First semester cost for those other future students that are wondering what the cost is.... it's about $1500.
They require you to buy a bag with several kits you'll need for nursing. Its about $128.
Also, this is the same as other schools I've visited, however, for those of you that are curious.... failing 2 classes will get you out of the program. Also, if you fail one class you have to skip the next semester and ONLY take that 1 class and PASS in order to continue the program.
On registration day, they open at 8am. People were waiting there since 7am in line to ensure they got the classes they wanted (sequence 1 or 2). Make sure you get there early. Some people actually were able to register online, and some were not. I've seen some inquiries about what sequence 1 and 2 are. They give the left side of the room in orientation with one color paper (sequence 1) and the other side with another color paper (sequence 2). The sequences are different teachers and different times. Sequence 1 you get Thursday off (for now) and Sequence 2 I wasn't able to see. Its so that you have some choices of teachers and some options with times but regardless of which one you choose the schedule never overlaps.
The cost of the books is about $250.
Take Micro Lab AND Psychology before the start of the program. They have a Baptist Scholarship that requires these classes.
https://baptisthealth.net/en/nursing/documents/scholars-application-packet.pdf
I made the mistake of not taking the classes since I didn't know about this program. Don't make the same mistake.
When you graduate, if you pass NCLEX within 6 months MDC (for now) will reimburse you $200! That's awesome encouragement
Oh! And try to keep your books because before you graduate (make sure to apply for graduation before your last semester starts or you won't be able to graduate regardless of passing your classes) you are required to take the HESI. It's basically confirming that you learned something before they release you. You need to pass it to graduate. If you give up your book you can't review
Also, starting Jan 2018 they will be breaking ground at the parking across the street to build a large parking garage for us! YEY! The bad this is that we don't know when it will be finished. I've decided to take the Metro Rail instead. There are three exits. Santa Clara you need to walk like 2 blocks. The Civic Center you'll need to walk through Jackson Memorial Hospital. CULMER exit is the way to go. Apparently, MDC has a trolley that takes you to MDC !!! The monthly student pass that is available at the bookstore is about $60. Parking if you will be parking at the station near your house is about $12.
They use pink scantrons. Sold at the bookstore for about $1.50 for. Make sure NOT to write your name on all of them. The professors asked that we not write our names on them.
Get your I.D at the medical campus. They give you a bonus thick hard plastic name tag that other campuses do not give. I learned this the hard way . But if you are a prior student, but your cover for about $2 at the bookstore. It's worth getting. It's very durable.
You don't need white shoes for school. Just use regular sneakers. You need white shoes for CLINICALS! You can wear a sweater in class but not in CLINICALS so use one of those Under Armor (white plain) shirts under your white clinical shirt.
Don't wait for the Fundamentals professor or any professor for that matter, to email you the syllabus until 2-3 days prior to the first day of school. Remember, they are on vacation too and everyone deserves a break! For Fundamentals, read chapters 1-7. For Pharmacology the syllabus said to read the first 3 chapters.
Don't forget to show a paid receipt of your schedule to get your Parking Decal. Take your ID and car registration too! Also, if you are on a payment plan, they will make you log in to your phone and show that you have a HOLD on your account for pmt Nelnet plan in order to get your tag.
Uniforms at Blue Angels are affordable. I bought mine at the bookstore, however, because the ones at Blue Angels (across from MDC) had a different shade of green on their bottoms than their top. I wasn't too fond of the look but it appears that there were quite a few students that purchased their uniforms there since you see them walking the halls with mismatched scrubs
I hope this helps everyone that is nervous and searching for answers. I wanted to pass the information along Good Luck everyone.
Found this on Allnurses for EXIT HESI. Mr. Dickson posted it and its pretty good info so I decided to repost:
Hgb
Hct
RBCs
WBCs
Platelets
PT (Coumadin/Warfarin)
APTT (Heparin)
BUN 10-20
Creatinine 0.5-1.2
Glucose 70-110
Cholesterol
Bilirubin Newborn 1-12
Phenylalanine Newborn
Na+ 136-145
K+ 3.5-5
Ca++ 9-10.5
Mg+ 1.5-2.5
Cl- 96-106
Phos 3-4.5
Albumin 3.5-5
Spec Gravity 1.005-1.030
Glycosylated Hemoglobin (Hgb A1c): 4-6% ideal,
Dilantin TR = 10-20
Lithium TR = 0.5-1.5
Digoxin ... Digiband
Coumadin ... Vitamin K (Keep PT and INR @ 1-1.5 X normal)
Benzodiazapines ... Flumzaemil (Tomazicon)
Magnesium Sulfate ... Calcium Gluconate?
