Full Course Description

2 Day: Advanced Assessment Skills: Respond to the Patient's Clues with Skill and Confidence

Program Information

Objectives

  1. Integrate sound critical thinking and clinical decision-making.
  2. Demonstrate advanced heath assessment knowledge and skills including therapeutic communication.
  3. Manage a comprehensive database including functional assessment, psychological assessment, health and pharmacological history, and physical examination.
  4. Formulate appropriate laboratory and diagnostic testing.
  5. Evaluate findings of laboratory and diagnostic testing along with suggestions for treatment.
  6. Determine a differential diagnosis based on assessment data.
  7. Diagnose the area of the heart where ischemia, injury, or infarction are occurring based on 12-lead ECG.
  8. Choose the best interventions for stabilization of the deteriorating patient.
  9. Determine the key interventions to stabilize the successfully resuscitated patient.
  10. Analyze the latest clinical practice guidelines for common pathologies and comorbidities.
  11. Formulate documentation strategies to protect yourself and your practice in the case of lawsuit.
  12. Evaluate early signs of clinical deterioration to identify key interventions to initiate.

Outline

Psychosocial Assessment

  • CALM acronym: How to set the person at ease during your assessment
  • Three key elements in determining the psychosocial assessment
  • Proven ways to assess stress in the patient
  • Two ways to quickly identify suicidal ideation
  • Is this an accident or abuse or neglect?
General Survey of the Patient: What You See is What You Get…Well Not Always
  • Symptom analysis…use the COLDSPA acronym
  • What the blood pressure and pulse tell you about the patient…even before the stethoscope
  • Four proven ways to differentiate neuropathic and non-neuropathic pain
  • Key steps when a patient says that they have a condition you have never heard of
  • Are the patient’s medications causing the problem…check the Beers criteria
Look Into My Eyes
  • Red-flags you must be aware of regarding the eyes
  • How medications affect the eye exam
  • Differentiating visual acuity and visual fields…impact of the cranial nerves
Respiratory System…Much More than Breath Sounds
  • Three age-related changes in the lungs you must know
  • The stethoscope is vital, but so are your hands
  • How to differentiate asthma, emphysema, pneumonia, and pleural effusion
  • Keys to indicate the patient needs a chest radiograph
  • The ABCs of ABGs: Four proven ways to contrast respiratory vs. metabolic acidosis and alkalosis
  • Four other laboratory tests to assess lung function
  • Medications for pulmonary conditions
Cardiovascular System…Beyond the Heart
  • Determine if that adventitious sound is during systole or diastole
  • Murmurs, rubs, opening snaps…what do they all mean?
  • What does the ECHO cardiogram tell you?
  • Identify the location of the ischemia, injury, or infarction based on the 12-lead ECG
  • Laboratory tests for heart conditions…Heart failure, myocardial infarction, pericarditis
  • Pearls for a thorough peripheral vascular assessment…arteries, veins, and lymph nodes
  • Must-know categories of medications that deteriorate the heart
Gastro-intestinal System…Beyond the Large and Small Intestine
  • Don’t worry about this prevalent finding…it is age related
  • GI laboratory tests that are vital for patient assessment
  • Could this be cancer or a normal finding?
  • Four most-ordered GI procedures and differential diagnosis
  • The effect of medications on the GI tract
Genitourinary System
  • Differentiate cystitis, UTI, and pyelonephritis…should medications be prescribed?
  • ”There is blood in my urine”; what you need to do right now for your patient
  • GU laboratory test and procedures; how to interpret the results
  • How contrast dyes affect the kidney…watch out for these signs
Musculoskeletal System
  • ”I have this back pain”; what you need to do now before the pain progresses
  • Differentiating muscular pain and nerve damage
  • Five time-honored tests for the musculoskeletal system
  • Medications that facilitate fluidity in the MS system
Neurologic System
  • Differentiating two- and three-reflex arcs
  • Four pearls when conducting cranial nerve assessment
  • Is this a motor or sensory problem?
  • Two tests for meningitis which do not require cerebral spinal fluid
  • Types of seizures and the latest medication options
  • Four deadly infections of the neurologic system
  • Does your patient need an MRI, Positron emission tomography, or CT scan?
  • Neurologic monitoring: Intraventricular, intraparenchymal, brain oxygen tension
Assessment of the Elderly Patient
  • Head to toe differences in the assessment of the elderly patient
  • ”I can’t seem to remember…is this normal?” Cognitive alterations occurring as we age
  • These laboratory parameters differ in the elderly
  • The effect of medications on the elderly
Rapid Assessment of the Decompensating Patient
  • AMPLE acronym: A must-know to quickly and accurately gather patient information
  • ”I have pain”…the PQRST acronym is vital to help the patient
  • Get these labs immediately for a crashing patient

Target Audience

  • RNs, RTs, NPs, and PAs from:
    • Medical-Surgical floors
    • Cardiology
    • Neurology
    • Critical Care
    • Urgent Care
    • Skilled Nursing Facilities
  • Anyone desiring next level skills to proactively assess and intervene for their patients!

