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While assessing a 40-year-old male who complained of abdominal pain, nurses did a routine mental health screening, which included asking if he was currently suicidal. "He answered 'yes' to all of the questions," says MaryEllen Swanson, RN, a senior staff nurse in the ED at Hennepin County Medical Center in Minneapolis. "It would have been missed if the screening had not been done."
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Is your intubated patient being transporte d for radiological studies? This increases the chance of disastrous consequences due to an unrecognized displaced or dislodged endotracheal (ET) tube, warns Catherine Payne, RN, MSN, CCRN, CEN, an ED nurse at the University of California Davis Medical Center in Sacramento.
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If a patient reports taking antibiotics during your medication reconciliation, you may learn these were prescribed for a urinary tract infection or dental work months earlier. "For whatever reason, they didn't take the antibiotics as prescribed, and now they will take a pill whenever they have a sore throat," says Kimberly Barker, BS, RN, CEN, an ED supervisor at St. David's South Austin (TX) Medical Center.
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If the patient standing in front of you appears jittery, unable to sit still, and is continually scratching at sores on his or her face and body, it's likely he or she is using methamphetamine. "It's unfortunate to say, but we can usually tell by looking at someone that he or she is a meth user," says Sue Williams, RN, a nurse with SSM Behavioral Health Services at St. Joseph Health Center-Wentzville in Wentzville, MO.
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Children are more susceptible to acute airway compromise due to the unique characteristics of a child's airway, according to Eileen Callahan, RN, BSN, an ED pediatric nurse educator at Tufts Medical Center and the Floating Hospital for Children in Boston, MA.
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Not every patient experiencing shortness of breath needs to have definitive airway intervention such as intubation, says Sybil Murray, RN, an ED nurse at St. Anthony's Medical Center in St. Louis, MO.
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Your next stroke patient may be aware there is a drug called tissue plasminogen activator (tPA), but he or she probably won't realize how few stroke patients are actually candidates for this treatment.
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If your patient has aspirated prior to being intubated, he or she is at increased risk for ventilator-associated pneumonia (VAP), warns Nicole Schiever, RN, MSN, ED team leader at Riverside Medical Center in Kankakee, IL.
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When an ED physician at Scripps Mercy San Diego (CA) decided to order lorazepam to help an elderly man sleep, the ED nurse caring for the patient got a very unexpected reaction.
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If your ED patient is taking multiple medications, he or she may have no idea what they are for. "They may tell us they are taking them because they were prescribed, without knowing what the purpose is or if the dosage changed recently," says Jocelyn Cajanap, RN, ED educator at Glendale (CA) Adventist Medical Center.
