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Acute Stroke and the Latest Information
In patients with symptoms of acute stroke, early recognition and interventions have been identified as critical factors in stroke outcomes. Evidence-based care can identify, manage, and prevent stroke-related complications. Nurses and physicians must understand stroke management to prevent disability and death. This course aims to present the most up-to-date practices for managing patients with acute stroke.
Discuss current diagnostic practices in patients with acute stroke.
Recall best practice protocols for early identification of acute stroke.
An Overview of Trial of Labor After Cesarean Section
This course provides an overview about the safety of patients undergoing a trial of labor after cesarean (TOLAC) to attempt a vaginal birth after cesarean delivery (VBAC). Research evidence has influenced where VBACs are performed, which women are eligible and how the practice is conducted, including the safe use of induction/augmentation medications. The safety of VBAC for mother and newborn always remains the primary underlying principle that guides care.
Identify three risk factors and benefits associated with TOLAC and recommendations for safe TOLAC.
Recall essential components of nursing education, informed consent, safe medication administration, and fetal assessment related to TOLAC.
CEN: Cardiovascular Emergencies
The Certified Emergency Nurse (CEN®) is required to demonstrate competency in the domain of emergency nursing which includes knowledge of cardiovascular conditions and emergencies, such as acute coronary syndrome, aortic aneurysm/dissection, and cardiopulmonary arrest.
Identify signs and symptoms of cardiovascular emergencies and conditions.
Describe a comprehensive plan for the care of cardiovascular emergencies, including diagnostic and treatment interventions, and patient education.
CEN: Communicable Diseases
he purpose of this course is to inform the emergency nurse of communicable diseases, including a comprehensive assessment and appropriate interventions.
Identify alterations in the biological, physiological, and psychological status of patients experiencing communicable disease emergencies.
Describe a comprehensive plan for the care of communicable disease conditions including diagnostic and treatment interventions, and patient education.
CEN: Environmental and Toxicological Emergencies
The Certified Emergency Nurse (CEN®) is required to demonstrate competency in the domain of emergency nursing which includes knowledge of cardiovascular conditions and emergencies, such as acute coronary syndrome, aortic aneurysm/dissection, and cardiopulmonary arrest.
The goal of this course is to inform the emergency nurse of cardiovascular conditions and emergencies, including a comprehensive assessment and appropriate intervention.
Identify signs and symptoms of cardiovascular emergencies and conditions.
Describe a comprehensive plan for the care of cardiovascular emergencies, including diagnostic and treatment interventions, and patient education.
CEN: Gastrointestinal and Genitourinary Emergencies
The Certified Emergency Nurse (CEN®) is required to demonstrate competency in the domain of emergency nursing which includes knowledge of gastrointestinal (GI) and genitourinary (GU) conditions and diseases, their signs and symptoms, management, and applicable nursing interventions.
Identify signs and symptoms of gastrointestinal and genitourinary emergencies and injuries.
Describe a comprehensive plan for the care of gastrointestinal and genitourinary conditions including diagnostic and treatment interventions, and patient education.
CEN: Gynecological and Obstetrical Emergencies
The Certified Emergency Nurse (CEN®) is required to demonstrate competency in the domain of emergency nursing which includes knowledge of gynecological and obstetrical conditions and diseases, their signs and symptoms, management, and applicable nursing interventions.
Identify signs and symptoms of gynecological and obstetrical emergencies and injuries.
Describe a comprehensive plan for the care of gynecological and obstetrical conditions including diagnostic and treatment interventions, and patient education.
CEN: Maxillofacial and Ocular Emergencies
The Certified Emergency Nurse (CEN®) is required to demonstrate competency in the domain of emergency nursing which includes knowledge of maxillofacial and ocular emergencies, their signs and symptoms, management, and applicable nursing interventions.
The goal of this course is to review the knowledge domains specific to maxillofacial and ocular emergencies included as a part of the Certified Emergency Nurse (CEN®) exam.
