worrywart

I have a few questions I am stuck on and can't seem to understand clearly. How can calcium channel blockers side effects produce both tachycarda and bradycardia depending on the medication? For example: Cardizem produces bradycardia Nimotop produces tachycardia If they both dilate coronary arteries how can they produce two different effects? I am really confused how to determine when you would expect to see tachycardia or bradycardia. This is what I understand: Vasodilation relaxes and opens up the vessels which eases the passage of blood through the vessel. The BP drops which decreases the workload of the myocardium. Vasodilators can act on the veins, arteries, or both which affects preload or afterload. Is this what determines if we see bradycardia or tachycardia? My thinking is that if you are dilating your BP is going to drop which decreases the workload of the heart causing bradycardia, but I know there is a reason for the tachycardia somewhere. I have a feeling I am way off center so if anybody could explain it simply it would be greatly appreciated. Thanks

I'm getting confused on the three types of pain management for labor and was wondering if anybody could clear up the differences. Is an intrathecal a type of spinal block and do you use a catheter for it? Does the intrathecal get inserted below the spinal block? Also do you get the spinal headaches from both spinal blocks and epidurals or just spinal blocks? I've heard different things about each of them and was getting them confused. I understand the placements of spinal and epidural but the intrathecal was throwing me off. Also, at the hospital that I do my clinicals at my teacher told me they do mostly spinal blocks, but when the pain wears off do you just keep injecting them? She said not many doctors are precise on doing epidurals, but I would hate to get poked everytime my pain came back. Why would they not train their doctors to do this more often? Any answers on these questions would be greatly appreciated. Thanks

As a new grad is it better to start out on an adult med/surg or a peds hospital if you know you want to work with peds someday. I have been told a lot of different things. Mainly to start out on an adult med/surg floor so you get a broad range of things. On the other hand i've heard not to waste your time on adults if you want to work with peds. I'm confused..what is the best advice?

I am in my peds/ob rotation right now and currently I am having doubts about nursing. I have 2 semesters left and have made it this far so I know it would be a waste to throw it all away. I am a very sensitive person and have been having problems forming tough skin around personnel in the hospitals. I love working with kids because the environment seems to be completely different and the staff seems more positive. However, I hated my med/surg rotation and I know part of it was because I had terrible experiences. The nurses were all very rude and made the students feel like we were more in the way than anything. I feel like everytime I go into clinical some nurse, doctor, or teacher always yells at me and makes me feel like I am stupid. I'm afraid I won't find a nursing job that I love that is stress-free or at least a little bit. I have been doubting this for awhile, but I'm so lost and i know my family would be disappointed if i changed my major my senior year of college after all this work. I feel like I am not cut-out for this profession. Any words of wisdom or advice? I have been feeling this way for a long time and it seems everywhere I look more and more nurses hate their job. Is there any hope? I feel like I have to have tougher skin to work in this profession.

I was wondering how many people graduated from nursing school without any nurse externships or clinical experience outside from nursing school clinicals. Is it possible to be a great nurse if you don't have that experience? I'm trying to get my foot in the door at some local hospitals just to get the experience and I already work at a nursing home. I have heard a lot about how nurse externships make the transition easier after graduation, but they are very competitive to get into. Obviously I know any experience would be useful, but I was just wondering from experienced nurses if you survived the real world after graduation without any externships and what you did to transition. Any input would be greatly appreciated.

I am in a BSN program in Northern Michigan and they recently switched our testing services over to HESI within the last year or so. It is mandatory that we pass every test after each semester Fundamentals, Assessment, Psych, Med/Surg/, peds/ob ect. We can not graduate and get our degree until we pass with an 850 at least on all of our tests. They don't prepare us for the tests at all, instead they tell you that you should know this and this but never go over the material. They expect that we will just know it. My sister just passed her NCLEX and told me the HESI is very hard compared to the NCLEX. As for how they prepare us, they really don't we are just expected to do well or retake them until we pass.

I am in the med/surg semester and I am very frustrated and worried about everything. We have to pass these HESI exams after each semester in order to graduate and I couldn't seem to pass my first 2 so I had to retake them. I just finished retaking my Psych Hesi exam and I failed it again worse than the first time. I am really frustrated and I just want to quit. If I can't pass these tests how am I ever going to pass the NCLEX? I study all the time and put so much effort into it and it seems as though everyone else in my class passes everything just fine. I got a 72 on my first med/surg test and we need to pass the class with a 73. I am always like 1% away from the borderline everytime and I've talked to my teachers about this but they don't seem to help. They just tell me different ways to study (which i've tried) and i've done NCLEX practice books and everything. I'm so close to changing my major but i've come so far I know i shouldn't give up and i'd be in school longer if i changed and probably a lot more unhappier. I just don't know what to do. It's embarressing when everyone in your class passes the tests but you have to retake everything like 4x. Any words of advice?