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Nurse Nacole
@nurse-nacole.bsky.social
11 followers 4 following 380 posts
Daily nursing tips from www.nursenacole.com & more!
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nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Usually, ileus is characterized clinically by hypoactive or absent bowel sounds, abdominal distention and delayed passage of stool and gas, but the process may involve nausea, vomiting and abdominal tenderness.
dlvr.it
December 31, 2025 at 4:10 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  In the postoperative surgical intensive care unit, evidence of postoperative ileus ranges from 24% to 75%. Ileus can affect the entire gastrointestinal tract or just a segment, from the proximal gut, to the small bowel, to the colon.
dlvr.it
December 30, 2025 at 4:35 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Acute colonic pseudo-obstruction (Ogilvie syndrome) characteristically has significant dilation of the cecum and right colon without any anatomic obstruction. There is a strong association with opiate administration.
dlvr.it
December 29, 2025 at 2:01 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Intestinal obstruction often presents with acute, diffuse, crampy abdominal pain coupled with nausea and vomiting, obstipation, distention and tenderness. Obstruction can be partial or complete and can involve the small or large intestine.
dlvr.it
December 28, 2025 at 2:25 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Colonic ischemia resulting from endovascular or open abdominal aortic aneurysm repairs most frequently presents as left lower quadrant pain. It is typically a crampy abdominal pain with loose bowel movements (with or without blood present).
dlvr.it
December 27, 2025 at 2:50 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Cytomegalovirus (CMV) colitis is seen in immunosuppressed patients, specifically transplant patients. Neutropenic enterocolitis is almost exclusively described in the ascending colon of immunocompromised patients with profound neutropenia.
dlvr.it
December 26, 2025 at 3:14 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Infectious colitis occurs secondary to a wide array of pathogens. Clostridioides difficile colitis results from prior antibiotic exposure, yet typically presents with more diarrheal complaints than abdominal pain.
dlvr.it
December 25, 2025 at 3:38 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Ischemic colitis can result from embolic disease or low flow in the setting of high-dose vasopressors. Not infrequently, these are diagnosed by either CT imaging with IV contrast or intraoperatively when patients continue to decompensate.
dlvr.it
December 24, 2025 at 4:03 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  For those patients who are too ill to undergo general endotracheal anesthesia, a cholecystostomy tube will temporize acute cholecystitis. The vast majority of patients with cholangitis respond to administration of antibiotics and resuscitation.
dlvr.it
December 23, 2025 at 4:27 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Patients with significant physiologic reserve are candidates for endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy for acute cholangitis and acute cholecystitis.
dlvr.it
December 22, 2025 at 1:53 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Patients in the intensive care unit setting receiving total parenteral nutrition (TPN) or vasopressors are especially at risk for acalculous cholecystitis. Confirmation can be made by hepatobiliary iminodiacetic acid (HIDA) scan.
dlvr.it
December 21, 2025 at 2:18 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  In the critically ill population, most cases of out of proportion abdominal pain are acute mesenteric ischemia, likely caused by embolic disease. In such instances, laboratory studies may reveal leukocytosis and elevated lactic acid levels.
dlvr.it
December 20, 2025 at 2:42 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Although an abdominal aortic aneurysm can be diagnosed using ultrasonography, the imaging modality of choice remains computed tomography. This provides meaningful data that can be used to plan an endovascular repair.
dlvr.it
December 19, 2025 at 3:06 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Patients with severe pain, yet their physical examination is negative, referred to as “pain out of proportion.” If this occurs and there is a palpable abdominal mass, the greatest diagnostic concern is a ruptured abdominal aortic aneurysm.
dlvr.it
December 18, 2025 at 3:30 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Patients presenting after a cholecystectomy or liver biopsy can develop bile peritonitis from slow, progressive biliary leakage into the abdominal cavity, but are also at risk for iatrogenic intestinal injury during the aforementioned procedures.
dlvr.it
December 17, 2025 at 3:54 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  For patients with end-stage renal disease who undergo peritoneal dialysis, secondary bacterial peritonitis can occur because of unsterile dialysis technique or catheter damage. Intraperitoneal antibiotic therapy is a treatment option.
dlvr.it
December 16, 2025 at 4:18 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  In patients with abdominal pain, cirrhosis and any degree of ascites, spontaneous bacterial peritonitis must be considered and treated appropriately. A diagnostic paracentesis may aid in directing antimicrobial therapy.
dlvr.it
December 15, 2025 at 4:42 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Consideration of transjugular intrahepatic portosystemic shunt (TIPS) occurs once patients require more than two paracenteses in a month. Complications include stent occlusion, liver, renal and heart failure and hepatic encephalopathy.
dlvr.it
December 15, 2025 at 4:54 AM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Transjugular intrahepatic portosystemic shunt (TIPS) involves placement of an expanding metal stent within an artificially created channel that diverts portal blood flow into the hepatic veins, thus decreasing portal hypertension and ascites.
dlvr.it
December 13, 2025 at 2:33 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Refractory ascites carries a mortality of 21% at 6 months and 70% at 2 years. Treatment consists of serial therapeutic paracentesis, transjugular intrahepatic portosystemic shunt (TIPS) or liver transplantation.
dlvr.it
December 12, 2025 at 2:57 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Refractory ascites is diagnosed when maximal medical management for at least 1 week or repeated large-volume paracenteses within 4 weeks are insufficient to remove ascites. Diuretic failure can often be a cause.
dlvr.it
December 11, 2025 at 3:21 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Patients with a low ascitic protein content are particularly at risk of developing spontaneous bacterial peritonitis. Treatment should start as soon as infection is suspected with a third-generation cephalosporin, such as ceftriaxone or cefotaxime.
dlvr.it
December 10, 2025 at 3:45 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Spontaneous bacterial peritonitis arises from translocation of intestinal bacteria, predominantly Escherichia coli and Klebsiella. Common symptoms include fever, abdominal pain, nausea and vomiting, encephalopathy and renal dysfunction.
dlvr.it
December 9, 2025 at 4:09 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Spontaneous bacterial peritonitis occurs in 30% of patients with ascites and is defined by: Positive bacterial culture, ascitic fluid polymorphonuclear cell count ≥250/mm3 and absence of surgically treatable source of infection.
dlvr.it
December 8, 2025 at 4:33 PM
nurse-nacole.bsky.social
Nursing Tip of the Day! - Critical Care Nursing
Category: Critical Care Nursing  Ascites signifies progression from compensated to decompensated liver failure and carries a 20% 1-year mortality. Within the first decade of diagnosis, 50% of patients with cirrhosis will develop ascites.
dlvr.it
December 7, 2025 at 2:00 PM