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I know how you feel, Kindhearted-08. I took the HESI and purchased a book called Med Surg Success. Also, the "Nursing Made Incredibly Easy" books are very helpful. Study up on your med surg and dosage calculations. Also , brush up on your assessment and evaluation skills. Good luck. I am pulling for you.

All of these are such good points. I would be dedicated as a nurse to the people we help, but, with a family at home, it would be very difficult to decide which place to serve first. It will take all of our combined talents and skills to combat a disaster such as a Pandemic, for sure. It is good to know we will all work together in different ways if such an incident arises. Now, with all honesty, I would probably be scared to death if this ever happened, and it may; however, I would let my heart guide me as well as my prayers as to where I would be most needed.

hmmm. After that description I would have to say "no". I agree that I cannot do much to help without PPE. My clients come first, however, I have a family that needs me also. That would be futile, given that info on percentages.

All the time. I work a 12 night shift and always take the opportunity to sing the praises of "allnurses.com". I find out that many of my co-workers enjoy it also.

Thanks,Daytonite. That is just what i needed to hear.

I really am just unsure about my priority diagnosis, and which ones to use because there is so much. It is a little overwhelming, this being my first trauma case. I can just use what advice I have gotten so far. I am just so excited to have people to talk with about my ideas, and how things work to create a story of how the body adjusts to this type of situation. Thank you for all your help. It it truely appreciated. :wink2:

Thanks for all that information. Sounds as if you are a wonderful source for information. My client had all the issues you mentioned , such as bowel and bladder, turning, and bathing taken care of by the dedicated nurses on staff. His dad comes in and does rom with him on some days. Otherwise, the nurses and PT comes in to do that. He has an automatic rotating bed to continually move him, since manual turning may increase his ICP. Also, he has a cooling blanket that circulates cool water when he has a fever, and warm water when he has temp below 97.7. I understand that it is not uncommon to see an irratic temp. fluctuation in closed head injury patients. The glucose levels were high, the anion gap was 14, which is high, the pH was 7.47 (alkalotic), the hco3 was 27.6 (high), the po2 105, the pco2 38, and the co2 29 (high). The foley was replaced within 7 days of admission due to sediment build up from all the sodium they put on board to decrease his ICP. I suspect that he may also end up with a uti. The platelets were hight (40.9) and the neutrophils were high ( 86.4). The rbc was low( 3.80) and the wbc was high (20). I am trying to use the skills I have been taught to see the "roadmap" to what is happening in his body due to the head injury. I think all the electrical impulses that are usually so well maintained by the cerebrum and the medulla oblongata are just haywire because of all the pressure built up in the brain. It is almost like a circuit board all messed up and there are some impulses getting sent, and some are not. He does have some "bucking" when the oral cavity is being suctioned . It is like his muscles jump but he cannot control them. His teeth are cleaned twice a day with a special solution and sponge, then he is suctioned. He seems to have a lot of secrestions. He also has already had a pnuemothorax, resolved. This is very a interesting , but heartbreaking case. This is my first trauma. Thanks for all the help.

Hello again. Sorry for the misuse of capital letters. :zzzzz No offense intended. I am just new to this and I am learning as I go. In reference to responses to my thread, my client was in t-boned with an automobile on an atv and presented to the ed unresponsive and an artificial airway in place. This client was unresponsive verbally, to eye opening, and to external stimuli. The client remained unresponsive for around 14 days, and then began to wiggle his left toes, but has done no further progress for the las 7 days. This body has responded to the medical diagnosis of closed head injury by shutting down. This client stopped breathing and stopped responding to any stimuli. Then the client developed a strep infection from, I am thinking, the artificial airway being in for so long? The client also has a continuous tpn, and we were goaling toward bolus feeding. I am not sure where that stands, as I have not been in to see him this week, other than just scooting in on my shift in the evenings. I am on a diffferent floor. Thanks for the help, and ya'll keep me straight. :wink2:

good morning, all. any advice on a third dx for a peds client with a l sub. hematoma, gcs 6, strep. pnem. infection, and sub. clav. line? so far i have, ineffective airway as first, hyperthermia as second, now i am torn between r/f impaired skin or r/f infection r/t sub. clav. line. which is priority? :bugeyes:thanks, i just love this site!

i am not sure what a concept map is. is this like a care plan? what are your goals? what interventions do you have so far? we'll put our heads together and come up with some more. don't forget about your therapeutic interventions,such as teaching and encouraging. let me know what you got so far. don't give up.

hey snowkie, i know where you are right now. i am a third sememster nursing student and i remember those days. first, always remember your nursing diagnosis has to be in a priority order. you know, airway first, breathing second , and circulation third. (abc) also, i was taught that a risk for diagnosis cannot be a priority diagnosis. try another NANDA diagnosis that has to do with his airway, breathing, and circulation. let me know what you come up with. the related to in your book are the reason why your patient has the problem. the as evidenced by is all your proof,like lab work, statements, and assessment data. ie-ineffective airway clearance ( nursing diagnosis) related to (why) increased lung secretions, as evidenced by ( proof, this must be objective data) increased wbc( give levels ), coughing, and wheezing. let me know if that helps. :yeah:you'll get there.

I am a nursing student, 3rd semester. this was a clinical rotation. I had trouble putting all the lab info, and ABG results together. THere was just so much, it is hard to think through. Thanks for the great sheets on critical thinking. That will help me find my way.

I had a 15 yr old in PICU yesterday with a left subdural hematoma, and other complications that have him with GCS of 5, 2 on the vent, and can wiggle his toes on left side. I need to do a care plan on him, and I am a 3rd semester student. I think they plan to trache him in a few days .His I&Os are good, so his kidneys are perfusing. No problems cardiac. My first priority is airway, however for the second I am a little confused. He is slightly alkalotic, metabolically and now has strep. pnemon. Should my second DX be related to the alkalosis or the strep. They are related , and I feel that the infection is due to the increased secretions in the lung field, plus he had a pneumothorax that resolved enough to remove the chest tube. any advice?