davidthenurse

No problems, and you're more than welcome !

Is you research in the MIMs (the drug Bible used here in Australia), Lasix must NOT be given during pregnancy unless it is absolutely necessary. If treatment with Lasix is to be used during pregnancy, then fetal growth has to be closely monitored. As you would know, Lasix is a "loop-diuretic" and it has the capacity to cross the placental cord and enter the fetal circulation. The biggest problem with this is that it can cause electrolyte disturbances, and worse yet, thrombocytopenia of the fetus. This is of the biggest risk during early stages of pregnancy. That's not to rule out risks during later stages of pregnancy. The MIMs indicates that "During the latter part of pregnancy products of this type should only be given on sound indications, and then in the lowest effective dose." An alternative drug which is commonly used to to treat HT in pregnant women is Aldomet, which CAN be used for pregnant women. Hope that helps !!

Hi, Thanks for your question ! Would you mind expanding a bit more, and perhaps giving a few more details? I think maybe you haven't received any answers yet because your question needs to be clarified. When you mention "school", I assume you are referring to "nursing school"? And what do you mean by "in my english"? Is this referring to the fact that english is not your first language...and so you have to complete a course in english? sorry, I'm from Australia, and perhaps its clear to others, but I'm a bit confused. In regards to what topics should you choose, what sort of things interest you the most in nursing......aged care, operating theatre nursing, children/babies, mental health nursing, etc...???? Choose an area that interests you, because it will be easier to research and write on. Best wishes with your paper !!

I agree !!

hmmm, three things that stand out to me: Maybe its just her - her personality. Maybe she was under a lot of stress from work, and its flowing over to her communication skills with patients and others. ............and maybe its one of those days that she simply forgot to leave her "personal baggage" at the hospital door. Oh well, I feel sorry for her patients. :yeah:Maybe another job would suit her -- like workin' in the morgue

sure can !! ......if i "google" it !! just jokin', caz i actually knew how its spelt anyway - i'm a pianist, and have been playing for nearly 19 years now (and did a degree in music too). i just couldn't resist missing an opportunity to comment on this one, haha !!

On a serious tone, yes, I thoroughly agree -- comments should be supportive, encouraging, gentle, and in a caring manner. If something needs to be rebuked or pointed out, then do it in a kind manner !! ......Remember, nurses work as a team, right? ......but a team can extend far beyond the "individual workplace", and include all other nursing staff - not matter what field of nursing he/she might be from. That's just my :wink2: David

better smacked with a fish.....:trout:....., than being stabbed in the back.....:smiley_ab......, or knocked over the head.......:lol_hitti..........haha !!!! (I just couldn't resist it !!!)

Hi, I was discussing with my teacher about a pt. scenario. The patient was involved in a road accident. To keep it short, there were major head injuries, including internal head injuries, and hence high intracranial pressure (which would require a craniotomy). However, the patient also suffered severe abdominal bleeding from the spleen, as well as a possible pneumothorax. In regards to the severe abdominal bleeding, the pt. has becom hypovolaemic, and hence tachy, hypotensive, and hypoxic. When I was discussing the need for hydration (along with blood transfusion), my teacher said that hydration is not a concern - due to the complication of the intracranial pressure. She said to consider the rold of dehydration in head injury, particularly regarding the balance between decreased volume, and the desire for increase in perfusion. Is there a paradox here? Whats more of a concern - intracranial pressure, or hypovolaemia - which is leading to brain hypoxia? Thanks.

thanks countyrat, for your help and encouragement. i am really enjoying nursing, and its great to have the support of other colleague like you and everyone else on this forum !! it's the true element of teamwork support !! :icon_hug: thanks too, kwkrnc ! i am always asking questions while nursing - haha, just hope no one at work gets sick of me asking questions !! on a serious note, one thing has really sunk down in me - that no question is a dumb question, because we are all still learning. that's what our lecturers have told us, and i believe its so true too !!

Very true !! When I think back about my placements I remember that I actually went through a "mini mental-analysis" with each of my patients whilst I care for them - of course not being obvious, but purely by observations and general questions! But observations go a long way, and for some reason, I have always had an ability to observe other people (patients or not) and glean information about people which might not be obvious to others around me, but which I can discern quite easily. Maybe its a gift, but either way, I think it will be a valuable tool in nursing !!

"shhh.... don't interrupt me! I am trying to recall the day's events so I can write up my patient notes!!" (in deep thought with your eyes closed :thnkg:)

Haha !! My mother is having a VERY Happy Mother's Day !! I have 10 brothers and sisters, so you can imagine how many gifts and surprises she is getting today !! :clpty::thankya::clpty:

Yes, I agree. Cheating is completely unacceptable. My attitude is: I would not want to be cared for by a nurse who cheated his/her way through their studies and training. If they have no conscience about cheating, then they most likely won't have a problem with falsifying the patient's records or denying medication errors that occur. And worse yet, if someone cheats in their studies because they couldn't be bothered learning, then what kind of a nurse will they make anyway? It simply indicates that if they cheat, then they are not serious about nursing - so that means they aren't going to give you the best possible care anyway. I know I'm only a student, but its my sincere desire to learn as much as possible about nursing and caring for others. In fact, it is quite disheartening and upsetting to see other student nurses who don't bother studying thoroughly -- are they a nurse purely for the money, and because its "just another job"? ... or for love and care for others??? I know what I believe the answer is !!

