Vani1925

Yay! I'm glad that you were able to benefit from this as well.

I didn't quite understand the question. Did you mean why I'm going to a med surg or tele unit if I want ER/ICU? I applied for ER and ICU positions but I did not get an interview. A nurse manager told me that they do not take new grads in the ICU and the ER I just never heard anything. So I want to start out in a unit where I can build my skills and that will get me a step closer to the ER or ICU. Thank you so much for the advise.

Hello everyone! I just graduated from nursing school in December 2016. I was so eager to finish school, but now that I am done I feel so scared to start working. I have shadowed in 4 different units already: 2 med-surg units, a medical unit, and a telemetry unit. out of the 4, I think I like the one that is med-surg/oncology and the telemetry. Well, I don't really like telemetry to be honest. Cardiac was my worse subject, but while shadowing the nurse told me that it would be a great unit for me to work at and that I would get lots of experience. She said that I would get to work on my skills and that a telemetry unit was basically a med-surg unit, but with a cardiac monitor. I would really like to work ER and ICU one day and she told me that having tele experience was essential for those places. The thing is that I don't know which unit would be of most benefit for me. In the med-surg I have a friend that works there and she said that they are required to take a 5-hour telemetry class. I do not know if this would be the same class that I would have to take for the telemetry floor, does anyone know? Also in the med-surg/oncology unit I may have to opportunity to get chemo certified which is a plus for me, but it is further away from me (7 miles compared to 1 mile for the telemetry unit). I need some advice to help me make a decision. which one would you choose? what would be the pros and cons? Thank you so much in advance :)

Ok Thanks!

Thank you. I understand that, but what I don't understand is what are the changes that cause the abdominal cramping that will lead to the hyperactive sounds. For the other electrolytes that I studied for if you have decreased excitability you get decreased or absent bowel sounds, and you get constipated, because you have that decreased excitability, yet for this one you have decreased excitability and increased bowel sounds. That is what does not make sense to me.

So I'm studying fluids and electrolytes for my test next week. For me knowing the rationale of things is what helps me remember and study best, but I came across the signs and symptoms of some electrolytes imbalances and for some of them they do not have a rationale. It is really annoying to me because I just can't try to memorize them because I will not remember. I need something to relate it to. I need the why and I have been looking everywhere and can't find the answers. So here it is: * in my book it says: "intestinal changes include increased motility, causing nausea, diarrhea, and abdominal cramping". I do not understand why if with hyponatremia there is reduced excitability of the membranes. I mean hypokalemia also causes decreased membrane excitability, yet with potassium you get decreased motility, which totally makes sense to me. Does anyone know the rationale behind hyponatremia causing decreased motility? *Whywould hypocalcemia cause hypotension. If it causes hyperexcitibility of muscleswouldn't it make the heart beat faster and increase blood pressure and pulse? Whywould the opposite happen in hypercalcemia if there is less sensitivity tostimulus? All my book says is this: "The heart may be slower or slightly faster than normal, with weak, thready pulse. Severe hypocalcemia causes severe hypotension and ECG changes of a prolonged ST interval and a prolonged QT interval." This does not make any sense to me at all. O_o TIA

Thank you! That makes sense YAY!

So I'm having a hard time understanding isotonic dehydration. So as far as I understand isotonic dehydration is when you lose water and electrolytes from the extracellular space (both intravascular and interstitial spaces). The part that confuses me is that there is no shift of fluid from the intracellular space to the extracellular space to try and balance everything out. I went and asked my instructor but to be honest it was like she was speaking a whole different language. I didn't understand anything at all whatsoever. I actually think she didn't understand what I really was asking. I do not understand why there would not be any shift in fluid from the ICF to the ECF. Isn't your body always aiming at homeostasis? Isn't that the whole purpose of osmosis, diffusion, and filtration? Why is it not happening in this case? This is what my book says: "Dehydration may occur with just water loss or with water and electrolyte loss (isotonic dehydration). Isotonic dehydration is the most common type of fluid loss problem. Fluid is lost only from the extracellular fluid (EFC) space, including both the plasma and interstitial spaces. There is no shift of fluids between spaces, so the intracellular fluid (ICF) volume remains normal. Circulating blood volume is decreased (hypovolemia) and leads to inadequate tissue perfusion. All along they have been teaching us that if the concentrations between fluid spaces are not in balance fluid will shift to equalize the concentration. So now I'm all confused because in this instance is not happening. I though that if you have a decreased blood volume, which you would have in this case, fluid would move from the inside of your cells, making the shrink, so that your blood volume increases. I'm I wrong? Now I feel like I'm crazy -_- Or is it because since you are losing both water and electrolytes at the same time it is still technically in balance but in smaller amounts, so your body doesn't think that there needs to be a fluid shift?? HELP please!

Oh no, I'm not a nurse yet LOL (I wish). I'm a nursing student. what I meant by that was that if I was in clinical and had a situation like that I would have started a new IV instead of pushing it back in. I just was not 100% sure if I was correct in the way that I was thinking, so I wanted to check with some actual nurses to see if what this nurse did was okay or not.

Thank you, thank you, thank you! You rock! That makes absolutely total sense. Now I can finally understand. Sometimes it takes me a long time to really get something, but when I get it it's like a ray of light shinning on me, LOL! Now when I have a patient with inflammation I'll be able to understand the pathophysiology behind it. Again thanks a million. God bless!

I'm learning about inflammation and infection. I understand the pathophysiology of inflammation when you get an penetrating injury or an infection. I know that it occurs because your body is trying to get rid of the pathogen or invader inside your body. The part that I'm confused about is the pathophysiology of when inflammation happens without an invader. Like for example if you get a burn or a sprain why does the inflammation occur if there is no invader to get rid of? I know it may be a silly question, but I tried looking it up in my book and have not found an answer (the inflammation section is very short. Like 2 pages) and I've also tried googling it and looking it up on YouTube, but have also not been able to find any answers. It just states that you get inflammation with a sprain or a burn and what the symptoms of inflammation are (which I already know all that), but it does not explain to me why. I'm the type of person that needs to know the why of things, even though I may already know the what, because I just learn better and retain the information and it helps me later on to build on it and understand other concepts better. I just need to know so that I can put things together. Thanks in advance.

I thought about that. The nurse didn't check if it was still patent. She didn't draw any blood back not did she flush it either. I told my friend to keep an eye on her IV'S because I was afraid that if it did not go back in the vein that it would infiltrate.

That's the same thing I told her. I would have started a new IV'S as well. Plus the nurse didn't even check if she was still in the vein.

I went to visit my friend at the hospital because she just gave birth to her baby. She had many complications and had many IV punctures on both her arms, plus an IV already in. Because I'm such a curious person I decided to look at her IV site. When I looked, her IV catheter was half way out and sort of curved. I called the nurse and told her to come look at it. She came in and looked at it and just pushed it back in and put some more tape on it. I was surprised by this because I thought that it could cause an infection after the catheter was half way out for who knows how long. Plus she did not have a tegaderm on her IV site, just a bunch of tape all over. I guess it's how they do it at that hospital, but I have only seen IV's get covered with tegaderms and not just tape, with all that tape it kind of made it hard to see the IV site clearly. So I asked the nurse if reinserting a catheter that was already half way out could not lead to an infection, and she said not as long as it didn't come out all the way. Is this correct?

LaterAlligator, I really like visuals like that. Thanks. I will look on pinterest and hopefully I can find some more.