H-town

***Edit*** Can't figure out how to edit my post.................. I wrote the wrong word in the post about. I meant to say that your patient has COMPENSATED METABOLIC ALKALOSIS. Sorry for any confusion.

According to those ABG results, you patient has compensated Metabolic Acidosis. The pH was high originally due to elevated HCO3, the lungs then compensated by decreasing the respiratory rate and conserving CO2 in the blood.... this lowered the pH back into an acceptable range. Hydrogen was also moved out of the cells to lower the pH as well, but when this happens then potassium and calcium have to move out of the blood and into the cell to keep the cell electrically neutral. The decrease of potassium and calcium in the blood results in serum hypocalcemia and hypokalemia. The signs and symptoms of these two conditions include: Neuromuscular- muscle cramping, twitching, hyperactive reflexes. and tetany. and And an overexcitement of the CNS and PNS- lightheadedness, agitation, confusion, seizures Hope this helps :)

From Fair-logic: "Mr H-TOWN, with all due respect. Did you write victimless? Laughing out loud . Nurses are responsible for the treatment, safety, and recovery of acutely ill or injured people. What can we expect with these people who as you referred to as beating the system. We can expect future evidence of injuries to a patient possibly being one of your family members. We are not talking about beating a system or escaping bad karma, we are talking about people's lives. Answer me this MR. I FOUND A LOOP HOLE, You have a patient coding on other words, the pt is dying and you are so lucky to have the I beat the system RN, HOW IS SHE/HE PLANNING ON BEATING THE SYSTEM THIS TIME? I know how, she/he has cheat sheet on the back pocket. I have to say that I find you to be very ignorant." To Fair-logic, I'm sorry, but I fail to see a real, live victim here. Now in your imaginary scenario there was a victim, but I can make up imaginary scenarios that involve you as well. How about I go through all your tests from school and pick a question you got wrong because you lacked knowledge and then I'll make up a scenario that involves this lack of knowledge/incompetance and point to you as the person that killed my imaginary victim. You sure do a whole lot of assuming. First you assume that I cheat when I never said that I did. Then you assume that just because I "allegedly" cheat that I would somehow be incompetant and a much worse nurse than everyone else. Then you assume that I, or someone who really does cheat, would let a coding patient die.......... this is silly. Just because someone uses less than honorable means to keep up their GPA doesn't mean that they wouldn't still do better than you on a test without the help, and it doesn't mean they wouldn't be able to competantly perform their nursing duties. You see, those are assumptions that are based on your emotional reaction to my previous post. ___________ To Pro-tattlers, I find that people that engage in this kind of petty behavior (tattling, gossiping, backstabbing, wild speculation, and basically just being in other people's business) are usually of a certain gender. Members of this gender tend to go through their whole lives without knowing what it's like to be at risk of physical violence. The opposite gender, however, tends to learn at an early age that this petty behavior can lead to some serious consequences. Once you've been kicked in the head a few times you tend to gain a little perspective, as in, someone else cheating on a test is pretty small potatoes compared to having to spit your own teeth out of your face. Really, there is no victim here... If you are of the moral standing that your tests should be taken as honestly as possible then GREAT! Revel in your purity! But, this need for vengance against everyone that does not share your moral high-ground is ......well, petty. "But it's just not fair!" There is no fair in life! It's not fair that someone was born richer, and it's not fair that someone was born stronger, and it's not fair that someone was born smarter. Now get over it, live your life the way it makes you happiest, and mind your own business.

Snitches get stitches where I am from. Nothing worse than a no good rat. Who cares what anyone does as long as it is victimless, mind your own business. Who cares if someone else takes a risk and gets away with it? This boils down to childish jealousy. You are jealous of those with the guille and cajones to take a chance and beat the system. I don't know where some of you get your holier than thou attitude that nurses are some blessed saint that can never have real human flaws. A nurse is someone that gets paid to provide a skilled service.... as long as the employer and client are satisfied with the service then there is no problem! If these suspected "cheaters" get through school and pass the Nclex and satisfy their employer and client on the job then what right do you have to complain? Focus on your own weaknesses.

" Jesus, you are exactly what nursing DOES NOT need! You egotistical loser. You probably couldn't even start an IV. " Yikes!

" I'm sure your school accurately laid out their grading policy before y'all started testing. I say stop whining and buckle down...... it ain't gonna get any easier, and will be over eventually. Grades aren't everything - I have some 4.0 students in my class I definitely would NOT want to take care of me in a situation......high grades alone does not make a great nurse. " I'm not so concerned with being "a great nurse", I am more concerned with getting into a good grad school so that I can delegate to "great" nurses like you. I just have a hard time accepting that I can score in the top 9% for a course and it not be considered an A. There is a nursing shortage and yet it seems they are doing everything they can to deter people from choosing this career path.

Why in the hell must a community college impose a grading policy that is absurdly difficult to maintain a 4.0 in? At my school an A is 92-100, B is 86-92, and C is 80-86..... WHY???!!!! This is only for the nursing program, the rest of the school has the standard policy of 90+A, 80+B, 70+C. So last semester I got a 90.8 in Nur 111 (8credits) and a 91.4 in Health Assessment (3credits) so my GPA is 3.0 when in any other school it would be 4.0! I am distraught. I am a 4.0 student with lofty goals of nothing less than grad school. How can I succeed like this? I went from above average 4.0gpa to an underwhelming 3.0gpa. People failed out of our school for having a 79. One person in particular was by far the best in our clinical group on the floor and is a CNA, yet she did not move on to 2nd semester due to scoring a 79 overall (a high C anywhere else). Why on Earth does a community college have a more difficult grading scale than many major universities? I love how my school's staff boasts about how they have the highest NCLEX pass rate out of any school in the state. Well of course you do! Anyone who isn't gifted in scholastics is beaten into submission long before they ever get to the NCLEX. My school is butt!

I can't believe how much some of you study. I think the problem is reading everything that is assigned. It simply takes too long and I refuse to do it. Here is my test taking system (and yes, I'm not so sure this is for everyone). The instructors post a basic class outline for each module. It is very incomplete, but it's a great guideline for areas to focus on. I then take the outline and go through the related chapters and highlight anything that is covered on the outline. I then browse through all the highlighted areas in the chapter and pick out info that could be used for testing *main points and important values* and I make note cards of this. I usually end up with 75-100 note cards for each test. I don't even worry about learning the info while making the cards... just make them *you will be so glad you have these come time for the final*. So how long do I spend to complete all this? Well, I honestly do NOT study at all until 3 days before the test. I don't even open a book. Tests are on Monday, so on the Friday before I start to systematically go through each module in the manner described above. I spend 4 hours on fri, 4 hours on sat, 4 hours on sun, and that usually gets all my note cards done. I then wake up about 3 hours before the test on Monday and start going over note cards and pretty much memorizing everything. So for each test, which is about every three weeks on average, I put in about 15hours total study time all completed in a weekend basically. My course grades are regularly low 90s, and I still have a social life. The best part about the note cards is the fact that you have most of the work done by finals. I ended up with a bit over 400 note cards that covered everything except the last few modules we did before the final. I spent less time studying for the final than I did for any one test during the semester. Everything you need is already on a note cards and all you have to do is memorize the info. I spent 5 hours memorizing note cards for the final and got a 91/100 on it. I'm sure that everyone is different, and that not everyone learns best this way, but I am fairly sure that doing it this way is much more beneficial than simply reading every page that is assigned. good luck! *edit* Oh yeah, taking a few mins to go through the Nclex style review questions at the end of each chapter can really help. Our instructors would at times steal question ideas from these and just word it a bit differently.