing numb. His wife, a nurse, suspects he may be having…
May Grossman, age 57, is admitted for elective surgery to reverse a colostomy from a previous surgical procedure. Her health has been good except for occasional diverticulitis bouts.…
Urinary tract infection (UTI) continues to attract clinical attention as one of the world’s most prevalent infections. UTI broadly describes several clinical conditions, including cystitis, pyelonephritis, and renal…
Venous Thromboembolism (VTE) is the number-one cause of preventable death in hospitalized patients. (See VTE facts.) A thrombus is a clot that forms in a blood vessel, most…
Prompt, proper care will help reduce complications and improve quality of life. Venous ulcers are the most common lower extremity wounds in the United States. Patients experience poor…
Learning objectives 1. Differentiate the three tiers used to identify ventilator-associated events (VAEs). 2. Identify key elements of VAE surveillance. 3. Discuss the practice implications of VAEs. Purpose/goal:…
Learn how understanding your organization’s staffing process can help you influence staffing levels on your unit.
Essential (primary) hypertension is one of the most important preventable contributors to illness and death in the United States. Frequently termed the silent killer, hypertension progresses with few…
How do we differentiate delirium and dementia and assess for DSD and prevent DSD and manage individuals with the condition? Distinguishing between the two conditions can help ensure…
Understand women’s unique risks and symptoms to ensure early identification and treatment of CVD. Takeaways: Cardiovascular disease (CVD) remains the leading cause of mortality in women; women of…
Why are new HIV cases still occurring when we have preventive treatment? One reason could be a lack of knowledge and experience among healthcare professionals to discuss, prescribe,…
6 surprising best resuscitation practices
Nothing is more important to the patient’s outcome than properly performed chest compressions.
A broader look at insulin
Approximately 34 million people in the United States have diabetes; 90% to 95% of them have type 2 diabetes. Insulin saves lives and helps…
A warming planet and human health
Although most Americans voice concern about climate change (climate breakdown), many remain unaware that they’re experiencing its effects today. In fact, those born in…
Acute kidney injury: Causes, phases, and early detection
When you arrive for your afternoon shift, you receive report from the day-shift nurse. He states he just admitted Marc Stevens, age 78, after…
Acute kidney injury: A nursing challenge
The renal system comprises the kidneys, ureters, and urethra, which maintain homeostasis via filtration and excretion of waste products, participate in acidbase balance, produce…
Addressing patient and caregiver suffering
Suffering—it’s a powerful word that evokes a visceral response. Actually, patient means “one who suffers” in Latin. To reduce patient suffering, we need to consider the experience of nurses…
Adults with chronic kidney disease: Overview and nursing care goals
Millions of adults in the United States have or are at risk for developing chronic kidney disease (CKD); incidence continues to rise and CKD…
Advocating for patients in an era of drug-delivery problems
Learn what steps you can take to help patients avoid drug contamination and cope with drug shortages.
Alzheimer’s disease and Lewy body dementia: Discerning the differences
As the U.S. population ages, the risk for age-related illnesses such as Alzheimer’s disease and other types of dementia increases. According to Lang and…
An overview of arrhythmogenic cardiomyopathy
Arrhythmogenic cardiomyopathy (ACM) is a description given to various rare conditions that can lead to life-threatening arrhythmias in the absence of ischemic, hypertensive, or…
An overview of neuraxial anesthesia
Understand the basics so you can effectively manage your patients. Takeaways: Neuraxial anesthesia is the administration of medication into the subarachnoid or epidural space…
Anxiety in primary care: A primer for APRNs
Anxiety disorders commonly present in primary care settings, and advanced practice RNs (APRNs) will benefit from understanding treatment options that promote positive outcomes. Several…
Are we making progress against autism?
Scientists are learning more about this baffling disorder, but a cure is a long way off.
