REDDOG RN

Okay, I'm going to throw a bunch of questions your way--How do you study for your tests? Do you have power points from your lectures? Do you tape your theory lectures?

what areas in med-surge are you struggling with? Can you be more specific? How far along are you in the med-surge class?

Oops-- I apologize!! The first part of the above post was meant for WANT2BANURSESOON!! On the second part about the uniforms, if either you or Househead4Life is interested in the uniforms let me know. REDDOG RN

Househead4life-- I think you have an excellent chance of getting into the RN program with a 3.85!! I've got my fingers crossed for you!! I graduated from OCC's RN program in 2009 and I had to wait over a year before I got into the program, but it was well worth the wait! It is an excellent program!! Also, I'm thinking about selling my OCC uniforms, if your interested. They have been sitting in my closet for the last year gathering dust (or so to speak)!! If your interested PM me. Anyways, best of luck to you and if you have any more questions about the RN program let me know!! Take care, REDDOG RN

I was reading your post and wondering what the term "POD O" means and also what you mean by "POD O banding of the same." Just very curious what that means! I tried looking it up but got nowhere! I would greatly appreciate it if you could explain this to me!

Listed below are some examples for your nursing diagnoses that I would suggest: 1. Ineffective Tissue Perfusion (Cardiopulmonary) r/t decreased circulating blood volume aeb death resulting from compression of vital areas within the brainstem that control respiratory, vasomotor, and cardiac function. 2. Decreased Cardiac Output r/t altered stroke volume aeb arrhythmias (tachycardia), decreased BP, cold, clammy skin, decreased peripheral pulses, pale, grayish color of skin, and adventitious lung sounds in RLL and LLL. *The aeb factors listed in #1 was another "fancy" way of stating many of the same aeb factors listed in #2! The reason why I'm suggesting these nursing diagnoses is because of the fact that your patient was declared brain dead and was going to be an organ donor. Since this is the case, to me the most important intervention would be to maintain adequate circulation and profusion to the organs. So that was my line of thinking. Since I'm not sure of your patient's actual symptoms, I made some up some to use in the examples. Some additional info when doing care plans--If your using a Nursing Diagnosis Handbook and you determine what your nursing diagnosis is, there are related to factors listed pertaining to that particular diagnosis. These r/t factors explain what the patient's "problem" is. Okay, let's clarify this a little bit better. For example, using our example of the nursing diagnosis of Decreased Cardiac Output, the r/t factor ("problem") is the patient's altered stroke volume. (Read up on what stroke volume is and the factors that encompass it and the effect on cardiac output). Trust me, it'll make more sense after you read it!). The result of this altered stroke volume is decreased cardiac output. Hence, our nursing diagnosis. Hope this makes more sense. Okay, so here's some more additional info: aeb are those symptoms that are specific to your patient and support your nursing diagnosis. It's like making a hypothesis and using specific facts that support your theory. So again, we will use our example of decreased cardiac output (hypothesis) and list the symptoms (specific facts) that our patient is experiencing: Decreased BP, tachycardia, cold, clammy skin, decreased peripheral pulses, etc. These specific symptoms under our aeb helps to support our nursing diagnosis. Hopefully, this will now be easier to understand. It is very important to make your symptoms specific to your patient. For you will use these later on to evaluate your patients progress and to determine whether to continue with the current plan of care or revise it. Okay, I've got to conclude this and get off my "soapbox" as I spent about 3 hours on this and I was supposed to be working on my resume!! Take care and if you have anymore questions or need help, please PM me and I'll be glad to help!!

PawashRN-- I apologize for this response not pertaining to the original poster's question, but the question you had about the pt. with a decreased O2 level and drop in SAT'S and what happens to the body and how the pt. compensates for the decreased O2 intriqued me and was driving me nuts. I love the challenge of a difficult question! So, I like to take a chance at answering it and if you could give me some feedback as to whether or not I'm on the right track. I would so appreciate it!! Okay, here goes. If the patient has these low levels I would immediately think of respiratory acidosis. This is due to the fact that more CO2 is binding to the hemoglobin which results in less O2 being available to the tissues. As a result the patient develops hypoxemia and becomes cyanotic. They may have additional symptoms such as dypsnea, tachycardia, tachypnea, sweating, etc. In addition, the patient will develop neuro changes such as confusion, decrease in LOC, etc. The body compensates by increasing the respiratory rate, increasing the heart rate, increasing body temperature, etc. Sorry, can't think of any more additional symptoms off the top of my head. Anyhow, so that's my overall summation of the question. Again, any feedback would be welcome and greatly appreciated. I am a newly licensed RN (got my license in June, so I guess that makes me still a new grad?). I'm currently looking for employment (like all the other new grads!). My desire is to be hired in the ICU as a new grad. The reason why is because I love the complexity and detail (and challenge!) of critical care. I enjoy all that pathophysiology and the technology that goes along with it. In additon to how the other aspects (such as intrepretation of labs, blah, blah, etc.) fit into the overall picture. I apologize for blathering on, but I could talk about this stuff forever!! Man, this stuff is so exciting to me. Okay, I really need to conclude this as I need to work on my resume that I've been procrastinating on. Thanks again for reading this dissertation that has continued on forever!! REDDOG RN

