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Nursing assessment

Assessment of the dermatology patient includes obtaining a detailed dermatological history as this may provide clues to diagnosis, management and nursing care of the existing problem, with careful observation and meticulous description and should cover the following areas:

• a history of the patient’s skin condition
• a general assessment
• a specific skin assessment
• consideration of the skin as a sensory organ
• assessment of the patient’s knowledge about his or her skin condition

History of the patient’s skin condition

• How long has the condition been present?
• How often does it occur or recur?
• Are there any seasonal variations?
• Is there a family history of skin disease?
• What are the patient’s occupation and hobbies?
• What medication is the patient taking?
• Are there any known allergies?
• Previous and present treatments and their effectiveness?
• Are there any treatments, actions or behavioural changes which influence the condition?

PFT Interpretation Chart: Simple Interpretation Of Pulmonary Function Tests Lung Capacity

Summary of Respiratory Volume and capacity for Males and Females

Addison’s disease is marked by deficiencies of aldosterone and cortisol, hormones produced in the adrenal glands. Aldosterone deficiency impairs water and sodium retention, which may lead to dehydration and hypovolemic shock.

symptoms of Cushing syndrome
weight gain.
obesity.
fatty deposits, especially in the midsection, the face (causing a round, moon-shaped face), and between the shoulders and the upper back (causing a buffalo hump)
purple stretch marks on the breasts, arms, abdomen, and thighs.
thinning skin that bruises easily.

Types of Sutures and Stitches

Sutures can be either absorbable or nonabsorbable. Absorbable sutures are intended to be broken down by the body over time and eventually dissolve completely. Some materials used to make absorbable sutures are derived from animal products that have been specially processed. Other absorbable sutures are made from synthetic polymer materials such as polylactic acid (Vicryl), polyglycolic acid (Dexon), polyglyconate (Maxon) and polydioxanone (PDS).

Permanent, nonabsorbable sutures are sometimes preferred because they are resistant to body chemicals that might otherwise dissolve them too early in the healing process. Non-absorbable sutures are useful for maintaining long-term tissue wound closure (apposition) and healing. Non-absorbable sutures can be made from nylon, polypropylene (prolene), or silk.

Stitches can be divided into the following sub-types:

• Continuous stitch: This is quick to perform using the same suture line without cutting, which helps distribute the tension along the length of the stitched wound.
• Simple interrupted stitching: The same suture line can be used more than once to make separate stitches that allow for more precise closure of the tissue, especially that of skin and fascia.
• Mattress stitches: These can be placed either vertically or horizontally. Mattress stitches go deeper into the skin layers and allow for excellent closure of incision edges while minimizing tension.
• Sub-cuticular stitch: Using an absorbable suture, the stitch is made at the dermal-epidermal junction to allow for better closure so that postoperative suture removal is unnecessary. This stitch is a convenient technique to close skin incisions.

Staple types are classified according to their material or shape. Medical staples are most commonly made from titanium or stainless steel. However they can also be made from other materials like iron, chromium, nickel or plastic. Medical staples may be straight, curved or circular.

Master the art of suturing like a pro! Share this comprehensive cheat sheet on the types of sutures and stitches with your nursing peers and elevate your clinical skills. Pin it now on Pinterest!

Pharmacology Dosage Cheat Sheet Easy Conversions

pharmacy conversion cheat sheet
Medical Dosage Calculations For Nursing Students Cheat Sheet
Dosage Calculation Conversions You Need to Know in Nursing

Cardiac Cycle, Phases of Cardiac Cycle, Cardiac Cycle & ECG Nursing Students

Electrical Events of the Cardiac Cycle ECG and electrical activity of the heart.

The electrical and mechanical events that occur from the beginning of one heartbeat at the beginning of the next heartbeat is called cardiac cycle.

There are total seven phases of cardiac cycle these are
1. Atrial systole
2. Isovolumetric ventricular contraction
3. Rapid ventricular ejection
4. Reduced ventricular ejection
5. Isovolumetric ventricular relaxation
6. Rapid ventricular filling
7. Reduced ventricular filling (diastasis)

Pathophysiology Acute Renal Failure for Nursing Students

Acute renal failure (ARF) is a clinical syndrome characterized by an acute fall in glomerular filtration rate. (GFR), resulting in decreased clearance of metabolic.

