Letter to my future students

Dear Students,

I am writing you today to inform you of how important obtaining an excellent education is in today's 21st century. I am on the younger end of the population obtaining a Master's in Nursing Education degree and through taking classes in the traditional classroom, online and virtual setting I am amazed at what today's technology has to offer. I was inspired and pushed outside of my comfort zone (which consisted of using powerpoint and word documents) by an instructor at Roberts Wesleyan College, named Dr. Treschuk. We used skype, discussion forums and chat rooms to communicate with one another. Eliminating the familiar technology such as cell phones and email we worked in groups to create Wiki pages filled with endless technology (check out my group Wiki Space). My point behind this is that I figured since I was a young "tech-savvy" individual that I was already current with today's latest technology. After learning about Nursing Informatics, I quickly realized I didn't have the slightest clue as to what a Jing, Glog, Virtual Reality or Smartboard was let alone how to work it. Did I mention that most of these tools are free?

My advise to you is to always remember that there is room for learning and change. Today's technology will be outdated in 5 or 10 years so it is important that resources are used appropriately so learning can take place! Once school is finished, don't just stop there continue on the journey and strive to learn as much as you can. Your patients, your family, your job and your life will depend on it! As a teacher I will strive to help engage you in learning by using various tools available for your use. Keep an eye out and "follow" by blog or twitter accounts to keep a tab on interests of mine. I hope that you too will engage yourself in what the 21st century has to offer.





Best wishes!
Hannah Kay, RN, BSN

What is happening peripherally?

When the heart stops pumping accurately look what is common...

Why is this happening? Take a look... Right sided heart failure commonly leads to peripheral pitting edema in the lower legs and arms.

-Treatment for those suffering from peripheral edema: Place extremity at or above the level of the heart to help improve circulation

-Patients may need to go on medications such as Lasix or Spironaldactone. If these medications are used keep in mind that strict intake and outputs need to be measured. Ask the doctor if a foley catheter is needed. -Patients may also be placed on a sodium restricted diet To tie last week's Blog Post to this week's post please watch the following slide-show and click through the activity regarding Pulmonary and Systemic Edema

Why Can't You Breathe?!

What happens to our respiratory system during cardiac compromise (heart failure)?

As nurses on any unit it is important to monitor for signs and symptoms of cardiac compromise or heart failure. One of the most common sign and symptom is related to the respiratory system is shortness of breath. This should be monitored during routine nursing assessments by using auscultation and percussion. If patients are on a cardiac monitor (which they should be!) then it will be easy to monitor oxygen saturation in the blood and respiratory rate.

Take a listen...

 Nurses need to practice and become comfortable with the different lung sounds. In pulmonary edema secondary to heart failure, crackles can be heard throughout the lungs noting fluid in the pulmonary tissue. The Auscultation Assistant is a great resource for listening to all types of lung sounds!

What it looks like...

Normal Chest X-ray

Chest X-ray with severe Pulmonary Edema

Ahhh...it is making sense why our patients struggle to breathe! Throw a history of COPD, emphysema and/or asthma into the mix and our patients end up suffering even more. Make sure to get a thorough health history!

As nurses what can we do?

• Monitor, assess, monitor, assess and repeat!
• Administer medications such as Lasix or spironolactone 
• Patients will most likely need a foley catheter for strict measuring of intake and outputs! 
• Apply O2 via nasal cannula
• Incentive spirometer teaching
• Monitoring a diet low in sodium
• Activity as tolerated
• Staying on top of daily medications (especially cardiac medications and nebulizers)

Not only will your patients be able to breathe easy but so will you, knowing that you were able to take such great care of the patient!

Who is at Risk?

This week I would like to focus on those who are at risk for cardiovascular compromise/disease and tips with how to treat it!

Modifiable Risk Factors:

• Smoking
• Diabetes
• Obesity
• Decreased physical activity
• Lifestyle choices
• Diet high in fat and sodium
• Sleep Apnea
• The Media*
• Hypertension
• High Cholesterol

Non-modifiable Risk Factors:

• Race (African Americans)
• Family History
• Age
• Preeclampsia 

Treating Cardiovascular Disease:

• Quit Smoking!
• Get diabetes under control
• Healthy Diet (Do not eat at the Heart Attack Grill*)
• Manage Stress
• Increase physical activity
• Patients may be put on medications to help lower cholesterol such as Simvastatin; may be placed on anti-hypertensives such as Lopressor; diuretics such as Lasix and anti platelet therapy such as Aspirin (this will be talked about in weeks to come).
• Some may need cardiac rehab, angioplasty, bypass and hormone therapy
• See the NIH website for more detailed information

*See how the media plays into a real problem that Americans are facing. Unhealthy eating habits are glorified and the medical/nursing fields are made to look glamorous (as if you were being rewarded for bad decisions). What are your thoughts after seeing this clip?

 

Take a look at this quick YouTube video on the blood flow of the heart. This is a great visual for those that learn better "seeing" rather than just "reading." These two images are to reiterate knowledge that you know already.

Here is where we will begin! This is considered Normal Sinus Rhythm, keep in mind the different parts and wave forms of each heart beat during our blogging!

This blog is created intended for nurses and those aspiring to be nurses. Here we will discuss how cardiovascular compromise affects the rest of the body. Each week we will target different body organs and discuss the following: signs and symptoms of cardiovascular compromise, medications to treat them, important patient teaching and other comfort measures. This should be a space where interaction and activity takes place! Enjoy!