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Welcome to Episode 104
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News–
Improved Jaundice Screening Can Protect Newborns
Children of Working Mothers Have Unhealthier Lifestyles
Health Experts Support Tools to Prevent Preterm Birth
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Tip of The Week- Care and Interventions of Newborn Jaundice
Most preterm and almost 50% of full term newborns present with jaundice, a yellow discoloration of the skin and sclera of the eyes. The yellowish hue comes from bilirubin, a substance produced from break down of red blood cells, when it reaches a blood level greater than approximately 2.5 mg/dL. This bilirubin is excreted in the stool via the liver, in the case of infants, this process takes more time resulting to accumulation in the skin. Jaundice appearing about 2-3 days after birth, called physiologic jaundice is normal in newborns,however, interventions like phototherapy should be instituted to help the infant’s body excrete the excess bilirubin.
There are also disorders that can cause bilirubin levels to increase in newborns like blood type incompatibilities, prematurity, polycythemia, etc. If left unresolved, bilirubin may continually increase and cause serious complications such as cerebral palsy, deafness, and kernicterus ( brain damage from very high bilirubin levels).
Infants receiving phototherapy, the first line intervention for jaundice, requires special attention to avoid chilling or burning of the skin. Intake and output should be monitored and carefully documented, including continuous assessment for skin breakdown and bilirubin lab values should always be updated. Serum bilirubin levels above 25 mg/dL or higher at any time is a medical emergency and the infant should be evaluated immediately for exchange transfusion.
For more on nursing care of newborn jaundice, follow links below
Newborn Jaundice by NIH Medline
eMedicine Article on Newborn Jaundice
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Other Podcasts from Jamie Davis:
- The MedicCast (for EMTs, Paramedics, EMS field work)
- MedicCast News (Weekly short medical news program)
- MedicCast Live (Monthly live call-in show with a single EMS topic)
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Song this week:
Music from The Podsafe Music Network
This week- “Wednesday Morning” by Slackstring
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Filed under nursing show podcasts, pediatrics for nurses by on Nov 6th, 2009. 1 Comment. 
An article published online by the Journal of Epidemiology and Community Health says that in a study that they conducted, children whose mothers worked full-time or part time were more likely to have unhealthy eating habits than those whose mothers stayed at home.
Apart from the differences in eating habits between children of employed and unemployed moms, the study also revealed that children of working mothers were more likely to have two or more hours more watching TV or playing computer games, to drink sweetened drinks, and to be driven to school rather than walk or ride the bike.
This study’s results is not alarming. Because of time constraints, mothers who juggle their time with work and family are having difficulty in providing a meal with a balanced nutritive value. Most meals take time to prepare so working moms who have less time at home would give their children easy to cook or instant meals. Also, these mothers spend less time at home so they cannot control the activities of their children when they are away.
Home settings with working mothers are inevitable, especially during this time when there is a need for more financial resources. What nurses can do in this situation is to help parents support a positive health behavior in their children. Help parents teach their children to choose what they eat and teach parents on food choices. For example, instead of filling the pantry with sweets and chips, buy fruits that can easily be eaten or foods that are easy to eat but still high in nutrients.
School nurses can also develop a health teaching program where they highlight the importance of having healthy eating habits and physical activity including the bad effects of unhealthy foods in later life like diabetes, obesity, and heart disease, which are the top health problems in the US today.
Filed under pediatrics for nurses, research for nurses by on Oct 15th, 2009. Comment.
For most people, their definition of a school nurse is someone who stays in the clinic and puts bandages on kids who gets cuts and bruises or attends to sick children in school. But for Jeanne Schwasman,a registered nurse and a certified teacher, there is more to a school nurse than being a band-aid station.
