AmIsmartenuff

Wow, I have so much to learn. Thanks for the support and helping me put things into perspective. I reviewed Cushing's Triad and I have a much better understanding of what the doctor might have been thinking. I also learned a great deal about my weaknesses, I just really want to be a great nurse someday.

I definitely learned from my mistake, and will never repeat it. I knew nurses had the hardest job on the planet, it is amazing watching them keep it all together. Deep breathing helps!

I am a second semester student, and I made a big error. I had a client with metastatic brain cancer with unknown origin, and history of hypertension. Client had been confused and lethargic the day before, and had a lung biopsy and was npo for about 30 hours, including no anti-seizure meds or antihypertensives. Upon arriving to the unit, I was told not to take vitals, they were just taken. But the staff nurse wanted me to change her bed sheets. I decided to change her sheets then get vitals, before I could do that x-ray came to get client. Went with her down to xray where I immediately noticed Left sided arm strength was greatly diminished and client could not answer my questions. Back on the unit after chest xray, client was tearing up and whimpering, I asked if she had pain, her response was yes, although she couldn't respond to where or pain scale. I took vitals and all were within normal limits, except bp 145/107. I rechecked bp manually 142/105. Then looked at flow sheet diastolic had been elevated 100-102 all night. Still no fluids or meds. I assessed and noted dry mucosa, dry skin, cracking lips, no pupil reaction, no accomadation, couldn't follow six cardinal signs of gaze. Went to tell staff nurse and instructor, followed staff nurse down the hall to her other patients room (this patient was coughing, in pain, and bleeding from the nose) to tell her my client was in pain and my other assessments. This is where it gets bad, told her everything but forgot to tell her high diastolic. Continued to check on patient, pain was getting worse client was now holding left side, and about 2 hours later, I finally got the staff nurse to give pain meds, did vitals bp was 135/93. Told instructor I was concerned client wasn't getting fluids or meds. Wanted to know why, so I asked staff nurse and got no response. I continued the rest of my clinical, feeling very uneasy. Got home and my instructor called and asked me did I report a high diastolic to staff nurse... All I could say was no I forgot. Sick to my stomach, what if client seized, should I really be a nurse?