Example of Nursing School Notes? Pls help!

swirlything · Jun 18, 2009

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.

scrublifenurse10, LPN · Jun 18, 2009

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!!!

Cilantrophobe · Jun 18, 2009

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.

fiveofpeep · Jun 18, 2009

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

obicurn · Jun 18, 2009

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

hdl >60 optimum

ldl

triglycerides

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

usually caused by atherosclerotic disease.

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

q

r

s

t

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

obicurn · Jun 18, 2009

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

XYcsccSN · Jun 19, 2009

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.

smartin13 · Jun 19, 2009

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

Cdnurstudent · Jun 25, 2009

Thank you so much for your responses guys! All your tips and examples were so helpful! I really appreciate your help!! :tku:

shann106 · Jun 26, 2009

For notes, I usually make an outline from the chapter concepts.

For studying a very good site is study stack. You can go on that site and search the nursing notes that others have put up and look at them.

Here is one that I made first semester (click on 'show all' at the top)

http://www.studystack.com/studytable-224033

You can even make your notes into hangman, crossword puzzles, tables(my favorite) or print them onto either note cards, paper, etc

shann106 · Jun 26, 2009

Indymom4 your notes are great!