J9G2008

Here's something that helped me: BB makes me LOL (Beta Blocker) CC is such a DIP (Calcium Channel Blocker) Aabe is a SINner (can also be ZIN) (Alpha Adrenergic Blocker) ACE is a real PRIL (like pill) (Angiotensin Converting Enzyme Inhibitor) Then all you have to learn is what each class does, learn the stem in each drug name, and you're good. I will never forget that AmloDIPine is a calcium channel blocker!

@ Ayvah: Yes, I think parents should be left in the position of comforter. There is plenty of staff in the hospital to hold a leg or arm if need be. And at the regular pediatrician's office, two nurses automatically come in when there are shots to be given. Each takes one leg, and boom they're done. Just FYI: My son had his trach decannulated after major surgery over two years ago, when he was two years old. Several times over the past 6 months, he has had nightmares. When he calms down enough to talk, he says, "I dreamed the doctor hurt me." while pointing to his throat (the old trach site). So even though we think kids can't remember, they do.

I disagree. A parent is someone who loves their child and protects them from harm. A nurse or doctor is a paid professional who is doing a job that may hurt that child, even if it is for their own good. When my son was smaller, like I said, I would hold him for procedures. Then, when he got to be about two, he would look at me like I had betrayed him. The doctors and nurses would not be taking this child home-I would. And while I would allow these procedures to be done to him, I was the loving pair of arms that comforted him when it was all over.

I don't think much you do is going to convince a child to allow you to clean/pack wounds. When my son was in the hospital, his nurse would always bring someone else with her to hold down his arms/legs/whatever was flailing. I used to help hold him down, but after a while I stopped doing that...he needed to know his mom was on his side and wouldn't help hurt him.

I think the only other people who get this as much as men in nursing are female doctors. Breaking down stereotypes is hard work, huh?

Our instructor told us to take a look at other areas nearby, such as Ohio, or more rural areas, where the quantity of freshly graduated nursing students isn't so high.

You might try calling the publisher and seeing if they have some. I have had luck with this in the past.

You can also google "Krames online" for patient education sheets on many or all of these topics. They are printable, easy to read, and something that you could hand to the families you will be working with.

What I do is get report from the nurse (or listen in to their reports to each other), go in to meet my patient with the Dynamap with me, take their vitals, do a quick assessment, chart all the info, then grab a change of linens, wash basin, gown, soap, toothbrush, deodorant, etc, and help the patient wash up (teeth and face). If they are on glucose monitoring, do that first before the breakfast tray gets there. Also check to see if they need any meds before breakfast (insulin, thyroid, etc). After breakfast, you can give them a full bedbath if they want one, then change their linens. After all this, when they know you, you can do the big assessment question and answer session. When you start to pass oral meds, you will give those between breakfast and the bath, and you will look them up, get them all together, and bring them and the MAR to your instructor to check. Hope this helps.

Um, my "system" consists of writing lots of little notes all over my worksheet at clinicals, then flipping madly through all of it when it's time to do my assessment paper. One thing I was taught in second semester was to write a complete "normal assessment" then change the info for my particular patient. Like, under gastrointestinal, "oral mucosa moist and intact, teeth present, no dentures, no lesions in oral cavity", etc, etc. Only change that info if your patient is different. It saved me a lot of time over the past year.

I don't think "Risk for Infection" is where you want to go. Those are for conditions that may develop, but haven't necessarily occurred yet. Like, a surgical patient has risk for infection due to the surgery itself, or another patient may have risk for infection secondary to immunosuppression. For your patient, I think maybe "Ineffective Tissue Perfusion" may be a diagnosis. When I start doing my care plans, I look in the book and try to find the biggest thing that my patient may have. Then you look at the actual diagnosis and see if the conditions they've layed out actually fit what you've seen. I don't have my nursing dx book in front of me, but "Delayed Wound Healing" or "Risk for Falls" if your patient is on antihypertensives or has walking aids like canes. If it's your first care plan, I would talk to your instructor to narrow down your options and maybe get a few ideas.

Not an experienced nurse, but here's what I think I know: 1) What could you do if a drug is distasteful/may color the patient's teeth? You could dilute it in orange juice (in the case of iron, this gives better absorption) and have the patient drink it through a straw. Also, provide mouth care after administration. 2) What creative teaching regarding drug therapy should be done for the following clients discharged taking several oral medications: a. person w/ decreased vision, b. school age child Have the meds dispensed as liquids, with flavoring that the child likes. Also chewable varieties of things like Tylenol are usually well-tolerated. 3) What should you do if the client is in x-ray when you go to administer medications? To avoid this, check the MAR before the patient leaves the floor and give any meds before they go. Also, you could just write "held" on the MAR and note that they were off the floor. What would you do if a client needed a prn medication and he/she is in x-ray? Depends on the med-do they really need it right then? I suppose you could walk down and give it, but I've never seen that done. Sometimes, the patient needs to be NPO anyway, so give the med when they get back. 4) What should you do if you drop a Demerol tubex/carpuject syringe cartridge and it breaks? Sweep it up and show it to another nurse to verify that it was actually wasted. Then dispose of the broken items in the sharps container. 5) What should you do if client complains of nausea and vertigo following ear irrigation? Don't know. 6)What should you do if you find a drug error where an ordered rug had not been given for twodays? Report to the charge nurse? Let the doc know? 7)What instructions should you give a patient regarding steroid containing inhaer? Why? You always give bronchodilators before corticosteroids, so that the steroid can go deeper into the tissues upon administration. The client needs to rinse their mouth with water after administration, since the med is irritating to the oral mucosa.

