luv2run851

Thanks so much for the responses, you've definitely got me thinking (or thinking less :)

Ya, Canadian here, and yes I "took" the exam (not sure where I "took" it to though?). Hmmm, overthinking things can be the downfall, for sure. I have discussed with other students who also 'took' the exam and answers are between either informing the doctor, stopping the med, and reassuring the patient. My personal thought was to reassure pt. because it's only bleeding gums and the pt is not bleeding out or anything, I don't think that I would inform the doctor FIRST, because I can hear my instructor in my head telling me that we are RNs and not LPNs, we need to be able to think critically (not that I wouldn't inform the doc, just not first). As for stopping the med, I assume the patient is on it because he is at risk for developing clots leading to an MI/PE/stroke and I would think that an MI/PE/stroke would be worse than bleeding gums. I suppose in my mind it comes down to either holding the dose (and then checking with the doc) or giving the dose, and whether or not bleeding gums is considered a mild side effect or is it a sign of something worse. Of course instructors won't answer these questions for you and the notes list bleeding as an adverse effect but don't really go into that much detail as to how much bleeding is bad (GI bleed - bad, gums - not sure), which is why I thought I might get an answer here.

Wrote the exam yesterday and I've just gotta know ... If you have a patient on Heparin and he reports bleeding gums when brushing his teeth, what would you do first? a) inform the doctor right away b) stop the heparin c) reassure patient it is a normal side effect of going on the heparin d) give coumadin to counteract the bleeding Thoughts??

Hi there, congratulations! I went through this 18 months ago, I had baby #3 at the end of semester 4 (of 8 semesters). Pregnancy concerns, obviously get enough rest and try to take any extra assignments/projects just incase you have to miss classes for health reasons, you'd hate to be penalized because you don't have enough practice hours. As for post-baby, I decided to take the year off from school because with my program it was full-time both semesters or nothing and I had heard that semester 5 & 6 (year 3) was the most difficult. I have to say that I thoroughly enjoyed my time off with my baby, but in reality I would have gone back in January (when she was 9 months old) if I was able to. Now starting back at school with an 18 month old and in semester 5 - it's really *******' tough! I would advise to get support and help with child care so you can study. I'm hoping my mom will come stay with us at the end of November and help out. Hope this helps, just know that it can be done :) All the best with your pregnancy, delivery and beyond!