School nurses do not only deal with illnesses and injuries, more than that, they also deal with educating the children with regards to health. In the event of an outbreak, like in the case of H1N1 or influenza virus, the role of the school nurse in educating the children on preventive measures is crucial to the control of the virus’ spread. Also, teaching students to identify the symptoms of the disease and telling them to go to the clinic as soon as they start to feel some of the said symptoms will aid in early diagnosis and avoid other students contracting the virus.
Apart from emergency health issues, health education in general is an important subject for children in the school age. Since not all teachers are well versed with the subject, and not all school nurses are certified teachers, coordination between teacher and nurse is the answer to providing a comprehensive, easy to understand health education program.
Nurses in the school setting also work as guidance counselors or sometimes even as second parents to the children. Though teachers are also capable of this responsibility, their authoritative figure puts a gap between students and teachers which makes it difficult for the children to approach teachers when they have issues at home or in school may it be with studies, with their peers, or even with family. Because of this, it is important that the school nurse show a positive persona to the children and let them feel that she is someone they can go to and confide in when they have problems. The nurse’s knowledge in the various developmental stages makes her understand the children better as well as provide good advices for them.
School nursing is a much broader nursing specialty and stretches farther than most people think. The majority’s perception of a school nurse’s responsibility is that she identifies children who are not well enough so they could be sent home. The truth is, it is the other way around, the main duty of the school nurse is to make sure that students are fit and healthy to stay in class and learn, and it doesn’t end there.
Filed under nursing education, pediatrics for nurses by on Oct 7th, 2009. Comment.
An alarming story out of the UK reminds all of us how easily nursing care mistakes can be made if careful procedures are not followed each and every time patient care is rendered.
Infant Fed Fabric Softener in NICU
A baby was accidentally fed fabric softener through a feeding tube in a neonatal intensive care unit. The mistake was quickly discovered after the infant reacted to the gastric tube feeding.
According to the story, the mother brought in the fabric softener from home in an unlabeled container. It is unsure, based on the account in the article, how the nursing staff mistakenly replaced this liquid for the baby’s regular feeding.
Keeping Nursing Patients Safe
Whenever an article like this one surfaces, I try very hard to not assign blame. In the early reports, the reporters often get details wrong or assume things that aren’t verified.
What I do try to do is wonder what I would do differently; how I, as a nurse, paramedic, or other health care provider can make sure that a similar mistake doesn’t happen in my own patient care interactions?
This story proves to me the importance of establishing a routine for patient care that ensures double checks on doses, medications, routes of administration, correct labeling, etc.
If bottle of saline is considered usable for 24 hours after opening but the person who opened it didn’t label it with a date and time, when was it opened?
It doesn’t matter –
There’s no accountability labeling on it so assume it was opened more than 24 hours ago. Go open another bottle. (make sure you label it appropriately – patient sticker, date, time, your initials for a start)
Nursing Care Safety System Ideas
Got your own system for keeping yourself straight and providing safe care for your patients? Share it with the others here in the Nursing Show community. Comment using the link below this article so that we all may benefit from your experiences.
Filed under RN tips, pediatrics for nurses by on Apr 23rd, 2009. Comment.
The National Association of Pediatric Nurse Practitioners (NAPNAP) released a strong statement against a recent article negating the benefits of breastfeeding that was published in the magazine The Atlantic.
In this article, the mother of three cited lack of any credible evidence that she could find to support the strong push by medical educators, nurses, and breast feeding advocates for mothers to breast feed their children. She said she found no evidence of any benefit over other methods of feeding.
The American Academy of Pediatrics (AAP) came out very strongly against this article and the subsequent news coverage. The pediatricians cited their 2005 position statement supporting breastfeeding. That statement includes references to over 200 peer reviewed studies supporting the benefits of breastfeeding over other methods of feeding.
The National Association of Pediatric Nurse Practitioners (NAPNAP) joined the AAP in the strong resonse to the article by releasing their own strong affirmation of the benefits of breastfeeding. “NAPNAP is committed to educating families and health care providers about the importance of breastfeeding and its impact on children’s health,” said NAPNAP President Linda L. Lindeke, PhD, RN, CPNP. “We stand with the AAP’s statements in response to the recent controversy and the scientific evidence that supports breastfeeding.”
