Features

STI guidelines

2021 CDC STI guidelines: A review of changes

Follow current recommendations for prevention, assessment, and treatment.  Takeaways: Sexually transmitted infections are epidemic in the United States with numbers steadily rising and reaching an all-time high for…
Addressing transgender myths

Addressing transgender myths

Transgender (trans) people encompass vari­ous genders and experiences, but generally speaking, their gender doesn’t match the sex they were assigned at birth. According to the Williams Institute, about…
arrhythmogenic-cardiomyopathy

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 valvular heart disease.
ECMO

Answers to the top 10 ECMO questions

ECMO, a form of partial cardio­pulmonary bypass, provides either venoarterial (VA) or venovenous (VV) support. The ECMO circuit pumps venous blood outside of the body to an oxygenator,…

Antibiotic stewardship for staff nurses

Over the past decade, antibiotic resistance has increased and spread dramatically throughout the world. According to the Centers for Disease Control and Prevention (CDC), antibiotic use is the single most important factor leading to antibiotic resistance. The…

APRNs and the Choosing Wisely® campaign

Advanced Practice RNs (APRNs) influence outcomes for patients in a number of ways, including better symptom management, reduced costs, and improved health. Demonstrating the outcomes of APRN care remains a…
opioid

Avoiding iatrogenic opioid dependency and addiction

The opioid epidemic poses a complex conundrum. Federal and state governments have implemented various policies and appropriated millions of dollars to address the problem, but the epidemic continues.…

Better safe than sepsis

Tips for a hospital sepsis prevention program Takeaways: The Surviving Sepsis Campaign international consensus guidelines summarize best practices based on the medical literature, but they don’t illustrate how…
biosimilars-lower-drug-costs-patients

Biosimilars: An alternative to biologics

Biosimilars may help lower drug costs for patients. Takeaways: Biologics and biosimilars are classes of drugs used to treat many complex conditions, including inflammatory bowel disease, diabetes, and…
candida auris emerging threat

Candida auris: Nurses’ response to an emerging threat

Prevention and management of “superbugs” or “nightmare bacteria” require that nurses understand the complexity of the organisms involved and their impact on the care environment. They also require…
cannabis

Cannabinoid hyperemesis syndrome explained

Cannabinoid hyperemesis syndrome is a three-phase cyclical syndrome characterized by periods of intense nausea and vomiting, frequently relieved with hot water bathing, that poses many diagnosis and treatment…

Carbon monoxide poisoning: The silent killer

In June 2013, a mother and her 11-year-old son drove to the North Carolina mountains for an overnight stay and checked into a nice hotel with an indoor pool. Shortly after their arrival, she went to…
cardiotoxic effects of cancer therapy

Cardiotoxic effects of cancer therapy

Treatment risks and how to manage them Takeaways: Some cancer treatments can have cardiotoxic effects. Cardiotoxic effects include decreased heart function, chest pain, arrhythmias, palpitations, edema, hypertension, vascular…

Caring for patients with lumbar drains

A LUMBAR DRAIN is a small, flexible tube placed in the arachnoid space to drain cerebrospinal fluid (CSF). Indications for lumbar drains include: to drain CSF leakage secondary to a…
common-hearing-loss-adults

Common causes of hearing loss in adults

Nurses can help reduce potential loss of quality of life. Takeaways: Approximately 16% of adults age 18 years and older report trouble hearing Symptoms of hearing loss can…
Cranial nerve assessment, healthcare, registered nurse, nursing, nursing journal

Cranial nerve assessment: A practical approach

Acute and chronic neurologic presentations exist in all healthcare settings. Abnormal findings—subtle or gross—reflect sensory, motor, and reflexive function and have significant implications for nursing care. However, many…
critically ill obstetric patients

Critically ill obstetric patients

ALTHOUGH evidence-based nursing guidelines exist to direct the care of acute and chronic conditions in obstetric (OB) patients while they’re in OB settings, few if any such guidelines…
DKA

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 higher insulin costs.
diagnosis treatment prevention cystitis

Diagnosis, treatment, and prevention of cystitis

A case report to guide nurse practitioners. By Myriam Jean Cadet, PhD, APRN, MSN, FNP-C Takeaways Early diagnosis of cystitis is important to manage and prevent renal complications. Antibiotic…
disaster regulation proactive response ant

