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Welcome to Episode 144 of the Nursing Show
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News–
Acetaminophen: Teen Asthma Trigger?
New Guidance on Care Record Violence Markers
Working Conditions Less Better for Nurses in Magnet Hospitals
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Tip of The Week- Acetaminophen (Tylenol) Medication Review
Acetaminophen, more popularly known as Tylenol is one of the over the counter drugs that can be found in most American households. This medication is mainly used for minor pain and aches and for fever reduction. Since this is a common drug taken by most people, nurses should be aware of the basics of this drug to be able to provide the correct information to patients and avoid overdosing or under dosing on the drug.
Knowing information like how it works, its interactions with other drugs, and contraindications is also necessary to avoid unwanted side effects that can arise. For more information on the medication Tylenol, nurses and nursing students can follow the links below.
Medicine Net.com on Acetaminophen (Tylenol)
Nursing Show Episode on Acetaminophen Overdose
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Don’t miss an episode! You can receive the Nursing Show Newsletter in your email inbox.
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: Johanna Stahley with “I’m Not Perfect”
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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 by on Aug 20th, 2010. 2 Comments.
Up til now, insurance companies have been reluctant to get into the technology game where we have something that maybe can provide an option for our patients but their insurance company isn’t going to cover it and so they end up falling into the same-old, same-old whereas we could have a patient that could be safely and effectively managed much less expensively in the long term, but because of the upfront cost of putting in some kind of technological solution in the near-term, the insurance companies have bulked. That seems to be shifting according to this article I found over at medical news today.com, there is a shift and they’re starting to look at some monitoring technologies that will wirelessly let a monitoring center, physician’s office, a telenurisng program, hospital center, whatever the case may be, let them know about daily updates for for instance Congestive Heart Failure patients, COPD patients, patients that are at risk for being hospitalized with complications related to their medications, management of their disease.
Think about it, if we can monitor I’s and O’s remotely, we could catch an early weight gain that shows signs of Congestive Heart Failure exacerbation,. The benefit of that of course is we can adjust the patient’s diuretic medication, we can adjust the patient’s beta blockers and other cardiac meds and by doing that remotely by having a nurse- because it’ll be a nurse that calls, by having a nurse call in and verify the information, talk with the patient a little bit, get the assessment and then provide the update and information from their prescriber, we could give this patient an opportunity to not have a long-term hospital visit with all of the concurrent issues, risk for infection and other illnesses and expense and time away from home and all of those things that come into play when we have to hospitalize a patient. Managing this patient remotely, keeping them at home, keeping them from having and exacerbated situation occur is of course part of what nurses do and part of our focus on health management and return to optimal health and so I think that this is just right up nursing’s alley. This is what we do, it’s what we do really really well. So I’m looking forward to opportunities to do more of this. Imagine that at risk diabetes patient, that patient who for whatever reason is having difficulty managing their illness. If we could monitor their diabetes with them and catch some early shifts and some changes; maybe their diet is not where it needs to be, maybe they need some encouragement, all of these things can be done remotely and we provide this patient upfront care that staves off years of complications simply by making a quick phone call. So I’m looking forward to really having some of our insurers be more forward thinking about the uses of technology and actually reducing health care cost.
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This article has been featured in the news segment of the Nursing Show episode Johnson & Johnson Campaign for Nursing’s Future Campaign and Episode 143
Filed under nursing news by on Aug 13th, 2010. Comment.
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Watch this episode of the Nursing Show weekly podcast recorded live this week in the Nursing Show podcast studios. Host Jamie Davis, the Podmedic covers this week’s news, commentary and a special nursing review tip with Lisa Booze from the Maryland Poison Center.
Check out the extra links, news items, and other resources at the shownotes page for this week’s podcast episode with a review of key techniques in patient communication and education for nurses.
Find more videos segments and studio podcast videos at NursingShow.TV
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Filed under nursing show tv, podcast studio video by on Aug 4th, 2010. Comment.
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Join Jamie Davis, the Podmedic and watch the video version of this week’s Nursing Show from the podcast studio at MedicCast Productions.
