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shrimpchips LPN

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  1. shrimpchips

    help w/ nursing dx/formulating my thoughts

    She is only hydrochlorothiazide, most likely because of the HTN. No edema at all, no crackles in her lungs...no s/s that would would be positive for hypervolemia. It's possible she has some CHF problems but she also has some renal problems, too (hence her elevated BUN & creatinine)
  2. This is driving me crazy! Maybe I'm thinking too hard about this but I'm struggling with coming up with appropriate nursing diagnoses. For my med-surg class, we have to write a fluid and electrolyte paper. We have to have four diagnoses total - two addressing an electrolyte problem and two addressing a fluid problem. There is a catch: we're not allowed to use hyper/hypo-electrolyte for the electrolyte problem and we're not allowed to use hyper/hypovolemia or risk for hyper/hypovolemia. It has to be a problem that we are concerned about related to the hyper/hypovolemia. Here is some background information on my patient: N.S., 66 y.o. female admitting dx: UTI, hypoglycemia comorbidities: HTN, DM, CAD, depression, anxiety, COPD, anemia, GERD, hyperlipidemia heplocked I/O that day: 1840 in, 1800 out Labs: K+ 3.0mEq/L Cl- 90mEq/L CO2 37mEq/L BUN 45mg/dL creatinine 1.87mg/dL RBC 3.75mil/cmm Hgb 11.8g/dL Hct 34.9% even though her BUN is elevated, that can't mean dehydration because her RBCs & H/H are all low, indicating hemodilution = overload. The patient has no history of renal disease but her creatinine is elevated...so I think she has some compromised kidney function going on. She is also retaining some fluid (aeb her I/O...I know that output should be equal to the intake). For the electrolyte problem, I decided to pick hypokalemia and have the following diagnoses: impaired physical mobility r/t muscle weakness (aeb blah blah blah...) constipation r/t smooth muscle atony (aeb blah blah blah...) but for the fluid problem, I'm struggling. I was thinking "risk for pulmonary edema r/t fluid volume excess" as one. As for the other, I would love to concentrate on the impaired kidney function but of course I cannot use the diagnosis, "hypervolemia r/t impaired kidney function aeb..." it has to be the other way around, but "impaired kidney function" isn't really a NANDA diagnosis. I was also thinking of "Impaired gas exchange r/t fluid volume overload secondary to COPD aeb hypoventilation and increased CO2 level" as the other one, but to be honest I'm not really sure. I already e-mailed my instructor regarding this. She helped point me in the right direction that this patient is more at risk for (or has) hypervolemia as opposed to hypovolemia, but of course it's up to me to come up with the diagnoses. Any help would be great. Thanks!
  3. shrimpchips

    lab values

    What is the name of the book?
  4. shrimpchips

    What grade is "passing" in your nursing school??

    My school requires a 74
  5. shrimpchips


    I love RNotes! I carry it to clinical with me :) My only gripe is that it can sometimes be hard to find information, even though they are tabbed off my sections but for example if you're trying to find some information on central lines, you know it's under the "Meds/IV" tab, but where? Other than that it's a great reference :)
  6. shrimpchips

    lab values

    I don't know any mnemonics but I'm hoping someone will share some...otherwise I just find notecards help with learning these!
  7. shrimpchips

    Cold sores and maternity nursing

    During my OB rotation they told us not to come in to clinical if we had cold sores. I have seen nurses on the unit with them but they just wear a face mask whenever they are around the baby.
  8. Here's my advice: 1) get a good NCLEX book. I recommend Saunders or NCLEX-RN: Reviews & Rationales. The Reviews & Rationales book is great but if you're a visual learner, the book might not be so great because it doesn't have very many pictures; however, the Saunders one does. I'm a visual learner but I like both of them. Use your NCLEX book to practice questions pertaining to whatever you are learning in class. It will help you learn the material and also help you study for the NCLEX at the same time :) 2) If making notecards works for you then make them! I find that making notecards for things such as lab values or for drugs helps, but other than that they don't help me. it sucks, but re-writing stuff helps me learn the information. 3) If you're allowed, tape record your lectures. 4) Look through your notes the same day of lecture after having lecture and also flip through your notes every day to help you learn the material. Hope this helps!
  9. shrimpchips

    What's the toughest part of A&PI?

