Kenneth Oja

Both are used to remove excess fluid from the blood, but they work in slightly different ways. 
Ultrafiltration only removes excess fluid from the blood – not waste products. The process involves the use of a pressure gradient across a semipermeable membrane to pull fluid from the blood.
With sequential ultrafiltration, excess fluid and salt are removed from the blood in two stages. In the first stage, a hypertonic solution in the dialysate pulls fluid out of the blood through a semipermeable membrane. Then, a normal dialysate solution is used to remove waste products. The two-stage process helps avoid pulling too much fluid too quickly and bottoming out the patient's pressure.

Smart move in doing a little research and learning the different methods in which you can write your end of shift note because it's going to vary by facility and type of unit / department.  
What's consistent across facilities is that a nursing end of shift note is a communication tool to update the oncoming nurse about the patient's status and any changes that occurred during your shift. They're important for continuity of care and making sure that everyone involved with the patient's care is aware of any relevant information.  
The ANA's Principles for Nursing Documentation is a good resource.
Other things to consider include: 
Be Concise: You don't need to include every detail of your shift. Stick to the important information that the oncoming nurse needs to know.  Use Clear and Objective Language: Avoid subjective language or making assumptions about the patient's condition. Stick to the facts and don't make judgments.  Include Vital Signs: Document any significant changes in the patient's vital signs, such as an increase in blood pressure or heart rate.  Document Medications: List any new medications that were started or discontinued during your shift.  Note any Assessments or Interventions: Document any assessments or interventions that you performed during your shift, such as wound care or patient education.  List Concerns: If you have any concerns about the patient's condition, document them in your note and notify the healthcare team.  Also, you're still learning and that's OK! It takes time and practice to find the right balance between including all relevant information, being concise, and following the guidelines for a specific facility or unit.  

I took AP I and II in two consecutive semesters and found II to be more difficult because of the endocrine system. I also had a heavier load the semester I took AP II along with other challenging courses (like Microbiology) and a clinical rotation.
Having lectures in person as opposed to online helped, but that's my own personal preference. I also did not work full-time, which is another factor to consider.
You did well with AP I and the two other classes, so I would recommend sticking to that for AP II! Especially since you also have the nursing entrance exam to consider.  

I don't see why not. We need to get out of the mindset that all new grads need to start in a specific setting or have a certain amount of experience in one area to practice in another. It also depends on your goals. Do you want to be an OR nurse?  
Most practice areas, including the OR, have an orientation process based on level of experience. This could range from new grad to 20 years of experience. When I started working in critical care, I went through an extensive orientation process even though I already had many years of experience as a nurse. So, I was oriented more as a "new grad" even though I was already an experienced nurse. 
When I worked as a hospital nurse educator, each of our service lines (med/surg, critical care, OR, etc.) had different pathways for orientation depending on experience and most of them, including the OR, had a pathway for new grads. Check with the hiring organization to see if new grads can apply for positions in the OR. Especially if this is where you want to work!  

There are multiple factors to consider here, and this is where nursing clinical judgement comes into play. Use your nursing knowledge and assessment to think beyond the written order and the task of giving or not giving the medication. 
What is the patient's blood pressure trend?  Are they showing any signs/symptoms of hypotension?  Is the blood pressure reading correct?  How long has the patient been getting furosemide?  What is the usual effect of furosemide on this patient's blood pressure?  Why does the patient have furosemide ordered?  What are the patient's current labs?  This list could go on, but my point is that there is so much more to consider beyond the actual number in this situation. Just make sure to keep the proper people informed of your decision and rationale, especially the ordering provider and your charge nurse.

Depends on the brand / manufacturer. PICC lines might have one, two, or three lumens. Typically, with a triple lumen PICC, the proximal port is white, medial is blue, and brown is distal.  
Although it may appear to be one line, since they are all enclosed in one sheath, each lumen (line) allows for separate infusions. So, no, medications going through different ports will not mix within the line. 
Each line also typically has a different exit port so not all infusions come out at the very tip of the PICC. This is to further reduce the risk of mixing.  
I would check the information from the manufacturer to confirm for the specific type of PICC you're using at your facility.