Heparin ... Protamine Sulfate (Keep APTT and PTT @ 1.5-2.5 X normal)
Tylenol ... Mucomist (17 doses + loading dose)
Opiates (narcotic analgesics, heroin, morphine) ... Narcan (Naloxone)
Cholinergic Meds (Myesthenic Bradycardia) ... Atropine
Methotrexate ... Leucovorin
RN Only
No infection patients with immunosuppressed patients
Weird Miscellaneous Stuff
Rifampin (for TB) ... Rust/orange/red urine and body fluids
Pyridium (for bladder infection) ... Orange/red/pink urine
Glasgow Coma Scale ...
Diabetic Coma vs. Insulin Shock ... Give glucose first - If no help, give insulin
Fruity Breath = Diabetic Ketoacidosis
Skin Tastes Salty = Cystic Fibrosis
Lipitor (statins) in PMs only - No grapefruit juice
Stroke ... Tongue points toward side of lesion (paralysis), Uvula deviates away from the side of lesion (paralysis)
Hold Digoxin if HR
Stay in bed for 3 hours after first ACE Inhibitor dose
Avoid Grapefruit juice with Ca++ Channel Blockers
Anthrax = Multi-vector biohazard
Pulmonary air embolism prevention = Trendelenburg (HOB down) + on left side (to trap air in right side of heart)
Head Trauma and Seizures ... Maintain airway = primary concern
Peptic Ulcers ... Feed a Duodenal Ulcer (pain relieved by food) ... Starve a gastric ulcer
Acute Pancreatitis ... Fetal position, Bluish discoloration of flanks (Turner's Sign), Bluish discoloration of pericumbelical region (Cullen's Sign), Board like abdomen with guarding ... Self digestion of pancreas by trypsin.
Hold tube feeding if residual > 100mL
In case of Fire ... RACE and PASS
Check Restraints every 30 minutes ... 2 fingers room underneath
Gullain-Barre Syndrome ... Weakness progresses from legs upward - Resp arrest
Trough draw = ~30 min before scheduled administration ... Peak Draw = 30-60 min after drug administration.
Most suicides occur after beginning of improvement with increase in energy levels
MAOIs ... Hypertensive Crisis with Tyramine foods
* Nardil, Marplan, Parnate
* Need 2 wk gap from SSRIs and TCAs to admin MAOIs
Lithium Therapeutic Range = 0.5-1.5
Phenothiazines (typical antipsychotics) - EPS, Photosensitivity
Atypical Antipsychotics - work on positive and negative symptoms, less EPS
Benzos (Ativan, Lorazepam, etc) good for Alcohol withdrawal and Status Epilepticus
Antabuse for Alcohol deterrence - Makes you sick with OH intake
Alcohol Withdrawal = Delerium Tremens - Tachycardia, tachypnea, anxiety, nausea, shakes, hallucinations, paranoia ... (DTs start 12-36 hrs after last drink)
Opiate (Heroin, Morphine, etc.) Withdrawal = Watery eyes, runny nose, dilated pupils, NVD, cramps
Stimulants Withdrawal = Depression, fatigue, anxiety, disturbed sleep
Hypoventilation = Acidosis (too much CO2)
Hyperventilation = Alkalosis (low CO2)
No BP or IV on side of Mastectomy
Opiate OD = Pinpoint Pupils
Lesions of Midbrain = Decerebrate Posturing (Extended elbows, head arched back)
Lesions of Cortex = Decorticate Posturing (Flexion of elbows, wrists, fingers, straight legs, mummy position)
Urine Output of 30 mL/hr = minimal competency of heart and kidney function
Addison's' Crisis = medical emergency (vascular collapse, hypoglycemia, tachycardia ... Admin IV glucose + corticosteroids) ... No PO corticosteroids on empty stomach
Potassium sparing diuretic = Aldactone (Spironolactone) ... Watch for hyperK+ with this and ACE Inhibitors.
Cardiac Enzymes ... Troponin (1 hr), CKMB (2-4 hr), Myoglobin (1-4 hr), LDH1 (12-24 hr)
MI Tx ... Nitro - Yes ... NO Digoxin, Betablockers, Atropine
Fibrinolytics = Streptokinase, Tenecteplase (TNKase)
CABG = Coronary Artery Bypass Graft
PTCA = Percutaneous Transluminal Coronary Angioplasty
Sex after MI okay when able to climb 2 slights of stairs without exertion (Take nitro prophylactically before sex)
BPH Tx = TURP (Transurethral Resection of Prostate) ... some blood for 4 days, and burning for 7 days post-TURP.
