Nurse Kelly’s Notes

10/16/2024

Let’s review D-TGV!

💜 WHAT IS D-TGV? D-TGV is a congenital cardiac defect in which the location of the aorta and pulmonary arteries is switched. Instead of arising from the left ventricle, the aorta arises from the right ventricle. And instead of arising from the right ventricle, the pulmonary artery arises from the left ventricle.

✨WHY IS THIS A PROBLEM? Parallel circulations exist! Mixing of oxygenated and deoxygenated blood via ductus arteriosus or ventricular septal defect is essential for survival.

💜 HOW DOES PGE1 HELP PATIENTS WITH D-TGV? PGE1 helps maintain patency of the ductus arteriosus by relaxing its smooth muscle. This allows mixing of blood to occur until the patient can undergo surgery for stabilization and repair.

10/15/2024

Here’s a VERY concise overview of EA/TEF! In my Neonatal Gastrointestinal Bundle and the Neonatal Intensive Care Nursing Bundle we take a deeper dive into EA/TEF, including the different variants of TEF.

Have you cared for a patient with EA/TEF before?

10/11/2024

Current (and future) NICU nurses, meet your bedside bestie!🖤🩵🩷💜💛

I created a NICU Nursing Storage Clipboard to make your patient care experiences, and giving and receiving report so much easier!

Tap the photo to order yours!

10/09/2024

Let’s review CPAP!

🫁 CPAP maintains positive pressure in patients with spontaneous respiratory effort and a heart rate above 100 bpm.
🤍 It’s indicated in patients with occasional apnea episodes (in part because it helps splint the upper airways), mild-to-moderate RDS, and atelectasis.
✨ Swipe to see a meme about CPAP belly!

What questions do you have about CPAP use in newborns?

10/08/2024

Discharge teaching, in conjunction with role modeling safe sleep practices, is crucial while preparing to discharge babies home from the NICU!

🌖 I’ve always found using the A, B, C’s of safe sleep to be an effective way to educate families about safe sleep practices!

10/02/2024

A comprehensive visual learning guide didn’t exist when I was learning to become a NICU nurse…
❗️or when I was studying for certification exams…
❗️or when I was a Nurse Educator responsible for onboarding new hires to the NICU…

💜 so I created the resource that I wish existed, and now it’s been used by hundreds of satisfied NICU nurses all over the world!

10/01/2024

👣 October is Pregnancy and Infant Loss Awareness Month.
💜 This month, we remember all of the families that said goodbye too soon and babies that we carry in our hearts - ectopic pregnancy, miscarriage, stillbirth, termination for medical reasons, and neonatal losses.

10/01/2024

🎃 👻 spooky season: NICU edition!

09/30/2024

Last week, I shared a post about fetal circulation. Today, let’s do a quick review of cardiac bloodflow in a structurally normal heart! Understanding how oxygenation and bloodflow should normally work is critical in understanding the physiology of different congenital cardiac defects AND the various approaches to repair that are used!

In a structurally normal heart…
💙 Deoxygenated blood returns to the right atrium via the superior vena cava and the inferior vena cava.
💙 From the right atrium, blood flows through the tricuspid valve into the right ventricle.
💙 The right ventricle ejects deoxygenated blood through the pulmonic valve and into the pulmonary arteries, where it flows into the vessels of the lungs to exchange carbon dioxide for oxygen!
💖 This newly oxygenated blood flows through the pulmonary veins and into the left atrium!
💖 From the left atrium, blood passes through the mitral valve and into the left ventricle.
💖 The left ventricle pumps oxygenated blood through the aortic valve into the aorta, where it is distributed to the rest of the body.

09/26/2024

09/22/2024

09/18/2024

I’m so grateful that I’ve only seen subgaleal hemorrhage twice in my career because it was terrifying. Knowing the signs and risk factors are important in identifying and managing it - swipe to see a few of them!

09/15/2024

Happy Neonatal Nurses Day! I’m so grateful to work alongside all of you! 💜

09/14/2024

September 13th is Sepsis Awareness Day!

Sepsis is the THIRD leading cause of death in newborns. Recognition of the subtle signs and symptoms of neonatal sepsis is so important in decreasing morbidity and mortality.

I’ve learned in my career that:
1. The trend is our friend. If I have a gut feeling that something is wrong with the patient, I’ll trend vitals, incubator temperatures, labs, etc. to see if my instincts seem to be correct!
2. If the patient’s family says that something seems off about their baby, validate their concern, get as much information from them as you can, believe them, and escalate until proven otherwise. Families are partners in care!

What tips do you have for identifying potential sepsis cases in newborns?

08/19/2024

I was recently messaged by a follower who wanted to know about how vacation/PTO is requested in my NICU! I created this post after messaging them back because it’d be interesting to see how other NICUs work.

Let me know in the comments below how your PTO/vacation policy works on your unit! I’ll be posting about my unit there too!

08/14/2024

NEW PRODUCT, available now!

If you have a folding clipboard, I’ve reformatted my NICU clipboard stickers so that you can use them! The larger clipboard stickers will still be available for purchase, as well as the NICU Storage Clipboards!

Orders will start shipping next week, but you can order today!

Tap the product icon on this post to view and purchase!