Disasters, regulation, and proactive response

Is nursing prepared for the next disaster? By David Benton, RGN, PhD, FFNF, FRCN, FAAN With alarming frequency, nurses are confronted with the professional, organizational, and personal consequences…
Discontinuing medically administered nutrition

Discontinuing medically administered nutrition

Support patient’s values, beliefs, and goals.  Takeaways: Medically administered nutrition and hydration (MANH) is indicated for individuals with chronic, complex, or serious illness for whom oral nutrition is…

Effective bag-valve-mask ventilation saves lives

Robert Walker*, your patient in the postanesthesia care unit, is recovering from laparoscopic cholecystectomy. The anesthesia provider tells you that the patient’s history is unremarkable and surgery went well.…

Frailty syndrome: A weakly addressed problem

Fran Covington, age 82, has a history of cardiovascular disease, chronic diastolic heart failure, type 2 diabetes, and chronic obstructive pulmonary disease (COPD). She lives at home with her husband and enjoys gardening and visiting with…

Helping patients who harm themselves

Why would someone deliberately hurt herself? The notion might seem odd—but as a nurse, you may encounter patients with signs of selfinjury (also called cutting, selfinflicted violence, self-harm, or self-mutilation). Cutting the skin is the most…
His Bundle

His bundle pacing

For patients with sick sinus syndrome and nonreversible atrioventricular (AV) conduction block, pacemakers provide the only effective treatment by electrically stimulating heart muscle contraction. Over the years, pacemakers…
design-thinking

How innovation and design thinking can improve care

Empathy and collaboration create opportunities to help vulnerable populations.  Takeaways: Design thinking is a problem-solving tool driven by the needs of the targeted population. The authors used designing…

How to help patients live with liver failure

A life-threatening condition, liver failure results from liver damage. In many cases, the damage is gradual and silent, causing few symptoms until the organ loses all of its functions. Liver failure can be acute…

How to recognize and intervene for pediatric sepsis

A life-threatening, life-altering emergency, sepsis can have catastrophic effects. When the condition progresses undetected, it can lead to multiple organ dysfunction syndrome and death. Mortality ranges from 9% to…

How to recognize delirium in pediatric patients

A syndrome  of acute brain dysfunction, delirium causes observable changes in behavior. A hallmark of delirium is a disturbance of consciousness and cognition, with inattention that develops acutely and fluctuates over time. (See Understanding diagnostic criteria…

How you can avoid laboratory errors

YOU MIGHT be wondering: Since when do nurses make laboratory errors? Actually, we make them fairly often—typically by using improper technique when collecting and handling samples and specimens. Preanalytic errors (those occurring before the sample…
Hypothyroidism and nursing care

Hypothyroidism and nursing care

Hypothyroidism, also known as myxedema, is second to diabetes mellitus as the most common endocrine disorder in the United States. It’s six times more likely to occur in…
Implementing trauma-informed care

Implementing trauma-informed care 

Childhood trauma can result in severe mental and physical consequences that reverberate throughout a person’s life. Despite the widespread occurrence of childhood trauma, most nurses remain unaware of…
influenza flight flu

Influenza vaccines and nurses

It’s that time of year again. Children are back in school, leaves are changing, the air is chilly, and signs of flu season are all around—sniffling, coughing, and…
glucose monitoring

Insights into glucose monitoring for diabetes

Refinements in glucose monitoring have opened a door to better glycemic management in patients with diabetes for both clinicians and patients. Clinicians are using the blood test glycated…

Interacting with individuals on the autism spectrum

Optimizing health encounters for patients on the autism spectrum (ASD) requires an individualized approach. Understanding similarities among people with ASD may improve communication, interactions, and health outcomes for…

Intimate partner violence in pregnancy

Screening, assessment, and intervention. Takeaways  According the Centers for Disease Control and Prevention, 32.4% of women in the United States have experienced physical violence by and intimate partner…
leadless pacemakers cardiac pacing

Leadless pacemakers: A new technology in cardiac pacing

Learn about the nursing implications of these innovative devices. Takeaways: The leadless pacemaker is a right ventricular single chamber pacemaker used to treat symptomatic bradycardia. The leadless pacemaker eliminates…