Only isotonic sterile saline for Bladder Irrigation
Post Thyroidectomy - Keep tracheostomy set by the bed with O2, suction and Calcium gluconate
Pericarditis ... Pericardial Friction Rub, Pain relieved by leaning forward
If a chest-tube becomes disconnected, do not clamp ... Put end in sterile water
Chest Tube drainage system should show bubbling and water level fluctuations (tidaling with breathing)
TB ... Treatment with multidrug regimen for 9 months ... Rifampin reduces effectiveness of OCs and turns pee orange ... Isoniazide (INH) increases Dilantin blood levels
Use bronchodilators before steroids for asthma ... Exhale completely, Inhale deeply, Hold breath for 10 seconds
Ventilators ... Make sure alarms are on ... Check every 4 hours minimum
Suctioning ... Pre and Post oxygenate with 100% O2 ... No more than 3 passes ... No longer than 15 seconds ... Suction on withdrawal with rotation
18-19 gauge needle for blood with filter in tubing
Run blood with NS only and within 30 minutes of hanging
Vitals and Breath Sounds ... before, during and after infusion (15 min after start, then 30 min later, then hourly up to 1 hr after)
Check Blood: Exp Date, clots, color, air bubbles, leaks
2 RNs must check order, pt, blood product ... Ask Pt about previous transfusion Hx
Stay with Pt for first 15 minutes ... If transfusion rxn ... Stop and KVO with NS
Pre-medicate with Benadryl prn for previous urticaria rxns
Isotonic Solutions
When in doubt - Treat for Hypoglycemia first
First IV for DKA = NS, then infuse regular insulin IV as Rx'd
Hypoglycemia ... confusion, HA, irritable, nausea, sweating, tremors, hunger, slurring
Hyperglycemia ... weakness, syncope, polydipsia, polyuria, blurred vision, fruity breath
Insulin may be kept at room T for 28 days
Draw Regular (Clear) insulin into syringe first when mixing insulins
Rotate Injection Sites (Rotate in 1 region, then move to new region)
Rapid Acting Insulins ... Lispro (Humalog) and Aspart (Novolog) ... O: 5-15 min, P: .75-1.5 hrs
Short Acting Insulin ... Regular (human) ... O: 30-60 min, P: 2-3 hrs (IV Okay)
Intermediate Acting Insulin ... Isophane Insulin (NPH) ... O: 1-2 hrs, P: 6-12 hrs
Long Acting Insulin ... Insulin Glargine (Lantus) ... O: 1.1 hr, P: 14-20 hrs (Don't Mix)
Oral Hypoglycemics decrease glucose levels by stimulating insulin production by beta cells of pancreas, increasing insulin sensitivity and decreasing hepatic glucose production
Leukemia ... Anemia (reduced RBC production), Immunosuppression (neutropenia and immature WBCs), Hemorrhage and bleeding tendencies (thrombocytopenia)
Testicular Cancer ... Painless lump or swelling testicle ... STE in shower > 14 yrs ... 15-35 = Age
Prostate Cancer ... > 40 = Age
Cervical and Uterine Cancer
Ovarian Cancer = leading cause of death from gynecological cancer
Syphilis (Treponema pallidum) ... Chancre + red painless lesion (Primary Stage, 90 days) ... Secondary Stage (up to 6 mo) = Rash on palms and soles + Flu-like symptoms ... Tertiary Stage = Neurologic and Cardiac destruction (10-30 yrs) ... Treated with Penicillin G I'm.
Gonorrhea (Neisseria Gonorrhea) ... Yellow green urethral discharge (The Clap)
Chlamydia (Chlamydia Trachomatis) ... Mild lady partsl discharge or urethritis ... Doxycyclin, Tetracycline
Trichomoniasis (Trichomonas lady partslis) ... Frothy foul-smelling lady partsl discharge ... Flagyl
Candidiasis (Candida Albicans) ... Yellow, cheesy discharge with itching ... Miconazole, Nystatin, Clomitrazole (Gyne-Lotrimin)
Herpes Simplex 2 ... Acyclovir
HPV (Human Pappilovirus) ... Acid, Laser, Cryotherapy
HIV ... Cocktails
Breathing Es taught in advance (before or early in pre-op)
Remove nail polish (need to see cap refill)
Pre Op ... Meds as ordered, NPO X 8 hrs, Incentive Spirometry & Breathing Es taught in advance, Void, No NSAIDS X 48 hrs
Increased corticosteroids for surgery (stress) ... May need to increase insulin too
Post Op restlessness may = hemorrhage, hypoxia
Wound dehiscence or extravisation ... Wet sterile NS dressing + Call Dr.
