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This happened to me, and it was because I recorded my email address incorrectly on the application. Just a thought!

Thanks Daytonite! This was what I was thinking, but just needed the reassurance. :)

if not a normal diet, then what kind of diet would be appropriate??

Here's the situation we were given: 82 year-old male with a history of renal insufficiency and CHF taking the following PO medication: Lasix 60 mg BID, K-dur 20mgEq Bid, Digoxin 0.125 mg QD, and Niforex (renal multivitamin) QD. He is transferred to the Medical unit with the admission diagnosis of nonketotic hyperosmolar dehydration. He has been unable to eat due to a lack of appetite and has been taking only Ensure. Medical management of this patient includes Glucose monitoring QD, NS @ 125/hr IV, Insulin by Sliding Scale, and regular Diet. Do not assume information that is not provided. What orders would you question? Well, the glucose monitoring at QD isn't going to cut it! I also thought you would question the insulin by sliding scale because he was diagnosed with nonketotic hyperosmalar dehydration. Don't these patients need IV insulin??? I'm clueless as far as the IV fluids. I can't find anything anywhere that helps me answer if this amount is correct. Most things that I have read suggest: Administer 1-2 L of isotonic saline in the first 2 hours. A higher initial volume may be necessary in patients with severe volume depletion. Slower initial rates may be appropriate in patients with significant cardiac or renal disease or in those who are not urinating. Caution should be taken to not correct hypernatremia too quickly, as this could lead to cerebral edema. After the initial bolus, some clinicians recommend changing to half-normal saline, while others continue with isotonic saline. Either fluid likely will replenish intravascular volume and correct hyperosmolarity; a good standard is to switch to half-normal saline once blood pressure and urine output are adequate. Once serum glucose drops to 250 mg/dL, the patient must receive dextrose in the intravenous fluid. HELP!

I'll give you the Powerlessness. There's a diagnosis there, but I'm just unsure of which one to use. The information we were given is: John also expresses a great deal of concern and anxiety about his current situation. Because he works for a construction company, he will be unable to work for many months; furthermore, he cares for his wife who has MS. He states, "I don't know how I am going to make the house payment and take care of my wife." Caregiver role strain? Anxiety? Ineffective role performance? I'm just not sure where to go with this information.

Thank you Bug Out! This was exactly what I was struggling with as far as going with the "risk for" or straight to the "impaired skin integrity". What you said makes total sense. Nursing diagnosis should focus on things I can fix or prevent! That'll certainly guide my thinking from here forward. I also have the nursing diagnosis' of acute pain, risk for infection, and risk for constipation. I also included ineffective tissue perfusion because we were given the information of overall pallor as well as a Hgb of 8.2 and a HCT of 29.6% I used powerlessness because he states, "I don't know how I am going to make the house payments and take care of my wife." Am I on the right track??

I'm working on a case study/concept map, and need a little bit of help. The case study is about a 52 year old with a right comminuted pelvic fracture that is stabilized by an external fixation device. He is on strict bedrest. I'm thinking a nursing diagnosis for this might include impaired skin integrity because he would have the external fixation device's pins going through the skin, but then I am unsure if "impaired skin integrity" applies only to things like pressure wounds, and not surgical incisions in the skin. Could anyone offer up some advice either way on this?

I don't know how to beat the semester end lazies. I suffered from it big time this past semester!! I'll be following this thread for ideas!

My plan is to not slack the last part of the semester. I went strong for the first 2/3 of the semester, but really started to slack and fall behind the last 1/3 of the semester. I plan on finding a way to keep me motivated throughout the whole semester!!

I received a B on my final, but an A- in the class. I care far more about my total course grade rather than any one grade on an exam.

I live on Diet Mountain Dew, and lots of it!! I am also a lover of a well placed nap. My naps are usually a couple hours long, but they help so much. A lot of times I'll go to bed at a decent hour and wake up 2-3 hours before I have to be to clinical to finish my paper work (medication lists, care plans, ect.)

My first semester of nursing school is over, and our class has become very close this semester. We're all friends and we all get along so well. It makes me sad that, as I move on to my second semester, many of my class mates won't be going with me. We had several people who dropped during the course of the semester. I don't know the exact number but it was at least 3, if not more. Now that finals are over, I have learned that at least 5 people in my class did not make the 80% to move on in the program. It kinda gets me down.

