need help with med surg also care plans asap

begalli · Mar 10, 2005

Hi!

As soon as I read that you wanted some easy way to remember how blood travels through the heart, I thought of that St. Joseph's Aspirin commerical....

http://www.stjosephaspirin.com/

If you click on "See Our New 'Pump Your Blood Commericals'" and then click on verse 1, you can see this commercial.

I think this commercial is SO CUTE!!!

They left off the semilunar valves in this song. The pulmonary valve is between the right ventricle and pulmonary artery and after blood travels through the heart and lungs, the oxygenated blood is pumped out of the heart (left ventricle) through the aortic valve and into systemic circulation.

This is a fun song to memorize, I think!

webbiedebbie · Mar 10, 2005

Hi...I found a wonderful website for care plans. I don't remember the exact website address, but I am sure you would find it if you search EHS: Nursing Diagnosis Handbook. It gives a lot of information! You can click on the symptom and it will give you all of the diagnoses for that as well as interventions.

Also, there is a website (darn, can't remember the address either) that a fellow does for ER with excellent tutorials.

Good luck.

stidget99 · Mar 10, 2005

It's been too many years since I've been in school so I can't help you much w/ your school questions. However, one piece of advice I feel is appropriate is this....take time for yourself and your family. That's it.....plain and simple.

I was in school w/ two young daughters. Of course I set my goals to be on the dean's list...which I did the first semester. However, I got to thinking at what cost. The cost was being neglectful of my daughter's needs and my own personal needs. I ended up coming down w/ Grave's Disease (overactive thyroid). My doctor told me (and I have since confirmed it) that it can be caused by stress. I ended up dropping out of the program 3 times because of the Grave's. So spending all of that extra time studying and making school and being on the dean's list my #1 priority caused me to mess up in the long run.

Now I know that a lot of people who read this might disagree w/ me. That is their perrogative. This is just my opinion. Take time for your kids. They will be appreciative of it in the long run. (My kids still harbor resentment towards me for that terrible first semester and they are now 21 and 24). Also, it is very important to take time for yourself. Your brain will work better if you are not so stressed out. It is okay to graduate in the middle of your class or even lower. An 87 is not so bad. It could be better yes. However, it might be the best that you can do and still do right by yourself and your kids. And I think that no matter how hard you try, you are not going to be able to retain ALL of the information that is presented to you. Out in the real world, you will always have reference books and more experienced nurse to consult w/ available to you if you need them If you continue at the pace that you are...you are going to burn out and maybe never graduate from the program. So, weigh the pros and cons of everything. I am not saying that you should strive for a minimal passing grade but understand that getting an 87 or 85 or even an 80 is acceptable. I am not saying that you should spend all of your non-school time w/ your kids and out partying and totally blow off studying. But allow yourself some "you" time every week. Whether it's just an extra 30 mins in the bathtub or one nite out (couple of hours) every week or two. Also, don't deny yourself much needed sleep. Get to bed at a decent time. Your brain will be more permeable/receptive. You will be surprised how much more sense those lectures and books and note cards will be if your brain is fresh.

All of this is just my opinion. I am sure that others will respond to this thread. It's up to you to decide. I am just passing on to you what I had to learn the hard way. And, by the way...I have the dubious distinction of graduating at the very bottom of my class. Now granted, many didn't make it all, but still. I am proud of myself for getting thru. I want you to know that I passed my state boards on the first try and today I consider myself to be one helluva nurse! Good luck to you! I truly hope that all goes well for you.

ScarlettRN · Mar 10, 2005

Regarding care plans, the best way to think about the nursing diagnosis, and what follows is to look at the patient, considering their medical diagnosis, and think about what is going to challenge that patient during the course of his hospital stay.

For instance, if the patient is admitted with CHF, you know it is heart related, so your first nursing dx will be altered cardiac output. Now, what goes with that? Breathing usually accompanies CHF due to crackles in the bases of the lungs, so you know that Air Exchange will be an issue.

