LiveYourDream

Im a nursing student. Have not really been assaulted but once was d/c-ing and IV and asked the pt if it hurt (I was taking a while to rip all the tape off- it was my first time) and he said, "well I havent slapped you yet" which I took to mean as a threat, "I will slap you if it hurts". Also working as a nurse extern my preceptor was sexually harrassed frequently by a patient who would say 'I just want to be alone with you' and make inappropriate sexual references to his penile prosthesis and try to hold her hand at times when he had no business doing so and when I asked her why she did not confront his behavior she said it would only make it worse, and awkward for her for the rest of his stay. She has also told me of other patients that have asked her inappropriate questions about me but fortunately that never translated into inappropriate commentary or action in my presence. I dont appreciate winking spouses of female patients that refer to the nurses as "love" constantly either. Just a funny-feeling undercurrent. But no physical violence thank goodness.

Heres some: Lose the silly sense of self-entitlement and grow up. Nobody owes you anything. No you do NOT deserve to watch a second c-section when there are people waiting to see their first. Keep your hands to yourself. Physically assaulting people (smacking, etc) under the guise of joking is just not cool. STOP.INTERRUPTING.CLASS.TO.ASK.IRRELEVANT.QUESTIONS. OH MY GOD. Stop arguing things you got wrong on the exam. Who are you gonna argue with when you fail NCLEX? If you disagree with the rationale, go have a civil discussion with the instructor privately. No, I dont want to tell you what I got for # 12. No, I dont care that you got a 100%. If you cant handle the fact that someone else got an externship and you didnt, dont ask!

The problem is not that she's excited about her learning. The problem is that she is disruptive to the flow of the class and asks questions that are not relevant to the class, only to herself. Everyone knows if you have a personal question that you ask it on your own time. There is a time and place to speak up and there is a time and place to shut up and we must know the difference if we want to be successful! It's called picking up on cues! It is not fair to the other students in the class to allow this person to dominate. OP I say take your concerns to the instructor. They tend to take these types of complaints seriously.

Hi - Im a student too. Just some possible thoughts, till someone else who knows much more replies :) For the edema I think you would be better off with decreased tissue perfusion than excess fluid volume, since youre describing peripheral edema. As far as secondary to: Is he on bed rest? If not, has he been ambulating? Does he have any chronic conditions that decrease perfusion such as hypertension or diabetes? Is he on any meds that could cause edema? Also similar to your idea, you could do something about ineffective management of therapeutic regimen since the NPO is to rest his system and he is having a hard time complying.

Hi all. I am to do a care plan on a post-partum patient (which I will describe in a minute). I know that the priority diagnosis is supposed to address what they came in for, which would be labor... But I only provided care once she was post-partum. I have some non-priority diagnoses but I never know what to do for priority. Here is here info: 25 y/o single white woman Gravida 7 Para 6. Delivered AGA little girl at gestational age of 37.5 weeks. 1 child was a SIDS baby at 2 months. 4 of her children live with her mother. New baby will be the 2nd baby to live with her. The other child that lives with her is a 2 y/o. During that (2008) pregnancy she was in jail for part of it (reason unknown). She has gestational diabetes (and has had it with every pregnancy), GBS positive (4 doses penicillin prior to delivery), chlamydia positive. Diabetes managed by glyburide during pregnancy, she did take prenatals however had late onset of care (still had >5 visits). Urine drug screen negative, perineum intact, breastfeeding with no significant problems, exhibits positive parental interactions, in good spirits, no maternal complications during delivery, minimal blood loss, multiple family members present after birth, motrin for pain, she is ambulating and voiding, fundus firm & midline @ U-1. Vitals WNL. Basically no abnormal findings during PP assessment. My dx are to be for the mom, not the baby. I can think of a million ndx for the baby r/t her infections, but mom seems to be in good shape. She did cry that she had to stay an extra day due to the baby being monitored for GBS and she wanted to get home to her 2 year old who she had never been away from before. So I have ineffective coping as a non-priority dx. Totally stumped for priority. Ideas? Guidance? Thanks!

Hi all. I am doing a case study for OB and am having trouble coming up with a priority nursing diagnosis. I just dont know where to start. The summary of the patient is that a patient has come in with spotting for the past week, saying she missed her last period. She has reflux, nausea & vomiting for past 2 weeks. She is diabetic & is obese. Gestational age is undetermined (but assuming new since missed only one period). Medical history currently undetermined, age, gravida & parity are unknown. The pregnancy is confirmed via ultrasound. She has pre-gestational diabetes. My approach is that the spotting is a result of implantation, so I am not going the route of 'risk for fetal demise' etc. I am not too worried about n&v & reflux as they are normal / can be treated. I can recognize that this is a high risk pregnancy d/t the diabetes and also a complicating factor is the obesity. What is the first thing I need to address with this patient? My ideas so far are: Risk for decreased perfusion r/t pregestational diabetes OR risk for maternal/placental insufficiency r/t pregestational diabetes knowledge deficit r/t ....something? I just need a nudge in the right direction. and an explanation as to why, lol.

Hi all, I am a Sr 1 nursing student. This is a personal question so forgive me but I cant think of a better group of people to ask about it than nurses. I donated platelets yesterday evening. When they return the remaining blood components, they do this with saline. On the screen I saw that they had processed my entire blood supply (it gave real-time whole blood ml's already processed and ml left to go-- the total amount of ml's it wanted to process was 5450 ml or 5.4 Liters which is clearly my entire blood supply). I did the two arm process which draws from one arm and simultaneously returns remaining blood to the other arm. I dont know how much saline was infused along with my blood being returned to me. Immediately after donating I went to the 'recovery area' where I chose a snack to munch on and noticed upon chewing that my tongue was hurting. Next day being today, I have had intermittent pain in my tongue. It is a muscular pain, not a superficial one that a sore might cause. I have never had this type of pain before and I dont know if this is completely coincidental to the donation. I have heard that anemia can cause tongue pain. My theory is that by infusing a large amount of saline that they may have diluted my ratio of RBCs to overall fluid volume, thus causing anemia and my strange symptom. What say you all? Is this possible?

Hi all, I'm writing a care plan for a patient and having such a difficult time. The patient has COPD (emphysema), idiopathic pulmonary fibrosis, has just been diagnosed with CHF during this hospitalization (though with an ejection fraction of 10% he likely has had CHF for a while now). His admitting symptoms were non-radiating substernal chest pain, and in the days preceding his admission, dyspnea on exertion. I have decided to use decreased cardiac output (he has an ejection fraction of 10%), and impaired gas exchange (secondary to emphysema) as my 2 nursing diagnoses. I am having a hard time coming up with realistic short and long term goals for him because recovery is not possible so I am trying to focus on quality of life (after consulting with my instructor). For his heart failure dx I tentatively have chosen as his short term goal to be able to resume activities of daily living before discharge, and the ability to return to work (he is self employed) after discharge. Im not sure what type of interventions to use though and how I could possibly evaluate them. Anyone have input? Thanks