Airway Case Nurse

It is important to know that the task a nurse performs is within the scope of practice. So that a nurse can perform his/her task in a permitted way safely.

During procedure nurse is usually passing instruments, making sure equipment is set up and ready to go, assisting with taking radiographs, taking care about patient’s escort during taking radiographs, making sure patient is comfortable and calm, processing x-rays, also working length have to be recorded in the patient notes either paper or digital or both

An evaluation of Mrs Smith circulation was the next step carried out by the nurse, as in the breathing assessment Mrs Smith pallor was noted as being flushed and the patient appeared confused this could be associated with poor cardiac output. The nurse recorded the patient’s blood pressure using a dinamap it was measured at 88/50, it was then rechecked manually to ensure accuracy. The pulse was checked manually for rate and rhythm it was recorded as 98 beats per minute. Capillary refill was checked, was found to be normal.

According to American Nurses Association (ANA), (2010) “the nurse promotes, advocates for and strives to protect the heath, safety and right of the patient” (p. 6). Nursing responsibilities should be acted at the highest standard and must be based on legal and ethical obligations.

As the nurse, it is your responsibility to ensure pain control. In A.W.s case, would you administer pain medication before the chest tube insertion?

Electrodes must be placed in the correct landmarks to prevent misinterpretation of the ECG. If the electrodes are placed incorrectly, the ECG may read as ST changes, electrical axis, location of bundle branch blocks and location of infarcts (Riddle, 2008, para. 5). During the ECG, a total of 10 electrodes are applied to the patient. Six electrodes (V1-V6) are placed on the anterior chest in the proper anatomical landmarks, and these leads must be placed precisely for an accurate ECG interpretation. Electrodes V1 and V2 are placed on the fourth intercostal space with V1 on the right and V2 on the left (Riddle, 2008). Electrodes V3-V6 are placed on the left chest wall on the fifth intercostal space in the following order: V3 to the right of V4, V4 at the midclavicular line, V5 to the right of V6, V6 to the midaxillary line (Riddle, 2008). The remaining four electrodes are placed on both upper and lower extremities without touching the chest.

The purpose of arterial pressure and the pulse lab is to determine the effect of posture and exercise on systolic and diastolic pressure and the heart rate. And also in order to find the differences in the reading taken under these condition compares to the baseline reading. The Sphygmomanometer and stethoscope are used to measure the systolic and diastolic blood pressure, counting the beat on the radial artery will give the reading for pulse rate and by using the lab scribe software and IWX214, the blood pressure will be measured. In the heart, the aorta and the carotid arteries have baroreceptors and the chemoreceptors that identify the changes in arterial pressure and the changes in

It is up to the nurse/delegator to determine the delegatee’s knowledge, skills, abilities, and any training that will ensure that the task will be handled appropriately and safely. If it is necessary the nurse/delegator must provide instruction and direction to the delegatee. The nurse/delegator or another qualified nurse must be available to supervise the delegate and delegated task. The level of supervision needed will be determined by the training, capability, and willingness of the delegate to perform the task. A delegate may not delegate to another person or expand the delegated task without the permission of the nurse/delegator. Once the delegated task is completed the nurse must evaluate the delegated task, patient’s health status, determination if the goals are being met and if the delegation of the task may be continued (UT Admin Code R156-31b. Nurse Practice Act Rule, 2013). In section R156-31b-704 the rules for the recognized scope of practice of an RN are outlined. It states that the RN, RN managers, and RN administrators should practice

The nurse is responsible for positioning the patient and should assess the patient throughout to see how well he is tolerating it. If the patient is on a heart monitor, the nurse should monitor vital signs and heart rate as the catheter is being put in for any fluctuations. Afterword’s, the nurse should assess for complications or adverse reactions like pneumothorax. Make the patient comfortable and listen to bilateral breath sounds. Obtain a stat XRAY to verify correct placement.

Flight nurse’s and Flight Paramedics performs as members of an aeromedical crew on helicopters (rotor wing), and airplanes (fixed wing) aircraft, providing for in-flight management and care for all types of patients. Responsibilities of this job include the planning and preparation of flight, safety, evaluation of an individual patient's in-flight needs and request appropriate medications, supplies, and equipment to provide continuing care from origination to the destination facility. They act as liaisons between facilities during an interfacility transport and from scene location to trauma center during medical and trauma related emergencies. They also initiate emergency treatment in the absence of a physician during in-flight medical emergencies. Flight nurses and Flight Paramedics have training in mechanical ventilation, hemodynamic support, vasoactive medications, airway, and other intensive care skills.

The pulse is an indication of an individual’s heart rate. When checking for a pulse in the primary survey, begin with palpating the patient’s radial or carotid artery (Basic Patient Care 2012, p. 50). This may reveal a normal (60-100 beats/min), tachycardia (<100 beats/min), bradycardia (> 60 beats/min) or asystole heart rate. Additionally, the capillary refill may also provide details about a patient’s cardiovascular status. This is performed by applying pressure to the nail bed and calculating the time it to takes to refill to a normal color, which should take no more then a few seconds otherwise suggesting capillary closure (Mick J Sanders, 2012, p. 1400). An additional accessory to Circulation is Hemorrhages, these involve more through examinations of the pulse, blood pressure and warmth of peripheries of patients. Additionally, you must thoroughly look for indication of bleeding, specifically in the areas around the chest, abdomen and externally seen by the eye.

I feel that with experience and practice that any medical-surgical nurse can tackle any situation whether stopping fluid from leak out of an abdominal incision site to suctioning a tracheostomy patient. A nurse should address situation under pressure but remain calm and to be able to think of the next step.

First everyone had to put on a mask, wear surgical head covers, proper scrubs, and shoe covers. Inside the operation room, the surgeon and scrub tech had to put on a sterile attire, which included sterile scrubs,gloves, and equipment because they were the first people to have contact with patient. The circulator or documenting nurse and anesthesiologist were around the sterile field (aseptic technique) without any contact with the patient whatsoever. As you would have guessed, the surgeon was the one who performed the surgery with the help of the scrub tech and monitored by the circulator nurse and anesthesiologist. The main duties of the circulator nurse was to document everything during the surgery from what medications used to how many sterile dressings were used, proving supplies to the surgeon and the scrub tech as needed,and making sure the room was prepare for the assigned surgery. This nurse also provides conform measurements for the patient while in the operation room. For instance, there was a patient who was too big for the operation bed, so the circulator nurse had to find additional supplies that would prevent the patient from sliding down the bed. Nurses always provide the finest education towards their line of duty but also take the time to teach those people who starting the nursing

Nurses are welcomed to be more involved to lead the discussion, keeping the focus on patient care and good nursing.

Urgency of acute care varies depending on the situation but can range to anything from emergency surgeries, to injuries, chronic illnesses, and also for the recovery of those procedures. Majority of the patients in acute care settings are critically ill. Nursing responsibilities in acute care settings are vital to patient’s recovery due to the front line position nurses play as well as the wide variety of tasks carried out. Assessments are made during every encounter the nurse has with the patient along with monitoring the patient’s progress. Nurses are responsible for recognizing symptoms the patient may be experiencing due to illness or injury and whether they fall in the spectrum of normal reactions. Vital signs are measured routinely and can be indicators of the patient’s current status. When vitals are questioned diagnostic tests can be arranged to further assess possible comorbidities the patient may have. Care plans are made to plan interventions the health care team can take to help patients through challenges they face, both physical and mental. Nurses administer medications as well as first aid as needed. They are responsible for maintaining special equipment patients may require including monitors and ventilators are well.