Breastfeeding has been shown to provide numerous benefits to newborn infant including (but not limited to) immune system protections, reduced chances of obesity later in life, and better nutritional content suited to the infants life stages.
Here are some additional resources on the topic of breastfeeding for nurses and nursing students:
NAPNAP page on Breastfeeding Education
NIH Medline Links Page for Breast Feeding
Filed under pediatrics for nurses by on Mar 28th, 2009. Comment.
A recent study on children with peanut allergies may have found a way to cure this life threatening condition. The findings were presented at the American Academy of Asthma and Immunology meeting recently.
Read the full article at WebMD here.
The children in the study were given minute amounts of peanut proteins daily for over two years while under the care of their physician. Changes noted in their immune system over time showed that they had outgrown the allergy with absolutely no symptoms of allergic reaction seen when exposed to peanuts after the treatments were completed.
This is a significant development and offer nurses an opportunity to educate their patients and their parents that there may be hope to evenutally find a cure for this and other common life threatening allergies.
Filed under pediatrics for nurses by on Mar 27th, 2009. Comment.
Why aren’t teens getting emergency conception prescriptions when they are treated in hospital emergency rooms? This is the question posed by the study reviewed by this article at MedicalNewsToday.com.
The study comes from the Children’s Hospital of Philadelphia (CHoP as it’s known around here). They determined that it may be because of a misunderstanding about this medication.
The study’s authors surveyed emergency physicians who treated pediatric patients and asked whether they had prescribed an emergency contraceptive pill along with questions about their understanding of the drug’s efficacy. Those physicians who were able to answer more of the questions were also more likely to prescribe an emergency contraceptive.
This points out for any health care worker, nurses and nursing students included, that it is important to read and review medications that might be used in your area of expertise but don’t necessarily get used that often. We all get in the habit of reaching for the treatment or drug that we are most comfortable with when the time comes to treat our patients. This bad habit robs our patients of the best options for care when that common treatment is not the best option for them.
There are many tools out there to use to keep up to date with your nursing skills and resources. They include the many excellent nursing journals out there. Also, many nurses would be well served by carrying a mobile drug and treatment guide around with them.
Our Nursing Show and ProMed Network sponsors, Lexi-Comp is one provider of these excellent tools. They offer versions for blackberries and Windows Mobile devices but my personal favorite are the great tools offered by the iPhone and iPod touch versions of these medical applications.
You can check out the iPod and iPhone versions at this link to the iTunes store.
You can find out more about Lexi-Comp’s complete line of mobile software by visiting www.Lexi.com/nursingshow and sign up to win an iPod touch and free software while you are there.
Filed under RN on the side, pediatrics for nurses by on Mar 10th, 2009. Comment.
Podcast: Play in new window | Download
Welcome to Episode 70
The Nursing Show is a proud member of the ProMed Podcast Network.
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News–
Seminars for Parents by Nurses
Nurses Week 2009 Theme Announced
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Tip of the Week– Hallucinogenic Plants
A ToxTidbits segment from Lisa Booze of the Maryland Poison Center
Jimsom Weed Intoxication article on EMSLive.com
Jimson Weed Overdose, Managing the Anticholingergic Effects
The following is an excerpt from an article from the Maryland Poison Center’s ToxTidbits email newsletter and is used by permission.