Call Dr. post op if ... 100 or
Post Op Monitoring VS and BS ... Every 15 minutes the first hour, Every 30 min next 2 hours, Every hour the next 4 hours, then Every 4 hours prn
1-4 hrs Post Op = Immediate Stage ... 2-24 hrs Post Op = Intermediate Stage ... 1-4 days Post Op = Extended Stage
Incentive Spirometry ... Inhale slowly and completely to keep flow at 600-900, Hold breath 5 seconds, 10 times per hr
Post Op Breathing Exercises ... Every 2 hours
Watch for Stridor after any neck/throat Sx ... Keep Trach kit at bed side
Staples and sutures removed in 7-14 days - Keep dry until then
No lifting over 10 lbs for 6 weeks (in general)
If chest tube comes disconnected, put free end in container of sterile water
Removing Chest Tube ... Valsalvas, or Deep breath and hold
If chest tube drain stops fluctuating, the lung has re-inflated (or there is a problem)
Keep scissors by bed if pt has S. Blakemore Tube (for esoph varices)... Sudden respiratory distress - Cut inflation tubes and remove
Tracheostomy patients ... Keep Kelly clamp and Obturator (used to insert into trachea then removed leaving cannula) at bed side
Turn off NG suction for 30 min after PO meds
NG Tube Removal ... Take a deep breath and hold it
Stomach contents pH =
NG Tube Insertion ... If cough and gag, back off a little, let calm, advance again with pt sipping water from straw
NG Tube Length ... End of nose, to era lobe, to xyphoid (~22-26 inches)
Tensilon Test ... Myesthenia Gravis (+ in Myesthenic crisis, - in Cholinergic crisis)
ELISA and Western Blot ... HIV
Sweat Test ... Cystic Fibrosis
Cheilosis = Sores on sides of mouth ... Riboflavin deficiency (B2)
Trousseau's Sign (Carpal spasm induced by BP cuff) ... Hypocalcemia (hypoparathyroidism)
Chvostek's Sign (Facial spasm after facial nerve tap) ... Hypocalcemia (hypoparathyroidism)
Bloody Diarrhea = Ulcerative Colitis
Olive-Shaped Mass (epigastric) and Projectile Vomiting = Pyloric Stenosis
Current Jelly Stool (blood and mucus) and Sausage-Shaped Mass in RUQ = Intussiception
Mantoux Test for TB is + if 10 mm induration 48 hrs post admin (previous BCG vaccine recipients will test +)
Butterfly Rash = SLE ... Avoid direct sunlight
5 Ps of NV functioning ... Pain, paresthesia, pulse, pallor, paralysis
Cullen's Sign (periumbelical discoloration) and Turner's Sign (blue flank) = Acute Pancreatitis
Murphy's Sign (Rt. costal margin pain on palp with inspiration) = GB or Liver disease
HA more severe on wakening = Brain Tumor (remove benign and malignant)
Vomiting not associated with nausea = Brain Tumor
Elevated ICP = Increased BP, widened pulse pressure, increased Temp
Pill-Rolling Tremor = Parkinson's (Tx with Levodopa, Cardidopa) - Fall precautions, rigid, stooped, shuffling
IG Bands on Electrophoresis = MS ... Weakness starts in upper extremities - bowel/bladder affected in 90% ... Demyelination - Tx with ACTH, corticosteroids, Cytoxan and other immunosuppressants
Reed-Sternberg Cells = Hodgkin's
Koplik Spots = Rubeola (Measles)
Erythema Marginatum = Rash of Rheumatic Fever
Gower's Sign = Muscular Dystrophy ... Like Minor's sign (walks up legs with hands)
Bench Marks
Autosomal Recessive Diseases
Autosomal Dominant Diseases
X-Linked Recessive Diseases
Scoliosis ... Milwaukee Brace - 23 hrs/day, Log rolling after Sx
Down Syndrome = Trisomy 21 ... Simian creases on palms, hypotonia, protruding tongue, upward outward slant of eyes
Cerebral Palsy ... Scissoring = legs extended, crossed, feet plantar-flexed
PKU ... leads to MR ... Guthrie Test ...Aspartame (NutraSweet) has phenylalanine in it and should not be given to PKU patient
Hypothyroidism ... Leads to MR
Prevent Neural tube disorders with Folic Acid during PG
Myelomeningocele ... Cover with moist sterile water dressing and keep pressure off
Hydrocephalus ... Signs of increased ICP are opposite of shock ...
Muscular Dystrophy ... X-linked Recessive, waddling gait, hyper lordosis, Gower's Sign = difficulty rising walks up legs (like Minor's sign), fat pseudohypertrophy of calves.
Seizures ... Nothing in mouth, turn hd to side, maintain airway, don't restrain, keep safe ... Treat with Phenobarbitol (Luminol), Phenytoin (Dilantin: TR = 10-20 ... Gingival Hyperplasia), Fosphenytoin (Cerebyx), Valproic Acid (Depakene), Carbamazepine (Tegritol)
o Meningitis (Bacterial) ... Lumbar puncture shows Increased WBC, protein, IICP and decreased glucose
CF Kids taste salty and need enzymes sprinkled on their food
Children with Rubella = threat to unborn siblings (may require temporary isolation from Mom during PG)
Pain in young children measured with Faces pain scale
No MMR Immunization for kids with Hx of allergic rxn to eggs or neomycin
Immunization Side Effects ... T
Call Physician if seizures, high fever, or high-pitched cry after immunization
All cases of poisoning ... Call Poison Control Center ... No Ipecac!
