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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...
A guide for adhesive removal: Principles, practice, and products
Combining skill and knowledge ensures safe removal.
Takeaways:
Improve your knowledge on how to remove medical tape or wound dressings
Discover products and strategies to...
Addressing substance use disorder and diversion in the healthcare environment
Early detection and response are key.
Takeaways:
Substance use disorder (SUD) affects people of all ages, genders, races, and religions regardless of socioeconomic status, professional...
Alzheimer’s disease and Lewy body dementia: Discerning the differences
Assessment is key for optimal management.
Takeaways:
An early symptom of Alzheimer’s disease is decline in cognition, most typically manifesting as short-term memory loss. Early...
An overview of arrhythmogenic cardiomyopathy
Understanding conditions that can cause this disorder will help nurses educate and care for patients.
Takeaways:
Arrhythmogenic cardiomyopathy (ACM) is a description given to various...
Answers to the top 10 ECMO questions
Take a crash course in extracorporeal membrane oxygenation.
Takeaways:
Extracorporeal membrane oxygenation (ECMO), a form of cardiopulmonary bypass, is a life-saving treatment for many patients,...
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...
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...
Avoiding iatrogenic opioid dependency and addiction
Assessment, empathy, and nonpharmacologic options are effective strategies.
Takeaways:
Pain perception is multifactorial and includes somatic and medical, cognitive, emotional, behavioral, social, and motivation factors.
...
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...
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...
Building experiential interprofessional education
Bridging the education-to-practice gap.
Editor’s note: This is an early release of an article that will appear in the November 2021 issue of American Nurse...
Candida auris: Nurses’ response to an emerging threat
Identifying, treating, and preventing an elusive infection
Takeaways:
Candida auris (C. auris)is an emerging pathogen that can be difficult to identify, spreads quickly, and is...
Cannabinoid hyperemesis syndrome explained
Learn how to identify this frequently misdiagnosed condition.
Takeaways:
Cannabinoid hyperemesis syndrome is a growing but poorly understood healthcare concern within the rising number of...
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...
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,...
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...
Centralized vs decentralized staffing: Two case studies
Strive for balance to achieve improved outcomes.
Takeaways:
Nurse staffing is influenced by an organization’s structure and culture.
Centralized staffing manages staffing through a central...
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...
Conservative treatment for the silent epidemic of pelvic organ prolapse
Pelvic organ prolapse (POP) is the protrusion of the pelvic organs against the vaginal walls towards or through the vaginal opening. The number of...
Considerations when a BON disciplinary process is based on substance use disorder: Part 2
New programs and laws help nurses get treatment and protect their licenses.
Editor’s note: Access part 1 at myamericannurse.com/?p=55520.
NURSES who face board of nursing (BON)...
Continuous-waveform capnography: A crucial tool for ED clinicians
Many emergency department (ED) patients are at risk for complications associated with airway management and ventilator problems. Continuous-waveform capnography (CWC) is a critical method clinicians...
Cranial nerve assessment: A practical approach
Use mnemonics to aid remembering and identifying abnormal findings.
Takeaways
Many nurses find remembering the cranial nerves and their functions to be challenging.
Neurologic assessments...
Critically ill obstetric patients
Be prepared to care for pregnant and postpartum patients in critical care settings.
Takeaways:
Some critical care nurses have reported that they don’t feel prepared...
Diabetic ketoacidosis and hyperglycemic hyperosmolar state
Early identification and management are key to good outcomes.
Learning Objectives
Compare onset, diagnosis, and treatment of diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state.
Identify...
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...
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...
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...
Dumping syndrome: Causes, management, and patient education
Learn how to identify and manage this under-recognized syndrome.
Takeaways:
Dumping syndrome is often misdiagnosed.
The clinical manifestations of dumping syndrome are categorized as early...
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...
Evidence-based practice: Medical device–related pressure injury prevention
Learn the risk factors and tailor prevention to device type.
Takeaways:
Medical device–related pressure injuries (MDRPIs) are a common but preventable patient care issue with...
Evidence-based strategies to prevent enteral nutrition complications
Follow these tips to keep your patients safe.
Takeaways
Enteral nutrition (tube feeding) can be administered safely but is not without risks.
Optimal nursing care can...
Exploring organ donation with families of pediatric patients
Use this evidence-based approach to help grief-stricken families make a critical decision.
Takeaways:
As the nurse of a dying child, you are perfectly positioned to...
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...
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...
His bundle pacing
These pacemakers provide an alternative for those who don’t respond to other devices.
Takeaways:
His bundle pacing offers a superior alternative to the potential adverse...
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...
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...
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...
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...
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...
Human trafficking: Preparing for a unique patient population
In most ways, human trafficking (modern slavery) is no different from slavery of ancient times: It’s a brutal, highly profitable business with no regard...