Lyme disease prevention and treatment

SCENARIO: When you meet your patient Tom for the first time, he reports fever, headaches, a rash on his stomach, and muscle aches. As you perform your assessment, he says, “I’m not sure…
manage mental health emergency ant

Managing mental health emergencies in the ED

The most important consideration when caring for this special population is ensuring, first and foremost, staff and patient safety. Both psychiatric patients and the staff caring for them…

Massive blood transfusion protocols

RACHEL BROWN*, a 74-year-old woman, is admitted to the intensive care unit (ICU) after a non-ST segment elevation myocardial infarction. She’s on a heparin infusion. A cardiac catheterization…

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 cutaneous cancers.
Motivate Gen Z nursing students

Motivate Gen Z nursing students

Facilitate—don’t direct—education.    Takeaways: Intrinsic motivators—learning facilitation, passionate presentation, content value revelation, concise information delivery, student and educator engagement, experiential learning, and meaningful feedback—improve Gen Z student learning retention.…
nurse-heroes

Nurse heroes of the Pandemic

Nurses share a common theme: Hope. Be prepared, be strong, and don’t panic Crystal Davis Campbell, BSN, RN Staff nurse, medical ICU, Vidant Medical Center Greenville, North Carolina…

Nurse research and the institutional review board

Learn how the IRB process works to ensure participant safety and quality research. Takeaways: The institutional review board (IRB) process is intended to ensure study participant safety and…
hurricane experience nurse

Nurses share hurricane experiences

AMERICAN NURSE TODAY asked nurses to share their personal and professional experiences related to Hurricanes Harvey and Irma. Here are a few of their responses. (more…)

Nurses’ essential role in supporting professionalism

What does it mean to be a professional? Providing care of the highest technical quality, of course. But professionalism also includes communicating clearly, being selfreflective, and consistently modeling responsibility, respect,…

Paternal postpartum depression

Paternal postpartum depression can affect fathers, the likelihood of the mother developing postpartum depression, and the ability for both mother and father to bond with the infant.
patient violence ant

Patient violence: It’s not all in a day’s work

Strategies for reducing patient violence and creating a safe workplace Takeaways: Nurses alleviate stress when they report incidents of workplace violence. Nurses need to be proactive and expect…
Pediatric Sepsis

Pediatric sepsis: Are you ready?

Sepsis has received much attention recently, but the pediatric population is missing from many of these discussions. Increased nursing knowledge about sepsis recognition, management, and emergency care can…
person-centered-care-dementia

Person-centered care and dementia

Best practices for residents living in long-term care Takeaways: A growing body of evidence supports the idea that personhood and selfhood are not lost even in advanced dementia.…
Postural orthostatic tachycardia syndrome

Postural orthostatic tachycardia syndrome

Mary Watson*, a 32-year-old woman, arrives at her provider’s office with complaints of dizziness, fatigue, and a rapid heart rate when changing from a sitting to a standing…
older citizens climate change

Preparing older citizens for global climate change

Older adults have increased vulnerability to the effects of climate change because of greater exposure to the impact of climate change as well greater susceptibility due to aging-associated…
Primary Care

Preparing RNs for emerging roles in primary care

Shifts in care delivery require a shift in nurse preparation.   The increase in the aging population, surge of chronic diseases, passage of the Affordable Care Act, and trends…
Nurse,With,Patient.,Routine,Health,Check,And,Putting,Elderly,Patient

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% to 23.9% in long-term…

Preventing surgical site infection

Stopping infection requires effective discharge teaching. Takeaways: Executing a successful discharge is the ultimate goal for all involved in the perioperative process. An interprofessional approach to discharge education…

Primary hypothyroidism: More common than you think

Be alert to this frequently unrecognized condition. Takeaways: Hypothyroidism develops slowly over time and if left undiagnosed may put patients at risk for serious conditions, including cardiovascular disease,…
DD

Recognizing and treating dissociative disorders

Dissociative disorders are a group of psychiatric disorders that result from experiencing or witnessing trauma; affects up to 10% of the general population. As essential partners in the…
recurrent respiratory papillomatosis

Recurrent respiratory papillomatosis in children

Treatment for this rare disorder may require repeat surgeries. Takeaways: Recurrent respiratory papillomatosis (RRP) is disease, but it’s progressive and can effect quality of life and even be…
What are descriptive statistics

Research 101: Descriptive statistics

Use these tools to analyze data vital to practice-improvement projects. By Brian Conner, PhD, RN, CNE and Emily Johnson, PhD Takeaways: Nurses at every level should be able…
Shortages

Retaining nurses to mitigate shortages

The pandemic uncovered new opportunities to explore flexible staffing options, address organizational policies, and experiment with new care models to leverage nursing expertise and retain new nurses.

