Provider Practice Essentials registered nurse continuing education

Ventilator Associated Pneumonia

Inpatient Management Guide Definition Community acquired pneumonia (CAP): Clinical diagnosis based on patient’s history, physical exam, and CXR. Can only be diagnosed in patients who have not been hospitalized or lived in a long-term care facility for the 14 days before presenting. Healthcare associated pneumonia (HCAP): Pneumonia in any patient who was hospitalized for two … Read more

Vasopressin

Inpatient Management Guide Pressors and Inotropes Agent Receptor Activity Physiologic Effects Indication Dosing (mcg/kg/min unless specified) Comments Norepinephrine (Levophed) α1: +++ β1: ++ β2: 0 INOPRESSOR SVR: ↑↑ CO: ↔/↑ • Septic shock • Cardiogenic shock • Undifferentiated shock Start: 0.01-0.04 mcg/kg/min Max: 3.0 mcg/kg/min • 1st line agent for distributive/septic shock • Can be … Read more

Upper GI Bleed

Inpatient Management Guide Definition Upper GI Bleed Blood loss in gastrointestinal tract proximal to Ligament of Treitz (junction of duodenum and jejunum). Can be described as: overt – visible; hematochezia (bright red blood) or melena (black, tarry stool) obscure – bleeding source not found on EGD, colonoscopy, enteroscopy, capsule occult – recurrent bleeding not visible … Read more

Transfusion

Inpatient Management Guide Definition For standardized definitions and clinical criteria for transfusion reactions see: https://www.cdc.gov…  Febrile non-hemolytic transfusion reaction: Development of benign fever (>1 C change to >38C) or shaking chills during or within 4 hours after a transfusion. Self-limited with no major sequelae. This diagnosis can only be made by sending a post-reaction workup … Read more

Supraventricular Tachycardia

Inpatient Management Guide Definition Defined as paroxysmal tachyarrythmias that require atrial tissue or AV nodal tissue (or both) for initiation and maintenance Almost always present as narrow QRS-complex rhythm with heart rate > 100 beats per minute on ECG Less than 10% of cases present as a wide complex tachycardia (i.e. Wolff-Parkinson-White syndrome [WPW]) Etiology … Read more

Stroke

Inpatient Management Guide Definition Ischemic stroke: Acute neurological infarction due to thrombosis, embolism or systemic hypoperfusion Hemorrhagic stroke: Acute intracranial hemorrhage, often intracerebral or subarachnoid, in setting of trauma, hypertension, underlying tumor, cerebrovascular abnormality, or other etiology Transient ischemic attack (TIA): Acute neurologic deficit without evidence of infarction on neuroimaging, classically defined as lasting < … Read more

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