    I would have to say learning all of the bones, muscles, and the nervous system. The endocrine is a pain in the butt, too.
  10. shrimpchips

    Bathing Classmates and Other Personal Boundaries?

    My school does not allow us to do any sort of invasive procedure on other students. Instead, we have dummies and sim men/babies and "injecta-pads," etc. When we learned how to do perform a bed bath, we didn't really do them on each other...They gave us those bath cloths (similar to those pericare wipes...I'm sure all of you know what I'm talking about :)) and we could practice on the hands/arms/legs/feet on each other if we wanted to, but no one told us we HAD to strip down or wear a bathing suite or anything like that. I think the thing that I did which might have made someone uncomfortable was trying to move my partner's big boobs out of the way when I was demonstrating how to listen to heart/lung sounds
  11. shrimpchips

    University of Akron Accelerated BSN

    I'm not really sure on how many students they admit into the accelerated program, but I'm in the basic BSN program there and we originally had 160 (some dropped/failed though... ). I'm currently in a class that's for the accelerated students but since I am currently out of sequence, they allowed me to take it (basically, I'm a semester ahead...so instead of graduating in Spring 2011 I should graduate this December ) - to my understanding, accelerated students all take the same class at the same time. They also take classes in the summer. Akron is a great program - I love it there :)
  12. usually around 6...but it just depends...
  13. shrimpchips

    What type of drug tests do nursing schools do?

    surprisingly, my school did not do a drug test; however, our student handbook says that they can do random drug testing, I guess. I've only ever had drug tests for my job - I work as a nurse tech in a hospital.
  14. shrimpchips

    I want to be a matirnity nurse and I was wondering..

    maternity/postpartum nurse...if you work in labor & delivery (L&D), that would make you a labor & delivery nurse. I'm a nursing student but I've already had by OB rotation in both maternity/PP and L&D so I can offer some insight. The hospital where I did my rotation at had a traditional well-baby maternity/PP unit along with a special care nursery which is basically like a step below the NICU...they have a children's hospital branch with a NICU so babies that need to be sent to the NICU automatically get sent there...but if the special care nursery can handle the case, they'll stay there. I went to the special care nursery. There were a lot of premature infants, a lot of them in respiratory distress. There was also a drug withdrawal baby, which was a sad case. The hospital also had it's own L&D unit. We would spend a few weeks on maternity/PP and then transition over to L&D. PP is a lot of teaching - you have a lot of new moms coming in that need to be taught how to care for her baby (how to feed, when to feed, how to change diapers, etc etc etc) as well as how to care for herself. The patient load depends on the size of the unit, but the average the nurses had on my floor is about 4 - so technically 8, because you are responsible for both mom AND baby. If you have twins or triplets or more, you're responsible for all of those babies. We assessed 3 times each shift - at 8am, 12pm and 4pm - on both mom AND baby. that includes vital signs. doing all of those assessments can be tedious after awhile lol. There is a lot of charting on PP. Medications were mostly on a PRN (as needed/as necessary) basis. Expect to do a lot of teaching with new moms but you will also get moms having their 2nd child or something, so usually those patients don't have a lot of teaching needs but you always need to make sure! We were responsible for making sure the baby got fed and also reminding mom to feed her baby. As for baby medications, Hepatitis B is pretty much routine on PP. PP was a good experience - some days it was busy, and other days it wasn't. On the less-busy days, after everything was done, I would hang out in the nursery taking care of the babies by feeding them/changing them and cradling them :)
  15. shrimpchips

    Fluid and electrolyte help

    Daytonite, THANK YOU!!! These will definitely come in handy for my upcoming nursing class this semester...we focus a lot on F&E
  16. shrimpchips

    Uniform badges: which sleeve?

    Our patches are sewn on the right shoulder/sleeve