It's great that you want to get extra practice, but my first recommendation is to use the equipment provided by your school. See if your nursing school lab has open lab hours if you feel you are not getting enough practice during scheduled lab time. If you're unable to do this, or still feel you are not getting enough time for practice, start with the banana! Your classmates were right in suggesting this, as banana skin can do an impressive job of creating the feeling of IV insertion. Or, if it is within your budget, order an actual IV practice arm or pad.

The PACU, Post-Anesthesia Care Unit, is where patients go directly after surgery. They are closely monitored by the nurse as they wake up from anesthesia and are then transferred to another unit once they are stable. It's a specific type of unit specializing in promoting a smooth transition from anesthesia to full consciousness. PACU nurses typically monitor vital signs, manage pain, and assess surgical sites for one or two patients. 
Check with the recruiter about what they mean by postoperative care unit. It is most likely a medical/surgical type of unit where patients further recover from surgery AFTER they are transferred out of the PACU. So, they could be on the unit anywhere from a day or two to several weeks. Nurses on medical/surgical units typically provide ongoing postoperative care for a group of five or more patients to promote recovery, prevent complications, and plan for discharge from the hospital. 
You will probably need more specialized training and skills to work in the PACU such as ACLS and critical care experience. 

This is what I used to tell my students and it always seemed to help:
The "related to" is typically the pathophysiology of the medical diagnosis. So, for example, a patient with chronic kidney disease, the medical diagnosis, might have a nursing diagnosis of "Fluid Volume Overload." This is because they have a decreased glomerular filtration rate (among other things, but I'm keeping it simple for example). So, the statement would be "Fluid Volume Overload r/t decreased glomerular filtration rate."
Your "as evidenced by" would be the manifestations (or symptoms) of having a decreased glomerular filtration rate. For example, "2+ pitting edema in bilateral lower extremities."
So, putting it all together, your statement would be:
"Fluid Volume overload r/t decreased glomerular filtration rate AEB 2+ pitting edema in bilateral lower extremities."
Nursing diagnosis statements are a way to identify problems and intervene within the nursing scope of practice without making a medical diagnosis. Nurses understand the pathophysiology of medical conditions, but it is not in our scope to diagnose. We can, however, recognize signs and symptoms of medical conditions and provide nursing interventions based on our assessment. In this case, nursing interventions to treat the edema might be:
Elevating the lower extremities Monitoring intake and output Assessing the edema (increasing or decreasing?) Administering Lasix per orders So, when you catch yourself stating something like "related to congestive heart failure," which is a medical diagnosis, convert it to the pathophysiology of that particular medical diagnosis like "related to impaired pumping ability of the heart" or something along those lines.
Hope this helps!

The safety and efficacy of combining different medications can vary depending on the types of medications, the patient's medical history and diagnoses, and the intended therapeutic outcome. It's also your responsibility as a nurse to verify if there are any interactions before you combine them and administer to the patient. 
This is a great question to ask a pharmacist or to look up in your Drug Guide for Nurses. Your hospital may also have free access to one of the many online medication indexing databases, like Micromedex, where you can easily check drug compatibility. That's what I always used as an ICU nurse!

You're correct in noting that it depends on the medication, which is why it's crucial for nurses to understand and follow the appropriate guidelines for safe medication administration.  
Pushing certain IV medications too fast can result in adverse reactions and/or harm to the patient including: 
Anaphylaxis  Shock or cardiac arrest  Rapid drop in blood pressure  Respiratory depression or arrest  Damage to veins leading to thrombosis or phlebitis Decreased therapeutic effect Knowing the rate at which an IV medication can be administered also falls under the Five Rights of Medication Administration that we all learned in nursing school. Following these rights when giving medications reminds the nurse to ensure they have the right patient, the right drug, the right dose, the right route, and the right time. So, if the route is IV, the nurse must know the right rate at which that medication can be delivered via that route. 
If you don't know the rate at which an IV medication is delivered, it's your responsibility as a nurse to find out. Look it up in a drug guide, consult with a pharmacist, or check the instructions from the manufacturer. Just don't give it without knowing!

