LaneRN

I live in North Carolina and I am an RN but our LPN's can push some IV meds and draw blood form a picc line if they take an IV class that is provided by the facility. This is just an FYI. and may not be true in other states but it is listed on our NCBON web site

I am also a new treatment nurse and would love to have info on like policies and procedures, pressure ulcer prevention, etc. Love doing the wound care but get so frustrated with finding things I know that could have been prevented .Would love the guidance from a fellow treatment nurse.

At the facility that I work at, we have weekly manicures where our activities staff and volunteers do the residents nails, such as filing and painting. We also have different church groups to come in and have church services. There is also a WII game that is used for fitness and coffee socials, cooking, which are just basic things,They also have wheel chair races during the summer and kickball games that are played in the dining area in their wheelchairs. But the residents get the most fun out of playing bingo two to three times a week and winning small prizes like lotion, powder and quarters. Our activities department funds this by selling drinks and snacks to the staff even though we have a breakroom. These funds are also used for differnt things throughout the year for our residents. Sometimes it just takes seeing what would interest the residents as far as activities and going from there, Most of our residents keep and eye on the calander that is in their room, dining area bulletin boards, etc. to see whats going on. Sometimes its just a matter of getting staff to make sure residents are taken to these activities if they want to go. We also have a daily juiice it up which consists of juice and a snack. They are always asking whats going on today if they are unable to read the calander. Activities also goes around to see who would like attend activities and make sure that they go if they want to.

Our pharmacy sent us a sheet for sites for the Exelon patch there are 17 sites whirch are on the back. It specifically states on back on our orders from pharmacy we do not use the chest for these or our fentanly patches.

I went into a LTC/SNF right out of LPN school. I also felt the same way you do, but my DON told me in the beginning that if i did not feel ready to be on my own to just let her know and I am pretty sure yours feels the same way she would rather you tell her you need more orienting than for you to just take over and not feel comfortable. Good Luck I love Long term care and will graduate on Friday from an RN program and plan to stay where I am. Like someone posted earlier either you love LTC or you hate it. Just talk to your DON and I am sure everything will work out fine.

I graduate may 13th so I am hoping to take the exam the 2nd week in june. I am just as nervous for my RN boards as I was when I took the PN Boards in 2009. Well keep us all posted on how you are coming with your studying believe it or not you are keeping me motivated

I got that way when I was getting ready to take my LPN boards the closer it got my scores started dropping my instructor told me to take a break i was over analyzing the questions and studying to much. take a break and do something fun and then go back to doing your questions and see if it helps

I am doing the Hurst review I have watched all the lectures so now i am just going over the packet

Thanks Great notes hope your studyings going well Good luck to everyone

here is the link to the random fact thread file and also check at nursereview.org plenty of info and questions just scroll down toward the middle of the page and search through the content in the brown box on the right hand side of the screen this is a place that you can find those q trainers i was talking about hope this helps just one person . if you have any questions just pm me and i will message you back here is the link to the file http://www.mediafire.com/?8joeselpf487p6k

hi everyone i am currently an lpn. i am also planning on taking my exam the 1st or second week in june, i am using saunders 4th edition , hurst review and exam cram. right now i am mostly studying content because i took a bridge program and have been out of school since 2009 before going back for the transitional class and will graduate may 13th. for you that are planning on doing kaplan just by the book for the test taking strategies and type in nclex q trainers or kaplan q trainers and you can find the questions and rationals online for free just though i would help some friends save a little money i also bought the hurst review cd off of ebay and the whole review was on a cd includding the review notes that you take during the lectures. if you look hard enough online you can find alot of these for free or cheaper than the 300 - 500 dollar review our school uses sylvia raye and the nursing made insanley easy books they have these on ebay and amazon their are plenty of mneumonics there and also check out the random fact throwing sticky there is a file listed on the last page that is a document of most of the whole thread it is a post by me . good luck to everyone and lets all help each other with motivation and encouragement as well as what seems to be working for you as far as studying it may just help someone else out

GigacomRN! , Are you reading all the chapters are just answering the questions I graduate may 13th and plan on taking boards either the first or second week in june, by the way I am an LpN also

For those of you that are looking for the random fact throwing documents please look at pg 385 post #3844 there r links for a download. Hope this helps and good luck to all of us who are trying to pass the NCLEX

I think what she is referring to is in LTC change over consists of the new MARs for the month, these have to be checked an placed in a chart or book that contains the patients MARS, usually takes place on the last day of each month. At our facility there are a few nurses that do 1st and second checks, then if new orders come in after 2nd checks are complete then all nurses are responsible for placing these new orders on the MARs for their residents. our third shift nurses are responsible for doing the actual changing out of the MARs. All of this starts taking place abou 4 to 5 days before actual change over and the third shift nurse do the changing out of the new MARs on the last night of the month

looks like you passed. Congrats. keep us posted when you get your final results.