This week’s show features the usual look at nurses in the news with commentary and links. Jamie also takes a look at Asthma in a review for nurses, nursing students, and educators in this week’s tip of the week.
Check out the Asthma Review for nurses podcast shownotes for links to the news items and resource links to check out related to asthma.
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Song this week: I’m Not Responsible by Laura Clapp
Click here to get Songs from the MedicCast at the iTunes Store.
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Find more video to come at NursingShow.TV
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Filed under nursing show tv, podcast studio video by on Jun 11th, 2010. Comment.
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Welcome to Episode 105
The Nursing Show is a proud member of the ProMed Podcast Network.
Subscribe to the show, free!
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Click the arrow below to listen to the show:
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News–
Government Urged to Modify 2009 H1N1 Guidelines for Health Workers
Health Care Jobs Plentiful But Difficult to Get
Florida Hospitals Deploy iPhones to Replace Alarms
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Tip of The Week- Neurologic Assessment for Nurses
Part of the overall physical assessment done by nurses is the neurological evaluation. Prior to performing the examination, patients are first asked if they have a history of seizures, loss of consciousness, loss or decreased sensation (especially to pain), twitches , tremors and changes in personality or mental status.
A complete neurologic exam covers assessment of the cranial nerve function, motor system, reflexes, sensation, and mental status. This process may take a little more time as compared to the usual head to toe assessment and nurses might go for a quick approach to doing it, however, they should always be thorough in performing any assessment and keep in mind that more is missed by not looking than by not knowing.
For a better understanding on neurologic assessment, follow these links
Physical Assessment- Neurological System
Neurological Examination Video
Nursing Care for Neurological Patients
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Don’t miss an episode! You can receive the Nursing Show Newsletter in your email inbox.
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
Song this week: Natalie Gelman with “Never Had You”
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Click here to check out other Songs from the MedicCast Network Podcasts 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 by on Nov 13th, 2009. 1 Comment.
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Welcome to Episode 104
To take the survey, click here takethesurvey.com/rawvoice
The Nursing Show is a proud member of the ProMed Podcast Network.
Subscribe to the show, free!
—–
Right Click to download (Macs Option Click)
Subscribe with iTunes here (need iTunes — it’s free)
RSS Feed to subscribe (copy url to Juice, Zune Marketplace, or your favorite podcatcher)
Click the arrow below to listen to the show:
[audio:http://www.podtrac.com/pts/redirect.mp3/media.blubrry.com/nursing_show/traffic.libsyn.com/nursingshow/NursingShow_20091106.mp3]
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Sponsors
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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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Don’t miss an episode! You can receive the Nursing Show Newsletter in your email inbox.
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
If you like the track, click below to go to iTunes and purchase it there:
Click here to check out other Songs from the MedicCast Network Podcasts 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 Nov 6th, 2009. 1 Comment.
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Welcome to Episode 94
The Nursing Show is a proud member of the ProMed Podcast Network.
Listen to the show!
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Right Click to download (Macs Option Click)
Subscribe with iTunes here (need iTunes — it’s free)
RSS Feed to subscribe (copy url to Juice, Zune Marketplace, or your favorite podcatcher)
Click the arrow to play the Nursing Show
[audio:http://www.podtrac.com/pts/redirect.mp3/media.blubrry.com/nursing_show/traffic.libsyn.com/nursingshow/NursingShow_20090828.mp3]
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Sponsors
NursingTopStudent.com all of the tools student nurses need for less than $1 a day. Audio and video study aids plus a whole lot more! More than 200 files and counting!
Try out Go To My PC for free for 30 days, visit www.gotomypc.com/podcast
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News–
Nursing Program Help Runaway Girls
American Heart Association Warns Against High Sugar Content in Foods
ANA President Among Top 100 Most Powerful Persons in Healthcare
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Tip of the Week– Assessment and Nursing Care of Delirium
Delirium is characterized as a progressive decline in memory and rapid changes in brain function that occur with physical or mental illness. Its symptoms arise from various underlying causes such as heart or renal failure, or withdrawal from medication.
