juniorminty

I'm with you DolceVita. You won't get by with people doing your work for you in real life. I rarely consult AllNurses unless I've exhausted my resources at home and my brain. This is what lead me to this post -- trying to find my one final diagnosis for a hemicolectomy, LOL.

Basically I have to write a short blip about how dementia effects the brain and how then a short blip about how the brain functions normally

This is the student section Silverdragon...this is the nursing student assistance section.

Ok, my pt this week at clinicals was diagnosed with 'altered mental status' for a number of reasons (bipolar, dementia, possible schizophrenia etc) My instructor suggested I go with dementia for my overall pathophysiology for my paperwork. She told me altered mental status was too broad and would be incredibly difficult to do and I would end up with too much information to 'swim through'. My pt has had many strokes/ischemia of the brain so I was able to narrow it down to possible multi-infarct dementia/vascular dementia. I have found some on the patho for dementia, but we also have to dicuss the normal functioning of the organ/system that is effected by dementia. Obviously it is the brain and more specifically cognitive function but I am not sure how to talk about that. Cognitive function isn't exactly a system and if I was to do the normal physiology of the brain, I'd be writing for days. (I should mention the page will do for the normal and abnormal is just one page and you write both items on the same page, not a lot of room for being lengthy). Despite my instructor's suggestion of doing dementia, I still feel like I am swimming through a lot of information. We haven't even covered mental function/disorders yet so I feel like I am going at this blindly. I am actually very good at clinical paperwork and usually breeze through it but this one has definitely got me stuck. ANY help would be so greatly appreciated!!!

Unless the instructor specifically asks us to bring a book to class I don't bring them. All my small chunky books (drug guide, dictionary, lab/diagnostic) stay home. At most I bring my binder, medsurg book and medsurg study guide in a fabric over the shoulder bag. Sometime I bring others but only if I plan on doing some studying during lunch.

I agree! While it is important to get vitals and meet patients, you never want to go into a room not even know anything about your patient. Our hospital is doing away with Kardexs, so I just take a quick glance over their meds and the h&p to see why they are actually there. Bathing is very important but unless the patient has urinated or defecated on themselves, it can usually wait -- especially if meds are due or an assessment needs to be done. After glancing at the kardex/computer (note things that are vital such as NPO orders, that they have an NGT, are they on bedrest or fluid restrictions etc), I go introduce myself and do vitals/assessment -- while I am doing that I note their IV fluids and tubing, ask about bathing (can they do it themselves or do they need assistance). If they need blood sugar checks, I take that in the room with me and do that as I am assessing. I've found the best thing to remember is that you are not there to be the patient's babysitter. You do not need or want to be in and out of the room constantly (unless they are total care of course) so I try to do as much as I without being unsafe each time I am in the room.

Okay I'm doing my clinical paperwork from this week and I am stuck on one little part...my pt has acute pancreatitis. We were resting her pancreas, started NPO on NGT, moved to clear liquid then was switched to 1800 cal ADA diet Wednesday at lunch. She still wasn't eating much, complaining of nausea despite getting Zofran. Anywho, I'm looking over her labs (she didn't have many) and her amylase/lipase are under control, calcium/magnesium are low (normal in pancreatitis) but her BUN and creatinine are low...and I can't figure out why. There is nothing in her medication that I see that would alter those values and the only reason I can find would be malnutrition. I guess malnutrition is possible since she was NPO then clear liquid and pretty much only ate her jello on the clear liquid. I just want to make sure I am not missing anything here!

From what I understand, that is pretty normal lol. We were told the same thing at orientation for my class -- usually start out with 30 and graduate with half or less. We lost 4-5 people already, we started in April. One person just goofed off and didn't take it seriously and got low scores, another one had all these 'excuses' for missing class in the first two weeks and I think decided she was too far behind to catch up (right now were on a 10 week quarter schedule) and another was working full time and trying to do school but couldn't keep their grades up because of exhaustion and the last person....well I'm not sure about her...I think she a 'problems at home/in my personal life' people. Nursing school definitely isn't for the weak at heart!