Your nursing dx is going to basically follow your head to toe assessment's findings. We as nurses are addressing the needs of the patient while in the hospital, so think about it in that way. It takes some practice, but if you can spend a bit extra time on the computer, you can create a template for a care plan, and save several versions of it, so that certain nursing dx will already be stored. Then all you have to do is cut and paste the plan, actions and outcomes. If this helps, I would be glad to be more specific on another post. Just let me know.

Susan

Cassinia · Mar 10, 2005

It's been many years since I was in school, but from the looks of your post, you are overly stressed and trying to make things a bit too hard. Take those breaks and breath. Sit there and study, and breath. Breathing increases the oxygenation to the brain. As a martial artist, I have learned the importance of breathing in many things. Okay, now on to a couple of your problems...

The care plans...I never had problems with this as I was a teacher first and they are a lot like teaching plans. Try a different angle, work backwards. You have the diagnosis, what is your goal? What steps do you need to take to get to the goal? What could be roadblocks to your goal? Sometimes going from the end to the beginning will give you a different perspective. It was how I did my lesson plans and how I did my care plans. Quick story...I floated to OB one day and had to work with one of my old clinical instructors; it had been about 10 years since I last saw her. There was two things she remember about me...first, I was hearing impaired, and, second, I did great care plans, which she made sure the other nurses were aware of.

As for memory techniques, create your own. Use what you know and what you are comfortable with instead of relying on someone else's methods. As for diagrams and such, I still find Gray's Anatomy to be the best resource for some things. You said you have small children, see if there's a way you can make a small game with them about memorizing the parts of the heart and the pathways...kind of like telephone with each one giving you a word starting with the same letter of the part you need to know, or associate the letter with somethings special about your children. Try to keep it personal.

Fast talking instructors? See if they will allow a small tape recorder in the lecture hall. Some of those small hand held ones are pretty inexpensive and well worth having.

As for studying, short sessions of 20 minutes, break, and then 20 minutes. Studies show the adult attention span is about that long. Your little ones too young to really understand bedtime stories but like to hear your voice? Read your assignment outloud to them; read it outloud to yourself if you're a multidisciplinary learner then you're getting visual and auditory learning. Read it onto tape and review it from the tape as well.

These are just a few ideas. But, remember, to take the time to breath.

grimmy, RN · Mar 10, 2005

i just graduated last june, so i hear your plight! care plans will become much easier over time...hard to believe, but true. save your care plans in word. later on, you can cut and paste certain scientific rationales so that you're not typing in citations over and over, and you will.

try not to look at the care plan books just yet. they will make more sense when you understand the reasons and techniques of writing a care plan. my all-time favorite book is "nursing diagnosis: application to clinical practice" by lynda juall carpenito.

you are looking for potential problems. so, for instance, you have patient a, who is a little old lady with pneumonia. i can think of 5 potential nursing diagnoses just off the top of my head. anyone, anyone, you will see in the hospital has the potential for disturbed sleep pattern. i set up my care plans in a table format, with two columns. the first column has the assessment points/contributing factors (i.e., pt a states: "sometimes i'm in pain, but i hate to bother you girls in the middle of the night") and the second column is the scientific rationale ("pain is one reason why patients have disturbed sleep patterns" vip nurse (2004) "med/surg nursing" p. 5004) come up with about 4 of these issues (could be a noisy roomate, anxiety, fear of the dark, etc.) and a scientific rationale for each one. go on to the planning: what will you, the student nurse do? make a bulleted list: "the student nurse will provide warm massage prior to bedtime each evening of hospitalization as needed." even though you won't be there every single night, write it as if you will be there...make sure you include what you will do, when you will do it, and the duration of order. then comes scientific rationale again ("warm massages have been shown to increase endorphins which promote restful sleep." supernurse (2003) "nursing techniques" p. 302) is this starting to make sense? usually you can come up with at least 2 diagnoses just by doing a careful assessment and listening to the patient, even those little things that don't seem terribly important at the time. if you continue to have problems, email me directly. i'll be more than happy to help. when i first had to do them, i was completely confused.