Most common causes and risk factors for delirium can best be remembered through the following mnemonic.
D- Dementia
E- Electrolyte disorders
L- Lung,liver,heart,kidney, brain
I- infection
R- Rx drugs
I- Injury, pain, stress
U- Unfamiliar environment
M- Metabolic
Since symptoms of delirium may often overlap with symptoms of dementia, especially in the elderly, nurses should be familiar with the clinical manifestations of both to be able to differentiate them. Symptoms of delirium involves a quick change in mental state and appear suddenly in a short time, usually hours or days. It includes alteration in mental status, inability to concentrate, alternating periods of agitation or restlessness and lethargy. Patients suffering from delirium also exhibits altered perceptions like visual illusions or hallucinations.
Preventing delirium can be done through treatment of the underlying cause that triggers the event. Reducing stimulation like avoiding psychoactive drugs, providing a calm and quiet environment especially at night can be done to reduce the occurrence of delirium. Other preventive measures include providing daytime activity, use of visual and hearing assistive devices, orientation devices and avoidance of the use of restraints.
Treatment of delirium is aimed at resolving the medical or mental disorder that causes it. Medications given are used to control aggressive or agitated behaviors and start at low doses which gradually increases depending on the need.
Medications include:
- Dopamine blockers (haloperidol, olanzapine, risperidone, clozapine)
- Mood stabilizers (fluoxetine, imipramine, citalopram)
- Sedating medications (clonazepam or diazepam)
- Serotonin-affecting drugs (trazodone, buspirone)
- Thiamine
Other treatments like behavior modification to control unacceptable or dangerous behavior and reality orientation to reduce disorientation may also be helpful.
Delirium from MedlinePlus medical Encyclopedia
Sorting out Delirium, Dementia, and Depression
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Don’t miss an episode! You can receive the Nursing Show Newsletter in your email inbox.
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)
——————————–
Song this week:
Music from The Podsafe Music Network
This week- Laura Clapp – Just Let Go
Click here to get Songs from the MedicCast at the iTunes Store.
————————————-

This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Filed under nursing show podcasts by on Aug 29th, 2009. 1 Comment.

Taking vital signs is a usual routine for nurses and student nurses. In an 8-hour shift, vital signs are taken at least twice and is regarded as the indicator of the patient’s health status.
After collecting the data, interpreting it, determining what is normal and what is not, and concluding that the patient is stable, what’s next?
Actually, you can do more during that brief period of time than just inflating a BP cuff and counting beats and breaths. Using this time for a variety of assessments is a good use of a nurse’s time.
During that time, use your other senses to gather more information. Look at the facial expression and position. Grimacing and splinting of a body part indicates feelings of discomfort. Listen to your patient. Different audible breath sounds can tell a lot about the respiratory status of a patient. Moaning or groaning is another indication of discomfort.
Talk to your patient. Subjective data is just as important as objective data. Ask your patient how he is feeling. If he is in pain, use the pain scale to rate the intensity of pain. Even if his BP, RR, PR, and temperature are in normal range, being in pain does not make him stable and is a problem that needs intervention. Engaging in conversation gives you the opportunity to establish rapport and gain trust.
Vital signs are important data in identifying client needs, but being nurses dedicated to patient care,we should see the patient as a whole. Even in the simple things, no matter how routine they already are, we should always remember that our goal is to provide quality patient care.
Learn more about vital signs and nurses in this episode of the Nursing Show podcast
Filed under RN tips by on Jun 29th, 2009. Comment.
Nurses play a key role in reducing hospital overcrowding based on a recent study commissioned by the Agency for Healthcare Research and Quality. The study published in the February 3, 2009 issue of the Annals of Internal Medicine determined that patients who clearly understood their discharge instructions were less likely to return to the hospital emergency department or need more follow-up care.
While this might appear to be a simple assumption to most in the nursing field, it points out a serious deficit in the way some RNs are implementing a basic component of nursing care, patient education. Students planning on a nursing career should pay attention to the lessons learned in this study.