This course is not affiliated with the Board of Certification for Emergency Nursing (BCEN).
Identify signs and symptoms and the management of life-threatening maxillofacial illnesses and injuries.
Analyze strategies to manage ocular conditions and emergencies.
CEN: Medical Emergencies
The purpose of this program is to inform the emergency nurse of medical emergencies, including a comprehensive assessment and appropriate intervention.
Identify signs and symptoms of medical conditions and injuries.
Describe a comprehensive plan for the care of medical conditions including diagnostic and treatment interventions, and patient education.
CEN: Orthopedic and Wound Emergencies
The purpose of this program is to inform the emergency nurse of common orthopedic emergencies, including a comprehensive assessment and appropriate interventions.
Identify signs and symptoms of orthopedic and wound emergencies.
Describe a comprehensive plan for the care of orthopedic and wound emergencies including diagnostic and treatment interventions, and patient education.
CEN: Professional Issues in Emergency Nursing
The purpose of this program is to describe the impact of professional practice issues as they relate to the emergency nurse, their patients, and the health care system.
Recognize vulnerable patient populations and sensitive care situations facing emergency nurses.
Identify professional practice issues across the health care system that support high-quality patient care and satisfaction.
CEN: Psychosocial Emergencies
The Certified Emergency Nurse (CEN®) is required to demonstrate competency in the domain of emergency nursing which includes knowledge of psychosocial emergencies, their signs and symptoms, their management, and the nursing interventions that are needed.
The goal of this course is to review the knowledge domains specific to psychosocial emergencies included as a part of the Certified Emergency Nurse (CEN®) exam.
Recognize signs and symptoms of specific psychosocial emergencies.
Identify strategies to manage psychosocial emergencies.
CEN: Respiratory Emergencies
The Certified Emergency Nurse (CEN®) is required to demonstrate competency in the domain of emergency nursing which includes knowledge of respiratory emergencies, their signs and symptoms, their management, and the nursing interventions.
The goal of this course is to review the knowledge domains specific to respiratory emergencies included as a part of the Certified Emergency Nurse (CEN®) exam.
This course is not affiliated with the Board of Certification for Emergency Nursing (BCEN).
Identify signs and symptoms of life-threatening respiratory illnesses and injuries.
Analyze strategies to manage respiratory conditions and emergencies that present to the emergency department.
Clinical Management of Category II Fetal Heart Tracing
Three different obstetrical scenarios, complicated by a Category II Fetal Heart Rate pattern, are presented to illustrate the importance of clinical context when formulating management plans. Emphasis, characteristics, and potential etiologies of Category II fetal heart rate tracings are reviewed. Management of the patient with a Category II fetal heart rate pattern is discussed, with special emphasis on the importance of the clinical context and fetal heart rate pattern evolution.
Describe characteristics of Category II FHR tracings.
Identify common etiologies for Category II FHR tracings during labor.
Examine clinical interventions for Category II FHR tracings.
Review the etiology-based management of Category II FHR tracings.
Clinical Management of Category III Fetal Heart Rate Tracings
The National Institute of Child Health and Human Development (NICHD) workgroup standard for fetal heart rate monitoring assessment and categorization, first proposed in 1997 and subsequently updated in 2008 was meant to promote commonality of FHR tracing nomenclature and interpretation. Based on these recommendations, a three-tiered categorization pattern based on the visual assessment of the fetal heart rate pattern was adopted. This module aims to review and apply essential FHR content in several clinical scenarios to highlight an important Clinical Pearl: The Category III tracing is a rare intrapartum FHR pattern that is highly associated with fetal acidemia and adverse neonatal outcomes.
Consistently apply 1997 and 2008 NICHD definitions and terminology when describing intrapartum fetal heart rate patterns.
Identify intrapartum fetal heart rate tracings using the 2008 NICHD 3-tiered system.
