fatrabbit

This "debate" came up in a clinical rotation of mine a few weeks ago. There was a patient who's SBP had been running in the 90s for a couple of days. His SBP was 85. His pulse rate was 80 and his potassium levels were normal. He was taking the digoxin for CHF. He also wasn't symptomatic for the hypotension. His nurse gave him the digoxin but then my instructor told me that the nurse shouldn't have done that. What would you have done? Thanks for the input everyone.

In my opinion, the hardest part about nursing school is the volume of information you have to learn. If you have good time management skills and find an efficient study method (and try not to be so type A), then you'll do fine. As for A&P, I've found that you have to have a good grasp on physiological concepts (not individual facts) to really understand the material in nursing. You don't have to be the best at memorizing facts and regurgitating them on tests. You have to have good critical thinking skills though. You need to be able to take the concepts that you've learned and apply them to individual patients. That's something that you learn in nursing school though (i.e. thinking like a nurse).

Is this a new thing? Do you think a lot of ICUs do daily CHG bathing?

I'm writing a paper for one of my classes. I have to briefly discuss what the role of the nurse was in the 1970s/80s. The only sources I can find talk about events pertaining to nursing in the 1980s. I really want to know the experience of being a nurse in the 80s. How much respect did nurses have? Where they able to question doctors? advocate for patients?

First off, no, mental health isn't considered in the application process. I'd think that if schools did exclude you due to your mental health that you could sue them. Secondly, don't let anyone tell you that nursing isn't for you because you have stress-induced depression. I'm in your same situation. Yes, the first couple of months is going to be difficult for you. The adjustment period was hard for me. But I've found coping mechanisms that have really helped me. For example, I decided not to be so type-A. I say that it's ok if I get Bs in my classes. This took a lot of pressure off of me (plus I ended up getting all A's my first semester). Before you start, make sure that you have good time management strategies and know how to "triage" your studies. Maybe start doing yoga once a week or see a therapist. Anything that'll help you with the stress of nursing school. Also, be aware of the fact that some antidepressants can make you very tired (which probably isn't the best if you're going into nursing school). Good luck!

buy a book of NCLEX style questions and use that for studying. I think that the hardest part of testing in med surg is taking what you've learned in lecture and applying it to an NCLEX style question.

Hang in there; I hated my clinical first semester, especially early on since i didn't have many skills and only one patient. Now, I'm in my second semester and am doing critical care; I love it. At least in my program, you don't really feel like a nurse until the second semester.

For example:NPH insulin my instructor's ppt says onset: 2-4 hrs, peak: 4-10hrs, duration: 10-16hrs my text book says: onset:1-2hrs, peak: 6-14hrs, duration: 16-24hrs UCSF website says: onset 1-2hrs, peak: 4-6hrs, durations 12+ hrs does it have to do with individual patient variation? doses? Sorry if there is an obvious answer to this; we never went too deep into insulins this semester (1st).

-A good pair of shoes (or insoles and compression socks) -hi-lighters and index cards -good frozen meals -mulitvitamin -a watch with a second hand -hand sanitizer -an NCLEX questions book

I'll be honest, this program is really competitive to get into. You definitely want to get at least an 88% on your TEAS test and probably have a 3.7 in your prereq classes. Also, if you're worried about grades, do some volunteer work. CSUS offers a lot of non-academic points on their application. As for the TEAS, I bought the study booklet and went through that. I also liked to save all of my notes from all of my pre-req classes so I could refer back to them (I still refer back to them). I did my pre-reqs at another school, so Idk about teachers. If you're at CSUS now, try to get your upper division GE done before you apply otherwise you'll have to take them during summer. Hope this helps =]

Hi! You get assigned a clinical group, hospital, and unit to work on. You'll be on a med-surg floor taking care of one patient, once a week. You're last week in clinical will be 2 days, with 2 patients each day. You stay on that unit but get other experiences outside of your regular med-surg clinical. You're other experiences are: about 3 hours at a SNF, 1 day of peri-op (pre-op, OR, and PACU), and 1 day of home health. As for switching hospitals after your first semester, it depends on which hospital you start at; some people switch hospitals, others don't. You also get a new clinical group each semester. Second semester you get to do ER and ICU. Hope that helped =]

At my school, pretty much everyone does this. It's actually encouraged. We have a mentor program where upper-classmen help us lower-classmen with things like study tips, how to answer NCLEX questions (all of our exams are NCLEX style questions), and past study guides. It really helps us focus our studying and gets us thinking like nurses right away. Also helps that our whole cohort shares these tips with each other via our Facebook page (and create google doc study guides that everyone contributes to). This isn't cheating because exam questions change. I guess our program's theory is that in the long run, you'll have more success reaching out to more experienced nursing students, and when you become an RN, to more experienced RNs. Seems to work with our program since we consistently have a 98% NCLEX pass rate.