Hey Newtress-- I didn't even know that about hiring agencies either!! I appreciate it that you told us about that!! I'll definitely steer clear of that!! I also agree about the *BS* ways that you have to apply for jobs now!! And too, the fact that you can't get ahold of a "live" person in human resources either! I hate that crap when you get the automated message and you have to push a bunch of buttons (and listen to that automated message too!) and after going through all that (yes, I'm going to use profanity again!!) s*** they either tell you you have to make an appointment (which is probably useless anyways) or it reroutes you back to the beginning and you have to start all over again!! Yes, this did have to me!! I had all I could do to keep from pulling my hair out and running around the house foaming at the mouth and laughing wildly like a deranged person!! Sigh...........Whatever happened to talking to a real person?

Katie803-- I apologize to you that I did not round the 0.006 up to 0.007. So I'm going to redo problem #1 for you. Problem #1: The order call for 1/100 gr and you have on hand 1/150 gr per 2 mls. How many mls would you administer? So I'll list the steps below again: 1. Change 1/100 gr to decimal form. This equals 0.01 gr. 2. Change 1/150 gr to decimal form. This equals 0.007 gr. So there is 0.007 gr per 2 mls. (0.007 gr = 2 mls) 3. Here's the algebra equation again: 0.01 gr Xmls 0.007 gr X 2 mls Again, there should be an "X" between the two equations (signifying multiplication.) God, sometimes I hate computers!! On the left side of the equation, you put the 0.01 gr on top (because that is what you want) and what you have--0.007 gr on the bottom. On the right side of the equation, you put the Xmls on top (because that is what you want to know the mls) and what you have--2 mls on the bottom. I would next cross out the "gr" on the left side of the equation because they cancel each other out. (Because you ultimately want "mls"). Do this before you cross multiply. After you've done that then cross multiply. You should end up with: 0.007X = 0.02 mls Next you would do this: 0.007X 0.02 0.007X = 0.007 Again the "=" should be in the middle between the two equations. You divide the left side by 0.007 because you want the "X" by itself. So you would cancel out the 0.007 on the top and bottom. Now that "wonderful" algebra saying again! "What you do to one side you have to do to the other." So on the right side you would divide the 0.02 by 0.007 (like I set up above). So after you do this your answer would be: X = 3.0 mls So as the nurse you would administer 3.0 mls. Again, I apologize. Hope this makes sense. Let me know if you have any additional questions!! One more note: Keep your chin up--YOU WILL get through this!!--and remember you are a wonderful person!!

Civilenginer2rn-- I've got a bit of egg on my face here! I went back and looked at my 1/150 decimal calculation and when I calculated it out, I got what you had: 0.00666667. So I should have rounded 0.006 to 0.007. I do appreciate you pointing that out. I feel kind of dumb here and embarrassed by it!! I wanted to really help katie803, because I know what it feels like when your really struggling with something!! But egg feelings aside here, I'm grateful that you pointed that out to me!! Hey, unfortunately I do have to ask one stupid question: what does BTW mean?

