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Noctor_Durse ADN, EMT-B

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Content by Noctor_Durse

  1. Noctor_Durse

    Seeking Volunteer tutor

    I'll tutor you! PM me!
  2. Noctor_Durse

    Nursing School Probs

    So true!
  3. Noctor_Durse

    Quitting Nursing school before it even begins?

    My 3rd semester starts tomorrow. I've been up since 430am today doing mandatory prep work, setting up my schedule, setting my alarms on my phone, printing out hundreds of pieces of mandatory paper work needded for the first day, organizing them, getting my uniform together, food prep for the month and studying because we have aTest the first day before lecture on the content we were given over Christmas break. It is stressful but you can do it and so can i. It's not easy but once you get settled in everything is manageable. And if you go to a good school you will be sported by staff and other classmates. Nobody is left to dry because everyone is under the same pressure. We all need help staying organized and a good school will promote collaboration between peers so that the objectives are met by everyone. You can do it with help just like i can! P. s. I have to keep telling myself that i can do it everyday or else i will break too haha! Because i know i can! Best of luck
  4. This is fantastic! Thank you for the link.
  5. You should also check residual per md order, patency of the tube, if the order is to be hooked up to suction, is the suction at the right level? and is it intermittent or low continuous. and if it's a salem sump and it's hooked up to low continuous you need to make sure the blue air vent is not blocked off.
  6. Noctor_Durse

    Physical assessment help?

    I would say personally before i do my assessment i look for any special orders regarding wound care and when the last dressing change was and when the next one is scheduled. If the dressing is dry intact and there are special orders saying that the surgeon wants to be the one to do the dressing changes or that the wound care nurse is doing them then i would verbalize to my instructor For instance this patient is postop day 1 and the surgeon has specific orders to leave the dressing so I will not be visualizing XYZ But if there are dressings that are soiled or anything that can be visualized without a special order then I would definitely at least take note of it
  7. Noctor_Durse

    Memorizing drug interactions!

    Hi everyone! I am a nursing student trying to prepare to be the safest nurse I can and I have been trying to memorize as many drug interactions, contraindications and major adverse reactions as possible lately. Please feel free to leave a comment with any and all interactions, interesting contraindications, or major adverse reactions or Rx. gems you have memorized or have come across or use on a regular basis. I'll list as many as I have in my head right now that I have come across recently .octreotide and pantoprazole in a Y site IVP .lorazepam and ondansetron IVP .Dilantin and D5 IV .succinylcholine(all depolarizing muscular blockades) For RSI Is contraindicated in CKD/ESRD, burns, crush injuries, and muscular dystrophy.(anything causing hyperK) .dantroline is a vesicant and hyaluronidase is the antidote for extravasation. .Bicarb, calcium gluconate/calcium chloride, Dilantin and potassium are drugs that should pretty much have their own primary tubing/no piggy and should not have meds pushed through them to be safe. This is just what's in my head at the moment. I'll post as I learn more or come across others that I know but am not thinking of at the moment! please feel free to ad or correct/clarify anything I have said. Thank you in advance. -ND
  8. Noctor_Durse

    Memorizing drug interactions!

    Thank you so much for this I will be looking into this handbook!
  9. Noctor_Durse

    Memorizing drug interactions!

    This is a non-supportive comment and quite off topic. It is not the direction im going with the thread. Thank you.
  10. Noctor_Durse

    Memorizing drug interactions!

    Thank you for taking the time to give me solid advice. Very helpful. I appreciate the direction you are turning me in. That book is on its way to my house.
  11. Noctor_Durse

    Memorizing drug interactions!

    I do nott understand How the above posters are so well versed in how my brain works and what my capacities are. I have many things memorized far beyond most. I.e. credit card numbers, Rubics cube algorithms etc. I really appreciate you mentioning a few compatibilities that you know and use. This gives me something to study and ad to my bag of medication familiarities. I believe I will be encountering these medications in the near future and this for me is a great jumping off point for study. It is also highly motivating because when I actually get the medication in my hands and it's my pt I'm giving it to I can look it up to confirm my knowledge. To me that is exciting.
  12. Noctor_Durse

    Memorizing drug interactions!

    The medications listed are all Rx I have given or come across in my short lived student nurse career. Every time I am giving a new med I 100% absolutely look up the medication interactions before giving anything. If I am not familiar with or have not previously given a medication there are hospital resources and pharmacy available 24/7. If there is even the slightest question of incompatibility I look the medication up. I have been getting so much guidance and mentoring at my employment from veteran nurses that I thought this might be a great recourse, clearly this forum is not keen on discussing specialized Rx. knowledge with students. That's fine.
  13. Noctor_Durse

    Memorizing drug interactions!

    As I understand it neither poster thus far has any specialized knowledge to impart on this highly motivated nursing student, eager to learn.
  14. Noctor_Durse

    Memorizing drug interactions!

