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Nurse.ICU

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In-depth guides and explainers for nurses and nursing students.

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A newborn baby held in gloved hands immediately after birth, arms flung wide, seen from above and slightly behind the head so the face is turned away
Women & Children

The Apgar Score: What It Tells You, and What It Doesn't

Five signs, scored 0 to 2, at one and five minutes. The Apgar is one of the most recognised numbers in medicine and one of the most misread — it describes how a newborn is transitioning, it does not start the resuscitation and it does not predict the child's future.
A blood pressure cuff and a stethoscope arranged on a pale wooden surface against a dark background
Neuro & Stroke

Blood Pressure in Acute Stroke: 185/110, 180/105, and When Not to Treat

Three different blood pressure targets apply in the first 24 hours after a stroke, and which one you're working to depends entirely on the type of stroke and whether thrombolytics were given. Here's how to keep them straight at the bedside.
A simple flat side-view silhouette of a person lying flat along a horizontal line, with equally sized solid ochre circles where the back of the head, the base of the spine and the heels touch the line
Med-Surg

The Braden Scale: Scoring Pressure Injury Risk, and Actually Acting on It

Six subscales, a total from 6 to 23, and a lower number meaning higher risk. How each subscale is scored, what the risk bands mean, and the part that matters most — turning a number into the specific interventions it points at.
A flat digital floor scale and a cloth measuring tape on a plain pale surface, seen from directly overhead
Outpatient

BMI vs BSA: Two Numbers That Aren't Interchangeable

One is a screening ratio, the other is a dosing surface. They're calculated from the same two measurements and used for completely different things — and the one that matters for chemotherapy is the one people know least about.

More articles

An older patient propped up in a hospital bed in the middle of the night, wide awake and staring at nothing, a completely untouched meal tray across their lap, the room dark except for one dim overbed light
Geriatrics

Delirium, Dementia, or Depression: Telling the Three Apart

They present similarly in an older adult and get confused constantly — but only one is a medical emergency. Onset and attention are the two features that separate them, and the quiet version of delirium is the one that gets missed.
A nurse in scrubs standing at a bedside at night looking up sharply at a telemetry monitor above the bed, its screen dark with bright traces running across it including a cardiac rhythm line, the patient below lying with a nasal oxygen cannula and grimacing slightly, the room lit by the glow of the screen
Med-Surg

Early Warning Scores: Catching Deterioration Before the Code

MEWS and its successors turn five ordinary vital signs into a number that flags a patient sliding downhill hours before the arrest. How the score is built, why the respiratory rate carries so much of it, and what to do when the number climbs.
A packed emergency department waiting room seen from the back of the room, every armchair taken, people waiting with their heads down
Emergency

ESI Triage: How the Five Levels Actually Get Assigned

The Emergency Severity Index isn't a severity scale in the way the name suggests. Levels 1 and 2 are about danger; levels 3 to 5 are about resources. Understanding that split is what makes triage decisions fast and defensible.
A clear rigid cylindrical IV drip chamber hanging below the spike of a fluid bag, filled a third of the way with clear fluid, a single drop hanging from the small inner spike in the air gap above the fluid line, close against a plain pale backdrop
Med-Surg

IV Drip Rates: The Two Formulas, and How Not to Panic

Gravity infusions need drops per minute; pumps need millilitres per hour. Two formulas, one thing you have to look up on the tubing packet, and a way of laying the maths out that survives being interrupted.
A person in surgical scrubs and a cap pulling open the drawer of a red emergency cart at speed, close on the drawer and one hand
Periop

Malignant Hyperthermia: The First Five Minutes

The name is actively misleading — by the time there's a fever, you're late. The earliest reliable sign is a rising end-tidal CO2 that won't come down, and the response is dantrolene, fast, by everyone in the room at once.
A midwife and a pregnant patient sitting together in conversation, close on the two of them
Women & Children

How a Pregnancy Is Dated, and Why the Due Date Matters

Naegele's rule, why gestational age is counted from the last period rather than conception, and why an early ultrasound can move a due date that a calculator was confident about. A short guide to the number that drives most obstetric decisions.
An angry patient in a gown standing and shouting with arms raised, a nurse several feet away with open empty hands held low
Mental Health

Verbal De-escalation: What Actually Works

De-escalation isn't a personality trait some nurses happen to have. It's a set of specific, teachable behaviours — one person talking, hands visible, limits stated as choices — and most of the outcome is decided before anyone opens their mouth.
A nurse in scrubs sitting at a kitchen table reading a letter, expression difficult to read
Critical Care

CCRN Pass Rate 2025: What the Numbers Actually Mean

The 2025 CCRN (Adult) first-time pass rate was 72.02% across 17,151 candidates — down from 81% in 2023. Here's what drove the drop, what the November 2025 cut-score change means, and how worried you should actually be.
Two hospital beds side by side as simple flat shapes, the one on the left ringed with machines and the one on the right with almost none
Critical Care

CCRN vs PCCN: Which Critical-Care Certification Is Right for You?

CCRN and PCCN are both AACN certifications, but they're for different patients and different units. A clear comparison of patient population, eligibility hours, exam format, and how to choose the one that matches where you actually work.
A nurse in scrubs studying at a kitchen table in the evening, notes spread out around a mug
Critical Care

How to Study for the CCRN: A Plan That Actually Works

A practical, four-step CCRN study plan built around the AACN blueprint — how to map the exam, drill the systems your unit doesn't expose you to, use practice questions the right way, and simulate the real 150-item exam.
A nurse charting at a computer-on-wheels workstation beside a patient's hospital bed.
Neuro & Stroke

Neuro Checks: Documenting Them Defensibly

A neuro check is only as good as the record it leaves. How to chart level of consciousness, pupils, motor, speech, and vitals so the trend is obvious, the change is caught, and the documentation holds up — with the specific phrasing that beats 'neuro checks stable.'
A flat illustration of a winding path climbing gently from the lower left of the frame to the upper right, with round markers spaced along it
Neuro & Stroke

New Nurse on a Stroke Unit: The First 90 Days

A realistic, phase-by-phase guide to your first three months on a stroke or neuro unit — what to master first, what can wait, and how to build the assessment instincts that make the rest click. Written for new grads and nurses transferring in.
A nurse holding up two fingers in front of an alert patient during a bedside neurological assessment.
Neuro & Stroke

NIHSS Scoring Walkthrough: The 11 Items, With Original Practice Scenarios

A plain-language walk through all 11 NIH Stroke Scale items, the scoring rules people miss, and three original written scenarios to practice on — built to teach the method, not to leak copyrighted test content.
A small syringe on the left and a tall hanging bag of fluid on the right, side by side as simple flat shapes on a pale ground
Neuro & Stroke

TNK vs tPA: What Stroke Nurses Do Differently (2026 Guideline)

The 2026 AHA/ASA stroke guideline makes tenecteplase a Class I, co-equal thrombolytic for acute ischemic stroke. Here's what changes at the bedside — dosing, the single bolus vs. the hour-long drip, and the monitoring that stays exactly the same.
An ICU nurse leaning in at the bedside during a rapid response, adjusting the oxygen mask on a patient in respiratory distress, with vital-signs monitors behind.
Critical Care

ABG Interpretation Made Easy: The Tic-Tac-Toe Method (With Practice)

Learn to interpret any arterial blood gas in four steps using the tic-tac-toe method and the ROME mnemonic — normal values, acidosis vs. alkalosis, compensation, the anion gap, and worked practice examples for nurses and nursing students.