Abington Jefferson Health Posters

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  Transformative Training: A Pathway Program for the Critical Care and Emergency Department Novice Nurse

  Kathleen Boyle, MSN, RN, CCCTM; Linda Seliga, MSN, RN, CEN, TCRN, CPEN; and Tehya Utah, BSN, RN, CCRN

  Background

  Working in a critical care and or emergency department is very challenging and stressful. Critical care and emergency departments have the highest acuity, are fast paced, and utilize complex technologies. Novice nurses experience a lack of confidence and increased anxiety being faced with the care of a patient in this demanding setting. Since Covid we are experiencing; a nursing shortage, high turnover, expedited nursing programs with minimal clinical experience. Due to the need for nurses, novice nurses are being hired directly into the critical care settings. High stress and low confidence can affect the novice nurse's ability to provide optimal care (Kimet al.).

  According to Kolb’s Experiential Learning Theory, experiential learning encourages critical thinking, problem solving, and communication skills. Learning develops from concrete experience, reflective observation, active experimentation and abstract conceptualization.

  For the novice RNs to be successful in their new role; a Critical Care & Emergency nurse pathway was developed by the Nursing Professional Development team. This pathway program offered both didactic and hands-on skills. Classes were held once a month for 3 months and offered various critical care skills. The skills were held outside of the clinical setting in a non-judgmental, no pressure environment allowing nurses time to review and reflect, thus promoting experiential learning.

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  HyperCKemia : Psychosis-Induced Non-Traumatic Rhabdomyolysis

  Mackenzie Kramer, Joann Butkus, Vincent Chan, Nathaniel Rosal, Stephanie Tzarnas, and Eunha Kim

  Rhabdomyolysis is a clinical syndrome that results from skeletal muscle breakdown and the release of intracellular enzymes into systemic circulation. We present a case of transaminitis and serum Creatinine Kinase (CK) levels exceeding 590,000 U/L without myoglobinuria or subsequent Acute Kidney Injury (AKI) after an acute psychotic episode. Case reports regarding such extreme serum CK elevations without myoglobinuria or ensuing renal failure in a non-traumatic case of rhabdomyolysis are minimal.

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  Clinical Challenges in the Diagnosis and Treatment in Neurosarcoidosis and Neurosyphilis

  Mackenzie Kramer, Melissa Margolis, Neelima Manda, Rehan Saeed, Stephanie Tzarnas, Nathaniel R. Rosal, Daniel Puga, and Rebecca Fallis

  Syphilis and sarcoidosis, both known as the "great mimickers," cause a wide range of symptoms making clinical differentiation between the two difficult.

  We present a case in which both neurosarcoidosis and neurosyphilis were considered in the differential diagnosis, posing a unique challenge in decision making.

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  Angioimmunoblastic T cell Lymphoma: A diagnostic dilemma

  Nishanth Thalambedu, MD; Seema Sethi, DO; and Herbert Auerbach, DO

  Angioimmunoblastic T cell lymphoma(AITL) is one of the rarest T cell lymphomas. Diagnosing the type of lymphoma is crucial, as the management differs depending on the type. We present a case of a sixty-one-year-old woman who presented with generalized lymphadenopathy and how we unfolded the diagnosis.

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  Hypercalcemia related to ectopic vitamin D production from a dysgerminoma

  Iqra Iqbal, Muhammad Atique Alam Khan, Puneet Dhillon, Samavia Munir, and Dina Nabwani

  Introduction

  While malignancy associated hypercalcemia is a common finding among 20% to 30% of adult patients with breast cancer, lung cancer and multiple myeloma, it happens in less than 5% of female genital tract malignancies. [1] The three most common mechanisms associated with hypercalcemia are: local osteolytic hypercalcemia, humoral hypercalcemia of malignancy (HHM) caused by the parathyroid hormone-related peptide (PTHrP), and other humoral factors including prostaglandin, tumor necrosis factor (TNF), osteoclast activating factor and transforming growth factor (TGF). PTHrP and 1, 25 dihydroxy vitamin D (1, 25 Vit D) have been reported as humoral factors for dysgermininoma. [2] Humoral hypercalcemia of malignancy (HHM) can be caused by ectopic paraneoplastic production of 1, 25 dihydroxy vitamin D due to hyperactivity of 1 alpha-hydroxylase enzyme.

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  Thyrotoxicosis Factitia: A Rare Cause of Junctional Rhythm and Cardiac Arrest

  Iqra Iqbal, Muhammad Atique Alam Khan, Waqas Ullah, and Dina Nabwani

  Introduction

  Little is known about the types of arrhythmias due to exogenous thyroxine. We present an unusual set of cardiac arrhythmias in a fairly healthy athlete who succumbed to the severe complications of exogenous thyroxine.