Copyright : 04/20/2020

12-Lead EKG & Chest X-Ray Interpretation: Enhancing Assessment Skills for Improved Outcomes

Program Information

Objectives

  1. Analyze EKG changes associated with ischemia, injury and infarction patterns.
  2. Specify the features of right bundle branch block from the features of left bundle branch block.
  3. Evaluate axis deviation and the implications for clinical practice.
  4. Assess common cardiac and pulmonary disorders using the chest x-ray.
  5. Detect the placement of invasive lines on chest x-rays.
  6. Develop a systematic approach to chest x-ray interpretation.
  7. Incorporate the clinical pearls of EKG and chest x-ray interpretation into daily practice.

Outline

Part I: The ABCs of 12-Lead EKG Interpretation

The 12-Lead EKG

  • Cardiac electrical conduction system
  • Electrical vectors
  • Normal polarity & P-QRS-T configuration of each lead

Ace the Axis

  • Left & right axis deviation
  • Causes & criteria
  • Methods of determining axis deviation
  • Clinical applications

Beat the Bundles

  • Right & left bundle branch blocks
  • Causes & complications
  • Left anterior & left posterior hemiblocks

Correlate the Coronary Anatomy

  • The coronary arteries
  • Left ventricular walls
  • Relationship to the 12-lead

Differential Diagnosis in Acute Coronary Syndrome

  • Ischemia, injury & infarction patterns
  • Reciprocal changes
  • STEMI vs. NSTEMI
  • Coronary spasm
  • Takotsubo cardiomyopathy

Putting it all Together

  • The 30-second diagnosis
  • Coronary angiographic correlation
  • Presentations, analysis & clinical applications

Advanced Interpretation

  • Atrial & ventricular hypertrophy
  • WPW – Wolff-Parkinson-White Syndrome
  • Prolonged QT intervals

Part II: Chest X-Ray Interpretation as Easy as Black & White

The Chest X-Ray

  • Technique
  • Black & white principles
  • Projections

Systematic Approach

  • Bone structures & Intercostal spaces
  • Soft tissues & vasculature
  • Pleural surfaces
  • Heart & great vessels
  • Invasive lines

As Easy as Black

  • Identifying pneumothorax & subcutaneous emphysema
  • Treatment priorities

As Easy as White

  • Identifying:
    • Pleural Effusion
    • Pulmonary Edema
    • Pneumonia
    • ARDS
    • Cardiomyopathy
    • Cardiac Tamponade
  • Clinical applications & interventions

Beyond the Basics

  • Identification & Initial Treatment of:
    • Aortic aneurysm
    • Post-op changes with pneumonectomy
    • Esophagogastrectomy
    • Dextrocardia

Target Audience

  • Nurses
  • Nurse Practitioners
  • Clinical Nurse Specialists
  • Physician Assistants

Copyright : 04/25/2019

Heart and Lung Sounds, 2nd Edition

Program Information

Target Audience

Nurses/Nurse Practitioners/Clinical Nurse Specialists, Other Professions

Objectives

  1. Analyze 6 extra heart sounds and distinguish what they mean when you hear them.
  2. Assess the difference between systolic and diastolic murmurs, as well as clues to expected assessment finding with each.
  3. Analyze 5 adventitious breath sounds and understand the clue and common causes for their occurrence.
  4. Evaluate voice sounds to confirm pulmonary pathology.

Outline

Cardiac Assessment Skills

  • Extra Heart Sounds
    • S2 Splits
    • S3
    • S4
    • Summation Gallops
    • Mechanical Clicks
    • Pericardial friction Rubs
  • Heart Murmurs
    • 4 Systolic Murmurs
    • 3 Diastolic Murmurs


Pulmonary assessment

  • Adventitious Breath Sounds
    • Wheezes
    • Rales
    • Rhonchi
    • Stridor
    • Pleural Friction Rubs
  • Using Vocal Fremitus to Confirm Pathology
    • Bronchophony
    • Whispered Pectoriloquy
    • Egophony

Copyright : 01/07/2016