starting med/surg 2 today

[EDnurse2009]

So I start med surg 2 (critical care) today. It is the most dreaded class in my program. Out of 30 students that begin the class, they usually lose about 12 (because they get below the 73 passing grade). I am terrified of this class. I have already read the first 10 chapters in the text and we have not even had our first lecture yet! Anyways, just wanted to vent. Any advice on getting a passing grade in this class would be much appreciated. Wish me luck...

[Daytonite, BSN, RN]

in critical care you are working with patient's whose illness has gone into the potentially fatal phases or patients who have advanced nursing procedures that need to be performed. so, you really, really, really, really, really have to know the underlying pathophysiology of what is going on with these people to understand why you are doing the things the doctor has ordered. did i mention that you really, really, really, really, really need to know the pathophysiology of the illnesses these people have? this is very, very important to understanding the procedures and treatments being applied. this is the reason that people fail out of this course. you need to know about the progression of heart failure and its manifestations and the different types of copd. heart and respiratory problems are the biggest reasons that people are in the icus. stroke is next and is considered a cardiovascular problem. the gi bleeders and people with dic are after that. common complications that land people in icu include pulmonary edema, blood clots anywhere, shock and sepsis. or, they are being monitored for the development of these things. you have got to know how these affect the body systems--there's your pathophysiology again. keep in mind that for each symptom the patient has, the doctor is ordering medications and treatments. a symptom is a manifestation of the pathophysiology that is going on. when you see how that rationale is applied, it will make critical care a whole lot easier to fathom.

check out the weblinks on the stickys of the ccu forum for more ekg websites and here are some others that you will find helpful:

critical care

• http://www.icufaqs.org/ - notes on icu nursing. links to icu procedures
  
• http://www.medicineau.net.au/clinical/icu/procedures/home.html - icu procedures, many links to lots of nursing procedures
  
• http://www.ccmtutorials.com/ - critical care medicine tutorials for medical students - some of the subjects covered include acid-base imbalances, shock and hypotension (hemodynamics), respiratory failure, and sepsis
  
• http://www.madsci.com/manuals.html - links to information on stabilization of chest pain, ekgs, acls, blood gases and trauma
  
• http://www.healthsystem.virginia.edu/internet/anesthesiology-elective/airway/airwayintro.cfm
  
• http://enw.org/can'tbreathe.htm (part 1)
  
• http://enw.org/can'tbreatheii.htm (part 2)
  
• http://enw.org/airwaycommandments.htm - the 10 commandments of airway management
  
• http://enw.org/airwayhell.htm - difficult airway management: action-plan for airway problems from hell!
  
• http://rnbob.tripod.com/ - nurse bob's micu/icu survival guide
  
• http://www.pacep.org/pages/start/ref.html?xin=sccm - this is a free online tutorial on how to use the pulmonary artery catheter in the clinical environment. you have to register to access this tutorial, but it is free.
  
• http://classes.kumc.edu/son/nurs420/unit4/hemomon.html - an short explanation of central venous pressure measurement (right atrial pressure).
  
• http://www.trauma.org/resus/moulage/moulage.html - from trauma.org this is a fun interactive site of patient scenarios where you get to test your trauma treatment skills!

ekgs

• http://www.hhmi.org/biointeractive/vlabs/cardiology/content/dtg/ecg/ecg.html
  
• http://www-medlib.med.utah.edu/kw/ecg/index.html
  
• http://www.12leadecg.com/intro/ - introduction to 12-lead ecg, the art of interpretation online companion website for the book.

abgs/acid-base balance

• http://maagnursing.com/abg/ - this is an abg and acid/base balance tutorial. you do not have to register to go through the tutorial.
  
• http://www.madsci.com/manu/indexgas.htm
  
• http://www.wisc-online.com/objects/index_tj.asp?objid=nur6906
  
• http://realnurseed.com/abg.htm
  
• https://allnurses.com/forums/f50/abgs-compensation-156641.html
  
• https://allnurses.com/forums/f205/easy-way-remember-abgs-144947.html
  
• https://allnurses.com/forums/f205/pathophysiology-p-fluid-electrolyte-resources-145201.html

[ohmeowzer RN, RN]

ooh yes the dreaded med/ surg 2.. we lost alot of people from that class .. we lost 16 from the class and then from the clinical 4 or 5... all i can say is get with a study group and review , and know the concept of the lecture... we had a study group and studied 40 hours a week ( no lie) there were 6 in our study group and only 1 girl did not pass. she failed by 2 points.... you can do this.. you will make it.. if i can do it .. you can to.. keep us posted