Double-Helix, BSN, RN 38,273 Views
Joined: Apr 5, '11;
Posts: 3,480 (55% Liked)
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I agree that this patient, excepting the postpartum status, was an adult trauma patient. This entire situation likely could have been avoided by some open dialogue and by having a postpartum nurse come to the PACU to assist with monitoring for the immediate postpartum complications.
Why Peds? Only you can answer that. What draws you to pediatric nursing? Use this forum as a practice interview. Tell us what YOU think. How would YOU answer those questions? We can help you with phrasing or help adjust your responses, but if you go into that interview with scripted responses from other nurses, what happens when you're asked a question you haven't thought of in advance?
It might be easier for you to think of implications if you brainstorm some situations where this might come up. I'll give you a couple of examples:
1. RN is working in an outpatient clinic and a female patient is prescribed an antibiotic for UTI. The patient's medical history indicates that she is sexually active and taking Ora contraceptives. What should the nurse do next?
2. A teenage patient presents to the ED with vaginal pain and green discharge. Patient states that she is sexually active but "uses protection". The nurse inquires about what protection is being used. The patient reports that she receives Depo Provera injections. What should the nurse do next?
The student handbook says an average at or below 74.49 will not be rounded up. It doesn't say that 74.5-74.99 will be rounded up. The handbook doesn't address this situation all. You can certainly inquire to the Dean and ask for policy clarification, but there is still a very good chance they will tell you that rounding graded between 74.49-74.99 is at the discretion of the instructor.
I'm glad you take ownership for your ooor performance. I suggest you make a concrete plan regarding improving your study habits so you don't end up in this situation again. Best of luck.
The heart is responsible for pumping blood through the body. One of the essential elements in that blood is oxygen. During an asthma attack, there are inadequate levels of oxygen in the blood. The heart tries to compensate for low oxygen levels by pumping faster- trying to deliver more blood/oxygen to the tissues.
Hypotension is more multifactorial. Remember that a major component of blood pressure is cardiac output (influenced by heart rate, force of the heart beat, and amount of blood in the heart). A process that contributes to hypotension in severe asthma is called dynamic hyperinflation. In simple terms, one breath isn't finished exhaling before another is inhaled. This leads to air trapping, increased pressure and over inflation of the lungs. In turn, resistance in the inferior vena cava is increased. This makes it harder for blood to get back to the heart, so cardiac output is decreased, thus decreasing blood pressure.
In an severe untreated asthma, hypotension may also be secondary to severe hypoxia. Muscles (like the heart) need oxygen in order to function. When there is a lack of oxygen, the heart begins to fail, contractions/heart beats become weak and blood is not pumped effectively.
Hope this helps!
I'm intrigued, but not threatened. There are many less conplex and more profitable medical professions to automate than nursing. Nurses use far more critical thinking, nursing judgement and therapeutic communication to guide our care than most non-nurses realize.
Why my patient gets picked up from the unit by a robotic anesthesiologist that takes the patient for a robotic surgery performed without supervision (and indeed one day they may), I'll start to worry about my job.
I think this quote from your last article link said it best about robots and the nursing profession: "This is one industry where it seems the integration of robots will lead to collaboration, not replacement."
If the patient requests information about changing physicians, I would explain how they can go about initiating that change. You are simply providing information about the process that the patient may act on, should they choose to do so, not assisting with any part of the transition.
It sounds like you enjoyed your job prior to this position. And it sounds like your feelings of stress and burn out are echoed by your colleagues on the floor. Also, is this your first night shift position? Lots of people have difficulty with the transition to night shift. You've got a lot of experience and if you think that a different unit or location would be a better fit for you, there's nothing wrong with looking for a new job.
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