Aseptic technique and perioperative I.V. medication administration
A study by Wax and colleagues found that each year in the United States over 500,000 healthcare-associated bloodstream infections are attributed to I.V. catheters,…
Assessing and preventing cognitive impairment in the elderly
All segments of the international population are living longer, and many will experience dementia. Policymakers are focused on the cost estimates of caring for…
Asthma education for pediatric patients
Asthma is not curable, but it is controllable, and requires disease knowledge and understanding, which is gained through proper education.
Atrial fibrillation: Recognition and management to improve quality of life
Atrial fibrillation is a complex medical diagnosis requiring a holistic and interprofessional approach to minimize symptoms, prevent adverse outcomes, and improve the patient’s quality…
Boost your confidence in caring for patients with insulin pumps
Beth T, age 42, is a Caucasian female with a 32-year history of type 1 diabetes and a 15-year history of Crohn’s disease. For the…
Breast cancer care gets personal
Learning objectives 1. State how breast cancer is diagnosed and evaluated. 2. Identify the implications of genetics for patients with breast cancer. 3. Discuss…
Breast cancer survivors: Assessment and management of long-term treatment effects
The number of new breast cancer cases is relatively stable (breast cancer represents 15% of all new cancer cases diagnosed in the United States…
Cancer immunotherapy update
Review of immune checkpoint inhibitor and CAR T-cell therapy adverse effects and treatments. Takeaways: The U.S. Food and Drug Administration has approved several immunotherapy…
Cancer treatment delays and survival outcomes
Delays in seeking treatment frequently lead to poor health outcomes. Especially with regard to symptoms associated with cancer, early detection and treatment can improve…
Cardiac resynchronization therapy: An approach to reducing heart-failure readmissions
Cardiac resynchronization therapy (CRT) can help reduce readmissions in patients with heart failure (HF). It uses an implanted cardiac device to boost the heart’s…
Caring for diverse patient populations in their homes
CS/PC strategies enhance the three essential skills of home health nursing: building a caring-trusting relationship with the patient, holistic and advanced assessment and care…
Caring for individuals with sickle cell disease
Nurses play a pivotal role in ensuring optimal care. Takeaways: Sickle cell disease is an inherited chronic condition that affects nearly every system in…
Caring for infants and families affected by neonatal abstinence syndrome
Opioid use disorder in the United States is a public health emergency not only for adults, but also for newborns. Infants exposed to opioids…
Caring for Patients after Transcatheter Aortic Valve Replacement
For many years, surgical aortic valve replacement (SAVR) was the gold-standard treatment for severe, symptomatic aortic stenosis (AS). For eligible patients, this procedure can…
Caring for patients in respiratory failure
Respiratory failure is one of the most common reasons for admission to the intensive care unit (ICU) and a common comorbidity in patients admitted…
Caring for patients receiving vasopressors and inotropes in the ICU
After shock is recognized and I.V. fluid resuscitation is initiated, vasopressors and inotropes are used as supportive therapies in critical care settings. Safe and…
Caring for patients with a left ventricular assist device
Nearly 6 million Americans suffer from heart failure (HF). The American Heart Association predicts that the number of individuals diagnosed with HF will increase 46% by…
Caring for patients with metabolic syndrome
A precursor to serious complications, this dangerous condition is on the rise among Americans.
Caring for patients with rheumatoid arthritis in the community
Key takeways Early diagnosis of rheumatoid arthritis is important to manage symptoms. A combination of biologics and non-drug management of rheumatoid arthritis can slow…
Caring for patients with spinal cord injuries
Spinal Cord Injuries (SCIs) are a significant cause of disability, with profound—and in many cases devastating— consequences. According to recent data, about 12,000 SCIs occur annually in the United States, and up…
Caring for patients with traumatic brain injuries: Are you up to the challenges?
Many patients face prolonged recovery and permanent disability after a traumatic brain injury. This article reviews appropriate assessment and intervention and highlights family care.
Central lines: Recognizing, preventing, and troubleshooting complications
Central lines can save lives. But dangerous complications can occur unless caregivers know how to identify, prevent, and solve potential problems.