It's important for nurses to understand the lumen configuration and designation when caring for a patient with a triple lumen. When I worked in the ICU, patients were often receiving multiple medications and fluids at once, so a triple lumen central catheter, and knowing the function of each port, was essential.  
This may vary by manufacturer, but typically each lumen of the catheter is a different color, its own separate line, and used for designated purposes.  
Color Location Gauge Designation White Proximal 18 Medications, IV solutions, and blood products if other lumens are not open.  Blue Medial 18 Medications, IV solutions, more viscous fluids like TPN and lipids, colloids, and blood products if distal lumen is not open. Brown Distal 16 Medications, IV solutions, lipids, and colloids. Always first for blood products if open. Also used for blood draws and monitoring central venous pressure (CVP).    
 
 
 
 
 
 
 
 
Hope this helps! But, most likely, you will never forget which port is used for what after getting questioned in clinicals! 

You'll want to consider the general risks related to any type of surgery/procedure as well as the risks specific to the cardiac system. The biggest priority for a CABG patient who is a fresh post-op sent to a telemetry unit from CCU is anything related to airway and breathing (think ABCs!) 
Risk for Ineffective Airway Clearance  Risk for Ineffective Breathing Pattern  Risk for Impaired Gas Exchange  So, your top priorities for the post-op CABG patient include assessment and monitoring of airway and respiratory status and intervening as necessary per the Nursing Scope and Standards of Practice. Possible nursing interventions for these diagnoses might include: 
Positioning the patient upright as tolerated  Encouraging coughing and deep breathing  Encouraging and assisting with ambulation as tolerated  Monitoring oxygen saturation and coordinating with respiratory therapy  Administering prescribed oxygen and other medications as necessary  In addition to the above, you also need to closely assess and monitor the cardiac system, since the patient is post-CABG. Some of the nursing diagnoses to keep in mind include: 
Risk for Decreased Cardiac Output  Risk for Decreased Cardiac Tissue Perfusion  Risk for Excess Fluid Volume  Based on the diagnoses specific to the CABG procedure, additional nursing interventions to those listed above might include: 
Monitoring the patient's heart rate/rhythm, blood pressure, and respiratory rate  Assessing extremities for color, temperature, cap refill, edema  There are multiple nursing priorities when caring for a CABG patient who is fresh post-op. The key is using your nursing knowledge to determine which priority is the "biggest,” or most important, at any given moment. Priorities will change, sometimes minute to minute. It is our responsibility as nurses to anticipate that change, and re-prioritize as needed, to provide the best possible outcomes for patients.   

Giving advance notice and leaving your position as a CNA does not constitute patient abandonment. Also, most patient abandonment laws are geared toward licensed healthcare providers such as nurses and physicians.  
Even if you were, for example, a licensed nurse, the situation you've described would not be considered abandonment. 
According to the National Council of State Boards of Nursing, abandonment is the "intentional leaving a patient for whom the nurse is responsible without providing for another nurse or appropriate caretaker to assume care upon the nurse's leaving.” You didn't do this. You quit the position and gave advanced notice. 
The California Board of Registered Nursing considers patient abandonment to have occurred when a nurse assumes care of a patient, or group of patients, and then stops providing care "without giving reasonable notice to the appropriate person (e.g., supervisor, patient) so that arrangements can be made for continuation of nursing care by others.” Again, this isn't what occurred in your situation. 
If there were no patients assigned to your care at the time you left the position, it cannot be considered patient abandonment. 

The RN license by endorsement process allows RNs with a valid nursing license to obtain a license to practice in another state. So, yes, you would be able to practice in both Texas and New York.
Relocation is the typical scenario in which an RN would apply for a license by endorsement.  
Requirements vary by state but generally include: 
Completing the application process  Providing proof of your current license  Undergoing a criminal background check  Paying a fee  Depending on the state, you may need additional coursework or continuing education (CEUs). Check with the New York State Board of Nursing to confirm any additional requirements.
Also, consider the Nurse Licensure Compact (NLC). This is an agreement between participating states that allows RNs to practice in other NLC states without needing to apply for another license.  
I applied for an RN license by endorsement a few years ago when I relocated and it's a straightforward process. Just be sure to research the specific requirements of the state(s) you want to practice in, and check the NLC as you may not even need to apply for a new license.