Latest Comments by chicagrl

chicagrl 1,198 Views

Joined May 29, '08. Posts: 24 (4% Liked) Likes: 2

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    i was also going to recommend the cherokee top that is 28.5 inches. One of my fave scrub tops!

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    UIMC NIDCAP Training Center

    Not sure how many practicing nurses check this discussion board but this conference may be of interest to anyone who cares for infants.

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    I am so confused by it too. As a first year nursing student who is overwhelmed by info overload, I find it very frustrating that all of our clinical paperwork must be filled out according to the Roy Model yet NO ONE has explained it very well. In fact I am beginning to wonder if any of my instructors understand it.

    I did find the article Daytonite linked while doing my own research - it is helpful but I still can't grasp how it all applies to our Nursing Process Worksheet and four mode assessment sheet that must be filled out for clinicals.

    thanks for listening to my rant

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    Daytonite:
    Thanks so much for your explanation and guidance! I don't think I have enough objective (or subjective either) data from my assessment to support the care plan for Ineffective gas exchange. (at least not the way I think my instructor will analyze it) I am going to focus on the Imbalanced Nutrition diagnosis. I feel more comfortable working with that.
    I am 2nd semester nursing student and we are not too advanced on care plans yet.

    leslee

    I

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    but i don't see any NANDA diagnosis that would pertain to this situation....

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    nevermind , i see there is a section of them under safety. i will post again with anything i come with to see if i am going in the right direction...

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    Thanks
    She had a fire in her kitchen. I did not see a NANDA listing for that type of thing : safety, evaluation of her living situation etc.

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    Hi
    I am hoping for a bit of guidance. I have to do a care plan and can't come up with anything so far. My pt was 84 and in for smoke inhalation. She was fine by the time my clinical day arrived. Her vitals were within range, and she had no IVs or oxygen. Her hosp care plan was impaired gas exchange. I have no objective data that points to that. She was ambulatory and able to carry out ADLs. She had low Hgb and Hct levels that were being investigated. Can I write a care plan on that ? I don't really see any NANDA entries related to that though. She seemed most concerned about her futute living conditions. Can I do a care plan on that?
    I am just feeling stuck . Any advice is MUCH appreciated.
    thanks
    lhr

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    bump

    anyone on allnurses taking RN to BSN coursework in ILLINOIS?

    I would love some info from those with firsthand experience.

    Do any hospitals pay for ADN TO BSN completion?

    Thanks

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    Thanks Daytonite!

    The problem is , I don't have any answers. I was only with her for about 5 hours this am. She had just finished the blood transfusion and SAID she felt better - they drew blood to check her levels but I don't have the results.

    She had a painful swollen ankle previously, her uric acid levels are in normal range but I guess she good still have gout - they don't really know. She does not currently have and S&S for gout.

    She was going for some type of gyne stuff to see if there were fibroids. She did not complain of any symptoms, has not had any S&S either but they are trying to rule everything out.

    Vitals, all within normal ranges.

    Don't really know where to go with this....

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    Quote from daytonite
    step #2 determination of the patient's problem(s)/nursing diagnosis - match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use
    1. acute pain?
      • better: acute pain r/t abdominal distension
        • abdominal pain
        • last bm 2 days ago
        • pain averaged 7-8, and after dilaudid, 5 at best
    2. nutrition less than requirements r/t bypass
      • better: nutrition: less than body requirements r/t inability to ingest adequate amounts of food secondary to gastric bypass surgery
        • 6 lb weight loss in past 4 days
        • nausea
        • vomiting
    3. deficient fluid volume r/t fluid volume loss (these are symptoms of anemia)
      • rbc: 3.75
      • hgb: 10.4
      • hct: 31.0
    4. impaired tissue integrity r/t surgical intervention
      • 5 small incisions in abdomen
    5. r/f infection r/t incisions?
      • better: risk for infection r/t surgical intervention
      • neut abs: 6.9
      • lymph abs:0.8
      • neut: 87.4
      • lymph: 10.0
    6. risk for injury r/t anticoagulation (on heparin therapy)
    hi daytonite,
    i had a pt today who had gbp surgery 7 years ago. she was hospitalized b/c her primary care physician requested she get blood. her h&h levels were low.
    do you think i could use #2 or #3 from you list above ? i am having trouble because i have no s & s except her lab values for h& h. by the time i met her she already received blood and said she felt great. not sure how to go about a care plan for someone who does not seem to have any trouble. they wanted to run some more test on her for fibroids . she also had some gouty issues which is why she went to see he pcp in the first place. she says she eats well and has not had any problems since her gastric bypass. can i do a care plan for imbalanced nutrition even though i am not sure why she is anemic? anemia apparently "runs in her family" ??????
    help
    thanks
    chicagrl

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    well from my 6 weeks in clinical I just wonder...Why are these pts. here and who is covering all their expenses...i hear whispers of medicaid and medicare. who is taking care of these people when they are not in the hospital? if they are older .....

    those are mostly the pts. i worry about. it is part of our nursing education to ask if they have family etc. and we check the chart, but some of the pts i saw today , obviously have noone caring for them ...they are hopeless in my mind . i feel so bad, no family comes to see them , they seem to be transfers from LTC ....
    for example 64yo male,feeding tube, wounds , full precautions. I have no idea what i am dealing with,he was awake but non communicative , combative but helpless. please someone help ....

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    Quote from suzy253
    How about something along the lines of:
    Ineffective Coping
    Caregiver Role Strain
    Relocation Stress Syndrome (or risk for)
    Anticipatory grieving
    Powerlessness
    THanks ..funny how my instructor did not mention any of these..perhaps too advanced for first semester...probably not?

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    pseudomonas and lpnflorida like this.

    Quote from HeartsOpenWide
    My class is full of a lot of younger students that all brag that they Ace their exams and never study...and of course are full of confidence; like they are trying to show each other up...the competition does not end once in nursing school...
    And the "competition" will never end -just don't play into it....Think about it....don't *some* people always want the "best car" or have the "most gifted child" etc....It happens in every facet of life.

    Just b/c someone aces a test does not mean they have good clinical skills, I would talk to an instructor, confide in someone who you feel will listen and work with you on this. Perhaps you are being to hard on yourself. Awesome for you that you are almost done with a BSN congrats


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