Epiglottitis = H. influenza B ... Child sits upright with chin out and tongue protruding (maybe Tripod position) ... Prepare for intubation or trach ... DO NOT put anything into kid's mouth
Isolate RSV patient with Contact Precautions ... Private room is best ... Use Mist Tent to provide O2 and Ribavirin - Flood tent with O2 first and wipe down inside of tent periodically so you can see patient
Acute Glomerulonephritis ... After B strep - Antigen-Antibody complexes clog up glomeruli and reduce GFR = Dark urine, proteinuria
Wilm's Tumor = Large kidney tumor ... Don't palpate
TEF = Tracheoesophageal Atresia ... 3 C's of TEF = Coughing, Choking, Cyanosis
Cleft Lip and Palate ... Post-Op - Place on side, maintain Logan Bow, elbow restraints
Congenital Megacolon = Hirschsprung's Disease ... Lack of peristalsis due to absence of ganglionic cells in colon ... Suspect if no meconium w/in 24 hrs or ribbon-like foul smelling stools
Iron Deficiency Anemia ... Give Iron on empty stomach with citrus juice (vitamin C enhances absorption), Use straw or dropper to avoid staining teeth, Tarry stools, limit milk intake
Sickle Cell Disease ...Hydration most important ...SC Crisis = fever, abd pain, painful edematous hands and feet (hand-foot syndrome), arthralgia ...Tx + rest, hydration ... Avoid high altitude and strenuous activities
Tonsillitis ... usually Strep ... Get PT and PTT Pre-Op (ask about Hx of bleeding) ... Suspect Bleeding Post-Op if frequent swallowing, vomiting blood, or clearing throat ... No red liquids, no straws, ice collar, soft foods ... Highest risk of hemorrhage = first 24 hrs and 5-10 days post-op (with sloughing of scabs)
Primary meds for ER for respiratory distress = Sus-phrine (Epinephrine HCl) and Theophylline (Theo-dur) ... Bronchodilators
Must know normal respiratory rates for kids ... Respiratory disorders = Primary reason for most medical/ER visits for kids ...
Acyanotic = VSD, ASD, PDA, Coarc of Aorta, Aortic Stenosis
Cyanotic = Tetralogy of Fallot, Truncus Arteriosis (one main vessel gets mixed blood), TVG (Transposition of Great Vessels) ... Polycythemia common in Cyanotic disorders
Tetralogy of Fallot ... Unoxygenated blood pumped into aorta
CHF can result ... Use Digoxin ... TR = 0.8-2.0 for kids
Ductus Venosus = Umbelical Vein to Inferior Vena Cava
Ductus Arteriosus = Aorta to Pulmonary Artery
Rheumatic Fever ... Acquired Heart Disease ... Affects aortic and mitral valves
Day 1 of cycle = First day of menses (bleeding) ... Ovulation on Day 14 ... 28 days total ... Sperm 3-5 days, Eggs 24 hrs ... Fertilization in Fallopian Tube
Chadwick's Sign = Bluing of lady parts (early as 4 weeks)
Hegar's Sign = Softening of isthmus of cervix (8 weeks)
Goodell's Sign = Softening of Cervix (8 weeks)
Pregnancy Total wt gain = 25-30 lbs (11-14 kg)
Increase calorie intake by 300 calories/day during PG ... Increase protein 30 g/day ... Increase iron, Ca++, Folic Acid, A & C
Dangerous Infections with PG ... TORCH = Toxoplasmosis, other, Rubella, Cytomegalovirus, HPV
Braxton Hicks common throughout PG
Amniotic fluid = 800-1200 mL
Polyhydramnios and Macrosomia (large fetus) with Diabetes
Umbelical cord: 2 arteries, 1 vein ... Vein carries oxygenated blood to fetus (opposite of normal)
FHR = 120-160
Folic Acid Deficiency = Neural tube defects
Pre-term = 20-37 weeks
Term = 38-42 weeks
Post-term = 42 weeks+
TPAL = Term births, Pre-term births, Abortions, Living children
Gravida = # of Pregnancies regardless of outcome
Para = # of Deliveries (not kids) after 20 wks gestation
Nagale's Rule ... Add 7 days to first day of last period, subtract 3 months, add 12 months = EDC
gb and Hct a bit lower during PG due to hyperhydration
Side-lying is best position for uteroplacental perfusion (either side tho left is traditional )
2:1 Lecithin:Sphingomyelin Ratio = Fetal lungs mature
AFP in amniotic fluid = possible neural tube defect
Need a full bladder for Amniocentesis early in PG (but not in later PG)
ightening = Fetus drops into true pelvis
Nesting Instinct = Burst of Energy just before labor
True Labor = Regular contractions that intensify with ambulation, LBP that radiates to abdomen, progressive dilation and effacement
Station = Negative above ischial spines, Positive below
Leopold Maneuver tries to reposition fetus for delivery
Laboring Maternal Vitals ... Pulse
NON-Stress Test ... Reactive = Healthy (FHR goes up with movements)
Contraction Stress Test (Ocytocin Challenge Test)... Unhealthy = Late decels noted (positive result) indicative of UPI ... "Negative" result = No late decels noted (good result)
Watch for hyporeflexia with Mag Sulfate admin . . . Diaphragmatic Inhibition
Early Decels = Head compression = OK
Variable Decels = Cord compression = Not Good
Late Decels = Utero-placental insufficiency = BAD!
