akaRNmle

I am a RN that is in school. This is a practice assignment. I am taking an internet class and there is only 1 other student in my class. She hasn't been responding to my emails so i'm trying to brainstorm with other people on what to do as a community health nurse.

I am working in the hospital setting and I'm trying to get in the mindset of a community nurse. I am having trouble getting started with this. I am trying to brainstorm out this case study. Use the following case to answer the questions. Ty Evans is a 73-year-old married male living with his spouse. You are making your first home care visit with Mr. Evans since his regular nurse is on vacation. He weighs 185 lbs and is 6 ft. 3 in. He has lost 10 pounds in the past 6 weeks. He had a central venous port implanted for previous chemotherapy administration for colon cancer, but the port is not currently being used. His apical heart rate is now 110 BPM, irregular and thready, with BP 110/60. His respirations are 25/minute, which he says is his usual respiratory pattern. He denies dyspnea but admits he uses three pillows under his head to sleep. The chart indicates medical diagnoses of COPD and CVA with right hemiparesis. Medications listed are as follows: Theodur 450 mg bid po, Furosemide 40 mg bid po, Proventil 4 puffs q4h INH, Lanoxin 0.25 mg qd po, Surfak 240 mg qd po. Focus Question: 1. What questions do you have? You learn that Mr. Evans' last ECG two weeks ago noted Atrial fibrillation with controlled ventricular response.” He has not had a digoxin level drawn for two months. He states that he was in the hospital a year ago for congestion in his heart. His respirations are recorded as being 20-27/minute and that he frequently has sonorous wheezes on expiration in the right bronchovesicular area with crackles in the right middle lobe, which you confirm through auscultation during your assessment. The home health aid has left a note from the day before for the nurse: Patient is flushed, has loose stools, and says he's nauseated.” Focus Question: 2. What questions would you ask the client? 3. Based on this case study, how would you compare the roles of the nurses in acute care and home health clinical settings. I feel like he is experiencing uncontrolled afib and heart failure. I am concerned with his orthopnea. extra fluid causing his sonorous wheezes? can be possible asp pna?? history of cva could he silently asp? and I know i need to get a dig level on him and ekg. I keep telling myself that i am not at a hospital and I am having trouble lasix, plus surfak could cause loose stools and caused electrolyte imbalance.

I am moving because I have always loved to travel and I like change. I grew up a military brat and moved every year or so. I like packing it up and moving. I have lived in Va for the last 10 years but still continued to change cities every few years. My ex was aware of this before we got married and we always decided that we'd leave Virginia after I became a nurse. Our intention was to move to the west coast but then I decided on PA because it is still within a few hours drive of family. I am continuing with my plans, just leaving the husband behind. The Ex and my mom are very supportive of the move, they just want to make sure that I go visit a few times and research schools and such before the move. I am planning on moving next summer so I have a year to plan everything.

I just need to find somebody out there that has some advice or something for me. I am currently working as a RN on a med/surge unit. I work weekend option nights (friday-sunday nights). I am doing this and I am a new single mom. I'm going through a divorce and have a 6 year old son. Right now my mom picks him up from school on fridays, watches him most weekends and then drives him to school monday morning. His father watches him at least a few days a month. I am attempting to start my life over and am looking at moving to another state. I live in Virginia now and I want to move to Pennsylvania, about 4 hours away. I have been trying to figure out what I am supposed to do about daycare for my son. I really like the night/weekend pay, hours, and the fact that I have all week off to be with my son. My son has Aspergers and has Dr appointments, play groups and various other things that we do during the week that I'm afraid that If I get a 9-5 or even 7-3 job there are lots of things that I won't get to do. I also hate the idea of working 5 days a week, I really enjoy the 3 12 hour shifts. I am just trying to figure out how it will be possible to continue to work AT LEAST nights. I love working nights at the hospital. I really don't want to give it up because i'm not sure if I can afford rent, student loans and medical bills without the extra money that the shift differential brings in. But what do people do for babysitting? I am moving to an area where I will not know a single person so I can't depend on family/friends. I was looking at nannies and babysitters on sittercity.com and it seems to cost about $12-20 an hour to hire somebody to babysit! PLEASE I am trying to brainstorm some ideas. If it's not possible to continue working at a hospital nights and/or weekends then I am trying to figure out what other jobs I can do that pay well. I have 3 years experience as a RN on a tele/med surge floor. For 2 of those I worked as Charge Nurse (Resource nurse). I am NIH stroke and tele certified have my BLS and associates degree. I make between $28-37 depending on what shift i am working. That is pretty much my only working experience. I'm 27 and was a stay at mom/student since high school. Any advice or ideas for jobs/childcare?