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  1. Anisettes

    Isotonic vs hypotonic vs hypertonic

    Oh, sorry - I just saw the previous post that you're not a student, didn't mean to lecture. Don't feel bad, I've been doing this for 20+ years and there are still things I get hung up on and have to stop and think 'now how does that go again?'
  2. Anisettes

    Isotonic vs hypotonic vs hypertonic

    All have to do with manipulating osmosis, which is the movement of fluid (specifically solutes as in salts like Na+Cl- and KCl-) across a semi-permeable membrane from an area of lesser to greater concentration. It helps if you remember that salt always follows water - so think where it is you want that water to go and you'll arrive at your answer as to what you'd treat with what. Ideally, extracellular and intracellular balance is maintained in healthy individuals, but get sick or injured and the balance can get thrown out of whack. Hypotonic - solution has less sodium than that of the patient's currently circulating plasma. Would be used to push fluid from the vascular spaces into the cells. Too much and the cells will explode. Will decrease circulating volume, so you'd use it when you don't want increased pressure like cerebral edema, or in a dehydrated patient with very high electrolytes, etc... Isotonic - has same sodium concentration of plasma. Use to replace volume in cases of blood loss, or to maintain hydration. No fluid shift between vascular spaces and cells - they're equalized. Hypertonic - has a greater concentration of sodium than circulating plasma. Pulls fluid from the cells into the vascular spaces. Too much and the cells will crenate or shrivel up like prunes. Will rapidly expand circulating volume and might be used to treat bad burns, septic shock, etc... Hypo and Hyper tonic solutions should be used carefully and patient observed for signs that treatment has progressed beyond the theraputic response. Hope that helps a little. Sometimes it helps if you don't try to memorize things as much as to stop and think what is actually going on and then use your logic (and certain basic concepts you DO need to memorize) to determine what's needed to fix whatever it is that's going on. You're never going to be able to memorize everything you'll go insane trying. Using your critical thinking skills is vastly superior over rote memorization because memory only takes you so far. But critical thinking will help you react to those weird things that come at you from left field.
  3. Anisettes

    Do you think younger generations have a sense of entitlement?

    I do notice it in some people, though by no means all. I think a lot of it is that people raise their kids differently these days, no one dares to even correct anyone else child no matter how gross the offense. When I was a kid, I could expect to get spanked by any adult if I misbehaved and again by my parents when they found out about it. When I was kid, you didn't get a ribbon for anything unless you were 1st, 2nd, or 3rd place. Now EVERY kid is rewarded - even for no effort. So what have you just taught that kid? That he is owed it, he doesn't have to earn it. And don't dare correct him for anything, one of his parents will chew you out, punch you out, or threaten to sue. That's only one of the possible causes, but yes, I have noticed that more and more. And this thing of kids slapping their parents (I saw it the other day in a fast food restaurant). I'd have been put in the ground and wouldn't be posting this now, if I'd dared such a thing. The thought would never have even occurred to me, let alone would I have possessed the balls to actually do it.
  4. Anisettes

    What Vaccine Refusal Really Costs: Measles in Arizona

    It doesn't help when 'celebrities' go around advising parents that vaccinations cause autism. Because after all, they received their medical training between acting classes and know so much more than those morons who slogged thru medical school.
  5. Anisettes

    nursing care r/t pregnancy termination

    I agree. Every person has the right to their own beliefs and opinions, but to keep medical, nursing, and scientific knowledge from a professional education is reprehensible. Reality is that abortion exists and you should be equipped to care for a woman who has had one whether or not you personally believe she should be allowed to have one - once it's done it is a moot point. The very idea that a woman could show up post-op in your care and you have NO idea how to care for her is unacceptable. UNACCEPTABLE and REPREHENSIBLE.
  6. Anisettes

    Summer Nursing Internship in Africa! Need Help!

    Congratulations! Sounds like an awesome experience for you. You asked about what companies you could contact - not sure if they would donate but I'd suggest you make inquires to companies that make/sell medical supplies like Baxter, Kimberly-Clark, 3M, Medline, Johnson&Johnson, etc... You could also query nursing journals AJN, Nursing 20111, etc... Have you also considered your local radio or TV stations? ZOLENSKI's offer is wonderful, take him/her up on it. Good luck and have a great experience.
  7. TV/Movie sets often recruit paramedics over nurses because of their 'first responder' abilities - especially useful for when stunts go bad, but may also hire nurses. I believe when there are infants/children on the set a nurse (or medic) is required to be avail. Your best bet is to check out industry sites that list job opportunities like http://www.media-match.com/usa/jobtypes/nurses-and-medics-jobs-402749.php Good luck!
  8. Anisettes

    New PACU/OR nurse!! Help..