If Variable or Late Decels ... Change maternal position, Stop Pitocin, Administer O2, Notify Physician
DIC ... Tx is with Heparin (safe in PG) ... Fetal Demise, Abruptio Placenta, Infection
Placenta Separation ... Lengthening of cord outside lady parts, gush of blood, full feeling in lady parts ... Give oxytocin after placenta is out - Not before.
Schultz Presentation = Shiny side out (fetal side of placenta)
Postpartum VS Schedule
Normal BM for mom within 3 days = Normal
Lochia ... no more than 4-8 pads/day and no clots > 1 cm ... Fleshy smell is normal, Foul smell = infection
Massage boggy uterus to encourage involution ... empty bladder ASAP - may need to catheterize ... Full bladder can lead to uterine atony and hemorrhage
Tears ...1st Degree = Dermis, 2nd Degree = mm/fascia, 3rd Degree = anal sphincter, 4th Degree = rectum
APGAR = HR, R, mm tone, Reflex irritability, Color ... 1 and 5 minutes ...7-10 = Good, 4-6 = moderate resuscitative efforts, 1-3 = mostly dead
Eye care = E-mycin + Silver Nitrate ... for gonorrhea
Pudendal Block = decreases pain in perineum and lady parts - No help with contraction pain
Epidural Block = T10-S5 ... Blocks all pain ... First sign = warmth or tingling in ball of foot or big toe
Regional Blocks often result in forceps or vacuum assisted births because they affect the mother's ability to push effectively
WBC counts are elevated up to 25,000 for ~10 days post partum
Rho(D) immune globulin (RhoGAM) is given to Rh- mothers who deliver Rh+ kids... Not given if mom has a +Coombs Test ... She already has developed antibodies (too late)
Caput Succedaneum = edema under scalp, crosses suture lines
Cephalhematoma = blood under periosteum, does not cross suture lines
Suction Mouth first - then nostrils
Moro Reflex = Startle reflex (abduction of all extremities) - up to 4 months
Rooting Reflex ... up to 4 months
Babinski Reflex ... up to18 months
Palmar Grasp Reflex ...Lessens by 4 months
Ballard Scale used to estimate gestational age
Heel Stick = lateral surface of heel
Physiologic Jaundice is normal at 2-3 days ... Abnormal if before 24 hours or lasting longer than 7 days ... Unconjugated bilirubin is the culprit.
Vitamin K given to help with formation of clotting factors due to fact that the newborn gut lacks the bacteria necessary for vitamin K synthesis initially ... Vastus lateralis mm I'm
Abrutio Placenta = Dark red bleeding with rigid board like abdomen
Placenta Previa = Painless bright red bleeding
DIC = Disseminated Intravascular Coagulation ... clotting factors used up by intravascular clotting - Hemorrhage and increased bleeding times result ... Associated with fetal demise, infection and abruptio placenta.
Magnesium Sulfate used to reduce preterm labor contractions and prevent seizures in Pre-Eclampsia ... Mg replaces Ca++ in the smooth mm cells resulting relaxation ... Can lead to hyporeflexia and respiratory depression - Must keep Calcium Gluconate by bed when administering during labor = Antidote ... Monitor for:
Pitocin (Oxytocin) use for Dystocia... If uterine tetany develops, turn off Pitocin, admin O2 by face mask, turn pt on side. Pitocin can cause water intoxication owing to ADH effects.