Needle gauges for injections Size chart

Types of Needles for Injection
Choosing a Syringe and Needle Size for an Injection
Principles of Injection Technique

There are several factors which need to be considered in choosing the size of a needle to use for an injection or “shot”. They include such issues as:

• the type and viscosity of the medication
• the size and age of the patient
• the mobility status of the patient
• the desired absorption rate for the medication

In general for IM (intramuscular) injections you would use a 21 to 23 gauge needle 1 to 1.5 inches long for an adult. In a child you use a 1 inch long, 25 to 27 gauge needle. In obese patients, 1.5 to 2 inch needles may be necessary.**

For SQ (subcutaneous) injections you would typically use a 25 to 27 gauge needle 3/8 to 5/8 inches long for adults and children alike. Some newer medications such as Byetta for diabetes recommends using 30 or 31 gauge 1/3 inch needles which are ultra fine.

SQ medications are deposited into the loose connective tissue just below the dermis. This is not richly supplied with blood vessels so the absorption rate is slow. There are many pain receptors in this tissue so only non- irritating, water-soluble medications in small doses should be given by the SQ route.

Intramuscular tissue is richly supplied with blood vessels so the medication is more rapidly absorbed by this route. There are few pain receptors so viscous and irritating drugs can be injected into the muscle tissue with less discomfort. In choosing a site consider deep muscle tissue for the most irritating or viscous medications to reduce the possibility of tissue damage. Using a Z-track method may be recommended as well.

Care must be taken to avoid blood vessels, and you must always aspirate with an IM injection to ensure that you have not hit a vessel. If you aspirate blood, remove the needle and prepare a new syringe. Never inject the blood back into the tissue.

Injection Sites
SQ sites typically used are the upper arm, thigh, and abdominal areas in children and adults alike. With frequent injections such as insulin, the site should be rotated with each dose.

Preferred IM sites include the deltoid (upper arm) and the ventrogluteal or rectus femoris, and vastus lateralis in children. In adults IM sites include the deltoid, ventrogluteal, vastus lateralis and dorsal gluteal (with careful land marking to avoid the sciatic nerve.)

In children, you do not inject into the gluteal muscle until they have reached approximately the age of 2 and have been walking for a time sufficient to develop the muscle.

Nursing Student Head to Toe Assessment Sample Charting Entry

Examples of Documentation: Forms and Formats (Nursing)
Head-to-Toe Nursing Assessment
The sequence for performing a head-to-toe assessment is:

Inspection
Palpation
Percussion
Auscultation
However, with the abdomen it is changed where auscultation is performed second instead of last. The order for the abdomen would be:

Inspection
Auscultation
Percussion
Palpation (palpation and percussion are done last to prevent from altering bowel sounds)
Provide privacy, perform hand hygiene, introduce yourself to the patient, and explain to the patient that you need to conduct a head-to-toe assessment

Ask the patient to confirm their name and date of birth by looking at the patient’s wrist band (this helps assess orientation to person and confirms you have the right patient). In addition, ask the patient where they are, the current date, and current events (who is the president and vice president) etc.

Collect vital signs: heart rate, blood pressure, temperature, oxygen saturation, respiratory rate, pain level

NOTE: Before even assessing a body system, you are already collecting important information about the patient. For example, you should already be collecting the following information :

Looking at the overall appearance of your patient: do they look their age, are they alert and able to answer your questions promptly or is there a delay?
Does their skin color match their ethnicity; does the skin appear dry or sweaty?
Is their speech clear (not slurred)?
Do they easily get out of breath while talking to you (coughing etc.)?
Any noted abnormalities?
How is their emotion status (calm, agitated, stressed, crying, flat affect, drowsy)?
Can they hear you well (or do you have to repeat questions a lot)?
Normal posture?
Abnormal smells?
How is their hygiene?
Assess height and weight and calculate the patient’s BMI (body mass index).

Below 18.5 = Underweight
18.5-24.9 = Normal weight
25.0-29.9 = Overweight
30.0 or Higher = Obese

cardiac rhythms heart blocks

Cardiac ECG Rhythm Analysis Flow Chart: Cheat sheet for interpretation of sinus, atrial, junctional, ventricular and heart block arrhythmias.

Heart block is an abnormal heart rhythm where the heart beats too slowly (bradycardia ). In this condition, the electrical signals that tell the heart to contract are partially or totally blocked between the upper chambers (atria) and the lower chambers (ventricles).