Central vascular access device complications:
APPROXIMATELY 5 million central vascular access devices (CVADs) are inserted into U.S. patients every year, and at least 85% of hospitalized patients receive some…
Chronic traumatic encephalopathy and traumatic brain injury
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder associated with repetitive head injuries.
Climate change interventions
Addressing climate change through corporate social responsibility is urgent and timely in the COVID-19 disaster recovery period for the nursing profession.
Coaching and evaluating new graduate nurses
Ongoing research shows a decline in new graduate nurses’ clinical judgment. Effective mentorship plays a crucial role in ensuring patient safety while new nurses…
Community-acquired pneumonia
Community-acquired Pneumonia (CAP) is exactly what it sounds like—a lung infection acquired while out and about in the world. The cause may be a…
Comorbid mental illness on acute medical units
What do you think when you have a patient with pneumonia and a history of mental illness? Before even meeting the patient, do you…
Concussion: Prevention, assessment, and management
Concussion, a subset of mild traumatic brain injury, can lead to long-term effects, including chronic traumatic encephalopathy. (See Concussion’s impact.) The Centers for Disease…
Continuous glucose monitoring: THE BASICS
Blood glucose self-monitoring helps patients with diabetes understand the interrelationships among food, activity, and medication to achieve their glycemic targets. It also aids treatment…
Conversations to inspire and promote a more civil workplace
“I believe we can change the world if we start listening to one another again. Simple, honest, human conversation…a chance to speak, feel heard,…
Decoding the oxyhemoglobin dissociation curve
Mrs. Glenn, a 72-year-old female on a medical-surgical floor, was hospitalized 3 days ago for pneumonia. Since her admission, she has been on continuous…
Depression and chronic medical illness in adults
MAJOR depressive disorder (MDD) affects more than 16 million adults in the United States each year and is a leading cause of disability for…
Diabetes and cardiovascular disease: A deadly duo
Eugene Jones, age 66, has a 10-year history of type 2 diabetes mellitus; 1 year ago, he suffered a myocardial infarction (MI). During today’s…
Diabetes— Pharmacologic management update
When large volumes of insulin are injected subcutaneously, inadequate absorption, poor adherence, insulin leaking at the site of injection, and increased drug and supply…
Diabetic ketoacidosis and hyperglycemic hyperosmolar state
Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are endocrine emergencies. Hospitalizations for diabetes and DKA are rising, possibly because of increased diabetes prevalence and…
Differentiation syndrome: An emerging oncologic complication
Nurses are critical to recognizing and managing this life-threatening condition. Learning Objectives Identify the pathophysiology of differentiation syndrome (DS). Compare DS with tumor lysis…
ECMO and nurse-led mobilization
Early mobilization involves the early application and intensification of physical therapy within the first 2 to 5 days of a critical illness.
End-tidal CO2 monitoring
ETCO2 monitoring, a tool once used almost exclusively in patients receiving anesthesia, has proven useful in various settings, including the emergency department, medical–surgical units,…
Enteral feeding: Indications, complications, and nursing care
Enteral feedings deliver nourishment through a tube directly into the GI tract. They’re ordered for patients with a functioning GI tract who can’t ingest enough nutrition…
Evidence-based epilepsy care
EPILEPSY is one of the most common disorders of the central nervous system, affecting 65 million people worldwide—3.4 million in the United States. It…
Evidence-based practices for osteoarthritis management
Osteoarthritis is a chronic disorder of the joints that is painful, prevalent, costly, and a leading cause of disability.· Management of osteoarthritis is multifaceted…
Evidence-based update on chest tube management
CHEST thoracotomy tubes (CTTs) have been around for centuries, but not until the late 1950s did they become standard of care for treating empyema,…
Families and post-intensive care syndrome
Post-intensive care syndrome (PICS) is defined as new or increased physical, cognitive, or mental health impairment in a patient after hospitalization in a critical…
Frequently asked questions about palliative care
Nurses can serve as leaders as they help patients and families through a difficult time. Takeaways: All nurses must be competent in providing palliative…
From surge plans to a culture of readiness
The more resource options available for day-to-day surge events, the more effectively hospital operations can withstand imbalances in supply and demand. Proactively addressing the…
Genetics in the clinical setting
This article explains basic genetic terminology and processes and describes assessment steps to help clinical nurses care for and manage patients at risk for…
Gestational diabetes
Gestational diabetes mellitus (GDM) refers to any degree of glucose intolerance that starts or is first recognized during pregnancy. Frequently, GDM represents pre-existing hyperglycemia…
Guiding your patients through menopause
The more you know about menopause, the more you can help patients understand and cope with symptoms.