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The Maryland Poison Center receives a number of calls each Fall about Jimson weed (Datura stramonium) exposures, usually in teens looking for a no-cost, easily accessible, hallucinogenic high. Other common names for jimson weed include:
- devil’s weed
- stinkweed
- locoweed
- thornapple
- Angel’s trumpet
- Devil’s trumpet
Jimson weed grows along roadsides, in pastures and in vacant lots reaching 3 to 5 feet in height. The plant has purple or white trumpet- or funnel-shaped flowers and prickly seed pods which split along 4 seams to reveal numerous small brown or black seeds. Poisonings from this plant are often seen in the Fall, when the plant reaches maturity. The seeds and dried leaves of jimson weed are ingested directly from the plant or in a tea, or smoked, to deliberately produce delirium and hallucinations.
Since the plant contains atropine, it produces anticholinergic effects similar to the ACLS drug including:
- blurred vision
- dilated pupils
- dry mouth
- tachycardia
- drowsiness
- confusion
Listen to this week’s episode of the Nursing Show to find out more from our Toxicology Expert, Lisa Booze of the Maryland Poison Center. She covers Jimsom Weed and several other plants that your patients may be using for their mind altering effects.
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Stay informed as a nurse:
Subscribe to American Journal of Nursing via Amazon.com here
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Comment or share ideas here on the comment link below or by email:
Other Podcasts from Jamie Davis:
- The MedicCast (for EMTs, Paramedics, EMS field work)
- MedicCast News (Weekly short medical news program)
- MedicCast Live (Monthly live call-in show with a single EMS topic)
- Headliner News Roundup (Weekly single new item with facts and commentary)
Contact Me!
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Song this week:
Great music by Johanna Stahley — Nothing I Would Change —
Click here to get Songs from the MedicCast at the iTunes Store.
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This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Filed under nursing show podcasts, pediatrics for nurses by on Mar 6th, 2009. Comment.
Nursing students hear all of the time about the importance of patient education, simple interventions, and access to care. The Parkland Memorial Hospital in Texas has released an amazing set of statistics based on their reduction in premature births over the last 20 years while the rest of the country’s rates continue to rise to alarming levels.
Premature Births Decline
The released report shows premature birth rates of 10.9 percent in 1988. In the most recent year on record, that rate has fallen to 4.9 percent (2006). Even more amazing is the fact that this hospital’s patient population contains a high number of transients, non-english speaking persons, and minorities – all groups identified as being at high risk for pregnancy related complications.
RNs and student nurses should pay attention to this hospital’s amazing turn around despite a patient population that “experts” would say makes such a thing impossible.
Nurses and Nursing Care Counts
How did this Texas hospital system make this happen?
Improved and open access to care, pre-natal planning, and education are the key parts to Parkland’s success. All of these program aspects are likely handled or administered by nurses in some capacity. This is another example of simple interventions and patient education making a huge difference to the patients.
Better Health Thru Nurses
The lesson for you and all of the nursing world to take from this article is to look at what small improvements can be made to the systems in your facility. Identify an at risk population of patients in your community and look at ways they are underserved by the medical establishment. Now, ask yourself this question:
What simple, measureable health care intervention would have the greatest effect on that population’s overall present and future health?
Work with your staff and supervisors to implement a study that examines the effects of this intervention over time. By contributing to the growing body of nursing research, you will show the widespread impact that qualified nursing care has on a community’s overall health.
Tell Us What You Think
Are you doing something like this already? Let us know! Leave a comment using the link below or email us at Comments@NursingShow.com to share with the rest of the community here.
Filed under pediatrics for nurses by on Mar 2nd, 2009. Comment.
My good friend, Dr. Ginger Campbell recently interviewed Dr. Paul Offit, author of the book – Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure
Check out the link here to Ginger’s excellent show and listen to this eye opening interview on the issues that surround the conflicting opinions on vaccine safety and causes of autism.
Brain Science Podcast Link on Vaccine Safety
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The Brain Science Podcast is one of the many excellent podcasts on the brand new ProMed Network. It is an excellent look at medical and neurological understanding of the brain. Check out Ginger’s other shows and more at ProMedNetwork.com.
Filed under RN on the side, pediatrics for nurses by on Feb 16th, 2009. 1 Comment.
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