Suspect uterine rupture if woman complains of a sharp pain followed by cessation of contractions
Pre-Eclampsia = Htn + Edema + Proteinuria
Eclampsia = Htn + Edema + Proteinuria + Seizures and Coma ... Suspect if Severe HA + visual disturbances
No Coumadin during PG (Heparin is OK)
Hyperemesis Gravidarum = uncontrollable nausea and vomiting ... May be related to H. pyolori ... Reglan (metaclopromide)
Insulin demands drop precipitously after delivery
No oral hypoglycemics during PG - Teratogenic ... Insulin only for control of DM
Babies born without lady partsl squeeze more likely to have respiratory difficulty initially
C-Section can lead to Paralytic Ileus ... Early ambulation helps
Postpartum Infection common in problem pregnancies (anemia, diabetes, traumatic birth)
Postpartum Hemorrhage = Leading cause of maternal death ... Risk factors include:
Tx includes ... Fundal massage, count pads, VS, IV fluids, Oxytocin, notify physician
Jitteriness is a symptom of hypoglycemia and hypocalcemia in the newborn
Hypoglycemia ... tremors, high pitched cry, seizures
High pitched cry + bulging fontanels = IICP
Hypothermia can lead to Hypoxia and acidoisis ... Keep warm and use bicarbonate prn to treat acidosis in newborn.
Lay on right side after feeding ... Move stomach contents into small intestine
Jaundice and High bilirubin can cause encephalopathy ...
K+ ... Bananas, dried fruits, citrus, potatoes, legumes, tea, peanut butter
Vitamin C ... Citrus, potatoes, cantaloupe
Ca++ ... Milk, cheese, green leafy veggies, legumes
Na+ ... Salt, processed foods, seafood
Folic Acid ... Green leafy veggies, liver, citrus
Fe++ ... Green leafy veggies, red meat, organ meat, eggs, whole wheat, carrots
Mg+ ... Whole grains, green leafy veggies, nuts
Thiamine (B1) ... Pork, beef, liver, whole grains
B12 ... Organ meats, green leafy veggies, yeast, milk, cheese, shellfish
Vitamin K ... Green leafy veggies, milk, meat, soy
Vitamin A ... Liver, orange and dark green fruits and veggies
Vitamin D ... Dairy, fish oil, sunlight
Vitamin E ... Veggie oils, avocados, nuts, seeds
BMI ... 18.5-24.9 = Normal (Higher = Obese)
Essentially everyone goes to Hell in a progressively degenerative hand-basket
Dementia = Irreversible (Alzheimer's) ... Depression, Sundowning, Loss of family recognition
Delerium = Secondary to another problem = Reversible (infections common cause)
Medication Alert! ... Due to decreased renal function, drugs metabolized by the kidneys may persist to toxic levels
When in doubt on NCLEX ... Answer should contain something about exercise and nutrition.
0-1 yr (Newborn) ... Trust vs. Mistrust
1-3 yrs (Toddler)... Autonomy vs. Doubt and Shame ... Fear intrusive procedures -
3-6 yrs (Pre-school) ... Initiative vs. Guilt ... Fear mutilation - Band-Aids good
6-12 yrs (School Age) ... Industry vs. Inferiority... Games good, Peers important ... Fear loss of control of their bodies
12-19 yrs (Adolescent) ... Identity vs. Role Confusion ... Fear Body Image Distortion
20-35 yrs (Early Adulthood) ... Intimacy vs. Isolation
35-65 yrs (Middle Adulthood) ... Generativity vs. Stagnation
Over 65 (Older Adulthood) ... Integrity vs. Despair
Sensorimotor Stage (0-2) ... Learns about reality and object permanence
Preoperational Stage (2-7) ... Concrete thinking
Concrete Operational Stage (7-11) ... Abstract thinking
Formal Operational Stage (11-adult) ... Abstract and logical thinking
Oral Stage (Birth -1 year) ... Self gratification, Id is in control and running wild
Anal Stage (1-3) ... Control and pleasure wrt retention and pooping - Toilet training in this stage
Phallic Stage (3-6) ... Pleasure with genitals, Oedipus complex, SuperEgo develops
Latency Stage (6-12) ... Sex urges channeled to culturally acceptable level, Growth of Ego
Genital Stage (12 up) ... Gratification and satisfying sexual relations, Ego rules
Moral development is sequential but people do not aromatically go from one stage to the next as they mature
Level 1 = Pre-conventional ... Reward vs. Punishment Orientation
Level 2 = Conventional Morality ... Conforms to rules to please others
Level 3 = Post- Conventional ... Rights, Principles and Conscience (Best for All is a concern)
Round final answer to tenths place
Round drops to nearest drop
When calculating mL/hr, round to nearest full mL
Must include 0 in front of values
Pediatric doses rounded to nearest 100th. Round down for peds
1 t = 5mL
1 T = 3 t = 15 mL
1 oz = 30 cc = 30 mL = 2 T
1 gr = 60 mg
1 mg = 1000 ug (or mcg)
1 kg = 2.2 lbs
1 cup = 8 oz = 240 mL
1 pint = 16 oz
1 quart = 32 oz
Degrees F = (1.8 X C) + 32
Degrees C = (F - 32) / 1.8
Fall Precautions
Room close to nurses station
Assessment and orientation to room
Get help to stand (dangle feet if light headed)
Bed low with side rails up
Good lighting and reduce clutter in room
Keep consistent toileting schedule
Wear proper non-slip footwear
At home ...
