ElliShay

Hi-- I would make up several scenarios--and have the students (in groups) search for the answers using the CDC website. Each group could then briefly present what they learned to the rest of the class. This doesn't have to be difficult--and immunization requirements and recommendations change frequently enough that memorizing schedules is futile. IMHO they need to know where to go to find the information. Some scenario suggestions include: a 5-y.o. who has never had any immunizations is preparing to start kindergarten--what is the recommended schedule for this child? Name the culprit--provide a picture of the rash, describe some of the clinical manifestations--and have the students try to determine which communicable disease is present--and then describe the appropriate vaccine that could have prevented it. Or---have the students perfrom immunization teaching for a new mom whose child is to receive (for example) 2-month immunizations. Or even a teen receiving Gardisil... or an older adult receiving the shingles vaccine. I also have my students visit the CVDC website to find current recommendations for the flu vaccine and antiviral therapy--new recommendations come out each year--so the idea is that they know where to go to find the most accurate and current info. These assignment can be really fun--and informative for students. Hope something here appeals to you! Good Luck!

how about 'Happy Puppet syndrome'-- this name is actually obsolete--the more correct name is Angelman syndrome...

I would need more info & some assessment findings to be sure, but did you consider a fatty emboli? If the CO2 level was from a BMP, the level is actually high--which supports your idea regarding respiratory acidosis. Check out this link-- http://emedicine.medscape.com/article/460524-overview

Um... where do you think the water comes from that the ice is made from and water pitchers are filled from???

You could open the airway via the jaw thrust maneuver... anyway, let us know what you find out!

I think your answer (and your reasoning) is correct. All the O2 in the world will do no good if the airway isn't open...

I am going to go with hydration. check out this link: http://emedicine.medscape.com/article/205926-treatment

I agree with Leslie-- the elevated RBCs make for sludgy circulation AND crowd out clotting factors-- increasing the risk of bleeding.

What a blessing it must be to be involved in research that may be lifesaving for her... I would concentrate on that. If she is immunosuppressed and received a vaccination, she likely wouldn't have been able to mount the immune response necessary to boost her titers to an acceptable level--and, more importantly, she wouldn't have been safe from the many harmful pathogens she would encounter in the clinical setting. In addition--she may have placed other vulnerable patients at risk if she was infected with something (due to her own vulnerability) and inadvertantly exposed them. The dream is following a longer timeline, that's all. I wish her all things good.

As you said--you paid for this exam and you can take as much time as you wish. However--the longer you take, the more your ability to critically think comes into question. In addition, after hours of testing, most people become fatigued and are more likely to make errors. When the testing time expires (as several posters have already said), only the last 60 questions answered are looked at in determining whether or not the tester has met the minimum standard for nursing practice. These are the questions answered when the tester is the most fatigued. IMHO, you are better off moving steadily through the exam answering the questions you know quickly and spending a little more time critically thinking through those you don't before making an educated guess--without allowing time to expire. The measurement of critical thinking is accomplished, in part, by your ability to think on your feet--so move through the exam in a timely fashion. Good luck.

Well-said. Post-CABG patients are a good example-- holding BP meds (resulting in increased BP) can damage the graft site.

I did this too--years ago. I did land a job in a doctors office--and quickly realized how much I still needed to learn so I enrolled in pre-nursing courses at the local community college. I will say that my experiences (mostly on the job though--not from the program I was in) helped me a ton in nursing school. I hope you will find a way to go earn a nursing degree--good luck.

Why not refer her to Wyoming? A GRE is required--but the score needed is very do-able. I had a great experience there and the price is right.

IITP here! introvert intuitive thinking perceiving My personality type seems well-suited for nursing--but I'd imagine it would be better if I were an extrovert...

an artist, most definitely.

Notifying the doc is a policy on your unit because it is a STANDARD OF CARE. I would remind the doc of this--and be very careful... he will be the first one to hang you out there when something goes wrong--and (if I am understanding your post correctly) your charge nurse will be the one to drive the last nail in your coffin!

need more info--- how far along is the patient (early vs. late gestation)? is the bleeding painless? bright or dark red? is the abdomen boardlike or soft? etc...

you can use denture adhesive on the teeth to keep the mouth closed--a mortician once suggested this--he said it keeps the jaw in a more normal alignment than can what be achieved by using a rolled up towel. I have yet to try it though... we never seem to have dentugrip when I need it! :)

Never did I say that I knew all of the meds that are on the market today... I have been a nurse for a long time, and I look things up A LOT! I agree with those posters who stated that you learn as much as you can while in school--and make educated guesses on unfamiliar medications encountered on the NCLEX. However, critical thinking is a skill developed over time--and is not possible without a sufficient knowledge base stored in the long-term memory. With this comes the ability to apply that knowledge to new and different situations. This knowledge base must be acquired in school... I would also add that if you are receiving difficult questions about obscure medications that require advanced analytical abilities in order to answer them, then you should take comfort in the fact that you are very far from the minimum passing standard on the NCLEX--and you will do fine.

wow. stunning. so... you are giving meds in clinical without knowing what they are, how the body reacts to them, and what the potential side effects are? not trying to be harsh--just genuinely curious.

I totally get your message--and agree with you... we are killing ourselves to just stay afloat on MedSurg floors these days. We need to keep our perspective, and separate the big issues from the minutea. Being 2 hours late with the Vanc is a biggy to me--not because of the "entire peak/trough thing" but because of the superbugs we are fighting. I would write that up if it were me. Everything else you mentioned? Probably not.

Wyoming

This has to do with his tumor burden--the cancer cells are still multiplying...and at some point he will begin experience respiratory symptoms, symptoms suggestive of metastasis-- or possibly a rapid decline due to tumor encroachment on other structures. Enjoy your time with him--I am glad he feels so well right now--this is a blessing for all of you for sure...

I buy a basket and thank you card for each department that the students rotated through. I then ask the students to bring a small snack item for each basket. I always let them know that this is voluntary (some of my students are really struggling to make ends meet). On the last clinical day, the students put the baskets together, sign the cards and go to all of the departments as a group to deliver the baskets and say a personal thank you. This works really well--the nurses always say they love it.

Are you paid double time?