Nursing Blog

Standard Precautions - Infection Control Standard precautions were developed by the Centers for Disease Control and Prevention (CDC) to provide the widest possible protection against the transmission of infection. CDC officials recommend that health care workers handle all blood, body fluids (including secretions, excretions, and drainage), tissues, and contact with mucous membranes and broken skin as if they contain infectious agents, regardless of the patient's diagnosis. Standard precautions encompass much of the isolation precautions previously recommended by the CDC for patients with known or suspected blood-borne pathogens as well as the precautions previously known as body substance isolation. They are to be used in conjunction with other transmission-based precautions: airborne, droplet, and contact precautions. Standard precautions recommend wearing gloves for any known or anticipated contact with blood, body fluids, tissue, mucous membrane, and nonintact skin. (See Choosi...

This phase of care begins when the patient arrives in the postanesthesia care unit (PACU) and continues as he moves on to the short procedure unit, medical-surgical unit, or intensive care unit. Postoperative care aims to minimize postoperative complications by early detection and prompt treatment. After anesthesia a patient may experience pain, inadequate oxygenation, or adverse physiologic effects of sudden movement. Recovery from general anesthesia takes longer than induction because the anesthetic is retained in fat and muscle. P.106 Fat has a meager blood supply; thus, it releases the anesthetic slowly, providing enough anesthesia to maintain adequate blood and brain levels during surgery. The patient's recovery time varies with his amount of body fat, his overall condition, his premedication regimen, and the type, dosage, and duration of anesthesia. Equipment Thermometer • watch with second hand • stethoscope • sphygmomanometer • postoperative flowchart or other docum...

Nurses value health promotion and well-being and assisting persons to achieve their optimum level of health in situations of normal health, illness, injury, disability or at the end of life. 1. Nurses must provide care directed first and foremost toward the health and well-being of the person, family or community in their care. 2. Nurses must recognize that health is more than the absence of disease or infirmity and must work in partnership with people to achieve their goals of maximum health and well-being. 3. Nurses should provide care addressing the well-being of the person in the context of that person’s relationships with their family and community. 4. Nurses must foster comfort and well-being when persons are terminally ill and dying to alleviate suffering and support a dignified and peaceful death. 5. Nurses should provide the best care that circumstances permit even when the need arises in an emergency outside an employment situation. 6. Nurses should respect and value the know...

Used to move the patient's joints through as full a range of motion (ROM) as possible, passive ROM exercises improve or maintain joint mobility and help prevent contractures. Performed by a nurse, a physical therapist, or a caregiver of the patient's choosing, these exercises are indicated for the patient with temporary or permanent loss of mobility, sensation, or consciousness. Performed properly, passive ROM exercises require recognition of the patient's limits of motion and support of all joints during movement. Passive ROM exercises are contraindicated in patients with septic joints, acute thrombophlebitis, severe arthritic P.45 joint inflammation, or recent trauma with possible hidden fractures or internal injuries. Implementation Determine the joints that need ROM exercises, and consult the physician or physical therapist about limitations or precautions for specific exercises. The exercises below treat all joints, but they don't have to be performed in the order ...

Glasgow Coma Scale The Glasgow Coma Scale provides a score in the range 3-15; patients with scores of 3-8 are usually said to be in a coma. The total score is the sum of the scores in three categories. For adults the scores are as follows: Eye Opening Response Spontaneous--open with blinking at baseline 4 points Opens to verbal command, speech, or shout 3 points Opens to pain, not applied to face 2 points None 1 point Verbal Response Oriented 5 points Confused conversation, but able to answer questions 4 points Inappropriate responses, words discernible 3 points Incomprehensible speech 2 points None 1 point Motor Response Obeys commands for movement 6 points Purposeful movement to painful stimulus 5 points Withdraws from pain points Abnormal (spastic) flexion, decorticate posture 3 points Extensor (rigid) response, decerebrate posture 2 points None 1 point Source : www.unc.edu

There are 12 pairs of cranial nerves. These nerves arise from the brain and brain stem, carrying motor and or sensory information. Cranial nerve I : Olfactory nerve The olfactory nerve is composed of axons from the olfactory receptors in the nasal sensory epithelium. It carries olfactory information (sense of smell) to the olfactory bulb of the brain. This is a pure sensory nerve fiber. Cranial nerve II: Optic nerve The optic nerve is composed of axons of the ganglion cells in the eye. It carries visual information to the brain. This is a pure sensory nerve fiber. This nerve travels posteromedially from the eye, exiting the orbit at the optic canal in the lesser wing of the sphenoid bone. The optic nerves join each other in the middle cranial fossa to form the optic chiasm. Cranial nerve III: Oculomotor nerve The oculomotor nerve is composed of motor axons coming from the oculomotor nucleus and the edinger-westphal nucleus in the rostral midbrain located at the superior colliculus leve...

The normal state of consciousness comprises either the state of wakefulness, awareness, or alertness in which most human beings function while not asleep or one of the recognized stages of normal sleep from which the person can be readily awakened. The abnormal state of consciousness is more difficult to define and characterize, as evidenced by the many terms applied to altered states of consciousness by various observers. Among such terms are: clouding of consciousness, confusional state, delirium, lethargy, obtundation, stupor, dementia, hypersomnia, vegetative state, akinetic mutism, locked-in syndrome, coma, and brain death. Many of these terms mean different things to different people, and may prove inaccurate when transmitting and recording information regarding the state of consciousness of a patient. Nevertheless, it is appropriate to define several of the terms as closely as possible. Clouding of consciousness is a very mild form of altered mental status in which the patient h...