Example of Nursing School Notes? Pls help!

In my program, the instructors give you their notes (posted online) before each class. Then you can just add to them during lecture as you see fit. It's a fantastic system that saves you from having to spend the entire class just trying to keep up with writing stuff down. I would be surprised if other programs make you actually write out all your own notes.

Actuallly, in my area; if you don't write it down then you don't get it! Instructors don't ever give notes, you are responsible for taking your own notes inside and outside of class.

I've finished my first year, and getting ready to start 2nd year in a few weeks. I too would love a sample or template because I don't feel that my "orgranization" (or lack there of) of notes was as affective as it could have been during my first year.

Thanks to the OP and to anyone that can help with this!!!

No matter what the subject is I always seem to use the same system. If I am reading my Pharmacology book, for example, I will start out by writing "Central Nervous System Stimulants" and then give a brief description of what their action is and what they do. The next line down would be "tabbed" and would be Analeptics, Amphetamines, and Anorexiants and a brief description of each, some of the common ones, etc. For similarly acting drugs the adverse reactions, contradictions, precautions, etc can be similar so instead of listing them for each type of drug, I tab back out to the original place of the first line (CNS stimulants) and then list the common reactions. Unless one particular type of drug has a unique feature-it gets listed next to the category it falls under. And then all the notable categories are underlined twice and later on when studying them I either reduce/refine my noted and/or study them with a highlighter. I basically write my notes the same way I would if I were to type them up.

If none of this made sense or was helpful I would suggest looking over the notes or handouts you have ever received form an instructor in the past, or ask an instructor for help.

mine go alot like this "womp womp womp womp womp womp" ... but we are knee deep in our summer session

I think it depends on the program. I used to be a big note taker, but our exams seem to be mostly from the book so I study from that

Here is 1 chapter of my notes from Med Surg 2. I use Microsoft One Note 2007. Usually I only re-write the info that I don't actually know yet. A lot of the things we go over in class get written in my "class" notebook, and then I put them in readable/searchable form in my laptop once I get home. If I tried to study off my in-class notes, I would never get anywhere because it all looks like chicken scratch and makes no sense after a couple of days. I have to re-do the notes ASAP if they are going to be of any value.
I am going to cut/paste and hope the formatting isn't all screwed up.

Chapter 28--Management of patients with coronary vascular disorders

• Coronary Artery Disease
• Atherosclerosis--abnormal accumulation of lipids and fibrous tissues in the vessel wall.
• The plaques protrude into the lumen of the vessel, narrowing it and obstructing blood flow.
• The thrombus may obstruct blood flow, leading to MI or sudden death.

• Coronary Atherosclerosis
• Blockages and narrowing of coronary vessels reduce blood flow to myocardium.
• Cardiovascular Disease is the #1 cause of death in the US.
• CAD is the most prevalent cardiovascular disease in adults.
  Under the age of 55, men are at higher risk. After 55, men and women have equal risk. Possible cause of this is higher estrogen levels in younger women.
  Symptoms in women are vague.

RISK FACTORS for CAD
Modifiable Non-Modifiable
Cholesterol Family history
HTN Age
Diabetes Gender
Smoking Race
Stress
Sedentary Lifestyle
Obesity

Total Cholesterol should be <200.
HDL >60 optimum
LDL <140 optimal. With CAD, <100
Triglycerides <200

Page 865
Table 28.2
*know this*

• Clinical Manifestations of CAD
• FOCUS IS PREVENTION
• Due to myocardial ischemia and r/t location and degree of vessel obstruction.
• Angina pectoris
• Heart Failure
• MI
• Sudden cardiac death

MEDICAL MANAGEMENT

• Prevention

-Cholesterol/Diabetes screening, Diet, Tobacco Cessation, managing HTN and stress

• Exercise Program

-30 minutes, 3/4 times per week

• Medications

-Statins, Bile Acid Sequestrants, Fibric Acids, Nicotinic Acid to reduce Cholesterol levels

• Antiplatelet Agents

-Aspirin, Plavix, Ticlid, Heparin, Lovenox

• Surgical Management---CABG, Stents

• Angina Pectoris
  Characterized by episodes of pain or pressure in the anterior chest caused by insufficient coronary blood flow.
  Physical exertion or emotional stress increases myocardial oxygen demand, and the coronary vessels are unable to supply sufficient blood flow to meet the demand.
  
