rt_to_nurse

I work night shift in the ED. At about 1AM woman and her husband came in to walk in triage with the wife complaining of urinary retention. Our usual procedure with ambulatory patients is to give them a gown and specimen cup and ask them to change into a gown and provide a urine sample. When I reached my patient, she was sitting in bed in her gown and she handed me a specimen cup with about 45 ml of clear yellow urine in it. When asked what she was here for she repeated "urinary retention." I asked if the urine in the cup she just handed me was hers. She assured me that it was. I then asked when she had last been able to urinate. She said, "8PM." Now, I'm not sure about you, but I've gone much, much longer than 5 hours without peeing. Also, I'm pretty sure that the urine specimen she handed me proved she was not actually suffering from urinary retention. To be thorough, I continued interviewing and assessing the patient who gave details consistent with a possible UTI (feeling of having to urinate with not much urine actually being produced, some mild lower abdominal pressure / pain, and burning with urination). I explained that she may possibly have a UTI and sent her urine to the lab. The husband proceeded to tell me that he was pretty sure she as having urinary retention and that he wanted me to "insert a tube to drain it out." I explained that 1). I didn't think a foley was indicated as she is obviously able to produce urine as evidenced by the urine sample she handed me and 2). I can't insert a foley without a doctor's order anyway. So... they eloped before seeing a doctor.

Hello, What has been your study / test taking strategy thus far? If we know, we may be able to better direct you. I am also a new grad. I took and passed the NCLEX earlier this month. Still looking for that job, though. My study strategy was: 1. Get a good review book. Pay special attention to any tables, lists, starred items, etc. in your review book. 2. Take many, many, many practice questions. I had a program called "NCLEX 3500" for my computer. I think this was invaluable. It allowed me to take numerous computer questions and gave instant feedback (when in "Review" mode). The feedback gave me the correct answer and the rationale for the correct answer. It also explained why the other answers were wrong. 3. Once you've taken enough practice questions, you'll probably have a pretty good handle on what your trouble areas are (meds, lab values, pathophysiology, nursing process, etc.). Make (and use!) flashcards that cover this material. 4. Schedule your test for your most productive time of day for YOU. If you are not a morning person, do not schedule your test for 8:00AM. 5. The night before the test, get plenty of rest. 6. The morning of the test make sure to eat a well balanced breakfast. 7. Be confident that you know the answer. Many times the first answer you pick will be the correct one. Try not to spend too much time changing answers. I hope this is helpful! -Valerie