jbedwards

Any and all, honestly. I can recognize normal sinus, sinus brady, sinus tachy. A-fib and coorifice v-fib look the same to me, as do v-tac (I think), & Torsades. I am so lost when it comes to this, and honestly didn't do all that well when it came to the strip interpretation part of the cardiac test during nursing school.

I have my ACLS test tomorrow and was curious to see if anyone had any tips on interpreting the EKG strips, some 'easy' way to memorize the algorithms. I have been working on these for the past week, but it is NOT sinking in for me. Any and all help will be appreciated!

I just graduated on May 6, and took my NCLEX (& passed, YAY) on on Friday. I have my first interview tomorrow at 10. Does anyone have any suggestions for me? Any ideas what kind of questions that I should be preparing for, when do we discuss salary, etc.?

I decided on deep vein thrombosis and anticoagulant therapy, but now am having an issue finding studies to back me up. Everything I look up says I have to buy the articles??

Ok, so I need to do a powerpoint on an evidence based topic, and format it according to PICO standards...but I am coming up with nothing. I have a few ideas that I am toying with, such as elective inductions leading to higher rates of cesarean sections or early ambulation after surgery leading to decreased formation of DVT's, but nothing is really speaking to me. Is there anyone that can maybe give me a nudge and help me find a good topic for this?

When I saw the patient all of his vitals were normal, lab values were normal....everything was normal, except he still had infiltrates in his lung. Doctor states that this is due to the fact that the cocaine he is using is 'cut' with 'bad stuff'. I am so lost!

Ok, I am starting a new care map. I haven't seen the pt yet, but this is the info that I have: 51 y/o m presenting to ED with c/o weakness & being sick x 10d. He cannot keep his meds down, & has been attempting to crush them in order to take them, but has been throwing everything up. CT scan done d/t c/o 'left flank pain' showed right middle lung pneumonia, & a slightly distended gallbladder. His urine screen came back + for benzodiazepines, marijuana, & cocaine, but he denies drug use. His past medical hx is significant only for bipolar disorder & chronic back pain d/t a 4 wheeler accident. He did threaten the dr in the ED w/bodily harm, but the dr stated that he didn't feel threatened & felt the pt was more of a manipulative antisocial personality. At home meds consist of albuterol, tessalon pearls, dolobid, lithium, Seroquel XR, tramadol, trazodone, flexeril, & naproxen. My issue here is that my clinical instructor wants us to have the beginning of a care map ready when we come into clinicals. She expects us to (& has this entire semester) make our care maps based off of the patient's medical diagnosis. I understand that this is 100% incorrect, however I have to do it the way that she wants in order to pass this clinical. Ok, what I have come up with so far is ineffective self-health management r/t presence of adverse personal habits (illicit drug use), & risk for [spread] of infection r/t inadequate secondary defenses. Any ideas here? I have to come up with 2 more.

I appreciate you letting me know that! I actually was never told that!

I just have to say I LOVE that I called my instructor asking for help in this matter & she tells me that I can only have one r/t, & that I should use the r/t impaired gastric motility BECAUSE that is the reason that he came into the hospital. His MAIN issue the day that I had him was the r/t accumulation of fluid within joints & he was dx with osteoarthritis while I was there!!! Unfortunately, I have to do as she says in order to pass...but I hate the idea that some student might get her who has no idea what they are doing & will start basing their care maps solely off of the admitting diagnosis because that is what she teaches!!

I have a question. If I am using a nursing dx of acute pain for my patient in my care map, am I able to use more than one r/t? (Ex: acute pain r/t accumulation of fluid within joints, dysfunctional gastric mobility, & changes in myocardial contractility). If there was more than one issue that was causing the pain, do I address all of those in the r/t portion, or would I leave the dx as acute pain without a r/t & address all of those underneath in my supporting data?

All right, my 4 diagnosis that I chose were decreased cardiac output r/t changes in myocardial contractility; fluid volume, excess; activity intolerance r/t generalized weakness, & urinary retention r/t blockage (in order of importance). Opinions?

Do you have an ISBN # for this, or is online?

Oh, and as far as care plan books, I use the back of my Taber's medical dictionary to being formulating ideas for nursing diagnosis, then I use my Cox's clinical applications of nursing diagnosis. I bought the newest book (Nurse's Pocket Guide: Diagnoses, Prioritized Interventions and Rationales) but it's not very user friendly so I rarely use it.

*btw, thank you for the wording change!!! (acute to severe)...that looks much better!

Lasix was last given at 2200 (I went in at 0700). No, I am not sure that the last shift emptied his bag. They put in his EMR that he did, but this is a hospital that is noted for its poor quality of care around here, & I have noted many discrepancies myself in his chart, so I cannot say that they did. That's part of why I am having such a problem. He stated that they did, & I almost believed him until his doctor came in to speak to him & he told her that she was the one that emptied his bag before my shift! Lung sounds were clear & equal bilaterally. Pulse was equal & strong, excepting that they were slightly less palpable in his feet.