    So you look up every time that labetalol is contraindicated below50-60bpm and should not be given With an SBP OF less that 90-100mmHg every time you give it?
  15. Noctor_Durse

    care plan

    Hi so with a decreased food intake your evidence would be more related to what happens to the human body when it does not get food. Like cachexia or low albumin or sarcopeia or recent weight loss. There are tons more AEBs that may be present; if I were you I would check your nanda book under imbalanced nutrition for examples. Anemia can be related to imbalanced nutrition but low H&h is not the only AEB for an inbalanced nutrition nanda. Also when you say "abnormal" that is very nondiscriptive and vague. For example the Hct could be high because they are dehydrated or low because of poor protein intake or lack of intrinsic factor or b12 or poor protein absorption From GI ISSUES or a thousand other reasons honestly so that is not a good aeb. Now a decreased RBC of 3.2, ALBUMIN of 1.5, CALCIUM 7.4, cachexic apearance and weight loss of 7 pounds in 2 weeks would be a great aeb. Examples. I don't have spell check so hope this all makes sense good luck. Let me know if you have any questions.
  16. Amcdade- I know it can be difficult to relay sentiment across the internet but please understand I hands down have some of the best pt. care in my cohort and it is simply due to my prior experience. I am very frequently told how amazing of a nurse i'm going to be by 20+ year veteran nurses. I have 10+ nurse mentors with well over 100+ of combined years nursing experience That have taken me under their wing. I just have a knack for caring for people and I really love it. I don't say these things to toot my own horn as a matter of fact I do not mention this to anyone, only online due to the anonymity; and honestly it really doesn't matter what so ever but I'm on a roll so might as well explain myself. I WILL be an amazing nurse and I am super excited to continue on my journey. Nothing will stop my drive and enthusiasm! I like to speak words of truth into my life and I believe in the law of attraction so I will say this: I will make an EXCELLENT, caring, inquisitive, compassionate, sharp nurse.
  17. Thank you for the kind words and I agree with you completely. It really depends on the individual.
  18. I don't formally study but I am constantly chopping it up and talking shop with critical care and rapid response nurses. If you look at some of my past posts you can get an idea of where I am mentally and what I am referring to; and how I have made my nursing school experience so stress free. I have lots of tips and tricks to make it fun and not scary. I know it can sounds offensive that I don't "study" and I will make a bad nurse because I "don't care" but that is quite far from my the reality.
  19. I'm scoring level 3s on my ATI and i have a 99% change of passing my NCLEX as of now.
  20. I'm in second semester, I have straight As and I literally don't open my book, study outside of class or even print the notes out. I've been sleep walking thriugh this program thus far. Nursing school is tons of fun but it's not hard and I dont really need to study any of the info.
  21. I think your definitely on the right track! Here is a list that would apply to your pt. i'm going to list them in in my personal view of priority. 1. ineffective airway clearance 2. impaired gas exchange/Ineffective breathing pattern 3. Risk for infection 4. risk for fall/injury 5. impaired nutrition less than body weight requirement 6.impaired tissue integrity/impaired skin integrity Those should all be totally acceptable NANDAS for this guy, and the goal as a nursing student is PRIORITIZATION!!! What will kill the pt the fastest, and what issue is keeping them from being transferred to a lower level of care? This should dictate your priorities, plans, goals, assessments, interventions and evaluations.
  22. Noctor_Durse

    Saddleback nursing spring 2017

    Do we have any students on here planning to apply for spring 2017 Saddleback nursing program? I am posting 4 month before applications are being accepted but oh well, I am very excited. Let me know where you think your gonna score and how things are going in your nursing journey. I have everything done that I need so i'm taking pharm this summer and so far it seems like it will be a fun challenge. Thank you
  23. Noctor_Durse

    Can a nurse help me with these questions plees?

    i'm gonna say 4 and 1
  24. Noctor_Durse

    Drug Screen

    I think subs get tested but if you have a script you should be fine yah?
  25. Noctor_Durse

    Fluid and electrolytes help

    For K+, the normal equilibrium potential is -85 mV or so, but the resting potential is -70 mV. That means there's a tendency for K+ to try and leave the cell at rest, because doing so would reduce the concentration gradient across the cell membrane. The K+ would continue to leave until the resting potential = the K+ equilibrium potential, at which point the force generated by the concentration gradient would equal that generated by the electrostatic attraction between the positive potassium ion and the negative cell interior. This doesn't happen, however, because the cell membrane isn't perfectly permeable to K+, and because the Na/K pump is constantly pumping in 2K+ for every 3Na+, but all in all it gets pretty close. In the hypokalemic state, you increase the concentration gradient between the inside and outside of the cell. There was already little K+ outside to begin with relative to the inside of the cell, and hypokalemia makes that worse. That increases the equilibrium potential (i.e., pushes it further negative), because now you need more electrostatic charge to resist an increased concentration gradient. Conversely, in the hyperkalemic state, you decrease the concentration gradient. That means that there's less driving force for K+ to get out of the cell, and you need less electrostatic charge to resist the concentration gradient. Therefore, the equilibrium potential is decreased (i.e., closer to 0 than -85 mV). So here's the kicker: after the AP upstroke (i.e., repolarization), Na+ channels close, more K+ channels open, and the cell potential is again being driven by the K+ equilibrium potential. The more negative the K+ equilibrium potential, the greater the energy available for repolarization, and the faster you're going to depolarize. Hypokalemia: more negative K+ equilibrium -> more force pushing K+ out of the cell -> faster repolarization Hyperkalemia: less negative K+ equilibrium -> less force pushing K+ out of the cell -> slower repolarization