Stargazn03

hi everyone! i am in my 3rd semester of my program and am doing my pediatric rotation. i have to write 2 priority nursing diagnoses for my patient and i am having a tough time with my second diagnosis. here is a little background: my patient is 13 months old, has been in the hospital for 5 weeks, admitted for respiratory distress. patient has a tracheostomy and a feeding tube as well. this patient has agenesis of the corpus callosum (acc) which by definition is: an abnormality of brain structure, present at birth, that is characterized by partial or complete absence of the corpus callosum. the corpus callosum is a bundle of nerve fibers that connects the two hemispheres (halves) of the brain and allows information to pass back and forth between both sides. patients meds are: acetic acid to clean trach site, budesonide inhalation suspension for prevention of asthma, lactobacillus rhamnosus-probiotic to stop growth of harmful bacteria in intestines, prevacid for acid reflux/heartburn, multivitamin with iron, oxycarbazpeine (anticonvulsant), vitamin k, and ursodiol. patients abnormal labs are: chloride 114 (norm 98-106) bun 20 (norm 5-15) cr 0.8 (norm 0.3-.06) bili 1.1 (norm 0.2-0.9) alb 2.6 (norm 3.8-5.1) height: 25.98in weight: 8.08kg (17.8lbs) at 13 months the patients growth and development should be: walking with increasing confidence, climbs stairs, etc., turns book pages, drinks from a cup by holding it with two hands, explores objects by banging, shaking, throwing, dropping, should be responding to simple verbal requests such as "no", tries to imitate words, etc. my patient however, layed in bed the majority of the day and showed no signs of any of the above. patient was not walking, no speech, but could follow sounds with his eyes and could squeeze my hands, and sleeps majority of day. assessment data: rr: 22 wob: labored (intermittently) o2 stats: 100% on 3 l/min, 24% concentration crackles in lung sounds, all lobes temp: 35.9 celsius absent cough apical pulse: 138 regular rhythm flacc score of 1 (given a 1 for activity; squirming, shifting back and forth, tense [restlessness]) suctioned 4x during shift, 1 deep suction humidified air patient gets tube feedings 45 ml/hr for 17 hours (peptamen junior) soooo.... i know that's a lot of info. here is the first nursing diagnosis i came up with: ineffective airway clearance r/t presence of secretions in the bronchi and presence of artificial airway (tracheostomy) aeb crackles in all lobes, intermittently labored breathing, and absent cough. and for the life of me, i can't come up with another one!! i was thinking about delayed growth and development r/t the effects of physical disability secondary to acc or impaired physical mobility but sometimes i come to a block in the road when it comes to making a realistic outcome and realistic interventions that i, as the nurse, can help with (i can't just assess something or monitor something, i have to actually do something for the interventions). could i even do something with imbalance nutrition: less than body requirements? i've been stumped for hours now! any help would be greatly appreciated, it's definitely a tricky one with an admitting diagnosis of respiratory distress and this person also has agenesis of the corpus callosum. thanks!!!!

I have a question... is the decision to use saline bullets for suctioning up to the nurse or does it have to be per MD order? Thanks!!

It will be a two year associates in nursing! Oh man, it sounds like most people are suggesting living at home. I guess I could try it the first year and if it's not working for me I can always move out later still right?!?!

Hi Everyone! I am in need of some advice ASAP! Should I live at home or should I move into an apartment while in Nursing?? I am 25 and living at home with my dad. I start the nursing program in 3 weeks! I have lived in an apartment, lived in the dorms, and lived at home in the past. When I was living with a roomate I feel that it helped my studying. I was able to concentrate more, have my own space, etc. And I am also 25 and feel like I should move out of my parent's house. My question is: is this silly when I can be living at home for free?? My finances are like this: I work part time as a bank teller 13-16 hours a week (making approx $580/mo). I set it up this way intentionally so that I wouldn't be working many hours while in nursing. If I move into an apartment my monthly expenses would be $1135. I will be getting 2250 in subsidized loans per semester to be used soley for living expenses (my tuition is already taken care of). I have 10K in savings. Income: 580/mo work 4500/year subsidized loan 10K total in savings Expenses: 1135/mo Is this realistic?? I have many people telling me to stay at home and save money, which I have definitely already done. And I have people telling me "do what you want". I'm also concerned that even 13-16 hours a week would be too much for nursing. What do you guys think? Another note: the apartment I am interested in is blocks from school, the hospital where clinicals will be at, and 3 miles from work. If I signed an apartment lease I could either do 6 months or 12 months. I would not have a roomate either. Thank you in advance for your advice!!