  Usually caused by Atherosclerotic Disease. When there is an increase in O2 demand, flow through the coronary arteries needs to be increased to meet the demand. When there is a blockage in a coronary artery, flow cannot be increased, and ischemia results.
  Causes of typical anginal pain:
• Physical exertion--increases O2 demand
• Exposure to cold--causes vasoconstriction and elevated BP, with increased O2 demand
• Eating a heavy meal--increases blood flow to mesenteric area for digestion, thereby decreasing blood supply available to the heart muscle. In a severely compromised heart, shunting blood flow for digestion can be sufficient to induce anginal pain.
• Stress or any emotion-provoking situation. SNS reaction increases BP, HR and workload
  ATYPICAL angina is not associated with the above factors and it may occur at rest.

• Types of Angina
• Stable--predictable and consistent pain. Occurs on exertion and relieved by rest.
• Unstable--(preinfarction) symptoms occur more frequently and last longer. Pain may occur at rest.
• Intractable or Refactory--severe incapacitating chest pain
• Variant--PRINZMETAL'S--pain at rest. Reversible ST-segment elevation. Caused by coronary vasospasm.
• Silent ischemia--pt. reports NO SYMPTOMS but has objective evidence of ischemia. (ECG changes with stress test)

Study this!!

• Medical Treatment of Angina Pectoris
• Seeks to ↓ O2 demand and ↑ O2 supply
• Medications
  • Nitroglycerine
  • Beta-Blockers
  • Calcium-Channel Blockers
  • Antiplatelet and Anticoagulant Medications
• Oxygen (keep sats >93%)
• Reduce and control risk factors
• Reperfusion Therapy

• Percutaneous Coronary Interventions
• PTCA--Percutaneous Transluminal Coronary Angioplastyballoon-tipped catheter is used to open blocked coronary vessels and resolve ischemia. The purpose is to improve blood flow within the artery by compressing and cracking the atheroma.
• Coronary Artery StentMetal mesh that provides structural support to a vessel at risk of acute closure.
• AtherectomyPlaque is removed from vessels

• Surgical Procedures
• Coronary Artery Bypass Graft (CABG)--a blood vessel from another part of the body is grafted distal to the coronary artery lesion, bypassing the obstruction.
• Cardiopulmonary Bypass--blood is mechanically circulated and oxygenated while bypassing the heart and lungs. CPB maintains perfusion to body organs and tissues and allows the surgeon to complete the anastomoses in a motionless, bloodless surgical field.

• ASSESSMENT
  
• Symptoms and activities, especially those that precede and precipitate attacks
• PQRST (see next section)
• Risk factors, lifestyle, and health promotion activities
• Patient and family knowledge
• Adherence to plan of care

• Chart 28-6 Assessing for Symptoms Associated With Angina
  ACRONYM
  FACTORS ABOUT PAIN THAT NEED TO BE ASSESSED
  ASSESSMENT QUESTIONS
  P
  Position/Location
  Provocation
  “Where is the pain? Can you point to it?”
  “What were you doing when the pain began?”
  Q
  Quality
  “How would you describe the pain?”
  “Is it like the pain you had before?”
  
  Quantity
  “Has the pain been constant?”
  R
  Radiation
  Relief
  “Can you feel the pain anywhere else?”
  “Did anything make the pain better?”
  S
  Severity
  “How would you rate the pain on a 0–10 scale with 0 being no pain and 10 being the most amount of pain?” (or use visual analog scale or adjective rating scale)
  
  Symptoms
  “Did you notice any other symptoms with the pain?”
  T
  Timing
  “How long ago did the pain start?”
  

• NURSING DIAGNOSIS
• Ineffective myocardial tissue perfusion
  -Treatment of anginal pain is a priority nursing concern. Patient should stop all activities and rest.
  -Assess the pt while performing other necessary interventions.
  