To be honest, I tried Danskos and they just did not work for me at all. Plus, I'm already 5'9" so they made me look like a giant. Right now I were standard tennis shoes with Spenco insoles (only $20 and work better than aetrex, super feet, etc.) https://www.spenco.com/product.aspx?prodid=42&catid=

This was my first time taking care of 2 patients and (at least) from 0700-1000 it felt so hectic. I was late for almost everything- vitals, assessment, meds... I felt so disorganized. When I asked my other cohorts, they said that they were doing fine. I know that I'm catastrophizing here, but I kind of feel like a failure in a sense. Any advice or inspiration, because I'm in desperate need of it.

*is it because we're giving it at a slow rate so the kidneys have time to excrete enough of it? So if you gave 20mEq KCl too fast, you'd kill the patient, right?

Is this correct: NS to replenish Na K because when Na goes up, K goes down Dextrose b/c NPO Also, dumb question I know, but is that 20mEq KCl per liter? If it is per liter, why would that not kill the patient? (p.s. I'm first semester so we're just getting a general overview of electrolyte balance now instead of going in depth; this is why I'm so confused)

for our class, the normative values are: Na 135-145 K 3.3-5 glucose 70-110 * question said nothing about diuretics

I'm reading through a power point and don't get why this solution is the best for the following situation: -pt NPO -Na 128 -K 3.5 -glucose 130 answer: D5NS with 20 mEq KCl at 75 ml/hr I get that you'd use NS since there's a low Na. But why include the dextrose, K, and Cl? thanks for your help

*just SIRS, not sepsis I haven't been able to find a definitive answer. The only two sources I found online stated that the Tx is fluids and treating the condition that incited the SIRS. Why would you not use a fibrinolytic agent or anticoagulant to deal with the micro clots that form? Or steroids to tamper down the inflammation? What is the main goal of SIRS Tx? to stop the inflammation? Will that in turn take care of the clots?

I really can find nothing on using anticoagulants to treat SIRS. I'd think that anticoagulant therapy would be included to prevent further formation of micro clots. How is SIRS treated?

So this was the first time I've done a head to toe on a patient by myself. I feel like I did an ok job, but I forgot some things and wasn't that good at assessing others. I need some tips on: -listening to a pt's lungs from the back when they're on spinal precautions. -assessing for PERRLA (I know how to do it, but sometimes i just can't tell if the pupils are constricting or not, and I don't want to keep shining a light in their eyes [also, the pt I worked with today was not a stroke a pt]) -telling the difference between ronchi and bowel sounds. The patient I did my head to toe on had LLL pneumonia and when I listened there, there was this medium/high pitched wet sound on inspiration. She had just woken up, but her bowel sounds were loud and seemed hyperactive to me. When I checked again an hour later, her lungs sounded normal. -How do you differentiate between what is hyperactive and what is normal bowel sounds? -Any tips on getting an accurate RR and respiratory pattern? I've noticed that with the patients I've worked with so far, sometimes they'll take a few shallow breaths but overall breath normally. I also have trouble sometimes counting respirations since I can't see their chest moving. Lastly, is Head to Toe just one of those things that you need practice on to get good at. It seems like it's supposed to be easy but I'm still making mistakes and second guessing what I hear (especially in the lungs and heart). Thank you for the help guys; I really appreciate it

glasgow coma scale... need some help please. Thank you

I wanted to ask some nurses who are experienced with heart sounds this question. I just learned cardiac assessment and while I was listening to my heart over the 2nd ICS, right sternal border I heard a very low pitched systolic whooshing sound. I've checked it 5 times over two days and I can still hear it. It was more pronounced after I had some coffee. Right now, I'm hearing it best with the bell of my stethoscope. I'm 22 years old and consider myself to be in good health. Could this possibly be a murmur? thanks for the advice

I know that NPO means nothing by mouth. However, for one of my assignments there's a stroke patient who can't swallow; an NG tube was ordered for a bolus feed. Does this mean that she is NPO?

Hi everyone. I just happened to stumble upon this thread. I'm 7 weeks into the Sac St nursing program. If you have any questions from a first semester student, feel free to ask. Some advice: -Start learning your medical terminology and abbreviations now! You'll feel a lot less lost in the first few weeks when they're throwing out those complicated medical terms =] -Also, get acquainted with some of the common pain and respiratory medications (e.g. albuterol, opioids, NSAIDs...) -Do NOT expect for the program to be easy, especially the testing (it's almost all based on clinical judgment). The concepts really aren't that difficult to grasp, it's just applying it which is challenging (like, choosing how much O2 to give a patient presenting with ___ symptoms). -Get a computer- it's impossible to take written notes, the professors go too fast. -Also, when asking questions, get used to the answer: "it depends" ( I can't even tell you how many times I've heard that=]) --Good luck everyone!