Neutropenic (Immunosuppressed) Precautions
No plants or flowers in room
No fresh veggies ... Cooked foods only
Avoid crowds and infectious persons
Meticulous hand washing and hygiene to prevent infection
Report fever > 100.5 (immunosuppressed pts may not manifest fever with infection)
Bleeding Precautions (Anticoagulants, etc.)
Soft bristled tooth brush
Electric razor only (no safety razors)
Handle gently, Limit contact sports
Rotate injection sites with small bore needles for blood thinners
Limit needle sticks, Use small bore needles, Maintain pressure for 5 minutes on venipuncture sites
No straining at stool - Check stools for occult blood (Stool softeners prn)
No salicylates, NSAIDs, or suppositories
Avoid blowing or picking nose
Do not change Vitamin K intake if on Coumadin
Want to memorize Hct and Hgb and dont like my mnemonics??? LMAO! Someone just told me something that would have saved me a loooooot of trouble. If you want to get the hematocrit just multiply the Hgb by 3. So you only have to remember Hgb.
OR
If you find the Hct numbers easier, just divide by 3 to get the Hgb numbers ?
Great pointers MOONNightNURSE! I'll definitely keep this discussion in mind when it's time for that exam. Right now I'm still working on the HESI for this summer. Got any good tips for that? LOL I have the HESI Admission Assessment 4th Edition study guide. I have also heard from a few people that it's worth paying the $25 for the HESI phone app.
4 hours ago, Grisso said:Great pointers MOONNightNURSE! I'll definitely keep this discussion in mind when it's time for that exam. Right now I'm still working on the HESI for this summer. Got any good tips for that? LOL I have the HESI Admission Assessment 4th Edition study guide. I have also heard from a few people that it's worth paying the $25 for the HESI phone app.
Definitely get the App! It's $14.99 and so worth it.
Just took my HESI Exit today. Here are the stuff you'll need to know:
All the professors will tell you you cant bring bags, phones, notes, sweaters blah blah blah.
You can bring all those things. In fact, I would encourage you to. They will require you to store your notes in a bookbag OR in a locker (which they will provide- they hold your driver license until you submit it).
DON'T FORGET YOUR MDC ID. Some people forgot about it and they allowed a DL but don't forget it just in case rules change.
You can go to the bathroom. Someone will escort you. Only one person is allowed at a time so dont wait till the last minute.
They do not allow any phones on vibrate only OFF!!! If any phone vibrates or goes off during the test they will nullify your test.
If you bring a sweater you can't take it off so make sure you can handle the heat or the cold ?
You are not allowed to use your own pencil. You are not allowed to chew gum or suck on candy.
They will check your forearms and your glasses. You are not allowed any watches, bracelets, or necklaces. No drinks either. This is very different from the other HESI's youve taken. There is no leniency here guys so as soon as you walk in through the threshhold of the testing center with the computers you are NOT allowed to talk. The girl who spoke in our sequence said good luck to someone and they escorted her out of the testing center. FOLLOW DIRECTIONS!!!! NO JOKE!
ONE MORE THING!!! We don't get our grades immediately!! Which you can imagine how stressful this is already and then going home just not knowing is very traumatizing. They should really send out the results maybe 1 hr after but they make us wait. I took it this morning and I won't have the grades until Monday. Maybe tomorrow they will post it on evolve but nothing there now
Ladies and gentlemen....I have passed my HESI! I failed every HESI after every class BUT passed the HESI EXIT. Every HESI I received 750's to 850's and I was very nervous about this test. Your best grades helped a ton and so did the HESI class MDC provided. What was ridiculous was the way we found out our scores. After weeks of worrying about our scores and sacrificing many hours and days with our family we finally took our test. We didn't get our scores immediately. Instead, they were emailed to our instructors for clinicals who then would email us our scores. Some of us knew hours later, others that same evening, others are having to wait till Monday to find out their test scores. You can imagine how nervous and stressful that is for those that do not have their scores yet.
BTW!!!!! Those 2500 evolve questions they MAKE you do didn't help. Those that passed the HESI exit "Christmas tree'd" those questions. I did 2500 questions from YBG and books etc and listened to HURST and made them count. Those evolve questions they make you do in your leadership course is a complete waste of time. You'll see when you have to take them.
MOONNightNURSE
197 Posts
This is the website to make an appointment to obtain your Jackson ID:
https://www.myenrollmentschedule.com/idbadge
You’ll need your MDC ID, Drivers License and $10. The office is located ......if you till go to where all the restaurants are (like Panera) you’ll notice a long hallway between Panera and Apollo Tropical. Take the long hallway till the end until you are outside (no roof on top of you) then turn right and it’s the second door before the end to the right)