sw122500

Does anybody know when these three states began requiring prospective nurses to take State Boards? There is a woman that has stated she worked as a nurse in these three states and never was required to take any State exam. This would have been in the time period of 1968-ish to 1976 or so. I was under the impression that there was always a state board exam. Thanks. Sue

Thank you so much. You pointed me in the right direction and it was a huge help. :redbeathe

Thank you. I'm not trying to get anyone to "do" my homework for me. There are many more aspects to this but these are the points that I'm having a very hard time figuring out. I've looked through the lab books and diagnostic books. I'm just a tad lost. I was hoping for some help.

I was asked to analyze this scenario but we have not covered any of this in class yet -- and will not for at least another month. I'm lost. Can anyone help me? Scenario: Patient (M.Z.) is 89 y/o female. 4-day Hx of dysuria, back pain, incontinence, severe mental confusion, and loose stools. Her MD had recently discontinued her HRT (hormone replacement therapy) 1 month ago. Her most current VS are 118/60, 88, 18, 99.4 degrees F. The medical director ordered several lab tests on admission. The results were as follows: WBC 11c/mm, CMP WNL(within normal limits). Postvoiding catheterization yielded 100 mL and UA showed WBC 100+/HPF ( high powered field.), RBC 3-6, bacteria rare. The urinary C&S results were as follows: E.coli > 100,000 colonies, sensitive to ciprofloxacin, trimethoprim/sulfamethoxazole, nitrofurantoin. 1. The medical director makes rounds and writes to start an IV of D5.25NS @ 75mL/h and insert a Foley to bedside drainage. Because M.Z. is unable to take oral meds, the MD ordered ciprofloxacin 200mg bid IVPB (intravenous piggy back). Is the type of fluid and rate appropriate for M.Z.'s age and condition? Explain. 2. As you insert the Foley catheter you note the introitus is red and dry; no lady partsl discharge is noted. You inform the managing physician that M.Z. has atrophic vaginitis and get an order for lady partsl estrogen replacement (Estrace cream). M.Z.'s daughter will need to be instructed how to insert the cream for her mother. Outline your teaching plan 3. You are the nurse assigned to M.Z.'s care. You notice that the nursing assistant emptying the Foley is not wearing personal protection devices. You also observe that the spout is contaminated during the process. What issues need to be considered in protecting M.Z.'s safety? Describe your actions in working with the nursing assistant. 4. The nursing assistant reports that M.Z.'s 8-hour intake is 520mL and the output is 140mL. Is this significant? Generate at least two possible factors that could account for the difference. For each factor, identify which item would be assessed and how? 5. M.Z. has completed her antibiotic therapy, her mental status has cleared, and she is ready for discharge. What instructions should you discuss with her daughter? (multiple answers) This is waaayyyy beyond anything we have done in class but this was assigned anyway. I really need help with this one. I have some ideas but don't even know where to start. Anything anyone can do for me will be greatly appreciated. THANK YOU!!!! :heartbeat

I'd like to thank all of you for your assistance. :)

Don't know the answer to that one.

You're right....CL is low. Don't know why I said high. Anyhow, what (if any) is the significance of the IV stoppage and the IV hurting? Would that be due to a blockage, infiltrate??? I'm a bit stumped on that one. I'm also leaning toward renal failure? But the urine specific gravity seems to contraindicate that to some degree. **sigh**

I have a question regarding a scenario that I just cannot seem to figure out completely. Could somebody help me? The patient is M, 50 y/o. NPO post abdominal surgery. IV D5RL @ 100cc/hr. IV stopped. Poor skin turgor and hypotensive. Large furrows on tongue. Chem K-2.8 Na-132 CL-95 Urine gravity >1.025 Hemat- My take is that he is hypckalemic w/dehydration. Also hypovolemic. This would be due to the IV stoppage -- the patient isn't getting the electrolyte-enhancing fluid. The IV is hurting because there is a blockage. The higher CL level indicates a possible acid-base imbalance but that is unknown due to the fact that no ABG's were ordered. The CL is probably related to the low Na. Does this sound correct? If not, what am I missing? Thank you for your help!!