Gut microbiome and health
Our skin, scalp, mucous membranes, teeth, and digestive system are covered with symbiotic microorganisms we need for health. Some researchers describe the microbes in…
Heart failure management: Updated guidelines
Heart failure (HF), a clinical syndrome that results from changes in the cardiac structure, leads to impaired ventricular filling or reduced blood ejected with…
Home care safety
Home care is unique, placing nurses and other healthcare professionals in patients’ homes and personal space, and doesn’t include typical healthcare organization requirements.
How to recognize, prevent, and troubleshoot mechanical complications of enteral feeding tubes
Feeding tubes are used for various indications in patients with either acute or long-term needs. Critical care, acute care, long-term, and home care nurses…
Hypertension update: Implications for nursing practice
According to the 2021 Heart Disease and Stroke Statistics, hypertension (HTN) affects nearly one in two (46%) adults in the United States. More men than women…
Implementation: The linchpin of evidence-based practice changes
Take a strategic approach to translating research into practice. Implementation is a major step in the evidence-based practice (EBP) process that’s often underappreciated and…
Improving care and outcomes for patients with bladder conditions
Key takeways Bladder conditions are common, costly, and hidden. With adequate information, individuals can participate in self-care for treatment and prevention. Nurses serve important…
Introduction to immunotherapy: What nurses need to know about emerging therapies
Understanding these rapidly evolving treatments will help you advocate for patients and manage side effects. By Beth Boseki, MSN, RN, OCN, CCRP; Lauren FInaldi, BSN,…
Knee Osteoarthritis: Assessment and management
The word arthritis denotes inflammation of the joint and the surrounding tissues. Initially considered a noninflammatory condition, knee osteoarthritis (KOA) results in joint structure…
Known fallers
Patients who arrive in the emergency department (ED) because of a fall or with a medical condition or after an accident that resulted in…
Living donor liver transplant coordinator
Living donor liver transplant has helped overcome the global shortage of donor organs. Live liver donors who electively undergo major abdominal surgery require specific…
Living with atopic dermatitis
A healthy 4-month-old baby boy of Eurasian descent is exclusively breastfed. This morning, his mother changes him and finds crusty, red oozing blisters covering…
Lung cancer: Not just a smoker’s disease
Jill Smith, a 58-year-old waitress in a local bar, comes to the clinic complaining of shortness of breath and a persistent cough for the…
Managing chronic pain in cancer survivors
Key takeways Patients may experience cancer pain even after their cancer has been adequately treated and is in remission or cured. Proper assessment is…
Managing delirium in hospitalized older adults
Lawrence Jeffries, age 78, is admitted to the hospital for an arthroplasty of the left hip. A retired roofer, he lives with his wife…
Managing pain in frail elders
Managing pain in any older adult poses unique challenges. But older adults who are frail are more likely to experience chronic pain, acute pain, or both. What’s more, they…
Medical Cannabis: What Nurses Need to Know
Nurses frequently care for patients who use or are considering using medical cannabis. In 2018, the National Council of State Boards of Nursing (NCSBN)…
Medication adherence in underserved populations
Bridging the gap requires nurse intervention. Individuals within underserved populations face many hurdles to healthcare. They lack access, experience disparities in health literacy, and…
Medication safety
Nurses work to ensure the safe delivery of medications, so they should remain current and knowledgeable about medication updates, side-effects, allergic reactions, drug–drug interactions,…
Mentorship: A strategy for nursing retention
The limited pool of qualified nursing staff readily available to provide safe, quality care taxes the human capital management of healthcare organizations worldwide. To…
Mitigating melanoma
Melanoma, which was once thought to be uncommon, is the most serious type of skin cancer. It accounts for 75% of deaths associated with…
Moisture-associated skin damage: The basics
Moisture-associated skin damage (MASD), inflammation and erosion of the skin, results from prolonged exposure to different sources of moisture such as feces or urine,…
Mpox: Be prepared for the next outbreak