Katie803-- Okay, so let's set up the problems here: Problem #1: The order calls for 1/100 gr and you have on hand 1/150 gr per 2 mls. How many milliliters would you administer? This is what I would do: 1. Change 1/100 gr to decimal form. This equals 0.01 gr. 2. Change 1/150 gr to decimal form. This equals 0.006 gr. So there is 0.006 gr per 2 mls. (0.006 gr = 2 mls) 3. So were gonna make an algebra equation here: 0.01 gr Xmls 0.006 gr X 2 mls Sorry this equation looks so bad. The "X" between the two equations should be in the middle! You put the 0.01 gr on top (because that is what you want) and what you have--0.006 gr on the bottom. You put the Xmls on top (because that is what you want to know the mls) and what you have--2 mls on the bottom. I would next cross out the "gr" on the first side of the equation because they cancel each other out. (Because you ultimately want "mls"). Do this before you cross multiply. After you've done that then cross multiply. You should end up with: 0.006X = 0.02 mls Next you would do this: 0.006X 0.02 0.006X = 0.006 (Again the "=" should be in the middle between the two equations--god, my computer skills suck!). You divide the first part because you want the "X" by itself on the left side. So you would cancel out the 0.006 on the top and bottom. Now hopefully you remember what they said in algebra "What you do to one side you have to do to the other." So you would divide the 0.02 by 0.006 (like I set up above). So after you do this your answer would look like this: X = 3.3 mls So as the nurse you would administer 3.3 mls. Problem #2: The order calls for 0.0006 grams. You have on hand 1/200 gr tablets. How many tablets would you administer? Step #1: You need to figure out how many grains are in .0006 grams. Step#2: 1 gr = 60 mg (1 gr = 0.06 grams). Memorize, memorize, memorize these two conversions! But were going to pretend that you don't know the grams part. Because many times you have to do multiple calculations in order to get to the unit that you want. So I want you to know how to do it--just in case. Step#3: So we need to convert 0.0006 grams to grains. Well, we know that 1 gr = 60 mg. But first we need to convert 60 mg to grams. Here's how you do it: 1000 mg = 1 gram You've got 2 options in how you want to set it up: Option #1 60 mg 1000mg X 1 gram = Option #2 60 mg x gram 1000mg X 1 gram = I'm going to use option #2 for the example. Again on the left side, cancel out the "mg" (ultimately want "grams"). Now cross multiply. You end up with: 1000X = 60 grams So again you want the "X" by itself on the left side. So you would divide top and bottom by 1000. Here we go again with that stupid Algebra rule: "What you do to one side you must do to the other." So we need to divide the right side by 1000. 1000X 60 1000X = 1000 So after you do this, your answer should look like this: X = 0.06 grams Whew! That was exhausting! Okay, now back to our story............... Step #4: So now that we know that 0.06 grams is equal to 1 grain, we need to find out how many grains are in 0.0006 grams. So here's goes our algebra equation again: 0.0006 grams X grains 0.06 grams X 1 grain You put the 0.0006 grams on top (because that's how many grams you have) and the 0.06 grams on the bottom (0.06 grams = 1 grain). You put the X grains on top (because that is what you want to know the grains) and the 1 grain on the bottom (because you know that 0.06 grams = 1 grain). Next cross out the "grams" on the left side of the equation (you ultimately want "grains"). Again do this before you cross multiply. Once you cross multiply you should end up with this: 0.06X = 0.0006 grains So you divide the left side by 0.06 because you want the "X" by itself. So now you need to divide the right side by 0.06 as well. So after you do that you should end up with: X = 0.01 grains So now we know that 0.0006 grams = 0.01 grains. Step #5: Now you need to convert 1/200 gr to decimal form. This equals 0.005 gr. So there is 0.005 gr in each tablet. (0.005 gr = 1 tablet). We're in the home stretch...............................So stay with me!!! Step #6: So now that we know that 1 tablet is equal to 0.005 grains and that 0.0006 grams is equal to 0.01 grains, now we just need to plug in the numbers. So here's how you would set it up: 0.01 grains X tablets 0.005 grains X 1 tablet Cross out "grains" on left side. Cross multiply. Here's what you should have: 0.005X = 0.01 tablets Divide left side by 0.005 to get "X" by itself. Then you divide the right side by 0.005. So after you do that you should end up with: X = 2 tablets So as the nurse you would administer 2 tablets. I really hopes this helps you. Like I said before, it really helped me alot when my tutor broke everything down to the most basic steps. Then I really understood why I was doing what I was doing (if that makes any sense!). Again you can PM if you want additional help. I think I better sign off here for a bit, as I've spent 3 hours outlining and typing this and my boyfriend is beginning to whine, so I better go spend some time with him! But like Arnold S. (the dude from "Terminator") says, "I'll be back!!" Take care!!!

Katie803-- I went back and looked at your original post this am. That question was driving me nuts last night! Because from the information that you gave in terms of them wanting you to round to the nearest 100th didn't make sense to me. So with a refreshing night's sleep(ahhhh.......)and fresh eyes I looked at it again. Now if they wanted you to round it to the nearest 100th, then technically the correct answer would be 1.80. But I think they meant to say round to the nearest whole number. Okay, why am I saying this? Let's break this down here: First of all the question is asking about tablets. Your never going to give 1.8 tablets. Think about it--have you ever taken or given your kids 1.8 tablets? I don't mean this in a derogatory way or to make you feel stupid--So please don't take it that way--I just mean it in taking a moment to think about it--for example,"Have I ever took that or given my kids that?" or "Do I know of anyone that has done that?" That's what I mean about it. So I apologize if it comes off that way. Sometimes it's hard for me to put into words what I want to say! Now, getting back to the math question: So if your talking about tablets--and after your calculations you end up with an answer such as 1.8--you would round up your answer to 2. Hence, you would give 2 tablets. Now, I'll explain why you'll do that: looking at the answer of 1.8--Look at the eight (this number is in the "tens" column). Since the 8 is more than 5 you would round up--the number you would round up would be the 1. So if we round up the 1 to 2 (remember because of the 8), you would then end up giving 2 tablets. I hope this makes sense. I struggled with the nursing math also--so I totally understand where you are coming from and your not alone!! Some of those stupid tablet questions threw me off too!! I had a wonderful tutor who broke things down for me (I mean were talking the basic level!!), in addition to giving me tips and suggestions on how to do the math. Her helping me and her encouragement really made the difference!! Just as she helped me and passed along her knowledge, I would love to do the same for you. Because once you master the nursing calculations (and YOU WILL), you too will be able to help someone struggling with this and pass along your knowledge and things that you have learned. That's the beauty of it!! Nursing school is all about working as a team and helping each other along the journey to becoming an RN. If you have additional questions about what I've talked about here, or if you have any more math questions, you can PM me. I'll give you some ideas, tips, and suggestions on doing the nursing calculations. I want you to know that YOU CAN AND WILL CONQUER this nursing math!!!