Recent episodes and articles here at the Nursing Show have discussed the importance of telemedicine follow-up on patient’s handling of complications, pain management, and other post hospitalization issues. The journal article above points out the importance of this key nursing intervention. For student nurses, I think it’s important to review some of the aspects of a good set of discharge instructions based on the tried and true ADPIE model.
Assess
Every nursing intervention begins with an assessment of the patient. Providing discharge instructions is no different. Before proceeding, the nurse or student must assess the patient’s ability to understand or comprehend the instructions. Communication with the patient who has a hearing deficit will be very different from the patient with perfect hearing. Understanding the individual’s particular communication needs starts with assessing them.
Things to look for include:
- Level of education
- Language barriers
- Visual disturbances
- Hearing deficits
- Cultural differences
- Economic concerns
Diagnose
Once potential problem areas are identified, use your nursing diagnoses to begin to lay out areas of concern. How is the patient likely to miss part of their discharge instructions. Planning is the next step, but it should not be rushed into until the nurse understands the patient’s particular needs. By planning based on a nursing diagnosis, the RN can start with a foundation clear patient needs in mind.
Plan
Planning is where the rubber meets the road. In this stage, a nurse takes the information from their assessment of the patient and puts that together with the nursing diagnosis to begin to formulate the goals for this particular patient. Setting these short and long term goals will help the nurse better implement interventions in the next step.
When planning, take the assessment data and ask key questions:
- Level of education: Will they understand big medical words? Can a family member help with understanding?
- Language barriers: Do they speak English and how well?
- Visual or Hearing Deficits: Do they need large type materials or additional print materials?
- Cultural barriers: Will some instructions be ignored due to cultural restrictions?
- Economic concerns: Can the patient afford the materials needed at home?
Take this information and lay out a plan of action including gathering additional materials as needed. You may have a standard facility print-out for a particular set of discharge plans. Do not assume that it will automatically be suitable for your patient. There is no “one-size-fits-all” discharge instruction sheet.
Implement
You have assessed and diagnosed a patient’s particular needs, laid out your plan of action, and gathered your materials. Now it is time to implement. A well known military tenet states that “no plan survives contact with the enemy.” Flexibility is the key.
As you begin to relay the discharge instructions, here are a few things you might need to do:
- draw a diagram or picture (stick figures work, too!)
- demonstrate care to be performed at home
- repeat key points of the home care plan
- underline or highlight the discharge sheet items
- revisit phone numbers and provider or nurse contact info
Evaluate
This the point where many patients needs are not being met. The most important part of any patient intervention is to re-evaluate the nursing intervention’s effectiveness in meeting the patient’s needs. Before the patient leaves the hospital, the nurse must evaluate whether the patient understood the instructions.
Good communication techniques are important here. Refrain from asking closed ended questions. These are questions that only require a “yes” or “no” answer. It is far too easy for a patient who doesn’t have a clue about what you just said to just nod their head in agreement because they don’t want you to think they are stupid.
Ask the patient to demonstrate home care needs back for you. When demonstrating a device or technique, use this useful phrase -
“You try it.”
ADPIE Again
The shampoo bottle says, “Lather, Rinse, Repeat.” This might be a ploy to get you to use more shampoo but sometimes you need to do it all again. The nurse must be prepared to revisit the ADPIE model to cover an evaluated deficits. Also, because of challenges with time management in the hospital setting, the follow-up telenursing call may be the best way to re-evaluate the patient’s understanding and provide opportunities for cost effective follow-up care.
What are your experiences as a nurse or student when dealing with discharge planning and instructions? Share them using the comments link below or drop us an email to Comments@NursingShow.com.
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Don’t let tough classes keep you out of the nursing field!
Student Nurses will find more resource articles, audio/visual study aids, and more at the brand new NursingTopStudent.com site.
Filed under nurse career guide, nursing education, research for nurses by on Feb 9th, 2009. 1 Comment.






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