jeno1308

Hi, I just finished Med-Surg this semester. This is how I would respond. Hope this helps! I]Shaun, a 24-year-old man, who lives on the Mornington peninsular, is highly allergic to dust and pollen and anxiety appears to play a role in exacerbating his asthma attacks. A..B.’s partner drove him to the Frankston hospital when his wheezing was unresponsive to beclomethasone (Qvar) and ipratropium bromide (Atrovent) inhalers. Upon arrival, his vital signs are 152/84mm.hg, 124, 42, 38° C. A.B. is started on 4 L O2/NC, an IV of Glucose5%W at KVO. His ABGs are pH 7.31, PaCO2 48 mm Hg, HCO3 26 mmol/L, PaO2 55 mm Hg, SaO2 88%. 2. The inflammatory response in asthma involves what mechanisms? Someone already answered this for you 3. Are shaun's vital signs acceptable? State your rationale. I don't think they are acceptable. His RR is high most likely due to dyspnea and anxiety. Tachycardia can be an indicator for hypoxemia. His ABGs show that he is in Respiratory acidosis meaning he is retaining too much carbon dioxide. 4. Comment on shaun's SaO2. Shawn's Sa02 is at 88% which is a sign of impaired gas exchange I would want it above 92% 6. Are Qvar and/or Atrovent appropriate for use during an asthma attack? Explain. Not during an acute attack because Atrovent is categorized as long-acting beta agonist which means these drugs need time to build up an effect, but the effects are longer lasting. These drugs are useful in preventing an asthma attack, but have no value during an acute attack. Qvar is an anti-inflammatory agent or corticosteroid, and corticosteroids decrease inflammatory and immune responses in many ways. The effectiveness of these drugs depends on regular use. Maximum effectiveness requires cotinued use for 48-72 hours, so are they appropriate for use during an asthma attack? No, not during an acute attack. Are they going to help his current situation? No, but they will prevent other attacks if they are used properly 7. The physician orders Salbutamol sulfate 3 mg nebulisation treatment STAT (immediately). What is the rationale for this order? Salbutamol is the same thing as albuterol. This is a short-acting beta2 agonist. These agents provide rapid but short-term relief. These drugs are most useful when an attack begins. They are called bronchodilators and they increase bronchilar smooth muscle relaxation and are very rapid. 8. What is the rationale for immediately starting shaun. on oxygen? Oxygen is prescribed for relief of hypoxemia and hypoxia. His ABG's show Respiratory Acidosis. His Paco2 is high because he is retaining carbon dioxide and he is having poor gas exchange. They are putting him on oxygen to prevent or reverse hypoxemia. 9. List five short-term nursing and medical interventions that may help relieve shaun's symptoms.[/i] 1. Deep breathing and coughing exercises to clear secretions 2. Semi-fowlers positioning to alleviate dyspnea 3. Incentive spirometry 4. Adequate fluid intake to help thin secretions 5. Find cause of anxiety; treat appropriately

I am with you neonurse97. I have not yet graduated, and I am a single mother of 2 who will not be able to do twelve hour shifts. All the hospitals in my area only offer the twelve hour shifts. It is really discouraging already.

I recommend Dosage Calculations 7th edition by Gloria D. Pickar. It is an excellent book.

I tutor people at my school with Dosage Calc. I'd be glad to show you how to do this problem. You need to remember specific formulas. For this one, you would use the D/H x Q. You will use this formula a lot. This one you could do in your head, but if you get into the habit of using the formula, you will only benefit. There are harder problems than this! Order: Metoclopramide hydrochloride 5mg. Po Label: Ten mg scored tabs how many tab should be administered per dose?________ D=Dose Ordered H=Amount on hand Q=quantity to be given Remember! Your D and H have to be in the same unit of measure always to use this formula. In this particular problem, the D and H are already in the same unit. So, your D= Metoclopramide hydrochloride 5mg H= 10 mg scored tabs Q= quantity to be given will be in tablets So, take 5mg/10mg x 1 tab Your mg cancel eachother out so, take 5/10=0.5 Then, 0.5 x 1 tab= 1/2 tab

USF is a great nursing school. I am originally from Albion, Indiana, and I applied at USF about seven years ago. I ended up moving to Tennessee and going to school, but I had a good friend that graduated from USF. A lot of great nurses come from USF!

I am now a senior nursing student at Walters State Community College in Morristown, TN. I live in Sevierville, TN. Home of the Great Smoky Mountains National Park. My school offers an ADN in nursing. I just finished up my second semester in Med/Surg I. I start my OB/Peds/Psych rotation in the fall. Spring 2007 will be my last semester which is called Advanced Med/Surg when you do your preceptorship. I cannot wait to graduate! I am so excited. It has been a long and tough year. I am going through nursing school as a single mother trying to support my children on $700 a month. I am glad to have the summer off to work a little bit. I got an externship at a hospital nearby, but I have another long tough year ahead, but it will all be worth it!