suppaduppaCNA

Coffee, Coockies, Exceptional Time Management..

Thanks for the reply Yes! @SubSippi, a better formulated question would be to ask when is the patient at greater risk for hypoglycemia and the perfect answer for that question would be "4-10hr" after the dose because technically the BS can be at the lowest anytime within that time frame. Unfortunately, at my school we often get questions that are not applicable to real life situation. You just have to go by the best answer choice or what the book says (by the way is the book always right??). And yes checking at the 4th hr post administration makes more sense because that's when the peak time begins. but how about the rest of the time? I know this is crazy question but I like to know what's the best answer. Let's say if you have these answer choices which one will you pick and why? a. @1400 (beguining of peak) b. @1700 (middle of peak) c. @2000 (towards the end of peak)

Hello, I don't get what is the exact time when to check on your patient after administering insulin. I understand that you should check during the peak time, however peak time is a range not an exact time. For example (just for the sake of understanding): XYZ receives NPH @1000. Peak time for NPH is 4-10hr. When should you check on XYZ? @1400? @1700 or @2000? I would check on the patient several times during the peak time but you usually don't get that option on the test. So what time would you check on the patient and what's your rationale? I really need your insight on this! Thanks for your input.

It is best to assess your patient's comfort level if you are going with a Dx of pain.

This patient has respiratory alkalosis to begin with..the pH should be above 7.45 or Bicarb beliw 22 because the body strive for homeostasis. Low CO2 means less carbonic acid pxn. if hypocapnia last for long enough, more bicarb is produced by the kidneys to pull the H+ out of the cells and form an acid (H+HCO3>H2CO3). It seems to me that this is why this patient has high bicarb levels. I don't know if this is a real or hypothetic case but it may help to check the potassium level to get an idea of what's happening. This is really interesting and I sure want to know what is the Dx..please keep us updated.:)

Correction: PaCO2 30 is not within normal range...This patient is hypocapneic to begin with. HCO3- level should be below 22 but if patient stays hypocapneic for long enough bicarb secretion increase (maybe to 29)

pH 7.45 is within normal range although on the edge to alkaline PaCO2 also within normal range O2 sat is within normal range as well HCO3- is high. Looks like Metabolic alkalosis not compensated

Do you kow what Legally Blind means first

Hi angelfocusbroken, Nursing school is very hard... It's nothing like you are used to. I have been where you are presently and I know what you are feeling. Your fear and anxiety are legitimate, however they won't help..you must get rid of it if you want to succeed. You need to tell yourself that you can do it just like others before you did. Your GPA doesn't really matter, all you need is to pass the classes. To pass the classes you need to calm down, listen, observe, parctice, practice, practice, memorize and master...:wideyed:..Yes! Competence is what matters..GPA comes next!! I truly believe in the power of practice..it helps me be confident with procedures and takes away some of my fear to commit a mistake. BUT, also keep in mind that Fear is healthy too. The fear of causing harm will help you be more meticulous. For instance, I am paranoiac when it comes to meds...I am always scared to unintentionally hurt my patient, I always "doubletriple" check my "rights" before I pass the meds. I feel like I can never be too cautious whit that...I suggest you do the same. Try your best to AVOID those errors that can be avoided!!! the rest is up to fate. I wish you the best of luck:) Suppa

Hi, I am not a RN yet. I'm just a fellow student. I don't think anybody here can tell you what your next step is. That is for you to decide... no one can tell you what to do! You may want to reformulate your question and ask the RNs what have been their experiences as of going from RN to BSN or RN to MSN. My suggestion would be to check with the NP schools you are interested in and know their admission requirements, asked them what is their typical candidates profile...etc. Whatever you do, just keep in mind that a BSN is very important in our field. Good Luck!!:)

Yes, I do not see an ethical dilemma here either. It's all about critical thinking...:)

I could have never guessed that one!...Thank you:)

Here is what I got: 1. The total time of infusion 2.5 hrs= (60min*2)+30min= 150min 2. The total amount of drops patient received 50gtts/min for 150min= 7500 gtts 3. The amount of mL infused by microdrips 7500gtts/60gtts for every mL = 125mL (gtts cancel out) The answer is 125mL:)

pH and K+ are inversely correlated. In DKA pH level drops therefore K+ level increases in ECF. Hyperkalemia will occur first. Then when the patient gets treated, the insulin drives back the K+ into the cells along with glucose causing Hypokalemia.

Practice, Practice, Practice!!!! The more you practice problems the more you understand what you are doing. This is why "Practice makes Perfect" Suppa