ED Nursing Archives – July 1, 2010
July 1, 2010
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Special Issue on geriatric ED patients
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Don't make dangerous mistakes with elder vital sign assessment
A heart rate in the 60s might be the expected result of a patient on a beta blocker. "But, it may really be a masked tachycardia limited by the medication," says Barb Smith, RN, BSN, MSA, CEN, trauma program manager at Botsford Hospital in Farmington Hills, MI. -
Don't make assumptions about older psych patients
If a 65-year-old patient came to you with acute visual hallucinations but no behavioral health care history, what would you suspect? -
Elders with seizures might surprise you
Do you suspect your elder patient is having a seizure? "Remember that presenting clinical features differ between the old and young," says Alison Hofheinz, RN, MSN, CPNP, a clinical nurse specialist in Bronson Methodist Hospital's Trauma & Emergency Center in Kalamazoo, MI. Hofheinz says to keep in mind these three things, Hofheinz says: -
Do your part to stop harmful drug interactions
Elders often have duplicate prescriptions and might take herbal supplements without telling ED nurses, warns Carol Howat, RN, BSN, CEN, clinical educator for the ED at Northwest Community Hospital in Arlington Heights, IL. -
Ask these questions for traumatic brain injuries
ED nurses are caring for increasing numbers of elders with traumatic brain injuries, mostly due to fall injuries, says a report from the Centers for Disease Control and Prevention (CDC). -
Dangerous handoffs with elders must end
There is no question that handoffs between long-term care facilities and EDs are high-risk times for elder patients. "Transfers because of an acute deterioration of the patient can result in a lack of communication related to pertinent history, medications, allergies, and code status," says Samuel Shartar, RN, CEN, director of the ED at Emory University Hospital in Atlanta. -
Beta blockers may mask symptoms in septic elders
Do you expect to see tachycardia in a septic patient? Don't forget that this response will be masked in elders taking beta blockers.