Hypoglycemia: An unwelcome companion to effective diabetes management
Tailor your assessment, prevention, and treatment to individual patient needs and risks.
Takeaways:
Hypoglycemia places people with diabetes at risk for injury and prevents them from...
Hypothyroidism and nursing care
Learn to recognize the symptoms of this commonly overlooked condition.
By Dorothy Moore, DNP, FNP-C, CCRN
Sandra Reynolds, a 64-year-old homeless woman, is admitted to your...
Improving nurses’ attitudes toward patients with substance use disorders
Editor’s note: The author uses substance use disorder as a diagnostic term. However, some of the research he cites uses a different term, such as drug addiction or drug...
Influenza vaccines and nurses
Find out how to improve influenza vaccination rates among healthcare workers.
Takeaways:
Barriers to influenza vaccination include inconvenience and cost, previous negative experiences, personal and...
Initial assessment and management of burn patients
Your quick action can help decrease morbidity and mortality, shorten hospital stays, and reduce costs.
Takeaways:
Large total body surface area burns require immediate...
Insights into glucose monitoring for diabetes
Developments in testing provide better outcomes for your patients.
Key Takeaways
- Self-monitoring of blood glucose allows patients with diabetes to take a more active role...
Interacting with individuals on the autism spectrum
Successful care depends on communication with patients, families, and caregivers.
Takeaways:
Optimizing health encounters for patients on the autism spectrum (ASD) requires an individualized approach.
...
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...
Intimate partner violence: When closeness turns deadly
A patient who experiences violence at the hands of a spouse or partner may think of it as a personal and private matter, but intimate...
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...
Looking beyond the pandemic: A virtual roundtable
The COVID-19 pandemic is far from over, but many are starting to ponder its lasting effects on nursing. The editorial team at American Nurse...
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,...
Managing medications for hospital patients with Parkinson disease
A progressive degenerative disease, Parkinson disease (PD) is marked by tremor, slow movement, stiffness, and balance problems. It affects about 1 million Americans—more than amyotrophic...
Managing mental health emergencies in the ED
Safety and continuity are key to successful care.
By Jessica L. Dzubak, RN
Takeaways:
The most important consideration when caring for this special population is ensuring,...
Massive blood transfusion protocols
Takeaways
Mass transfusion operates best under a protocol developed by a multidisciplinary team.
Using the ABC score can help rule out the need...
Medical device reporting—a model for patient safety
As a nurse, you’re well aware of medication safety and error prevention initiatives, but do you also know about the Food and Drug Administration’s...
Medication-assisted treatment for opioid use disorders: Implications for surgical patients
Perioperative considerations nurses need to know for elective surgery.
Takeaways:
Nursing care requires familiarization with medication-assisted treatment (MAT) for opioid use disorders, as well as...
Medications for heart failure management: What nurses need to know
Learn about heart failure medications to ensure improved outcomes
Takeaways:
Learn about the newest medications to treat heart failure, including adverse effects, indications, and nursing implications.
...
Mitigating melanoma
Early detection and intervention is key for higher survival rates.
Takeaways:
Late identification and recognition of melanoma lead to worsening health outcomes.
Nursing patient education...
New CDC guideline for the prevention of surgical site infections
A new format and structure allows for timely updates and distribution.
Takeaways
The 2017 updated Centers for Disease Control and Prevention Surgical Site Infection Guidelines...
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
Crystal...
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...
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...
Nurses’ role in continuous renal replacement therapy
Expand your knowledge for safe, quality care.
Takeaways:
Acute kidney injury (AKI) in combination with other disease processes, such as COVID-19, significantly impacts patient mortality...
Nurses’ essential role in supporting professionalism
Key takeaways
- Most nurses behave professionally and ethically.
- A tiered approach to intervention when unprofessional behavior occurs offers the opportunity for self-directed, nonpunitive change...
Nursing communication and the gender identity spectrum
It’s a hectic day in the emergency department (ED), where the triage nurse Laura* is interviewing 30-year-old Shawn. Shawn’s girlfriend is close by his side.
Laura...
Nursing considerations for procedural sedation and analgesia: Part 1
This first in a two-part series reviews patient assessment, red flags, and pharmacologic agents.
Takeaways:
Registered nurses providing moderate procedural sedation and analgesia must demonstrate...
Nursing considerations for procedural sedation and analgesia: Part 2
This second in a two-part series reviews sedation implementation and monitoring.
Takeaways:
Signs and symptoms of airway obstruction during procedural sedation include increased respiratory effort,...
Ostomy management: Nuts and bolts for every nurse’s toolbox
Learn the facts about ostomy care.