For nursing school, we were required to have "Davis's Drug Guide for Nurses." It's by Judith Hopfer Deglin and April Hazard Vallerand. They upgrade the editions each year. It also comes with a disk. I love it because it has extra stuff like pictures of what the drugs look like, a classifications section, measurement conversion table, Centigrade/Fahrenheit conversions, pupil scale and other stuff, in addition to the drug listings. Not sure what other drug books have because like I stated before, this drug book was what my nursing school required. I know that when I first started nursing school and began clinical, the book seemed like a real pain in the a**. But that was only because I wasn't familiar with using it. As I got more familiar with it, it was a great resource and I wouldn't use anything else. *Sigh*.........I love that book!!!! Now this is the book that worked for me. Other nursing schools I'm sure require and use different drug books. I have heard from other people that Mosby's books are really good. Trust your instructors for I'm sure they picked it and require it for a certain reason. I'd suggest sticking with what your school requires (for now) and give it a chance for at least a semester. By then you should know if it works for you. Best of luck in nursing school!!

I agree with all of the posters. If you conduct yourself as a professional and know your stuff it shouldn't matter how old you are. Heck, there are alot of nurses out there who are older and don't know how to act professional and don't know their stuff! I envy you. I wish I was 21 again. I'm in my 40's now and finally feel like I've found my "niche" in life when I decided on a career in nursing. I think it's wonderful that at 21 you know what you want to do and are passionate about it!! Don't ever let someone tell you you can't do something--either because they think your too young, not experienced enough, etc. If you have that confidence in yourself, are passionate about what you want to do and willing to work hard, then what others say and think is not important. Why? Because you have that belief and confidence in yourself and know that you are capable and can do it!! Many times when I was around your age, I let what others say influence my decisions and I didn't have enough confidence and belief in myself that I could do it. Now when I look back, I wish I had not done that. Why? Because I have regrets. You never want to look back and have regrets. I wish I could go back, but I can't. All I can do now is move forward and learn from my mistakes. Now that I'm in my 40's I've developed the attitude of "Who gives a s***. I know I can do this. F*** them!! Why? Because I've learned from past mistakes (trust me, there were many!) and have developed that "quiet" confidence and belief in myself that I can do it. I've done many amazing things with that concept. Things that I never believed I could do. It's truly amazing what the power of the mind can do when you have that mindset. My mother told me that concept many years ago (she was in her 50's by then) and at that time I was about your age. I thought to myself "Why is she saying that? Shouldn't you care about what others think? Oh she's SO WRONG. She's old and doesn't understand things nowadays." *Sigh*.........Well now that I'm older--once again mom was right!! Like I said, I wished I had done some things that I wanted to do, but can't go back, can only learn from past mistakes. So I hope you follow your heart and go to nursing school NOW and accomplish your dream. Sorry to keep blathering on here forever!!! One more thing, you know the one beauty I see about nursing and it fascinates me--is that so many people from all walks of life and experiences come to nursing. Sometimes I wonder what happened in their lives to bring them to nursing. One thing that we all have in common and one aspect that has brought us to nursing is that we all have empathy and care about helping others. Never lose that focus, cherish it-- for it is a wonderful thing!! Especially now in this world we live in. Seems like that quality has vanished and most people have forgotten about it. It saddens me sometimes when I think about that. I've learned so much from nurses--young and old. Sometimes I've looked at some situations with blinders on, but those I've encountered and learned from--both young and old alike--have helped me to look at situations from different angles and perspectives. Keeps me in touch with reality and gets rid of my "preconceived notions." I'm very grateful for that and really appreciate that. Doesn't matter how old or how young you are--WE ALL have something to offer. You have SO MUCH to offer!! Again, sorry about my blathering and that this is so long!! I pray that you will take everyone's advice and push forward and accomplish your dream (NOW!) of becoming an RN!!! Best of luck.

katie803-- Do you remember what the original question asked? The one that you were talking about with the grains?