Knowledge can help reduce stigmatization and improve access to care. Takeaways: Cases of human Mpox had been considered rare, but current data show rapid…
My patient is a victim of human trafficking
The growth of human trafficking increases the odds that you’ll encounter a patient who’s a victim. We can’t afford to miss any opportunity to…
Navigating Long COVID
Long COVID, a stigmatized and somewhat controversial condition, has begun to gain the public’s attention as some who previously had acute COVID-19 began reporting…
New lung cancer treatment modalities and their adverse effects
New treatment modalities for lung cancer, including targeted therapy and immunotherapy, have contributed to improved patient survival rates. However, these treatments come with unique…
NP role in medication-assisted treatment for opioid use disorder
Combine medication and counseling with shared decision-making to treat addiction. Takeaways: Medication-assisted treatment (MAT), an evidence-based intervention for opioid use disorder and withdrawal symptom management,…
Nurses can help improve outcomes in severe sepsis
The body’s systemic response to an infection, sepsis can progress to severe sepsis and, in some cases, to septic shock. More than 1 million Americans suffer from severe sepsis annually. This…
Nursing ethics and shared governance model
Through shared governance, nurses are encouraged to participate in organizational decision-making to satisfy professional obligations. Incorporating ethical competence and professional development into everyday nursing…
Obesity in adults: Pharmacologic options for successful management
Marcy Taylor*, a 48-year-old woman, visits her nurse practitioner, Bryan Thomas, to discuss weight loss management. Marcy is 62 inches tall, weighs 182 lbs,…
Opioid and non-opioid analgesia during surgery
Understanding how and why anesthesia providers select analgesic agents. Takeaways: Many options exist for managing intraoperative and postoperative surgical pain. Medications used for pain…
Optimizing postoperative pain management in patients with chronic pain
Evidence-based recommendations. Takeaways: Inadequate postoperative pain relief can increase length of stay, delay discharge, increase readmission rates, and delay ambulation. Exploring the postoperative challenges…
Oral anticoagulants: Pharmacologic management update
Stay-up-to-date to avoid complications and achieve the best treatment for patients. Takeaways: This article discusses the use of oral anticoagulants. Indications, side effects and…
Oral Chemotherapy: Not just an ordinary pill
Fran, a triage nurse in a busy primary care office, receives a call from Marla Rodriguez, whose mother is a long-time patient. Marla says her mother has an intense red…
Outpatient care of patients with COPD
Controlling symptoms and preventing exacerbations are the key to patient quality of life. Takeaways: Nurses must be able to identify patients with chronic obstructive…
Pain assessment and nonpharmacologic management in older adults
Accurately assessing and detecting acute or chronic pain in older adults (65 years and older) is challenging, especially if they have difficulty recognizing, interpreting,…
Patient care in the dawn of the genomic age
Application of genetics and genomic science to health care is emerging in full force and having a powerful effect on nursing practice. Genomic medicine—using an…
Pediatric otitis media: To treat or not to treat with antibiotics
A bacterial or viral infection of the middle ear, acute otitis media (AOM) is the most common childhood infection in the United States for which…
Pediatric pain management
An individualized, multimodal, and interprofessional approach is key for success. Takeaways: Many pediatric patients experience unnecessary pain because of undertreatment and inadequate pain management…
Postmenopausal women and urinary incontinence
According to the American Congress of Obstetricians and Gynecologists, about 6,000 women in the United States enter menopause every day. During menopause (which is…
Premature ventricular complexes
Your patient has heart failure exacerbation, hypertension, type 2 diabetes, peripheral vascular disease, chronic renal failure, and depression. She says that she feels lightheaded…
Pressure injury prevention in long-term care
The Centers for Medicare and Medicaid Services report that pressure injuries (PIs) affect millions of patients each year, with incidence rates ranging from 2.2%…
Preventing falls in hospitalized patients
Fall prevention “bundles” applied to all patients are ineffective; fall prevention interventions must be tailored to each individual patient’s fall risk factors.
