[FutureNewYorker]

Originally Posted by Jules A

Thanks for this, I just ordered one from Amazon used for under $12 shipped. Always looking for good books.

Pagandeva2000,
Not sure how it is done elsewhere but if we get a high lab value we assess the client, hold the med and call the Doc. Adverse effects from lithium tox was often a question I saw in school.

FWIW as a LPN I do almost exactly the same thing as the RNs but this is a small facility. I know at the larger state hosp the LPNs are mostly med nurses. I'm just counting the minutes til I pass NCLEX and get the $15/hour raise!

No problem. My bf actually bought that book for me as a little gift when I got the job. It was one of the most thoughtful things he could have done. I love it. BTW, you're exactly right about what to do with an elevated level, though I can remember the sx of it. Lethargy and disorientation and malaise I think. Would need to look that up. Rarely see lithium in use anymore down here actually. Too much upkeep with it and many other options these days. And I feel ya about the $15 raise!!! Sucks doing the same work for about half the pay! lol.

[pagandeva2000]

Originally Posted by FutureNewYorker

No problem. My bf actually bought that book for me as a little gift when I got the job. It was one of the most thoughtful things he could have done. I love it. BTW, you're exactly right about what to do with an elevated level, though I can remember the sx of it. Lethargy and disorientation and malaise I think. Would need to look that up. Rarely see lithium in use anymore down here actually. Too much upkeep with it and many other options these days. And I feel ya about the $15 raise!!! Sucks doing the same work for about half the pay! lol.

I saw confusion, tremors and seizures, I think. I believe they give Depakote rather than Lithium these days. Have to draw electrolytes and renal functioning. I've been reading the stuff, folks. The agency called me back and asked me to email them a new picture ID because it came back too dark, and I should be getting the address of the place today. Wish me lots of luck!

[Jules A]

Good luck and keep us posted!

[pagandeva2000]

Well, I am a few steps closer-the agency called me yesterday and told me that I had to do an on line exam on psych (not related to the one that has to be taken at the facility) the same day. I wasn't able to access it from work, but when I got home, I saw that they actually had me down for three on line exams. One was for psych terminology-about 30 questions, a test assessing LPN skills (about 60 questions) and then a dosage calculation test with about 60 questions as well. I was totally unprepared for that, so to speak, because math is a subject that still freaks me out to no end (you would NEVER believe I got an A in medical dosages-not that I can't do it, but it take constant review due to my math phobia). Had I known THAT, I would have reviewed math. I had many IV calculation questions-it blew my mind. But, somehow, I got an 85% and I'm good to go.

Now the agency has to send the profile to the client and I will be contacted to go to the facility to take the psych exam and orientation is the 17th, if I do well on that. Thanks, everyone for their suggestions, words of support and advice!

[Thornbird]

FYI: Anti-hypertensives such as clonidine are often used for psych patients who are agitated/manic as they can have a sedating effect. I believe this is an "off-label" use but is common.
Duties for an LPN vary as stated before depending upon the hospital policy.
Definitely look up side effects and symptoms of toxicity. Be sure you are familiar with EPS symptoms and the drugs used to treat/counter them (Cogentin, Artane, Benadryl). Good Luck.

[pagandeva2000]

Originally Posted by Thornbird

FYI: Anti-hypertensives such as clonidine are often used for psych patients who are agitated/manic as they can have a sedating effect. I believe this is an "off-label" use but is common.
Duties for an LPN vary as stated before depending upon the hospital policy.
Definitely look up side effects and symptoms of toxicity. Be sure you are familiar with EPS symptoms and the drugs used to treat/counter them (Cogentin, Artane, Benadryl). Good Luck.

Thank you. I just discovered that fact about clonidine as recent as a few days ago. We give it like candy in my clinic for the hypertensive patients (we get many that are over 200/100), and a friend of mine that works with mentally challenged children revealed this to me.

I didn't hear from them as of yet, but hope to soon!

[pagandeva2000]

Well, things didn't pan out. The agency sent my profile over to the facility and the facility didn't think I had enough experience in psych as a nurse (actually, none, but had many years as an aide that administered medications). I have to admit that I was a bit peeved, because most times, in this place (I found out who the client was-and it was the place I suspected), the LPN primarily administers meds and that is about it. Another thing that annoyed me is all of the time I spent reviewing psych medications, terminology and such to prepare for this. I kknow these people had their criteria, but I also know that I would have been a phenomenal nurse for them.

Oh, well, I will begin to pursue again for other venues, and thanks, everyone for your advice. :0)

[TheCommuter]

Originally Posted by pagandeva2000

Well, things didn't pan out. The agency sent my profile over to the facility and the facility didn't think I had enough experience in psych as a nurse (actually, none, but had many years as an aide that administered medications). I have to admit that I was a bit peeved, because most times, in this place (I found out who the client was-and it was the place I suspected), the LPN primarily administers meds and that is about it. Another thing that annoyed me is all of the time I spent reviewing psych medications, terminology and such to prepare for this. I kknow these people had their criteria, but I also know that I would have been a phenomenal nurse for them.

Oh, well, I will begin to pursue again for other venues, and thanks, everyone for your advice. :0)

Well, the client lost out on a good nurse. It's totally their loss.

[Jules A]

Originally Posted by TheCommuter

Well, the client lost out on a good nurse. It's totally their loss.

I agree!

[pagandeva2000]

Thanks. I am quite ******, really. I know that there are other opportunities, and will be pursuing them, but I did take a great deal of time to review medications, psych conditions and was well prepared because I take each position very seriously. I plan to show nursing professionalism wherever I go. I feel, especially, for LPNs that we have to demonstrate intelligence and express ourselves accurately so that they are aware that we are not dummies. I'll get over it within a few hours, but, yes, I know that they missed out on a great, caring and willing to learn nurse.

They do have home hospice cases, that I may consider for the moment, but for now, I'll focus on the health fairs that we provide for the community in the summertime. It will improve on my teaching and it still gives me incentive to review because I get approached with many health issues.

Thank you all!