:hpygrp::ancong!:

here are a few facts gathered from my studying today atropine overdose hot as a hare(temperature) mad as a hatter(confusion, delirium) red as a beet(flushed face) dry as a bone(decreased secretions, thirsty) emergency drugs to lean on lidocaine epinephrine atropine narcan 1. widening pulse pressure is a sign of increased icp 2. a child with kawasaki disease might be given a high dose of aspirin to reduce the risk of heart problems 3. pt taking digoxin should eat a diet high in potassium (hypokalemia-> dig toxicity) 4. key sign of pud... hematemesis which can be bright red or dark red with the consistency of coffee grounds 5. common symptom of aluminum hydroxyde: constipation 6. allen's test- done b/f an abg by applying pressure to the radial artery to determine if adequate blood flow is present. 7. in a child anemia is a the first sign of lead poisoning 8. diuretic used for intracranial bleeding, hydrocephalus (increased icp,...) mannitol (osmotic diuretic) 9. vent alarms: high alarm (increased secretions then suction......, biting tube-need an oral airway,...... or coughing and anxiety- need a sedative) low alarm- there is a leak or break in system...check all connectors and cuff. 10. treatment of celiac disease: gluten free diet 11. cystis fibrosis==> excessive mucus production, respiratory infection complications,... 12. cholelithiasis causes enlarged edematous gallbladder with multiple stones and an elevated bilirubin level. 13. fat embolism is mostly seen in long bones (femur,...)

found these on this forum while reveiwing thought they may help transmission-based precautions: remember adc - airborne, droplet, contact airborne my - measles chicken - chicken pox hez - herpez zoster tb private room - negative pressure with 6-12 air exchanges/hr mask, n95 for tb droplet think of spiderman! s - sepsis s - scarlet fever s - streptococcal pharyngitis p - parvovirus b19 p - pneumonia p - pertussis i - influenza d - diptheria (pharyngeal) e - epiglottitis r - rubella m - mumps m - meningitis m - mycoplasma or meningeal pneumonia an - adenovirus private room or cohort mask contact precaution mrs.wee m - multidrug resistant organism r - respiratory infection s - skin infections * w - wound infxn e - enteric infxn - clostridium difficile e - eye infxn - conjunctivitis skin infections vchips v - varicella zoster c - cutaneous diphtheria h - herpez simplex i - impetigo p - pediculosis s - scabies private room or cohort gloves gown