Preventing high-alert medication errors in hospital patients
Mistakes involving medications are among the most common healthcare errors. Medication errors lengthen hospital stays, increase inpatient expenses, and lead to more than 7,000…
Preventing hospital-acquired pneumonia
Hospital-acquired pneumonia (HAP) is a serious complication of an acute care admission, particularly for patients noted to be at risk. HAP can be reduced…
Preventing medication errors by empowering patients
Preventable medication errors cost the U.S. healthcare system more than $21 billion annually, according to the National Priorities Partnership and National Quality Forum. This…
Providing optimal care for patients with central catheters
Confused about central catheters? Here’s what you need to know.
Psychiatric assessment strategies for inpatients: Resources with a purpose
Adults with psychiatric conditions who are admitted as inpatients need to be assessed carefully to ensure they receive the best possible care. Although staff nurses don’t make the diagnosis, your assessment…
Pulmonary embolism: Surveillance is key
Pulmonary embolism (PE) occurs when a clot (thrombus) that formed somewhere in the body dislodges, travels through the right side of the heart to…
Recognizing and Managing Complications of Acute Myocardial Infarction
About every 40 seconds in the United States, someone experiences an acute myocardial infarction (AMI)—that adds up to about 600,000 AMIs every year. This…
Recognizing heart failure symptoms can improve patient self-management
Click here to download the PDF. Despite life-sustaining medical management for patients with critically worsening symptoms, heart failure (HF) prevalence continues to rise. An…
Recognizing oncologic emergencies
The American Cancer Society estimates that in 2023 over 1.9 million individuals will receive a diagnosis of some form of cancer. Many will seek…
Reducing intracranial pressure in patients with traumatic brain injury
Traumatic brain injury (TBI) refers to blunt or penetrating head injury that disrupts normal brain functioning, causing impaired thinking and memory, personality changes, and possible sensory and motor changes. Some people…
Reducing nasogastric tube misplacement through evidence-based practice
Is your practice up-to-date? This article will discuss current research, steps for improving the verification process, reducing nasogastric tube misplacement.
Reducing readmissions in in COPD patients
A preventable and treatable lung disorder of adults, chronic obstructive pulmonary disease (COPD) is one of the most common causes of hospitalizations and readmissions. It affects 15 million Americans; nearly one in five…
Reducing readmissions in stroke patients
Stroke readmissions are multifaceted and complex. In addition to recognizing risk factors for recurrent stroke, nurses should focus on impacting potentially preventable readmission complications…
Reducing sepsis deaths: A systems approach to early detection and management
An interdisciplinary sepsis initiative eases the sepsis burden on patients, families, and the healthcare system.