Thanks very much for the info!

Hello all! I am (hopefully) graduating from an ADN program in May. I am really hoping to get a job in pediatrics, and U of M is the place I want to work. Do they hire ADN nurses? What units do they typically hire new grads for? Do you like working there? Can you give me any info on who I should contact? I am figuring I will start talking to them in December or so. Any advice you can give would be much appreciated.

I really don't think that learning to make beds puts the nurse in a "servant" role. When you start nursing school, there is a right way to do everything. And making a bed, especially if there is a person in it, is a skill that you do not learn in the "outside world". There is nothing that a CNA can do that a nurse can't do, and I am not above anything that will benefit my patient. If it were one of my children, the least I would do is straighten out their bedsheets, wash their face, and brush their teeth. I also would not let them sit in their own waste for any length of time. This is caring behavior, not servant behavior.

I haven't taken it. I am in my second year at HFCC (nursing program) and have had no need of it thus far. They make readmit students take it, but there are a lot of classes that they say are "good to have" like Critical Care, and Patho, and Supplemental, that really are not necessary in the actual program. If I were you, I would look into the BSN programs (if you're interested in pursing that route) and find out what you would need for that, so you're not wasting time and money. You may also want to actually talk to the schools you're considering to find out whether you want to take the classes on their campus (some have minimum credit requirements for you to get your degree there). Just a thought.

thefreedictionary.com describes it this way: " specific instructions for implementing the nursing care plan, including the patient's preferences, timing of activities, details of health education necessary for the particular patient, role of the family, and plans for care after discharge. Nursing orders must be signed by the professional nurse who writes them. They should not duplicate the orders of the medical staff or of other members of the health team. " Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier Hope this helps.

At the hospital we have clinicals at, the nursing orders are those that do not require a doctor to fulfill. For example, my patient needed lotion for their skin that was not in clean utility, so the nurse wrote a "nursing order" to call it up from supply. Don't know any more than that.

Anyone who says they feel ultraconfident is lying. No, not really, but there are many many of us just trying to keep our heads down and not look stupid. Make sure you know what you're giving meds for (the nitty-gritty actions, not just the Cliff Notes version). Also, start getting familiar with pulling labs and actually knowing what they're saying. And yes, don't pass meds without the instructor checking it off. Even if you've given that med a million times, and the instructor has watched you pass a million times. It's just better that way.

Why do we do three checks of medication? Why do we double check high-alert meds? Why do we put compression boots on post-surgical patients? Why do we administer prophylactic heparin on just about every patient? Why do we auscultate bowel sounds post-surgically?

I was in the happy "this is so great-I'm so glad to be in this program" mode last year. This year, though, I have lost my buzz, and am looking forward to graduation. That being said, I think I will miss school when it's over. All of a sudden, it's gonna be, "Ask the nurse", and people will be looking at ME!!! Yikes!!!

Love it! Great post!

I really think that the discs are gross. Simply because, if he decides to take them out later, they just hang there, or will need plastic surgery to fix. I think piercings are much less of an issue than they used to be, but I really don't get the "rebellion through holes in my flesh" thing. Oh, well...

To the OP: Let your wife know that it was nurses who first came up with the idea of anesthesia, and in the 1800s medical students would come to them to find out ways to safely anesthetize their patients. "Nurses were the first professional group to provide anesthesia services in the United States. Established in the late 1800s, nurse anesthesia has since become recognized as the first clinical nursing specialty. The discipline of nurse anesthesia developed in response to requests of surgeons seeking a solution to the high morbidity and mortality attributed to anesthesia at that time. Surgeons saw nurses as a cadre of professionals who could give their undivided attention to patient care during surgical procedures. Serving as pioneers in anesthesia, nurse anesthetists became involved in the full range of specialty surgical procedures, as well as in the refinement of anesthesia techniques and equipment." From the Michigan Association of Nurse Anesthetists website.

I don't know...my ob doc is male, and I've never had any problem with him seeing my girly bits! Also, in the delivery room, my CRNA was male. I think that if you're respectful of the patient's dignity (not pulling up the gown and showing the whole world my breasts/perineum/what-have-you) then it wouldn't be a problem. Although certain cultures may have more issues with it than others.