EP 161: The Basics Every Nurse Should Know

The Basics Every Nurse Should Know

There are three basics every nurse should know by heart. You must understand that being a nurse comes with significant responsibilities. It’s like being a superhero, but your powers are stripped off when you make a mistake! You can say goodbye to your career and beloved profession if that is the case. 

Because medical errors are common these days, you must know all the nursing basics. Knowing all the basic procedures, SOPs, etc., will save your patient and your license as a nurse. 

As a nurse, you have to perform your job to the best of your abilities. It will also help you if you can memorize all the nursing basics there is to know so you can also serve your patients better. 

Keep in mind that there are many work-related basics that every nurse should know. These are all essential in making your job more effective. Nursing is composed of many different units and fields, each requiring its level of competence. Here’s what you need to know:

Basics Every Nurse Should Know About

 

1. Medications

Not every nurse works in the ER or ICU.  But there are specific medications that are often shared amongst most if not all units. Over the course of your work, you will get used to your unit’s medications. Those are unit-specific, but there are also medications that you’ll be familiar with.

Some of these are emergency medications and are often used as a quick solution to acute issues. The meds we’d like to address are more for emergent use and used as problem solvers. Medications like levothyroxine or pancrelipase are essential. But those are more unit-based. These are usually given the next day. We want to focus on meds that can benefit nurses in stressful situations.

  • Pressors

Vasopressors are among the common medications you’ll see in the ER or ICU. But if you don’t work in these units, you might think you’ll never use them.

Before you call that rapid or even during a rapid there are things you can do. If the patient is hypotensive there are 2 major things you can do; give fluid and/or start levophed. For patients with low blood pressure, norepinephrine is a good backup med. Levophed, Levo, norepi, and norepinephrine all mean the same thing.

You don’t have to memorize all vasopressors. Remember only the basic medications used like levophed. It is usually the first line of meds used in emergencies.

  • Antihypertensives

There are many ways to lower blood pressure and many meds. The most common ones we’ve seen are Nicardipine, metoprolol, and hydralazine. Each works differently but has the same functional effect on lowering blood pressure. 

  • Beta-blockers like metoprolol tartrate (Lopressor) or metoprolol succinate

Metoprolol tartrate is also referred to as Lopressor. It’s different than succinate because Lopressor wors quicker but not as long. We use Lopressor to bring down a patient’s blood pressure quickly. Metoprolol succinate is a common med prescribed outside the hospital because it can be taken once or twice a day vs. 4-6 times.

Keep in mind that this is a beta-blocker, which lowers blood pressure and heart rate. You’ll need to find a delicate balance in the amount of med to give for that reason, you need blood pressure control, but you can only give them so much before you throw them into heart block and need to pace them.

  • Vasodilators like hydralazine

Hydralazine is one of the main antihypertensives used in heart failure. It is an interesting medication because it primarily affects the arteries causing decreased peripheral resistance; reduced blood pressure; and reflexively increased heart rate, stroke volume, and CO.

The main contraindication is coronary artery disease because increased cardiac output increases cardiac work and may provoke angina and myocardial ischemia or infarction.

  • Calcium channel blockers like nicardipine

Calcium channel blockers are medications used to lower blood pressure. They work by preventing calcium from entering the cells of the heart and arteries. 

It also causes the heart and arteries to squeeze vigorously (contract). By blocking calcium, calcium channel blockers allow blood vessels to relax and open.

Nicardipine is given intravenously. Sometimes, patients with a stroke get placed on it for strict blood pressure management. It is a titratable drug. 

  • Insulin

So many different insulins. You don’t have to remember the exact hourly effect or half-life, just the basics. Lantus or glargine is long-acting. You’ll give it once a day, twice tops. 

NPH: this is the insulin you will give with meals. Regular is usually used for coverage.

 

2. Report

Each unit is going to have its own specific things they like in the report. For example, a cardiac ICU nurse gets more information about the heart. In the report, they write about the cardiac index, output, and pulmonary artery pressures. 

Regardless of what unit you are in, you need to know the basic information that is standard for each report. If by chance you are new, floating, or a travel nurse, your report improves over time. But, you will always be in the clear if you know the core basics. These are:

  • Room, name, age, code status, and allergies
  • Past medical history, contact info
  • Admission day, why they came in, and events during hospital stay/shift.
  • Planned procedures, able to DC or transfer, patient plan.
  • Neuro: Mentation, commands, fever, activity, RASS
  • Card: HR/rhythm, BP, pulses, and meds
  • Resp: O2, trach/ET size, tubes, vent settings, ABG, and lung sounds
  • GI/GU: Drains/tubes (NG, PEG, ostomy, etc..), output, last BM, and diet
  • Skin
  • Lines
  • Drips and important meds
  • Labs

 

3. Emergency basics every nurse should know

Not all floor requires ACLS, but BLS is a standard in the hospital. You should also know what to do in certain situations. Even though you may not perform all tasks during an emergency, it is always a good thing that you know what to do. 

Having a basic understanding during an emergency situation is essential. It is also good to know some of the algorithms, so you have an understanding of what to do in case of emergencies. 

 

  • Assess your patient, what has changed? Are they hard to arouse? Breathing? Pulse? 
  • ACLS
  • Bradycardia protocol 
  • Tachycardia with pulse
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