Nurse Nacole ◂ Nursing Resources

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 13 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
In rapid-sequence intubation, the initial induction agent doses should be reduced by 25%–50% in the elderly and in patients with hypotension, hypovolemia or significantly impaired cardiac function.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 12 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Rapid-sequence intubation (RSI) is the standard of care in most emergency airway management settings because of its high rate of success. The goal of RSI is to optimize conditions for intubation before desaturation and to prevent aspiration.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 11 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
A soiled airway increases the risk for aspiration complications and decreases first-pass success. Emesis, hematemesis and hemoptysis are more often encountered during emergency airway management.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 10 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
During intubation, vasopressors should be used for periprocedural hypotension. Although a fluid bolus before induction has been shown to reduce the incidence of associated cardiovascular collapse, this practice remains controversial.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 09 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Critically ill patients are at risk for periprocedural hypotension, which can lead to cardiac arrest. Hypotension during intubation is common, often the result of decreased catecholamines, the physiologic effects of many induction medications.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 08 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
If the BMV using an oropharyngeal airway technique fails to improve hypoxemia, a second-generation supraglottic airway should be used. The devices are designed to provide a better seal of the airway and are safer since they allow gastric aspiration.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 07 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Avoiding hypoxemia is essential to preserve safe conditions during intubation. If oxygen saturation drops, the first rescue maneuver is the BMV technique using an oropharyngeal airway and meticulous attention to patient positioning.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 06 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Rapid-sequence intubation has an inherent delay of 45-90 seconds between medication administration and laryngoscopy. In patients with refractory hypoxemia, there is no safe apnea time and awake intubation should be strongly considered.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 05 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Critically ill patients run higher risks of hypoxemia. Preoxygenation is limited by functional residual capacity and the ability to denitrogenate this space. In the critically ill, the degree of physiologic shunting is a major factor to preoxygenation.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 04 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
With intubation, optimal patient positioning is important to maximize the success of both preoxygenation and laryngoscopy attempts. Upright positioning can optimize functional residual capacity, especially in obese and pregnant patients.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 03 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Features that predict difficult laryngoscopy include limited ability to open airway (interincisor distance), displaced tongue (large tongue, short mandible, short thyromental/hyomental distances) and/or impaired visual axes (cervical mobility).

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 02 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Emergent airway management leaves little time to perform a thorough airway assessment. In conscious and cooperative patients, an inability to bite the upper lip with the lower incisors may be the single best predictor of difficult laryngoscopy.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 01 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Hemodynamic instability is an predictor of death after intubation, underscoring the importance of an individualized approach to high-risk patients, including those with valvular disease, pulmonary hypertension, heart failure and high shock index.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 30 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
With tracheal intubation, decompensated cardiopulmonary disease and shunt physiology make preoxygenation more difficult in the critically ill, shortening the safe apnea time during intubation before hypoxemia develops.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 29 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
Reported complication rates from tracheal intubation in the critically ill patient population can range from 4.2% to 22% and remain unacceptably high in comparison with operating room procedures.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 28 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
Risks associated with emergent intubation in the critically ill include hypoxemia, hemodynamic instability, cardiac arrest and death, underlining the importance of a systematic approach to optimize conditions and maximize first-attempt success.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 27 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
In shock states, ScvO2 may exceed that of SvO2 by up to 20%. This tendency also applies in patients with cardiogenic, septic and hemorrhagic shock. Therefore, one has to assess these saturation values within the context of the clinical scenario.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 26 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
SvO2 is a better indicator of whole-body balance of oxygen supply and demand, whereas ScvO2 more closely reflects the status of upper body tissues. In hemodynamically stable patients, ScvO2 is usually 2%-5% less than SvO2.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 25 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
ScvO2 and SvO2 findings can differ due to vena caval blood streaming into the right atrium and ventricle causing mixing during ventricular contraction. The blood from the coronary sinus and Thebesian veins result in further discrepancies.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 24 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
Monitoring of SvO2 has been used as a surrogate for the balance between systemic oxygen delivery and consumption during the treatment of critically ill patients. An SvO2 of less than 65% indicates inadequate oxygen delivery.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 23 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
Pulmonary causes of respiratory alkalosis include pulmonary embolisms, pneumothorax and asthma or COPD exacerbations. Iatrogenic causes are almost universally among intubated patients receiving mechanical ventilation support.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 22 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
In the case of medication-induced respiratory alkalosis, the ABG and further studies with toxicology panel would help to identify the causes. Hypoxia could lead to hyperventilation to correct hypoxia at the expense of CO2 loss.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 21 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
Respiratory alkalosis is induced by hyperventilation with causes originating from central, hypoxemic, pulmonary and iatrogenic causes. Central causes include head injury, stroke, hyperthyroidism, anxiety, pain, fear, stress, drugs and medications.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 20 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
Failing respiratory muscles, pain preventing effective breathing, increased abdominal pressures and agents that suppress respiratory drive - all depress ventilation, leading to CO2 retention with subsequent respiratory acidosis.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 19 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
Acetazolamide is a carbonic anhydrase inhibitor promoting the renal excretion of bicarbonate and has been demonstrated to be effective in treating metabolic alkalosis in ICU patients. A single dose of 500 mg is recommended.