Right-sided heart failure
Right-sided heart failure (HF) doesn’t get the attention that left-sided HF receives, but it’s an important factor in HF symptom severity and mortality. Right-sided…
Secondary prevention of stroke
Every 40 seconds, a stroke occurs in the United States. This translates to approximately 795,000 strokes annually; of these, about 25% are recurrent strokes.…
Sepsis in the hospital setting: A case study
A 42-year-old man arrives in the ED. He reports not feeling like himself. Three days ago he stepped on a nail, which punctured his…
Short peripheral and midline catheter complications
The nurse’s role at point of care Takeaways: Short peripheral and midline catheters can be essential to accomplishing patient therapeutic regimens. Nurses must be…
Skin failure: A historical perspective
Kennedy terminal ulcer. Kennedy lesion. Skin failure. Skin changes at life’s end. Terminal ulcers. Trombley-Brennan terminal tissue injury. End-stage skin. Skin changes associated with…
Sleep and the glymphatic system
The glymphatic system, a glial-dependent waste clearance pathway in the brain, drains away soluble waste proteins and metabolic products, much like the lymphatic system…
STIs: Antibiotic resistance and treatment challenges
Since the discovery of multidrug-resistant infections, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci, concern has grown regarding antibiotic resistance among sexually transmitted infections…
Suicide among nurses: What we don’t know might hurt us
When celebrities die by suicide, discussion of this stigmatized topic makes its way into the headlines and conversations at work and home. That was…
Supplemental nutrition in hospitalized patients with diabetes
Continuing Nursing Education Learning objectives 1. Differentiate between enteral and parenteral nutrition. 2. Discuss how to manage hypoglycemia and hyperglycemia in patients with diabetes…
The case for capnography in patients receiving opioids
It’s your worst nightmare: At 8 A.M., you walk into the room of Laura M, a 35-year-old patient who had surgery yesterday, for your morning…
Therapeutic hypothermia after cardiac arrest
Cooling the temperature can protect the patient’s neurologic function and increase the chance for survival.
Time is brain
According to the American Heart Association (AHA), more than 795,000 Americans experience a stroke each year, and first-time strokes account for over three-quarters of…
Transitional care can reduce hospital readmissions
Avoidable hospital admissions are a key patient safety and quality concern. A significant cause of preventable readmissions is poor communication and coordination of care…
Treating pain while mindful of opioid risks
Nurses can help avoid negative effects of opioids while ensuring patient pain is managed. Takeaways: Pain management can be complicated by individual patients’ previous…
Urgent care for stroke patients: Timing is everything
While relaxing at home at about 4 PM, Alan Sarangelo, a retired 62-year-old respiratory therapist, feels the left side of his face growing numb. His wife, a nurse, suspects…
Using oral care to prevent nonventilator hospital-acquired pneumonia
May Grossman, age 57, is admitted for elective surgery to reverse a colostomy from a previous surgical procedure. Her health has been good except…
UTI revisited: Optimizing best practices
Urinary tract infection (UTI) continues to attract clinical attention as one of the world’s most prevalent infections. UTI broadly describes several clinical conditions, including…
Venous thromboembolism: Very troubling events
Venous Thromboembolism (VTE) is the number-one cause of preventable death in hospitalized patients. (See VTE facts.) A thrombus is a clot that forms in…
Venous ulcer care
Prompt, proper care will help reduce complications and improve quality of life. Venous ulcers are the most common lower extremity wounds in the United…
Ventilator-associated events: A new outcome measure
Learning objectives 1. Differentiate the three tiers used to identify ventilator-associated events (VAEs). 2. Identify key elements of VAE surveillance. 3. Discuss the practice…
What every nurse should know about staffing
Learn how understanding your organization’s staffing process can help you influence staffing levels on your unit.
What goes up must come down: Hypertension and the JNC-8 guidelines
Essential (primary) hypertension is one of the most important preventable contributors to illness and death in the United States. Frequently termed the silent killer,…
When up is down: Delirium superimposed on dementia
How do we differentiate delirium and dementia and assess for DSD and prevent DSD and manage individuals with the condition? Distinguishing between the two…
Women and cardiovascular disease
Understand women’s unique risks and symptoms to ensure early identification and treatment of CVD. Takeaways: Cardiovascular disease (CVD) remains the leading cause of mortality…
Women and HIV pre-exposure prophylaxis
Why are new HIV cases still occurring when we have preventive treatment? One reason could be a lack of knowledge and experience among healthcare…
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