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 HF, which can cause…
screening management hepatitis-c

Screening and management of hepatitis C

Use education to dispel the myths about the disease and increase screening and treatment. Takeaways:  Hepatitis C infection is a significant public health issue in the United States. …
secondary hyperparathyroidism chronic kidney disease american nurse journal

Secondary hyperparathyroidism in chronic kidney disease

Through early recognition and prompt treatment, you can help relieve patient pain and discomfort. Key Takeaways – Patients with chronic kidney disease, particularly those who have end-stage renal disease…
Sepsis

Sepsis identification: A race against time

Nursing assessments and recognition of risk factors aid prompt recognition and treatment.  Sepsis is a life-threatening condition that occurs when the body’s response to infection causes organ injury.…
reversible-causes-of-dementia

Seven reversible causes of dementia in older adults

Some causes of dementia can be reversed through proper identification, intervention, and treatment. Nurses play an essential role in improving the lives of many older adults by recognizing…

Sharps injuries: Where we stand today

Needlesticks and other sharps-related exposures to bloodborne pathogens (including HIV, hepatitis B virus [HBV] and hepatitis C virus) continue to pose a significant occupational risk for healthcare workers. Largely…
smart-pumps-smart-management-safe-patients

Smart pumps, smart management, safe patients

When organizations and clinicians team up, patients are protected.  Takeaways: Medication administration errors continue to occur due to mistakes in smart electronic infusion pump setup, programming, and clinical…

Spontaneous coronary artery dissection

Nurses should have a high level of suspicion for spontaneous coronary artery dissection (SCAD) when patients, especially young women, present with chest pain and other acute coronary syndrome…
stop acute upper gi bleed ant

Stopping acute upper-GI bleeds

Risk stratification and quick intervention can save lives. Takeaways: GI bleeding remains a major concern, particularly for the elderly with multiple co-morbidities. Management of acute GI bleeds in…
support-nurse-health-walking-program

Support nurse health with a structured walking program

Identify barriers and create structure to aid participation.  Takeaways: Supporting nurses to embrace a healthy lifestyle can have a positive outcome on their well-being. A structured walking program…
surviving sepsis campaign hour 1 bundle

Surviving Sepsis Campaign hour-1 bundle

This 2018 update to the sepsis bundle focuses on beginning treatment immediately. Takeaways:  Sepsis bundles are designed for bedside application of key elements of the Surviving Sepsis Campaing…
targeting zero cautis

Targeting zero CAUTIs

 Empower nurses and proactively reduce urinary catheter device use  Takeaways: A nurse driven quality improvement project improved catheter utilization rates in one hospital. A urinary catheter insertion decision…
sepsis challenge develop process educate staff lead reduce mortality

The Sepsis challenge

When 35-year-old Tom Jenkins* arrives by ambulance at the emergency department (ED), he’s lethargic. His medical history indicates idiopathic thrombocytopenia purpura (ITP) that hasn’t required treatment since age 18.…

Understanding medical management of aortic stenosis

Key takeways Medical management of aortic stenosis can’t cure or delay its progression. Nursing expertise aids in maintaining the often precarious hemodynamic stability of patients with aortic stenosis.…
Female,Doctor,Holding,Up,Oxygen,Mask,As,If,To,Put

Understanding noninvasive ventilation

Knowing the benefits and drawbacks of the options helps drive patient-centered care. Takeaways: Traditionally, oxygen delivery systems are categorized as low, moderate, and high flow. Understanding oxygen delivery…

Understanding radiation dermatitis

According to the National Cancer Institute, an estimated 1.6 million new cases of cancer will have been diagnosed in the United States in 2015. During the course of…

Unplanned Extubation: Eliminating preventable deaths

Unplanned extubations (UEs) can be reduced through the implementation of standardization of best practices, policies and procedures for institution-wide reliability for airway management safety. While organizational change is…

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