Nurse Nacole ◂ Nursing Resources

Nursing Tip of the Day! - Critical Care Nursing

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

Category: Critical Care Nursing
BNP remains a good indicator of ventricular dysfunction and myocardial wall stress, but which cutoff levels should be used and what the clinician should do when the BNP exceeds those levels remain unclear.

Nursing Tip of the Day! - Critical Care Nursing

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

Category: Critical Care Nursing
Women and older individuals traditionally have higher BNP levels, and so age- and gender-specific cutoffs may be needed. Whereas obese individuals have lower values, renal dysfunction increases BNP serum levels, sometimes dramatically.

Nursing Tip of the Day! - Critical Care Nursing

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

Category: Critical Care Nursing
ProBNP is released by the heart in response to stretching of the wall and after ischemia. Subsequently, it is cleaved into active B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP), both of which can be measured in blood.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 07 Mar 2026 13:00:00 +0000

Category: Critical Care Nursing
Cardiac myosin-binding protein C (cMyC) rises more rapidly in the systemic circulation than high-sensitivity cardiac troponin T (hs-cTnT), perhaps as a result of its higher myocardial concentration.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 06 Mar 2026 13:00:00 +0000

Category: Critical Care Nursing
Cardiac myosin-binding protein C (cMyC) is a cardiac-restricted protein that enters the systemic circulation after myocardial injury, is more abundant than troponin and has been recently identified as a new candidate biomarker of cardiac injury.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 05 Mar 2026 13:00:00 +0000

Category: Critical Care Nursing
Regardless of the cause, it is clear that elevation of serum troponin levels is associated with a worsened outcome both in and out of the intensive care unit, even after adjustment for severity of the disease.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 04 Mar 2026 13:00:00 +0000

Category: Critical Care Nursing
Although detectable troponin levels usually emanate from myocardial cells, they may not always represent irreversible cell death or myocardial ischemia. Renal dysfunction is another factor associated with elevated troponin levels.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 03 Mar 2026 13:00:00 +0000

Category: Critical Care Nursing
Troponin release in the critically ill may not always represent myocardial cell death. Endotoxin, cytokines and inflammatory mediators, along with catecholamines and conditions such as hypotension or hypoxia, may cause the breakdown of troponin.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 02 Mar 2026 13:00:00 +0000

Category: Critical Care Nursing
Demand ischemia (type 2 MI) can also lead to troponin release. Other causes of elevated troponin include sustained brady-/tachy-arrhythmias, hypotension, shock, cardiomyopathy, sepsis, pulmonary embolism and strenuous exercise.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 01 Mar 2026 13:00:00 +0000

Category: Critical Care Nursing
The challenge for the clinician, and particularly for the intensivist, is that although the elevation of serum troponin is highly specific for myocardial cell damage, not all of the damage is a consequence of the rupture of an atherosclerotic plaque.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 28 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
Troponin elevations are sensitive and specific for myocardial cellular injury. False positives because of fibrin interference or antibodies are infrequent. Even minor increases in troponin values correlate with adverse outcomes in NSTE-ACS.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 27 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
Creatine kinase (CK) and its isoenzyme MB (CK-MB) were the initial biomarkers of choice for myocardial injury and infarction in the 1970s, but were later superseded by troponin T and I, because of their increased sensitivity and specificity.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 26 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
With cardiac cell death, proteins are released into the blood and detection of these proteins has played a key role in establishing the diagnosis of ACS, predicting its outcome and directing treatment.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 25 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
“Nondiagnostic” ECGs are common in the setting of true acute MI, characterizing up to 8% of such patients. Nondiagnostic ECG findings may be due to occlusion of small vessels or insensitivity of the ECG in lateral or posterior myocardial territory.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 24 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
Preexcitation, bundle branch block, pericarditis, pulmonary embolism, subarachnoid hemorrhage, metabolic disturbances and left ventricular aneurysms can be associated with ST elevation in the absence of acute myocardial ischemia.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 23 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
Acute coronary syndromes (ACSs) are a group of conditions characterized by acute myocardial ischemia resulting from inadequacy of myocardial blood flow. The ACSs are classified by clinical, biochemical and electrocardiographic data.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 22 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
Type 4C myocardial infarction is associated with percutaneous coronary intervention restenosis, while type 5 myocardial infarction is associated with CABG (≤48 hours after the procedure).

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 21 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
Type 4A myocardial infarction is associated with percutaneous coronary intervention (≤48 hours after the procedure), while type 4B myocardial infarction is a stent/scaffold thrombosis associated with percutaneous coronary intervention.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 20 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
Type 3 myocardial infarction involves the cardiac death in patients with symptoms suggestive of myocardial ischemia and presumed new ischemic ECG changes before cardiac troponin (cTn) values become available or are abnormal.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 19 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
A type 1 myocardial infarction is caused by atherothrombotic coronary artery diseases, while a type 2 myocardial infarction is caused by myocardial injury in the context of a mismatch between oxygen supply and demand.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 18 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
In pericarditis, pericardiocentesis is performed for therapeutic purposes in the case of tamponade and for diagnostic purposes if tuberculosis, bacterial infection or malignancy is suspected.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 17 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
Pericarditis treatment is aimed at the underlying etiology. Nonsteroidal antiinflammatory drugs (NSAIDs) relieve pain and inflammation in viral or idiopathic pericarditis. Colchicine is used in reducing bouts of recurrent pericarditis.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 16 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
Common ECG findings in pericarditis include diffuse ST-segment elevation and absence of Q waves. Although ECG findings for pericardial effusion are useful, echocardiography should be performed to confirm the diagnosis.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 15 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
Chest pain from pericarditis is often retrosternal, pleuritic, and sharp, radiating to the back/arms and exacerbated when lying flat. A pericardial friction rub is highly specific for pericarditis and is present in most cases.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 14 Feb 2026 13:00:00 +0000

Category: Critical Care Nursing
Pericarditis commonly results from viral or idiopathic causes, but other etiologies include infection, malignancy, tuberculosis, autoimmune diseases, transmural MI (Dressler syndrome) and cardiac surgery (postpericardiotomy syndrome).