tobagosama

Hello, I'm very new to caring for LVAD patients and am still trying to wrap my head around some of the basics. I was hoping someone might help clarify a few of them for me. I had a patient the other night who at change of shift increased his flows & power while his PI remained stable. The flows had been about 5.4 - 5.9 overnight and he bumped up to 6.5 - 7. The PI remained unchanged. Not a huge change, but it took him outside of the ordered parameters. I was just wondering if someone could break down potential causes of increased power for me and what it can mean? I know the flows are just estimated based off the power and RPM's, and that clots are a possibility with an increase in power, however, I was told that these would also show a deviation in the PI. I'm a little unclear of the effect of fluid status, preload/afterload on the numbers. These changes were explained as the result of the carvedilol that the patient had been started on 3 days prior. Seems to make sense to me that with a high afterload, the watts would be higher to push against it, but apparently the opposite is true. Can someone explain to me how this works? Also if anyone has a simple explanation of PI I would really appreciate it, its still a little fuzzy for me as well. Thank you!

Hey all, Hoping to get a little information here from someone who has had a similar experience. I have been attending a direct-entry Master's program, but since completing the RN portion of the program and beginning to work have decided that I need to take a break for awhile. I'm pretty far along in the program, but have been told that without completing a degree in nursing my license won't transfer to other states. Does anyone know if this is in fact true? If so, I was interested in potentially looking into completing an online RN-BSN program, but was hoping to find one that would accept transfer credits. I've already completed far more than the required BSN requirements at my school, but they are unwilling to grant me a BSN since I am not enrolled in that program. Anyone have any experience with this? I would like to get my BSN to allow me to travel, but not at the expense of having to repeat the classes and clinicals that I've already done. Any information would be very much appreciated. Thanks!

I am a SFSU nursing student. I don't know about any specific pitfalls, but I would just say be prepared to be flexible. Dealing with the administration can be unbelievably frustrating. You will have some of the most amazing teachers you have ever encountered along with some of the worst. When it comes time for your final clinical (N557), stay on top of the faculty to make sure they don't drop the ball in finding you a placement. There have been some definite issues with that in my cohort. Other then that be proactive in seeking out learning opportunities in your clinicals, and have fun! If you have any other questions, or some that come up as you go along feel free to PM anytime.

Congratulations on getting in! Taking pharm over the summer would definitely help lighten your class load in future semesters, but unless you are going to be working while in nursing school, I would say hold off on taking it for now. You will get far more out of the class by taking it while you are getting some clinical experience at the same time. This will allow you to see the drugs you are learning about in clinical practice, which will reinforce the material. You can indeed use calculators! Have fun!