Many nurses I talk to agree that their assessment skills are up to scratch. Where do yours sit? Personally I know I never stop learning. I am preparing for another clinical sabbatical into the remote world of outer island nursing in the Torres. Even with the local knowledge, and confidence of 25 years of emergency nursing under my belt, I'm a bit nervous. I was preparing for our newest course (Nursing assessment skills- booking for Toowoomba on 8 December). In this I cover respiratory and cardiac assessment including lung and heart sounds. One of the exciting new sessions is a comprehensive physical cardiac assessment.
It starts looking at the hands and fingers of the patient.
One interesting assessment is to look for Janeway Lesions and Splinter nail haemorrhages.
Janeway lesions are Janeway lesions are painless reddened nodular lesions on the palm of hands and sometimes the soles of feet. They are only 2-5 millimeters in diameter but may indicate an of infective endocarditis where the inside lining (think wallpaper) of the heart's ventricles are infected with a microbe. A common bacteria in indigenous Australians is the common Streptococcus (same one that causes school sores and Strep throat). This classically inflames and damages the endocardium and attacks the valves leading to pump failure.
Interesting to note that looking at someone's hands can give nurses and paramedics a windo into a potential life threatening heart condition.
If you found this interesting (like I do) and you want to tune up your assessment skills, then seriously look at this fantastic seminar we have running for nurses, paramedics and students in both disciplines. Make that trek to Toowoomba and check me out. You'll love this gig.
Webpage and enrolment
http://www.ect4health.com.au/nursing-assessment/
More info -- admin@ect4health.com.au
No comments:
Post a Comment