  • Vital signs
  • Observation for respiratory distress
  • Assessment of pain
  • In the hospital setting, ECG is assessed or obtained
  • Administer O2--don’t need an order (usually 2L/min NC)
  • Administer meds as ordered or by protocol, usually nitroglycerine sublingual up to three doses

• NURSING DIAGNOSIS
• Anxiety
  -Use a calm manner
  -Stress-reduction techniques (ex: music therapy)
  -addressing spiritual needs may assist in relieving anxieties
  -Address both pt and family needs

• NURSING DIAGNOSIS
  
• Knowledge Deficit-Lifestyle changes and reduction of risk factors
  -Explore, recognize, and adapt behaviors to avoid and reduce the incidence of episodes of ischemia.
  -Teaching regarding disease process
  -Medications
  -Stress reduction
  -When to seek emergency care: after 3rd nitro with no improvement in pain

• Collaborative Problems/Potential Complications
• Acute Pulmonary edema
• Heart Failure
• Cardiogenic shock
• Dysrhthmias or cardiac arrest
• MI

Well....so much for formatting. LOL All my tables have been removed. Oh well...hopefully you can get some use of it.

We either get notes (power point) in a “course packet” or they are posted online. They are a broad overview of the lecture and I just jot down anything I think is important.

We get a power point for each of our lectures. To study I read the assigned text and outline it, usuall I write it first, then type it if I have time. The repitition helps me. Here is an example, hope it helps. I also will put tables in if it is something that I want to compare
Thrombophlebitis

• Thrombus-blood clot believed to result from and endothelial injury, venous stasis, or hypercoaguability
• Thrombophlebitis-thrombus with inflammation
• Phlebothrombosis- thrombus with out inflamamation
• DVT-more common and more serious than superficial thrombophlebitis due to greater risk for pulmonary embolism
• Pulmonary embolism (PE)-dislodged blood clot travels to the pulmonary artery
• Etiology
  • Highest incidence of clot formation occurs in hip surgery, total knee replacement or open prostate surgery
  • Immobility, pregnancy, and heart failure can also be a cause
• Assessment
  • Calf or groin tenderness and pain, sudden onset of unilateral swelling of the leg
  • Physical assessment findings are usually adequate for diagnosis
  • Diagnostic tests

§ Contrast venography-“gold standard”
§ Dopplar flow studies
§ Impedance plethysmography
§ Venous duplex ultrasonography- preferred diagnostic test, accuracy dependent on the skill of those doing the test
§ MRI
§ D-dimer-detects coagulation activation and measures fibrin degradation products produced from firbolysis

• Interventions
  • Non-surgical

§ Rest
· Do not massage the effected extremity to prevent clot from dislodging and becoming an embolis

• • Drug therapy

§ Anticoagulants, IV heparin then oral warfarin
§ Unfractioned heparin therapy
· IV unfractioned heparin at high doses inhibits practically all clotting factor
· Does nothing to existing clot, used to prevent formation of other clots and to prevent enlargement of existing clot
· Before administration INR, PTT, PT, CBC, UA, creatinine and stool for occult blood are all checked
· Assess clients for signs of bleeding
§ Low molecular weight heparin
· Have a consistent action, approved for prevention and treatment of DVT
· Binds less to plasma protein, blood cells, and vessel walls resulting in a longer half life and more predictable response
§ Warfarin therapy
· Works in the liver to inhibit synthesis of the vitamin K dependent clotting factors and takes 3-4 days before it can exert therapeutic anticoagulation
· Monitor PT and INR, INR should be between 1.5-2.0
· Check for bleeding
§ Thrombolytic therapy
· Effective in dissolving thrombi quickly and completely
· Prevents valvular damage and consequential venous insufficiency
· Contraindicated postoperatively, during pregnancy, after childbirth, trauma, strokes, or spinal injuries

• • Surgical Management

§ Rarely removed surgically unless there is a massive occlusion that does not respond to medical treatment and is of recent onset
§ Thrombectomy- most common surgical procedure
§ Inferior vena caval interruption
· Recurrent DVT or PE that do not respond to medical treatment and for clients who cannot tolerate anticoagulation
· A filter device or “umbrella” is inserted into the inferior vena cava, the device traps the emboli before they progress into the lungs
§ Ligation or external clips
· If inferior vena caval filter is not successful in preventing PE or if it becomes blocked with thrombi the surgeon may perform ligation or insert external clips on the inferior vena cava to prevent PE