My grades came in. I received two A's and one A- for my 1st semester of classes. I'll certainly take those grades!!!!!!!!!!

I'm playing the waiting game as well . . .

I'm a nontraditional student. I'm 30 years old. Married 10 years. Have 2 young children, and have been a stay at home mom for the last 6 years. I did attend college right out of high school, but did not get a degree because I decided 4 years in that I wanted to be a nurse. Due to fertility issues, my husband and I decided to have children first and then send me back to college once our kids were school age.

I work full time, 40 hours a week, as a night auditor at a hotel. I make $8.25 an hour, which is enough to cover my expenses. My job allows me 4-6 hours a night of study time. I am in the night and weekend program at my nursing school.

I'm in my first semester of the night and weekend program at Kirkwood. So far, it rocks!!

I can't wait to vote tomorrow! I'm so excited! I'm voting as soon as I get off work at 7:30am.

There is also the National Sudent Nurses Association. You do have to pay to join, but you get access to the NSNA as well as your state student nurses association too. http://www.nsna.org/

We have clinical from 7am-12pm Saturday and from 7am-12am Sunday. That's the amount of time we spend on the floor with our patient. On Saturdays, we are required to have all our paper work done for clinical. If you don't come in on Thursday or Friday to get your patient assignment, you come in Saturday at 6am to get your paper work done. Then we have post conference from 12pm-1pm with our instructor. On Sunday, this time includes a nursing math quiz.

Our first day of clinicals was orientation to the hospital and the unit. The next week we were thrown into the fray! We were totally responsible for our patients, except any skill we were not trained to do (mostly IV related stuff). We got report, did vitals, got out patients ready for breakfast, did baths and bed making, I and O, toileting, Accu checks with instructor present, charting, passing meds with instructor present . . . you name it, we did it! It was a total blast!

I am a nursing student and I did not have to disclose my Bipolar diagnosis to anyone at the college I am attending. I did have to have a physical and have a form filled out and signed by my doctor, and on that form was a list of my medications, Bipolar meds included. So, for school I did not have to declare my mental illness.

This sounds just like me before a clinical. Right down to the Ativan!!!!!!!

I love nurses like you madwife! I had my first clinical experience this past weekend, and I had a nurse who really loved having students . . . which was good because she had three!! She allowed me to do the things I was qualified to do, and pushed me to explain things and to know my stuff. When I was hesitant to do something, she gently guided me and never minded a question or a request for an explanation. Because of having such a great nurse to work under, that first clinical experience was awesome, and I got to do more things than most of my classmates. When I become an RN, I'll treat students the same way this nurse treated me. I'll treat them with respect. I'll guide them gentle, and I won't be afraid to push them in the right direction if they need it!

So, it seems a mutiny is occurring in my first semester nursing class, and I'm not sure what to do about it. Our nursing instructor for this semester is new. It is her first semester teaching, and I think she does a great job. She teaches the material well, and encourages us when we need it. She's a wonderful woman all around. Always understanding and willing to help you in any way she can. She wants for all of us to pass her classes and move on in the program. I happen to be doing very well in her classes, a A- and an A. It is the first semester that the nursing program as instituated perception testing into the PN portion of our program, and many students are struggling with this type of testing. It seems to me that a lot of the students who aren't doing well want to place the blame on our instructor. During clinicals, through email and before and after class this week, the students are coming up with a list of names of people in the program who think their bad grades are directly related to our instructors teaching ability, and they plan to take this list, as well as their list of complaints, to the Dean of the nursing program. I, of course, side stepped placing or having my name places on this list because I think our instructor is doing a fine job of teaching our classes, and she has avocated for us within the program . . . bringing our concerns to the program directors and Dean. Now my problem is I feel I should make the instructor aware of what is going on with the students in her classroom. I think she has a right to know that her students are, essentially plotting against her, but I'm not sure if I'm in the right or wrong bringing this to her attention. I don't know if I should tell her my concerns with the class's actions or just stay out of it and let the chips fall where they may. Your opinion??