JoanRN05

So.far, so.good! Creatinine clearance (CrCl) is used as an indicator of how well the renals are functioning. It is a more specific indicator of functioning and therefore used to determine medication adjustments. You are correct, USUALLY when you have a very low CrCl, you will see an elevated serum Cr, but that usually takes time, so not a good indicator to eval renal function. This is why the GFR / CrCl are better indicators. In the case of only one kidney, they often do have permissible elevated serum CrCl, however, it should normalize most of the time as the kidney just responds to what it is filtering. It doesn't "know" the other kidney is gone, it just "sees" higher levels and filters appropriately. Hope it helps! The kidneys can be tricky guys; super interesting and do a lot for us, so treat them nice! Remember, they are a pressure dependent organ so they need fluid and pressure to function - don't deny them - they will get angry!! Happy to help if you have more questions! Good luck! ~Thenurseteacher.com

What topics do nursing students struggle the most with? For example, most of my students struggle with learning meds and integrating their application to patient care. I am curious if this is unique to our program or students in general. Please don't limit your responses to just meds... Really looking for what students seem to be worrying about or having difficulty grasping. Thanks in advance!

Create a routine and stick with it - so when you get off task, you have a routine to return to. Ask around to your peers and see what works for them. I am VERY nosey, s I would watch what others did. That being said, here's what worked for me... after report take a few minutes to get organized. I make a list of thing that needed to be done - for example, labs, med times. Staying organized will help you stay on task and I like to have my list to refer to as the day goes on. Stay ahead as much as possible. As you well know, things change so quickly and you then find yourself even further behind. Yes, it's fun to hang out with your friends, but make sure your work is done and charting is all caught up before the gossip session starts. Again, I had a routine- get report, organize, assess my patients, chart assessments, pass meds, amend plan if needed and repeat assess / chart /meds as dictated. The routine was the key to me! Hope it helped and happy to answer more specific questions! Good luck! -thenurseteacher.com

Wow- those are some loaded questions...where to start... First, take your NCLEX as soon as you feel comfortable, don't delay. You are still in the "test mode".... stay in it! I had a delay in taking my exam due to relocating to another state. I had started working, but it was really challenging to learn a new job and study for boards. And, of course, practice those questions! I recommend a test taking strategy book - I used a Kaplan book late in the game - wish I had it in school. Really will help you analyze the questions. Start looking for a job now! As mentioned, hopefully you made some connections while in school. Now is the time to call in all those favors! When starting your first job, remember what you learned, but be open to new ways, as long as they are safe and appropriate. Happy tonhelpore, if you have more specific questions! Good luck!! - thenurseteacher.com

I always believe any education and degree is a good thing! If you have a passion then keeping forward. I do believe the push to BSN prepared nurses is gaining momentum, so definitely consider that in you future plans. All the major hospitals in the area have mandated their staff to have a minimum of a BSN, but most have 5 years to get it done. They also have beefed up tuition re-imbursements, which is a good thing!! Good luck and enjoy your journey!! - thenurseteacher.com