gutym

Why don't you think our congress had more to do with it than Bush? Everyone finds it so easy to blame one person, but maybe your blaming the wrong person. These bills are out of congress and called PORK, and the congressmen bring them home for their states, call them and complain first....if we do not address who really is at fault then it will never get fixed.

Took the NCLEX in June 2005, and found it to be nothing of what I was expecting. I used Saunders, Lippincot, and a program called (can't remember off hand, will fill in later) but I also studied my major text for Med-Surg. I had found this site and others where persons passed on their views. From all that researching here was my plan. 1. Study, study, study -- did about 3500-4500 questions in all, from the books, for on-liane and type in practice nclex and there is a site that will test your knowledge for free-use search engine "www.overture.com". Just do as many questions as is possible. 2. Studied 1-3 hours a day prior to two-weeks before taking the test. Tried to go over 1-2 meds per day, starting one month prior to test, just went over and over. 3. Last two weeks before the test, I locked everyone and everything out--just me and the books to study with. 4. Studied lots on diabetes, CVA, heart, shock, prioritizing, basic nursing skills, BCLS, geriatric nursing, and meds. 5. Did questions, practice test, repeat, repeat and most of all read the answers all the time. 6. Plan for test was given we had 5-1/2 hours I think or six I had heard that alot of people had it shut off on 75 questions and had passed. Everyone stated first question would be the most important question, as if you get it right the next question is harder, get it wrong and the next is easier as the test is used to find a line between right and wrong, not how many can you get right. By finding where you right/wrong line is they compare it to others that have passed, and then the fun begins. If at 75 questions your line is at the or above the level of those whom have passed then your done, if not it continues until it establishes where it thinks your right/wrong answer line is, and that could be at 300 questions...then all the rules change..can't go in to all of this but there is info available. So my plan was to take my time on the first 75 questions, then if it didn't shut-off I would have to rush. Test is not about how many right so if you don't finish it has no bearing on pass/fail. Luckily at 2-3/4 hours I finished 75 questions and it shut off---Did I feel like I passed-no I FELT NUMB, but I did pass and I feel that jsut studying helped me. I felt is was really hard and made you think, you choose the right answer after considering all the factors, choose and hope! It is over and I can only wish you luck. I Had lots of prioritizing, just lots and it took into account everything else. Do study AIDS/HIV too! Also as it relates to the family members. Good luckski to one and all! You'll all pass and then practice, best of luck in your futures. Remember---kindness is the key, and your are the arm that turns it--don't forget to turn, become to tired to turn, or forget to praise othrs that turn it too. Be positive and want to make a difference and you will!!! Please excuse my typing errors, Mikey.

I agree that this is not the way but let me tell you --it is the way in many nursing programs "Off with the Head" is commonly the term I hear so many say...It must be that they are trying to wed out the weak, not guide the willing. In order to succeed you must first believe in yourself, believe you can and then you will...do not let them get you down, instead get them back---get smarter----bounce back with a smile and more ability....take each test that they present with self-confidence and belief in you, then it will come naturally---so many of my fellowstudents were afraid of losing their heads, but most of us left with them intact...got humbled many times, but so what!!!Always remember to smile under pressure, it makes that person so angry--off with the head--I did not say to laugh, but maintain your humor and your sense of pride and you will make it....I talked to God alot, it felt good and no one could take him away..Again Good Luck, and having experience will help, but they will still try to chop your head off!!!

Just some thoughts- During the 3-to-4 hour dialysis treatment you are removing toxins that have accumulated over the last 2-3 days, it is called a saw tooth graph, but it is lop-sided since we clean the blood so quickly...sometimes this causes compartmental shifts that take time to correct post treatment....such as fluid shifts from the extravascullar to the vascular, from tissue to blood...and sometimes the peritoneal cavity holds extra fluid (ascities) that can only be removed slowly or via tapping the area using a needle and syringe,, problem here is many times lipids, globulains, and the like are lost, thus diet comes into play to correct for this, and that takes time also. So many, so many areas to consider....diabetes, heart, lungs, and sometimes the blood-brain barrier is involved---dialysis dimentia--disequillibrium syndrome...and just sometimes it is as the one above stated, some patients have an easier time and others do not....some patients never have a problem while others always seem to have problems, why? Let your physician/charge nurse know and ask them why--ask for suggestions....talk to your dietitian. But again, there are so many variables, again some people are allergic to certain dialysis membranes (dialyzers), if this is so then you have the body experiencing an allergic reaction which could be mild, and recovery takes time after exposure...you could search forever. Sometimes just kindness and letting them know you care can make their day better, as so many dialysis professionals forget whose there for who, and mental health is a big issue in relationship to being healthy. Good Luckski!!

First of all, one thing you will see in every dialysis unit is a different way of doing things--there is more than one way to accomplish a task in this field. I gave you my reasoning and how I perform tretments, but if you want it from the horses mouth simply read the package insert from a box of Fresenius blood lines or whomever bloodlines you use...it sttes I believe to keep it above the pour line and have some distance (approx 1/2 inch) from the top to prevent stagnation and possible foaming at the top that leads to clotting. Hope this helps and you need to relax--anyone worrying this much has got to be a careful person and I'm sure you are--so do yoour best and continue to learn and eventually you'll have lot's of expertise!! Good Luck!!

I have seen patiens with 10-15 kilo's on, and no this is not compliant! And sometimes patients are not compliant with their meds also, or their diet, or their dialysis regimen, or their mouths for that matter, just no compliance ability. But please remember that these people too are patients and that we are there to serve them, and sometimes this tests every limit known to us...but in the end the one they are killing is themselves-slowly but surely. It is their crdiovascular system expanding, their tissue drowing, there lungs losing capacity due to excess fluids in them, their heart pumping more and more, harder and harder...and in time no more. I sometimes want ot just make them aware, or scream back, or just jsut....but remember you are the one in charge and if you feel it is unsafe you have the right to refuse...but do not refuse cause your angry, and don't let anger get you to do something you'll regret....take a breathe, ask for help, and remember your a good person and so are they....God created us all and he doesn't make junk! We used 3L/hr UF, as usually BP stays up with Ultrafiltration. Try starting them in Trendelnberg, maybe that will be enough. Try education of the physician so that trying different Sodium Programs along with UF programs to pull the weight off normally. Try using patient advocate groups to talk to the patient. Whatever, keep your coll! Good Luck!

For all chambers on all dialysis machines the chambers should be full enough to avoid splashing as this will lead to clotting in the chambers. Usually 3/4 full is enough, all though I keep mine slightly fuller, say 7/8--I want to avoid it going into the transducer line and transducer protector which causes one to both loose pressure readings and then losing the transducer protector. The clotting in chambers can plug up the transducer line and cause false pressures or no pressure readings. On the H & K Fresenius machines there is nothing to detect an empty chamber until the venous chambers empties and air goes through the air detector---by this time you have a real problem. The machines, as do most have knobs, buttons, or some type of switch to adjust the levels. On the Fresenius H there is no adjustment for the Arterial Chamber, what I do is use the small extra line with a syringe to adjust the level, just clamp the long transducer line while your adjusting to avoid the alarms, then open after the adjustment has been made. Good Luck,