Latest Comments by Double-Helix

Double-Helix, BSN, RN 36,737 Views

Joined: Apr 5, '11; Posts: 3,364 (54% Liked) ; Likes: 6,615
Nurse, Children's Hospital from US
6 year(s) of experience in PICU, Sedation/Radiology, PACU

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  • 0

    I agree with the above posters- pause the feeding, check residual, return the aspirated contents, and restart the feed (if the residual is within normal limits). Assuming that you have a consistent rate of gastric emptying, your residual should be consistent also. If gastric emptying is too slow, the residual will be high, so you can get the information you need without interrupting the feeding.

    Castiela gave a great summary of methods used to check tube position. The best answer is to follow the policy at your facility. It will vary from place to place. Our facility uses pH of gastric contents to confirm tube position. A x-ray is warranted if the pH is inconclusive or you have other reasons to suspect tube displacement.

  • 0

    You're correct. Our policies instruct us to gently pull back on the catheter after inflating the balloon until slight resistance is met.

  • 0

    It is not normal in my experience. The dates and times of my classes and clinical rotations were set the previous semester so that students could register for the classes that worked best for their schedules. But this was a 4 year university program, and there were other non-nursing courses that were required as well.

  • 0

    I haven't heard about the ATI virtual program, but I haven't taken an ATI in over 6 years. And yes, you are not actually an LPN until you have become licensed, and thus not eligible for a bridge program.

  • 4
    Esme12, KelRN215, Here.I.Stand, and 1 other like this.

    #1, thank you for being clear, specific, and including your work and thought process when you posted this question.
    #2, unless the question specifically asks you to reconstitute or dilute the medication, I don't assume that I need to add additional volume. If both these questions were presented to me exactly as you worded them, I wouldn't add additional volume to either.

    If you have a question this ambiguous on your actual exam, just ask the instructor to clarify. As long as you have a good understanding of the process (and it seems that you do), I don't think you'll be faulted either way.

  • 2

    You're not alone. I routinely feel faint or pass out when I get blood drawn, get immunizations, sometimes even with my annual TB test, and there's no chance I could ever donate blood. And I'm not the only one of my colleagues who have the same problem. I've been a nurse for 6 years, given hundreds of injections and placed hundreds of IVs. There's no reason you can't be a nurse because you don't like needles.

  • 0

    What kind of school did you attend? Community college or a for-profit nursing program? It sounds like you may have attended a for-profit program that lets almost all the students pass each semester so that they can continue to collect your money. Then, they set a high final passing requirement (like the HESI), which keeps their NCLEX pass rates higher. Failing the exit HESI and the NCLEX-PN twice suggests that you either have difficulty answering NCLEX-style questions, or you lack understanding of the content. Which do you think is the problem? I would recommend you take an NCLEX review course to refresh yourself on the content and practice as many NCLEX-style questions as you can. The quickest way to get your RN would be to obtain your LPN license and then enroll in an LPN-to-RN bridge. Returning to another nursing program is also an option, though I highly suggest you choose an accredited program.

  • 1
    tacmed123 likes this.

    I agree wholeheartedly with both posters. You stated you're in your second year of what is likely a 4 year program. This is the time where you learn the basics of assessment, pathophysiology, critical thinking, and basic interventions. The advanced skills and knowledge required for ED/Trauma nursing will come later.

  • 2
    Sour Lemon and Sylvajms like this.

    This will depend on your school. My advice would be to take some prerequisite classes and do very well. Nursing programs are very competitive. Have you identified the reasons why you were not successful in high school and taken steps to correct that?

  • 2
    jjimbop and conjer like this.

    Live your life. Nursing school is school. Do what you need to do, and dedicate the time to need to be successful. But nursing school is not so difficult that you need to have no social life. People have babies raise families while in medical school, residencies and fellowships, or other strenuous programs or time consuming jobs. You can go on dates in nursing school.

  • 7

    Actually, I’m going to disagree with everyone on this thread. I DO think you should discuss this with your nursing faculty advisor- not because of this patient or his care- but because there’s a nursing instructor out there teaching students dangerous procedural techniques. If her instruction regarding indwelling catheter placement goes against best practice, what other incorrect information could she be spreading? This incident should be reported to the nursing school administration/faculty out of concern for the quality of clinical education and safety of other patients that these students might care for.

  • 0

    I’ve worked in a few facilities where the policy was to sign the MAR immediately prior to administering the medication. So the real answer is that you follow whatever the policy is where you work.

  • 1
    brownbook likes this.

    I suppose the other concern is that if you have a severe extravasation in the AC, you've compromised all IV sites distal to that AC. If a hand vein extravasates, you can still use veins above that site.

    Absolutely, frequent site assessments and brisk blood return are a must.

  • 0

    Your agency isn’t able to tell you? Or just call the hospital and ask.

  • 0

    Only the California BON can accurately answer this question. However, since you are foreign-educated and already received a degree and a license, I expect it may not be as big of an issue than if a California-educated student were applying for licensure for the first time.