In my experience, people are not booted out left and right for no reason. There are stipulations and rules set by not only the schools but the state board of each state that a person must maintain a certain GPA in each class they take and can only miss so many days/hours before they are dimissed from the program they are in. Nursing programs, whether RN or LPN, BSN or Diploma are notoriously hard to get into and notoriously hard to stay in without a very high level of commitment. I am assuming (and excuse me if I assume wrong) by 'supportive' you mean 'understanding' that you have children who may get sick and what not, which I can understand being worried that you may miss more than the allowed time because of that or maybe not be able to 'keep up' with the rest of the class. However, unfortunately, that is how the cookie crumbles. Because these programs are SO fiercely competitive (my school has about 100+ people apply in spring and fall and they only take 30 people in the program), they cannot let some get away with things because of their situations at home while others must be held to a higher standard.

Can anyone suggest a good nursing care plan book? Were going into our second round of clinicals and will be doing care plans every week for a grade. I've done a few care plans for practice in class and have done OK on them but didn't really feel like I was completely understanding. I found the following two books on Amazon.com...they seem to have good reviews and I like the way both books are set up but I want to get all suggestions I can before I buy one since they are not cheap. If you can suggest any or if you've used either of these books (or their previous editions) I would appreciate the input. There are just soooo many to choose from! Thanks! http://www.amazon.com/Nursing-Diagnosis-Handbook-Evidence-Based-Planning/dp/0323071503/ref=sr_1_1?s=books&ie=UTF8&qid=1309987113&sr=1-1 http://www.amazon.com/Nursing-Care-Plans-Diagnoses-Interventions/dp/0323065376/ref=sr_1_1?s=books&ie=UTF8&qid=1309986875&sr=1-1

I have to laugh when people think that community/vocational/trade colleges have it easier. I am going to a technical college for my LPN and I have to say, it is by far the most challenging experience I've ever had in school. The pace is much quicker than a university and there is no room for 'extra credit' or 'extensions' on assignment that are usually given out in universities. I have a friend who graduated a 4 year school for her RN and she was shocked out how far we are in my class and it's only the second quarter. I think community and trade/voc schools have an advantage as well. Smaller class sizes means more one on one with instructors and more opportunities for 'hands on' learning. I went into this thinking that I was taking the easy way out by going to a technical college but I am so happy with that I did. I have so many friends who hold bachelor degrees and have either been unemployed for a year or more or are working in a job that is totally unrelated field to their degree.

Yes I would say speak to a lawyer and also talk to your state's board of nursing education.

I have Dermablend and I have used it to cover a tattoo on my back for my wedding. I wouldn't use that at the hospital because, as you said, some clients may be allergic to some of the ingredients. Being that my tattoo is on my wrist it will be in close proximity when I'm caring for patients. Also it is water proof but not soap proof so as much as I wash my hands, it will probably not last a whole shift.

Hello! I just started my clinical rotation for school last week and it's been really really great! I am in the LPN program at my school and we've just been doing bed baths and changing linens and charting but it's been awesome getting out of the classroom and 'getting my hands dirty' finally! I just had a question for those of you out there with tattoos. I have several, most are covered by clothing except for one on my wrist. Our program and both hospitals we do rotation at have a strict 'no visible tattoos/piercing' policy when we're in clincials. Currently I use just white sports tape wrapped around my wrist to hide it, and that has worked out fine. Our instructors suggested either long sleeve shirts under your scrubs (but we're in South GA so it's already hot as heck here), or some kind of ACE wrap/bandage. I know that most hospitals have tattoo policies and I am not sure that what I am doing now would fly once I am working at a hospital. I have also been wanting to get a tattoo on my shoulder that extends down partway on my upper arm, and I am sure scrubs would cover it but I would like to know what to do in case they don't. Does anyone currently working in a hospital have tattoos or know someone that does? What did you or they do to cover them? What is acceptable at your hospital?

I'm not going to lie...it is a very hard test. And not because the material itself is difficult to understand but because it is a lot of material and much of it no one has had since highschool or earlier. If you can take it multiple times, that is great (my school only allows 2 tries then you have to wait a YEAR). Take it now, see how you do. When you get your scores it will have a sheet that tells you what areas in each section you need to review more -- that may help you cut down on how much you truly need to study.