By Mary H. Zeigler, MS, CRRN, CWON, and Allison Min, BSN, CRRN
An Ostomy is a surgically created diversion for...
Paternal postpartum depression
Prevent and screen for depression in new fathers.
Takeaways:
Paternal postpartum depression effects one in ten fathers.
Paternal postpartum depression can affect fathers, the likelihood...
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...
Patient-centered medication selection for type 2 diabetes
A collaborative, patient-centered approach that considers a variety of factors will be most effective.
Takeaways:
Before selecting medications for type 2 diabetes and to promote...
Pediatric sepsis: Are you ready?
Implement protocols for early identification and management.
Takeaways:
Sepsis has received much attention recently, but the pediatric population is missing from many of these...
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...
Preparing older citizens for global climate change
Collaborate and advocate to meet patient needs and implement policy change.
Takeaways:
Older adults have increased vulnerability to the effects of climate change because of greater...
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...
Pressure injury prevention in long-term care
Follow the evidence to improve outcomes.
Takeaways:
High quality healthcare is established using evidence-based practice in nursing protocols and procedures.
To decrease pressure injury (PI)...
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...
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,...
Providing effective communication to patients who are deaf or hard of hearing
Nurses have a legal duty.
Communication is the bedrock of patient care. If a patient can’t comprehend the care being provided or the clinician can’t...
Recognizing and treating dissociative disorders
The nurse’s role in supporting patients and their families.
Takeaways:
Dissociative disorders are a group of psychiatric disorders that result from experiencing or witnessing trauma;...
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...
Redesigning healthcare: Global insights for nurses
A look at best practices.
Editor’s note: This is part of our continuing series designed to tackle issues related to how the profession will move...
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...
Retaining nurses to mitigate shortages
Flexibility, creative policies, and new care models are key to retention.
Takeaways:
22% of RNs and 20% of nurse leaders may leave their position within...
Right-sided heart failure
Give the right side of the heart the attention it’s due.
Takeaways:
In right-sided heart failure, ventricular independence (between the right and left ventricles) can...
School nurses: Keeping school children, families, and communities healthy
This specialty provides many challenges—and rewards.
Takeaways:
School nurses play an integral role in the health of children and youth, by increasing access to healthcare,...
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...
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...
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...
Seven reversible causes of dementia in older adults
Early identification and accurate diagnosis can improve patient outcomes.
Takeaways:
Some causes of dementia can be reversed through proper identification, intervention, and treatment.
Nurses play...
Sharps injuries: Where we stand today
Needlesticks and other sharps-related exposures to bloodborne pathogens (including HIV, hepatitis B virus and hepatitis C virus) continue to pose a significant occupational risk...
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,...
Spontaneous coronary artery dissection
Be aware of this often misdiagnosed and possibly deadly condition.
Takeaways:
Nurses should have a high level of suspicion for spontaneous coronary artery dissection (SCAD)...
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...
Strangulation: A silent but deadly form of intimate partner violence
Awareness and assessment are keys to getting victims the help they need.
Takeaways:
The effects of strangulation can be delayed.
Nonfatal strangulation victims are at...
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...
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...
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...
The “Nu” way for nurses to screen for delirium
The right tool can make all the difference in proper screening for delirium.
Takeaways:
The Nursing Delirium Screen Scale (NuDESC) is a nurse-driven tool for...
The Sepsis challenge
Developing processes and educating staff lead to reduced mortality.
Takeaways:
Sepsis requires early identification with rapid treatment.
Sepsis core measure bundles are a challenge for...
Toward rational conversation about race, health risk, and nursing
How race correction affects risk assessment and treatment.
Takeaways:
Race correction refers to a practice in healthcare that treats race as a risk factor.
...
Ultrasound-guided peripheral I.V. access: Guidelines for practice
Learn more about a noninvasive technique that can help spare your patient pain.
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...
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 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....
Unplanned Extubation: Eliminating preventable deaths
Know the risk factors and take steps to prevent harm.
Takeaways:
Unplanned extubations (UEs) can be reduced through the implementation of standardization of best practices,...
When a BON disciplinary process is based on substance use disorder: Part 1
This first in a two-part series reviews the complaint process and approach alternatives.
Takeaways:
Nurses misuse drugs to the same extent as the general population.
Boards...
When the heart stops: Life-giving updates on cardiac arrest
Timely intervention saves lives.
Takeaways:
Nurses can save lives after in-hospital cardiac arrest if skills and knowledge are up-to-date.
Survival rates after cardiac arrest are...
Why do adolescents engage in nonsuicidal self-injury?
How nurses can screen, intervene, and provide appropriate referrals.
Takeaways:
Nonsuicidal self-injury is a commonly hidden behavior among adolescents
Screening in primary care and schools...