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Related Concept Videos

Nursing Diagnosis01:22

Nursing Diagnosis

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Following assessment, a nursing diagnosis is the next step in the nursing process. It begins after the nurse has collected and recorded the patient data. The purpose of diagnosing is to identify how the client responds to actual or potential health processes, identify factors that bestow or that cause health problems, the etiologies, and identify resources or strengths the individual, group, or community can draw on to prevent or resolve problems.
The nursing diagnosis focuses on evidence-based...
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SBAR II: Application of SBAR01:14

SBAR II: Application of SBAR

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SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
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Documentation of Nursing Diagnosis01:10

Documentation of Nursing Diagnosis

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The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
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Formulating and Validating Nursing Diagnosis I01:26

Formulating and Validating Nursing Diagnosis I

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A nursing diagnosis is written when the nurse recognizes a cluster of essential patient data indicating health problems treated with independent nursing interventions. The standardized terminologies of a nursing diagnosis help nurses identify and treat patients' problems. Every electronic health record that uses nursing diagnosis must employ standard diagnostic terminology. Developing an efficient, individualized care plan begins with accurate nursing diagnoses.
There are thirteen domains...
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Formulating and Validating Nursing Diagnosis II01:25

Formulating and Validating Nursing Diagnosis II

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Nursing diagnoses represent a problem validated by major defining characteristics. There are four categories of nursing diagnoses: problem-focused, risk, health promotion or wellness, and syndrome. The anatomy of a nursing diagnosis includes three components: problem statement or diagnostic label, defining characteristics, and related factors.
Risk nursing diagnoses represent clinical judgments of an individual, family, or community more vulnerable to developing the health problem than others...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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A BRASH Diagnosis With a Timely Intervention.

Sahrai Saeed1, Ronak Rajani2, Eivind Solheim1

  • 1Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.

Current Problems in Cardiology
|July 20, 2023
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Summary

BRASH syndrome, a dangerous condition involving bradycardia, renal failure, atrioventricular block, shock, and hyperkalemia, requires early recognition. Prompt treatment of this case successfully restored normal sinus rhythm and prevented severe complications.

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Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • BRASH syndrome (bradycardia, renal failure, atrioventricular block, shock, hyperkalemia) is a critical condition requiring early diagnosis.
  • Patients with diabetes, hypertension, and atrial flutter are at risk.

Observation:

  • A 74-year-old woman presented with dizziness, presyncope, and bradycardia.
  • She had severe hyperkalemia (8.4 mmol/L), renal failure (creatinine 161 mmol/L), and was on apixaban, digoxin, prazosin, and telmisartan.

Findings:

  • Diagnosis of BRASH syndrome was made despite hypertensive presentation (180/65 mmHg).
  • Rapid stabilization included insulin/dextrose, fluid resuscitation, SZC, and hemodialysis.
  • ECG normalized with sinus rhythm (65 bpm) and QRS duration after potassium correction (4.7 mmol/L).

Implications:

  • Highlights the importance of recognizing BRASH syndrome and its hypertensive variant (BRAHH).
  • Timely intervention is crucial to prevent life-threatening brady- and tachyarrhythmias.
  • Management involves addressing hyperkalemia, renal failure, and medication review.