    Hahaha! Good luck with that because you will learn that even if you've done EVERYTHING right - some surgeons will yell anyway (about something). That's another important thing to learn - develop a tough skin. Many surgeons take their stress out on the staff (esp. if the case has the potential to go south or is already headed there) and taking it personally will burn you out. That, and learning to anticipate - but that will come with experience as you are exposed to each new type of case. Before you know it you'll see the procedure listed on the board and already know what you need to gather in order to set up your room. EX: case is a V.A.T. That's a video assisted thoracoscopy - automatically you will think: beanbag, axillary roll, pillows, arm positioner, foam or gel padding, SCD's, double towers, etc... But you will learn, as will you start to remember individual surgeon preferences/quirks as you work with them. We have a surgeon here that actually has on his preference card "Absolutely no music by Cher allowed in the room." Congrats & Good Luck!
  9. Anisettes

    Military CRNA

    Hi - I noticed your post still has received no replies - I think you would have better luck re-posting to either the CRNA forum or to the Military Nursing forum - you'll get a lot more response there. Or perhaps request one of the moderators to move the post for you. I'm a civilian at Landstuhl and we are staffed mainly by both military and civilian CRNA's - Army, AF, and Navy are here, with the civilians maintaining continuity as they military gets deployed. Don't forget you pay is also supplemented with BHA, prior enlisted money, post allowance (if you're OCONUS), etc... So try reposting in the above forums and you'll get better info. Good Luck!
  10. Anisettes

    Dead body vs. Live patient

    No, you're not psycho. I've never personally had that experience, but that doesn't mean you didn't. Operating on the assumption that such a thing is possible, perhaps you are just more sensitive or attuned to such an occurrence, whereas others are not. Then again, it may just be that as the body settled in death, it had changed in ways so subtle that you didn't pay attention (you were occupied with prepping the body) until it became noticeable. Either way, you felt what you felt.
  11. Anisettes

    Rocephin Question

    I had IM Rocephin about 10 years ago and don't remember it being very painful at all. I do wonder, though if it's like the reactions I've seen with IV propofol for surgical induction - patients either don't feel anything at all (like me) or it's VERY painful with people actually thrashing around - there seems to be no middle ground with either - it's all or nothing.
  12. Anisettes

    Song Ideas?

    They played Pachabel's Canon in D for our processional followed another classical piece that I can't remember offhand. The committee in charge decided against modern or anything with lyrics. I guess they were aiming for subtle and classy? I never thought to ask because they didn't play anything during rehearsal and none of us (except those on the committee) even knew what was going to be played. And we never had a slideshow or anything cool like that. They also played classical when we lit each others candles. An odd thing just occurred to me - I've never been to anyone else's nursing graduation and wondered if everybody's class does the candle lighting thing? The auditorium lights were off and the Dean lit the first nurses candle (we all had little ceramic Aladdin-type candle holders) and then she turned and lit the nurse next to hers and so on thru all three rows of us until the whole stage was lit up by us. My sister said it awesome from the audience POV. Not to hijack the thread, but I suddenly wondered if all graduating classes did that. Congrats on graduation! \O/ \O/
  13. Anisettes

    How to avoid daycare fees working 12hr shifts.

    That's what I did for years when my kids were small - I worked nights, husband worked days - we simply couldn't afford the childcare. We didn't have the time overlap problem like you, but assuming you can find someone to cover for those 4 hours, it's a good plan. Of course, you will be getting the short end of the stick because they are small, needy, and home all day just when you need to sleep - unlike your husband who will go to bed and stay there (or will once the newborn starts sleeping thru the night) once he puts them down for the night. BUT as someone else mentioned - YOU will be raising your kids and who else cares more about their safety and well-being, so it's a worthwhile trade-off. Best of luck!
  14. Anisettes

    methadone clinic..good 1st job?

    I'm thinking this poster was meaning that what must of us think is that a nurse in one of these clinics just passes out pills. I was curious as to what else you would do as a nurse in a clinic like this. It's true you mainly pass meds, but you also do referrals for other health-related issues, there are times when you do assessments and take vitals - and you'd use your nursing judgement to withhold a dose if you thought the patient vitals warrant holding it, there is counseling - both about drug aspect as well as disease prevention as addicts don't tend to take good care of themselves and often engage in risky behaviors, you also do urine spot checks to see if they're taking other drugs/ETOH (which they frequently are), etc... It's like working in a clinic or doctors office or a quick care - except they are not in the best neighborhoods as a rule. Nothing from my POV that should keep you from proudly putting it on your resume - it's good experience.
  15. Anisettes

    methadone clinic..good 1st job?

    Could you explain your rationale for this opinion? I don't understand why this (or any nursing job) would be a 'black mark' on a resume. If anything I'd think the more diversified you are as a nurse, the more varied your experiences, would only serve to be a positive thing. Please, I'm really curious as to your reasoning - because if so, I've got some serious black marks on mine as I once worked briefly in a methadone clinic as well as in a prison (among other places) and I've never encountered any negative reactions - ever. Patient care is patient care - she's not taking the methadone - she's administering it - so where would the black mark come from? I'm really confused and obviously missing something. Or is not the methadone clinic itself, just the fact that it's not an acute care job is what you mean? I'm confused because the way the post is written makes it sound like there's something wrong with the clinic. In that case disregard this post! But I'd still advise her to take it - it might not be ideal, but you can starve waiting for ideal.