Thanks, I didn't know this - but you live and learn ! :lol_hitti

[color=gray]oh, and a special thanks to you, daytonnite ! i did receive your private message, but unfortunately i can't reply back to private messages due to my basic subscription level. maybe one day when i can afford to upgrade, then it will make it easier for me to reply !! thanks again, david

Wow !! Thanks so much everyone !! And I really appreciate the openness of some of the members here who are willing to discuss their Hx of depression and how they coped with it - thanks to Daytonite, cursedandblessed, and ~Mi Vida Loca~ !! As is the case with all nursing care, I can see the importance of listening to the depressed pt., and spend time talking o/c them - and building up a positive interpersonal relationship that will allow for best care for that pt. (Empathy and/or symphathy) :icon_hug: And many thanks to Daytonite for your efforts. I have found the input and opinions from you all to REALLY help. And it has been an eye-opener regarding this mental illness. Kind regards to you all - David

Hey, many thanks to Daytonite and nerdtonurse? !! You have both given me a clearer framework for some of the "extras" when caring for pts o/c depression, or who are suicidal. WOW!! I never really thought about this aspect !!In nursing we generally try to be caring, thoughtful and gentle in our words, but yes, you're right, its so true - the direct to-the-point approach when dealing with suicidal pts works the best. It is simply because if you use gentle kind ways of asking them about their possible self-harm/suicide, they will tend to "duck-shove" the question - and usually give you a false response. But ask the question directly, and they can't help but hesitate because you've "hit the nail on the head". And then they know that the nurse has worked out their intentions, so there's no point in trying to hide their potential action. Thanks, Daytonite, I appreciate your input and feedback. You've given some very basic, and practical points. I will save you the time having to write up the rationales for me - I'm going to see if I can track down this book reference you have given me, and read the book through. It's obviously has some very valuable info in it !! Thanks again

Maybe I have much to learn yet about psych pts, including suicidal pts, but we were trained that whilst we create as "safe as possible" environment as we can, that suicidal pts. will sometimes go to extreme measures to carry out their will if they want to - so basically "safe" environment for these types of pts. is individual - depending on the circumstances (But I take your word to be true, as I guess that you must have lots of knowledge and experience in working with suicidal pts. ) As mentioned before, I am not directly referring to pts. who are depressed, but rather to psych pts. who are suicidal. In regards to "turning your back", I was thinking along the lines of "keeping an eye on their behaviour" that they will not harm themselves.

Sorry, maybe my wording could have been a bit more clearer - I was referring to psych pts who are suicidal.

Hi donnabellaluna,No, I'm not currently in psych nursing clinicals just yet, but recently I had to care for a pt on Ward 5 (Cardiac/High Dependency) who was diagnosed o/c Psych issues - depression and schizophrenia... It's just that for one of my nursing assignments, I am to research a mental health issue, so I am looking at depression (unless you can recommend a better topic for a mental illness !!) I have to include in my assignment things like (1) the causes, (2) the characteristics/signs/symptoms, (3) how it can be treated (the mental illness), and (4) how to manage someone on the ward with this illness. I'm fine o/c the first 3 points, but the last one "(4) how to manage someone on the ward with this illness" is a bit of a different story. To be honest, aside from the one pt from Ward 5 of our hospital, I have never had to deal with pts with a psych history, so its a little difficult to fathom what is required in order to manage such a pt. (But what I DO know from other colleagues is that you NEVER turn your back on the pt :smackingf - for both your own safety, and for the safety of the pt. !!)

Hi dolcebellaluna, Yes, you are right, I found this out just last week - its truly amazing !! (Do you have any other tips, haha :blushkiss) Thks

Hi everyone !! I'm doing some research about mental illness, particularly depression. Can anyone please give me some feedback about how to manage and care for a patient diagnosed o/c depression? I believe there would be things "out of the norm" to look out for or take care of when dealing with patients diagnosed with the mental illness depression, but I'm not quite sure what they might be. I appreciate all your help, everyone. (I hope too, that as my nursing knowledge grows, I can return all the help you guys give me by helping out others on this discussion board :typing !!)

Hi, thanks, I'll have a look at these sites and see if I can piece the puzzle together !! :typing

Hi, I'm a student nurse in Australia, and I'm trying to find out what the "life-cycle" of the following three drugs are: Clexane by S/C injection(also known as Lovenox or Enoxaparin Sodium) - anticoagulant/antithrombitic Warfarin orally- anticoagulant/antihrombitic Topical GTN patches (Glyceryl trinitrate) I particularly need help regarding what actually happens to these medications once they get INTO the body. For example, the step-by-step process by which the medication is absorbed (how and where), metabolised (how and where), and then excreted (how). I have been researching for these details for the last 3 hours, but with little results!! :urgycld: Oh, dear, maybe its just me, [sigh], but I've looked on the internet, in pharmacology books, in MIMS, etc... but not much luck. Thanks in advance everyone!! I can't tell you all how much I appreciate help - I would rather be humble and ask, then just guess it myself!! (besides, there's no room for guessing with medications, you have to either get it "RIGHT" or "RIGHT" with pts.) :plsebeg: So if anyone is willing to help me out - THANKS SOOOO MUCH !!!!