TessaMae

This is honestly the most vaugue assignment I have had, thank goodness it is the last! We had to pick a topic based on a real person with a real issue that we could teach outside of school. The paper actually is not going to have an actual nursing diagnosis in it, so no related to or as evidenced by we just need to identify the persons issue, what teaching the person needs related to their issue, and then based on what they need to know, we pick one of those things to develop a teaching plan on (we describe in paragraph form over 3-5 pages of the 10 page paper this teaching plan, the goals and how we will measure them, etc) pick something to teach that is measureable, explain why we picked it, how we will teach it and why. I think I made it tough on myself with my topic being low back pain. Most people picked hypertension, asthma, diabetes, and things like that.

Our final project is to identify a patient in need of teaching regarding a disease/illness/problem they are having, and develop a plan of care based on one of the things they need to learn. My broad topic is low-back pain and my patient is a pregnant woman. I initially thought (after talking with her) that she would need some nonpharmacologic measures for reducing low back pain. I thought I would teach her techniques to reduce/relieve back pain during pregancy - like exercises, posture, lifting, good shoes, etc. but it turns out she was given all that info from her doctor...she is feeling so overwhelmed(has a small child at home, not sleeping well, hormonal changes) she just can't focus on helping herself. The back pain is something she wants to work on but doesn't know where to start, makes lots of excuses, and puts her own needs last in the list of priorities for the day. I really want to change directions and make my patient teaching be geared toward stress management techniques or relaxation techniques. I know stress can affect how a person manages pain and managing it would also probably assist in her trying out some of the techniques to actually help with the pain. Does that make sense? I just don't know how to directly relate the stress management to the back pain, like how will I measure if my teaching was effective? I am kind of thinking out loud here because my dear husband has no clue about this stuff and can't really bounce any ideas back and forth with me. TIA for any feedback.

Do you have a nursing diagnosis book? I think that would help you alot. You would not ever say acute pain related to excessive alcohol. Heres some examples directly from the book: Acute pain may be related to obstruction of pancreatic/biliary ducts, chemical contamination of peritoneal surfaces by pancreatic exudate/autodigestion, extension of inflammation to the retroperitoneal nerve plexus, possibly evidenced by verbal reports, guarding/distraction behaviors, self-focusing, grimacing, autonomic responses (changes in vital signs), and alteration in muscle tone.....secondary to pancreatitis. I actually just did 2 care plans today on acute pain and anxiety but my patient had diverticulitis. I will try to attatch some generic careplans that are from the companion website to one of my books which serve as good examples for what to include in your more specific careplans. Hope I helped a little! Generic_Care_Plan_for_the_Surgical_Client.pdf Medical_Care_Plan_for_the_Hospitalized_Adult_Patient.pdf

The 1 yr program to complete my BSN is 45 credits, so assuming I earn an A in all those courses my GPA could potentially be a 3.75ish.

I had a 4.0 before nursing school and got a B throughout the ADN program, leaving me with a cummulative of around 3.5. I am going to be attending an RN to BSN program BUT once I finish that...how important is my GPA if I want to try and get in to a NP or CRNA program? The schools I am considering ask for at least a 3.0 but admission is competative so I am concerned that the 3.5 might hurt me.

Constipation can be used as a nursing diagnosis, it is in my carpinito book. There is Constipation, risk for constipation, and risk for constipation. An actual nursing diagnosis according to carpinito has to of been validated by the presence of major defining characteristics. A nursing diagnosis is a way to describe a client problem that the nurse can manage on his/her own. In many cases, that is true for constipation. The ND I wrote in the post above was directly from my nursing diagnosis handbook

I use the Handbook of Nursing Diagnosis by Carpinito-Moyet and in the back of it there is a section for medical conditions and ND and PC that go along with them. For DM it has the following listed: the most common is ND: imbalanced nutrition more than body requirements - risk for injury (could use right from the book r/t lack of awareness of environmental hazards s/t hypoglycemia) then base your careplan off all the info right in the book - risk for ineffective coping - risk for noncompliance - risk for ineffective therapeutic regimen All of the risk for's would be changed to actual ND if the patient actually had them obviously. They also have the following Potential complications/collaborative problems PC: ketoacidosis PC: hypoglycemia PC: infection I don't know if all the books are like this one but they list the major and minor factors associated with each ND and related factors.

My professor said you should really take them from the book. As far as the one you wrote, I think by making your own it makes it a little confusing because it leaves out information. The person is constipated related to urinating excessively secondary to diabetes. Generally those with uncontrolled diabetes are excessively thirsty in addition to urinating frequently and those with controlled diabetes wouldn't be urinating all the time. So why is this person urinating but not drinking more? Are they unable to for some reason, unwilling? The way my professor explained it to me, you want to be able to read the ND and understand what is going on with the patient and with yours, you can't do that. If you use what the book has an make it a 3 or 4 part statement it can explain what is going on with your patient. Constipation r/t inadequate fluid intake s/t uncontrolled diabetes as evidenced by FBG of x amount I am not a pro at these yet so I could be wrong. Good Luck!

The rhythm method

Allopurinol reduces myocardial oxygen demand...according to my professor. I personally remembered it for completely incorrect reasons apparently. I thought it was an alpha beta blocker (ilol) I thought it dilated the vessels. Oops!

Not sure if it is the same when you are studying for a retake but at my school we have a 98% first time pass rate. They suggest that we take the nclex within 4 weeks of finishing school and not to self study for 2-3 months. We take finals, the school conducts 40 hrs of nclex review and within the next few weeks, take the nclex. Maybe that is the key for those of you that are retaking. If you enroll in a kaplan course or some other prep course, take the test right after it is through? Good Luck

Did this guy yell in front of everyone in the loby specific information about the patient? It seems like he was violating HIPAA in addition to lacking professionalism. I think if you send this email account of events in an objective manner with just the facts that you are doing what you are supposed to do. Good Luck!

I am in my last year of school. I did not read everything they assigned, just the info that I needed. I used a book by FA Davis called Fundamentals Success, it also has a CD with many nclex questions. I think most students would suggest a nclex book. Nursing school is different from your prereq's, memorizing facts from the book will onky get you so far. If you feel you have a good understanding of the material, I would go to barnes and noble and grab this book or one like it, do questions and read the answer rationales every day until the exam. Also I suggest reading the first chapter on test taking strategies, it is VERY useful. I did this and easily got an A on my first exam. Good Luck!

just reviewing my notes and realized I made a typo...nitro tabs should tingle under tongue.