Hi Matt, Can you tell me what you think of NHCC's program? I got accepted into both Anoka Ramsey and NHCC and I don't know which one would be better. Both are about equal distance from my home and are nearly the same price in tuition. So those aren't really factors. So at this point I am trying to determine which school people tend to like more. Thank you!

Almost forgot one of the most important things.... CONGRATS on getting in at NHCC! It's always a good feeling when you get the "you have been chosen to enter the 2010 class" letter! Way to go! I also am accepted for the day program.

Did you decide what school you are going to go to yet? Or are you still waiting too!?

Thank you! :) Well I am still waiting to hear from Anoka Ramsey. I called them and they said they were mailing their letters on on the 30th. So..... I'm not quite sure yet!! Did you get your letter from NHCC? Did you get in?!

I got a B in both AP 1 and AP2 and an A in Micro. I already had my generals degree done with a good GPA in those classes. I have no CNA or medical experience at all. :)

Hey there! Yep, I got mine on Saturday as well. I applied at three schools, NHCC, Anoka Ramsey and Century. I got accepted to North Hennepin, and alternate number 283 at Century (so a no-go there) and now I am just waiting to hear back from Anoka Ramsey. So you didn't get your letter yet!? I'm assuming you'll probably get it in todays mail then. Good luck to you, let me know if you get in!!! :) -Emma

I just heard from Century today! I am alternated number 228. So check your mail, you probably got a letter too!

I have been thinking a lot about going into Nursing. I have debated becoming an RN or becoming a elementary school/preschool teacher. I could combine the two and do Pediatric Nursing, but I think I would enjoy becoming a School Nurse even more! I see that Eden Prairie schools is hiring a Health Service Paraprofessional, $15.95/hr, 5 days a week, 6 hour days and it says "LPN preferred". However according to the MN Board of Nursing, you must have a bachelor's degree in nursing and be registered as a public health nurse in order to be a school nurse. What is the difference between the two? What would a nurse paraprofessional do vs a school nurse? And why does one ask for a LPN preferred and the other requires a bachelors? Does anyone know? Also, I am applying to Nursing schools in January (North Hennepin, Mpls Comm and Tech, Anoka Ramsey and Century), all of which have Associates degrees and not bachelors... any recommendations on schools to go to if I want to become a school nurse? Thanks so much for any advice!

Lola, thanks so much for your post, it was very helpful. It confirmed was I was thinking, I figured it would be tough to get a job as a CNA in a hospital setting. I am finishing my pre-reqs this semester and applying in January in hopes to get in for the fall. The reason I am so curious about CNA is because I am going to have to leave my current job to take the CNA course, and instead of going back to what I am currently doing, I would like to get experience in the medical field for as long as I can until I get accepted into the Nursing program (fingers crossed, the sooner the better!). "I think their website states that 800 people applied for 160 spots in Fall 2008." If this is the case, that's about a 20% shot of getting in this year, eek! What are you doing in the meantime while you wait to get into the program? Are you taking any classes at MCTC right now?

I would really like to job shadow a nurse in a hospital or somewhere, does anyone know how you can do this? I live in the Twin Cities, MN.... could you just call up a hospital or clinic and ask them? Thanks!! :-)

Hey Guys!! I am new to the site, I posted this somewhere else too before I realized there was a part of the cite just for CNA's! I am going to Minneapolis Community and Technical College and am taking the CNA course this semester. Will the experience of the CNA course be enough experience for a Hospital or elsewhere to hire me? How hard is it to find a job as a CNA in MN? Also, is there anyone who knows what the wait list looks like at MCTC? I am applying for the RN program this January, and none of the advisors at the school will give me any kind of insight as to the wait list or how many people typically apply and how many are accepted. Thank you!!