sarahmac09

I am so happy to see this article on AN! Wonderfully written and highly informative, OP! Pronouns and names are a huge issue for those struggling with gender identity. Getting these right is the simplest way to begin developing a trusting relationship with patients because it shows that the nurse is on the patient's side. I am excited for the day when an admission assessment or health assessment includes the question "With what gender do you identify?" and "What pronouns do you prefer?"

I think a lot of the posts seem negative because this is our place to vent! lol. I personally have a serious love-hate relationship with nursing school. If you enjoy the adrenaline rush of having a lengthy to-do list and slowly checking those items off your list... BUT would rather spend most of your time watching netflix then you might be in the same boat as me. Everyone's experiences are different. And, as previously stated, you get out of it what you put into it! Best of luck to you!

I really enjoy creating and writing out care plans. Am I insane? I get excited about the interventions and rationales that go right along with patient care goals and I don't even mind spending hours on one care plan. I feel like I learn much more about disease processes and critical thinking while creating care plans than I do just from reading out of my textbooks. I guess I use this time as an extension of the clinical day? Does anyone else feel this way about care plans?!

@lvnlrn honestly I'm not sure. I figured his O2 saturation would be well below 98% and/or he would be on oxygen but alas that was not the case.

I was just answering your question... I wasn't trying to insult your intelligence (sorry if it came across that way)! According to my care plan book, Ineffective airway clearance can manifest in patients with COPD. Since the pt is unable to create a productive cough and has wheezes on auscultation (indicating that there is an airway obstruction) I am assuming that his inability to clear his airway is the most significant problem.

He is end-stage COPD which is why the palliative care order was ordered. I'm not sure if it was comfort care, but the case study says that he is "tearful" and "voices a fear of dying" which is why I chose death anxiety. His b/p and pulse are normal, respirations are rapid and he has wheezing on auscultation. I'm thinking that SOB could affect his oxygen levels? But his O2 saturation is 98% on room air. Ineffective Airway Clearance definitely makes sense, though!

I'm currently working on my second care plan for a case study before we start going to LTC facilities next week. This is my assessment info: Objective: 1. T 97.7 oral, P 86, RR 21, O2 sat 98% on room air 2. no edema, less than 3 second capillary refill 3. Hx of HTN, diabetes, tobacco use, COPD 4. On bed rest with SOB on exertion, including turning 5. Audible wheezing on auscultation 6. Labored breathing,; rapid & deep respirations 7. Patient is tearful 8. Palliative care order for medical diagnosis of end-stage COPD Subjective: 1. c/o SOB and non-productive cough 2. Voices a fear of dying potential Diagnoses: 1. Activity Intolerance r/t immobility, bed rest, generalized weakness, and imbalance between oxygen supply/demand. 2. Death Anxiety r/t experiencing dying process, negative thoughts about death and dying, reported fear of dying, and palliative care order. We are supposed to have a total of 3 diagnoses. I have considered impaired skin integrity, but I don't feel like I have enough information to support that diagnosis because although he has difficulty turning and is on bed rest, he does not have impaired circulation, edema, incontinence, etc. If anyone could give me some guidance (I'm not asking you to do my work for me; I know I need to learn this stuff) I would appreciate it!

thank you so much!

Yes! For some reason I wasn't understanding the concept of a syndrome diagnosis but having it written out/explained more in depth helps. Thank you!

So, for example (I'm using the one in my book), if a patient is immobile due to a medically diagnosed issue, the Syndrome Diagnosis "Risk for Disuse Syndrome" is just the guidelines of things to keep an eye out for like pressure ulcers, constipation, thrombosis, etc.? The patient doesn't necessarily have to have all of the complications? Also, when I'm documenting the syndrome diagnosis, would I write something along the lines of Risk for Disuse Syndrome r/t immobility caused by broken leg?

I'm studying for my first exam and I'm a bit confused about the differences between a Syndrome Diagnosis and other diagnoses. If a patient is given a syndrome diagnosis (such as Risk for Disuse Syndrome), is this just a more complex Risk Diagnosis? Or is it more similar to an actual diagnosis? I'm not sure why I'm having a hard time grasping this, but any outside viewpoints would help!

I feel like it's more beneficial to go through and learn WHY those other answers were incorrect. If you can't understand the rationales behind correct/incorrect answers you aren't really doing yourself any favors. Just my opinion I suppose.

I just started my upper-level nursing courses, but I think something that will work wonders is to STAY AHEAD of schedule! Never allow yourself to fall behind on reading and assignments. Create calendars, schedules, etc. to help you stay organized. I've found that organization works wonders when it comes to managing anxiety and stress levels. If I know I'm ahead on reading and understanding learning objectives and concepts, I don't have to scramble to understand things in lecture and I can focus on important information and reinforcing the material I have already studied.

You can definitely be a nurse! I think a lot of the time introverts have an advantage in that we tend to be more empathetic and aware of others' moods and needs (even if they can't vocalize them).

I will owe over 200,000 by the time I graduate. I've been out-of-state at both of the major universities I have attended, including the university where I'm working towards my degree currently. I used to spend quite a bit of time crying about how insane my loan repayments are going to be... but I know I have options. I've thought about quitting school to start repaying my loans but at this point I would be in a far worse situation if I gave up now!