cory39

ROFLMAO, that is rather hilarious. But hey, I would give the student a thumbs up for critical thinking, lol

So your implying that everything you do in the hospital you use sterile technique? I would like to see that.....

But "technically" they say it causes false readings as well. I'm not saying I agree with that theory but for learning purposes she has to know that. In the real world I have found that theory to be false. I have had pt's hooked up to dynamaps and taking their pressure every 3 minutes when they were coding or had really low pressures. I have yet to see any inconsistencies while doing that. I think there needs to be some updated research concerning blood pressures. And they need to include the people that are actually out their on the front lines taking pressures.

I'm just wondering if your going to tell a doctor "NO NO NO NO" when he writes an order for a wet to dry dressing change? My suggestion is do not believe everything you read or see, lol

It really depends on what kind of dressing your changing regarding if it is a sterile or clean procedure .......

You have some good points EmergencyRN, but I have one comment. Another reason they say to wait a certain period to obtain a blood pressure on the same arm is also because you will possibly get false readings. But I am with you, in the real world you don't see nurses looking at their watches and waiting until the next time they can take the pressure, lol. It has been my experience that almost everytime you take a pressure, your going to get a different reading than the one you got before anyway. Of course it will be close, but as far as the systolic and diastolic being the same exact number, NOT going to happen most of the time. And I also agree with another point you made, DO NOT go in the check-off acting like you don't know what your doing. DO NOT tell them anything like "oh I have been having a problem with that," or anything that portrays you as being inconfident about it. My check off's I have coming up are trach suctioning, foley catheters, NG tubes, central line dressings, and enemas (all at the same time!). Of course, I have been working in this field for years prior to going to nursing school so I already know how to do most of those things just from doing them on the job. I thought it was kind of funny because my instructors did not even know that you could plug the NG tube up with the anti reflux valve. In fact they were telling people NOT to do that, lol. But what it boils down to is you have to do things the way your teachers are telling you, even if it may not be accurate, lol

Just because it is covered with a sterile 4X4 does not mean you have to use sterile technique. I'm not sure where you were trying to go with your comment

And that goes both ways; Just because it's not indicated is not an absolute that it doesn't have to be clean either : )

You said you were having trouble hearing it. This may sound dumb, but if your stethescope has a double bell make sure you have it turned the right way for the right bell. I'm also in nursing school and I have to tell you, I think all nursing schools make their own rules as they go. If you were suppose to take a test on a certain chapter but they tested you on a completely different chapter, then I would definitely go to the teacher and voice you concern and if that does not help, go to the director of the school. But you have to remember, they can test you on chapters that you have PREVIOUSLY went over because it is cumulative. Don't be afraid to stand up for what is right. Bottom line is your paying thousands of dollars to get a degree, so they need to be held accountable if they are not giving you the right information. As far as helping you with the BP's, wow, about all I can say is keep practicing. I have found that in nursing school you cannot go wrong with repetition. I also don't know if I would initially inflate the cuff to 200. That seems a little high to me. Best thin to do is ask the person what their normal pressure is and go from there. You were talking about the "tubes" coming from your cuff. Those are usually real close to where you place your stethescope because you have to be over the artery. Of course cuffs can be different. Someone earlier told you to put your hand on top of the bell. You do not want to do that. Hold the bell on the arm using your first and second fingers (they should be on top of the bell that is touching the pt. but under the smaller bell that is on top). So basically, you two fingers are in between the two bells. Good luck and I wish you well...

All dressing changes are not done by sterile technique. Obviously, the ones that ARE sterile are the central lines and open wounds where your doing wet-to-dry. If you have a pt. that just got out of surgery and had staples or stitches and dressing changes are ordered for them, why in the world would you use sterile technique? You put the sterile 4X4 on, tape it and move on. What it boils down to is basically what type of dressing change are you performing. Commen sense tells you to use sterile technique if the pt. has a open wound so big that you have to pack a foot of kerlix in it. There are many types of dressing changes, not all are sterile..............