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Mystery Diagnosis: Recognizing Serotonin Syndrome

Wendy Blatchley

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Serotonin syndrome (SS) is a rare condition that is believed to be induced by ingestion of serotonergic medications, leading to an increased serotonin level. Although many medications are thought to be responsible, some of the more common are antidepressants and opioids. There are no definitive tests to confirm SS, therefore diagnosis is based on clinical findings and can be somewhat difficult. A triad of symptoms, neuromuscular hyperactivity, altered mental status, and autonomic hyperactivity, are considered the hallmark signs, but are not present in all cases. Symptoms can vary from mild and almost undetectable to severe and life threatening. Three diagnostic systems are currently utilized to assist with diagnosis if SS is suspected: the Hunter, Sternbach, and Radomski criteria. A diagnosis of SS should prompt discontinuation of the suspected offending agent. Increased awareness of this issue is needed, including symptoms and risk factors, so that the advanced practice registered nurse (APRN) may promptly recognize and diagnosis this condition to avoid further complications. Completing a thorough history and physical, along with accurate medication reconciliation can assist the APRN in identifying high risk patients. While there is still so much about SS that remains unknown, current information and education on this issue will ensure the APRN is providing safe and high-quality care. Databases utilized were CINAHL, PubMed, and ScienceDirect. These databases provide access to numerous nursing, biomedical, and scientific journals and were useful in locating up-to-date, peer reviewed research on this subject. Cont'd

What Can We Do to Promote Professional Socialization in Nursing?

Author 1: Nancy Bellucci, PhD, MSN, RN, CNOR Author 2: Shakeeka Misher, DNP, RN, RNC-MNN, NE-BC

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Transitioning to a new work setting is challenging for many nurses regardless of the time spent in practice. Promoting professional socialization, through mentoring and precepting, helps to facilitate a smooth transition. Effective mentoring, using role play, reflective exercises, and debriefing, provides the transitioning nurse the opportunity to self-actualize his or her potential in the new work environment. The use of Benner’s Novice to Expert Theory and Duchscher's Stages of Transition Theory as a basis for mentorship enhances safety and quality in the provision of care. Cont'd

Case Study: A Systematic Approach to Early Recognition and Treatment of Sepsis

Madeleine Augier RN BSN

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The term sepsis is often misunderstood. The public and often healthcare workers are unaware of the severity and high mortality rates this infection process has upon the world. Sepsis has vague symptoms that make diagnosis difficult. Often, sepsis is diagnosed in the later stages, when more obvious yet severe symptoms occur. This case study discusses a female who presents to the emergency department with sepsis secondary to pneumonia. Over the course of three days, the patient’s health quickly deteriorates, demonstrating the rapid progression of sepsis. Clinical findings, such as vitals signs, lab abnormalities, and symptoms of sepsis are discussed. The term bundle of care is presented to educate the reader on the golden standard of care for treatment of sepsis. This case study intends to increase community awareness and education to health care providers as well as providing an evidenced-based treatment guideline. More education and raised awareness will help prevent a deadly yet treatable infectious process. Cont'd

Evidenced Based Guidelines: Ischemic Heart Disease

Madeleine Augier RN BSN

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Evidenced based guidelines to provide primary prevention and improve correct diagnosis and treatment. Cont'd

Ethical considerations for the mentally unwell in a global pandemic

Anthony Ragnauth

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A case review on a mentally Ill patient during the covid pandemic. Cont'd

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