Recognize the fetal heart rate characteristics that define a Category III pattern.
Review the diagnostic imprecision and clinical significance of minimal fetal heart rate variability.
Clinical Management of Uterine Atony
A case of obstetrical hemorrhage due to uterine atony, requiring medical and surgical interventions and blood component replacement therapy is presented. Emphasis: A review of obstetrical hemorrhage, etiologies, and treatments is provided. The importance of early recognition and response to excessive blood loss is stressed. Medical and surgical interventions for uterine atony are reviewed. Current recommendations for blood component replacement therapy for massive hemorrhage are discussed.
List common risk factors for OH.
Review medical treatments for uterine atony.
Identify pre-surgical and surgical treatments for uterine atony.
Describe blood component therapy for massive hemorrhage.
Cultural Perspectives in Childbearing
As the population of the U.S. soars in diversity, healthcare professionals must be prepared to care for childbearing families from many different cultures. All cultures and families should be given the same respect, be assured of the highest quality of care, have their religious, ethnic, and cultural values respected and integrated into their care, and have their physical and educational needs met in a way that honors their spiritual beliefs and individuality. Knowledge of the cultures one is serving and the influence they have on women’s perceptions of childbirth are important for achieving positive outcomes. Equally and perhaps more important is applying the principles of cultural humility to nursing care.
The goal of this continuing education course is to improve the ability of nurses and health educators in acute care settings to assess and meet the sociocultural needs of childbearing families of diverse cultural and social groups.
Recall the relationship of culture, subculture, acculturation, assimilation, ethnocentrism, cultural relativism, and cultural humility to healthcare practice.
Recognize elements of cultural assessment and respectful maternity care that can improve quality of care and meet the unique needs of culturally diverse families.
Emergency Department: HIPAA and CFR42
In an emergency department, information often flows amongst providers and patients quickly because of urgent, sometimes life-threatening, situations. Due to the volume of information being shared, as well as the need for it to be shared quickly and accurately, emergency department providers must be especially careful to safeguard patient information.
The goal of this course is to update nursing professionals in the acute care setting with basic information about the Health Insurance Portability and Accountability Act (HIPAA) and 42 CFR Part 2.
Identify information sharing standards under HIPAA and 42 CFR Part 2.
Define the concept of consent, when you must obtain it to share or receive information, and the types of information that may not be available to you.
Emergency Management of Abdominal Pain
Abdominal pain is the single most common ED complaint (up to 10% of visits) and is in the top four for emergency medicine litigation. Emergency providers must be proficient in diagnosing abdominal pain to provide excellent care to patients and reduce their risk of being named in litigation. This course will address abdominal pain diagnosis and treatment in the ED for the elderly, adults, children, and young women (of childbearing potential).
State the evaluation of abdominal pain in the elderly.
Recognize the approach to abdominal pain in the post-bariatric surgery patient.
Discuss the presentation of testicular torsion.
Describe the scoring systems for appendicitis in adults and children.
Assess the non-abdominal causes of abdominal pain.
Emergent Delivery of Infant
The management of the female who presents to the emergency department (ED) in active labor is stressful and overwhelming. Ideally, the ED has a plan in place, based on hospital resources, for the imminent delivery of a newborn. Decisions regarding delivery in the ED or transferring the patient to labor and delivery are based on a variety of factors. Knowledge of the possible complications of delivery will provide anticipatory guidance to improve maternal and fetal outcomes.
Know the clinical presentation and physical exam findings associated with pregnancy.
Recognize the common complications associated with pregnancy. Plan the steps to prepare the process of delivery of a newborn.
Recognize common complications of delivery of a newborn.