Found these on a website. Your nclex book may have the steps in simpler terms. Nasotracheal suctioning (1) Open suction kit or catheter using aseptic technique. If sterile drape is available, place it across the patient's chest. Do not allow the suction catheter to touch any nonsterile surfaces (2) Unwrap or open a sterile basin and place on the bedside table. Be careful not touch the inside of the sterile basin. Fill the basin with approximately 100 cc of sterile Normal Saline (NS). (3) Apply one sterile glove to each hand, or apply nonsterile glove to nondominant hand and sterile glove to dominant hand. Attach nonsterile suction tubing to sterile catheter, keeping hand holding catheter sterile. (4) Secure catheter to tubing aseptically. Coat distal 2-3 inches of catheter with water-soluble lubricant (K-Y Jelly/Lubricant). (5) Remove oxygen delivery device, if present, with nondominant hand. Without applying suction and using the dominant thumb and forefinger, gently, but quickly insert the sterile catheter into either naris during inhalation with a slight downward slant. Do not force the catheter. Try the other naris if insertion meets resistance or is difficult to insert. NOTE: Never apply suction during insertion. Application of suction pressure while introducing the catheter into the trachea increases risk of damage to the mucosa and increases the risk of hypoxia because the removal of oxygen present in the airway. Remember that the epiglottis is open during inspiration and facilitates insertion of the catheter into the trachea. (6) Insert the catheter approximately 16-20 cm (6 ½-8 inches) in the adult patient. One method of measuring the correct length of catheter to insert is to use the distance from the patient's nose to the base of the earlobe as a guide. (7) Apply intermittent suction by placing and releasing nondominant thumb over the vent of catheter. Slowly withdraw the catheter while rotating it back and forth with suction on for as long as 10-15 seconds. (8) Assess the need to repeat suctioning procedure. Allow adequate time between suction passes for ventilation and oxygenation. Ask the patient to deep breathe and cough. Keep oxygen readily available in case the patient exhibits signs of hypoxemia. Administer oxygen to the patient between suctioning attempts (9) When the pharynx and trachea are cleared of secretions, perform oral suctioning to clear the mouth of secretions. Do not suction the nose or trachea after suctioning the mouth. (14) Rinse the catheter and connecting tubing by suctioning NS from the basin until the tubing is clear. Dispose of equipment as per facility policy. Turn off suction device Endotracheal or tracheostomy tube suctioning (1) Performed through an artificial airway (endotracheal/nasotracheal or tracheostomy). Artificial airways are indicated for patients with deceased level of consciousness, airway obstruction, mechanical ventilation and for removal of tracheal bronchial secretions. Artificial airways allow easy access to the patient's trachea for deep tracheal suctioning. (2) Prepare suction equipment, suction catheter using sterile technique and don sterile gloves as previously described for nasotracheal suctioning (3) Hyperoxygenate the patient before suctioning, using manual resuscitation Ambu-bag connected to an oxygen source. (4) Open swivel adapter or if necessary remove the oxygen delivery device (ventilator tubing) with your nondominant hand. (5) Without applying suction, gently, but quickly insert the sterile catheter using the dominant thumb and forefinger into the artificial airway until resistance is met, or the patient coughs and them pull back the catheter approximately ½ inch. (6) Apply intermittent suction by placing and releasing nondominant thumb over the vent of the catheter while rotating it back and forth between the dominant thumb and forefinger. Encourage the patient to cough, if possible. Observe continuously for respiratory distress. NOTE: If the patent develops respiratory distress during the suctioning procedure, immediately withdraw the catheter and administer additional oxygen and breaths as needed. (7) Close the swivel adapter, or replace the oxygen delivery device (ventilator tubing). (8) Rinse catheter and tubing with NS (9) Assess for secretion clearance. Repeat suctioning procedure 1-2 times more to clear secretions if necessary. Allow adequate time between suction passes (at least one full minute) for ventilation and oxygenation. (10) Perform oropharyngeal suctioning as needed. Catheter is now contaminated. Do not reinsert into the artificial airway. (11) Dispose of suctioning equipment per policy. Turn off suction device (15) Reposition the patient as indicated by condition

here this is how i remember it. hope this helps when mixing insulin's, inject air equal to the dose into cloudy (long-acting) with the same syringe inject air equal to the dose into clear (short acting) do not remove syringe- withdraw the correct dose. return to the long acting ( cloudy) and withdraw correct dose. the objective is not to contaminate the clear (short acting) with the cloudy. the way i remember it, cloudy clear cloudy. administer the mixture within five minutes of preparation. regular (clear) insulin binds with the long acting (cloudy) and action of the regular insulin is reduced.

1. In nursing, ASSESSMENT comes first 2. ABCs mean airway before breaths before circulation 3. If its out of your scope of practice, dont do it. 4. Patient care always comes first......... 5. Nurses DONOT delegate assessment and teaching 6. If it ends with an ..ol, its probably a B-blocker 7. With hip issues, leg abduction is almost always the right choice 8. Peroxide does wash blood out pretty good 9. Chlrohexidine is best 10. If the infectious agent starts with myco - it probably doesnt require contact precautions. Seen these in another thread thought I would post them here to. Hope the original poster doesn't mind.

I have already started reviewing i guess thats why i feel like i have forgotten everything. Thanks

I am an LPN who is currently in a LPN to RN bridge program. I feel like I have forgotten everything I learned even though I have only been out of school for a year. Will graduate in May and really freaking out about having to take the NCLEX. Where do I began to study? I feel like I have forgotten it all. I felt well prepared at this point during the pn program, but not so much in this transitional phase. can someone please help me, or at least give me some advice on where to begin? I have a little over four months till graduation

I used this thread over a year ago to study for the NCLEX PN and will be using it again these next four months while waiting to graduate fron the LPN to RN program to take the NCLEX RN soon after graduation I am glad to see that there are members still using it because it really helped me when I got tired of reading the books and doing practice questions has anyone taken the NCLEX RN recently and what are your recommendations as far as content review needed? Thanks and good luck to those who are testing now and in the future.

Prado can you please post a link somewhere. Silverdragon has already reqested that the topic of this thread be stuck to and i do not want to see them close the thread possibly because of those not abidin by this. this thread helped alot with my review for NCLEX and I even spent time copying these and sending them to others but now it is just becoming a posting center for the files.And others are hing to look through these posts to get to the facts. i only feel that this is fair to everyone. If I offend anyone i am sorry. You are not suppose to post email addresses on here either if they are found they will be removed.