EMTALA Requirements
The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted to prevent patient dumping by hospitals seeking to avoid unrecoverable costs of care for patients without insurance or the ability to pay for medical services. Language within the statute has led to inconsistencies in how it has been interpreted. Patient dumping and inappropriate medical screening examinations (MSEs) are the most common reasons for EMTALA violations (Ladd & Gupta, 2021). This course will describe how key terms are currently interpreted and how they apply to hospitals with a dedicated emergency department (ED). In addition, learners will have an opportunity to review cases where EMTALA violations were alleged and judgments applied by the courts.
Define key terms and requirements associated with EMTALA.
Describe how EMTALA applies to certain situations.
Fetal Heart Tracing Pattern Evolution
Intrapartum fetal heart rate monitoring is an integral part of modern day obstetrics and when properly interpreted, may provide valuable insight into the fetal metabolic state. During labor, the physiologic stress posed by regular uterine contractions and maternal expulsive efforts may adversely impact the fetal acid-base status, leading to changes in the fetal heart rate pattern.
This module aims to review and apply essential FHR content in several clinical scenarios to highlight an important Clinical Pearl: Management of the laboring patient requires that the FHR pattern trends are interpreted in context with the clinical scenario and progress of labor.
Consistently apply 1997 and 2008 NICHD definitions when describing intrapartum fetal heart rate patterns.
Identify the importance of FHR variability evolution when assessing the FHR pattern.
Review the importance of FHR tracing trend assessment when managing the abnormal intrapartum FHR tracing.
Recognize the importance of clinical scenario, FHR pattern evolution, and stage of labor when managing the Category II tracing in labor.
Management of Obstetric Hemorrhage
Worldwide, postpartum hemorrhage (PPH) accounts for high rates of maternal morbidity and mortality. It is important to understand the definitions and causes of PPH, as well as the many risk factors associated with PPH and how to assess a woman’s risk. Early recognition is key to have good outcomes. Recognizing PPH, the stages of PPH, and how to measure blood loss is essential, since treatment is based upon the stages of hemorrhage. Additionally, it is important to understand nursing interventions, treatments for PPH (including medication, surgical procedures, and blood products), and teamwork and communication needs to improve perinatal outcomes.
Identify causes and risk factors for postpartum hemorrhage.
Classify the stages of obstetric hemorrhage.
Recall nursing and medical interventions used during the management of postpartum hemorrhage.
Management of Respiratory Emergencies in Children
Nurses, respiratory therapists, and emergency medical professionals who care for children must have the requisite skills and training on the unique characteristics of a pediatric patient’s respiratory system. Children have significant respiratory system differences compared to adults. These include, but are not limited to: Anatomy, physiology, signs and symptoms of respiratory distress, and respiratory emergencies. In children, the leading cause of cardiopulmonary arrest occurs from etiologies within the respiratory system. Clinicians must understand these differences and be prepared to work collaboratively to quickly respond and provide safe and competent care to any child who is in respiratory distress.
Describe the anatomy and physiology of the pediatric respiratory system and differences vs. adults.
Recall techniques for conducting a focused assessment of the respiratory system in pediatric patients and interventions for facilitating assessments and treatments.
Identify clinical manifestations of respiratory distress in pediatric patients.
Recognize conditions associated with respiratory emergencies in pediatric patients including treatments and interventions.
Managing Pain Amid the Opioid Crisis
Pain management in the emergency department relies heavily on the use of opioid analgesics, which generates risk for patients to develop long term opioid use or an opioid use disorder. Multimodal analgesia can improve the patient experience and reduce the risks of opioid use if emergency providers approach pain with a more critical mindset.This activity is designed to help emergency providers improve management of pain while decreasing patient exposure to opioids. It is also designed to help providers navigate how to manage patients with opioid use disorder.
Identify different types of pain (acute pain, chronic pain, chronic cancer pain, and social pain) and the neurobiological origins of this pain.
Describe the risks associated with opioid analgesia.
Demonstrate knowledge of multimodal analgesia regimens to manage pain in the emergency department.
Describe the characteristics of opioid use disorder and the effectiveness of medication assisted therapy.