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Posts by ladysyrah

  1. Edited by ladysyrah

    All of that is actually irrelevant to the OP. Nowhere in the literature is vecuronium prescribed for PET scan-induced anxiety. The nurse in question didn't give it because she thought it was a superior option to versed.

    I was specifically responding to a question that audrey2976 who asked about potentials of why versed would be prescribed instead of something like lorazepam. I was not directly talking about anything within the report, because as I said I have not finished reading it and want to do so before making any statements about the actual situation. I probably would not have even responded to her had I known that wondern posted such a great response for audrey2976.

  2. Well, I was having a brain-dead moment. I was forgetting that midazolam IS considered a benzodiazepine (I work home health and have limited experience with this drug;therefore, it is outside my wheelhouse). Therefore, please ignore my thoughts about the idea that allergies could have been a contributing factor to the choice of Versed; however, adverse reactions or ineffectiveness may still be a consideration. I know a someone who cannot use any other benzo except lorazepam for their panic attacks because the other meds just do not work as effectively in their body. Also, if the anxiety was more than a simple "talk you down" type of anxiety that was well put and though of (and should be first course of action if the patient does not have history of panic attacks/etc). These are just thoughts.

    Once again I am still working on reading the report so I do not know if that is included in it. I will probably state my *actual opinion on this topic once I read the whole thing but I can only look at potentials without having all the information at this point.

  3. Audrey2976:

    Maybe they are allergic or it would was determined to be too risky of a combination with the current meds? Although benzodiazepines allergies are rare they do exist. Without a pertinent health history, we cannot reasonably surmise why one was chosen over the other. If benzos were off the table for whatever reason, they would need something fast acting which eliminates other anti-anxiety meds generally. I haven't had time to read the full report yet, so please forgive me if it was in there and I haven't gotten to that part!

  4. I recommend doing the Kaplan study program or the ncsbn course (they are the nurses who write the questions for the nclex). Kaplan is really great at explaining how to break down the question to know what they're looking for and how to answer, even improving chances to answer correctly when you have no clue of the answer at all. I credit it as the reason I passed first time.

  5. I used Kaplan only and was able to pass the NCLEX with that. It helps you determine how to do those types of questions and understand what the question is looking for. It helps you be able to extract what you need and be able to toss away the extra information they give you to throw you off. It costs but I felt it was worth it. Also comes with a guarantee if that helps. You will be able to pass. The great thing about failing is what we learn from it. I'v failed in my nursing journey but used it as a means to learn and grow, which has made me a better nurse. Yes it does suck when it happens but we can use it to our benefit if we allow ourselves that.

  6. Thanks!!!! This helps! Regarding the math section, can you use the provided calculator for every math problem? I heard it's a digital calculator on the computer screen. Also, I had no idea the ati had free practice tests. I'll check it out!

    They are not free, but are well worth the money if you can swing it. It was by far the best guideline to see where I was prior to my TEAS test.

  7. I would say that depends on the type of home care service you perform. I take care of ventilator patients with trachs and GT tubes and fragile health so what I would research would be different than what Elfreida would research. It is worth understanding your role and types of services you'll expect to perform. From there I'd recommend highly reviewing all complications and signs of them so when you are there you may be able to help your patients seek medical attention in a timely manner.

  8. It sounds like you should talk to your employer about clarifying your role and what is expected of you. Do not be afraid to do this, but unless someone has worked for the same agency/state government as a CM no one will be able to truly answer your questions. A clear job description and explanation of your duties is a smart thing to get directly from the horse's mouth so to speak. I've personally never known a CM to do anything other than biannual assessments, POC and be responsible for ensuring the medical team for the patient is paid appropriately within the allowed budget.

  9. "Either things in Vanderbilt are run by a group of recent Acute Psych unit escapees, or I do not know."

    "Or I do not know" That is correct. You don't know. Trust me, Vandy is run by a expert and knowledgeable group of physicians and nurses. My daughters have both worked there in the summer between their third and fourth year of med school.

    I have some knowledge of this hospital because I have been there numerous times to investigate sentinel events very much like this. There are mistakes made at this very large hospital complex and I have substantiated several of them.

    Please read the 2567 to obtain more details so you will know.

    It is good to know more about the facility. It does seem there was issues from protocol and job description down to the nurse's incompetence here that all played a role in this. It seems like a "perfect storm" so to speak

  10. Haha. Thank you for all the responses! I apologize I haven't said so earlier. Obviously, I would not do this either as it is out of scope of practice. We were talking over such situations in class so I used this post as an experiment to see how other nurses would react to a similar situation. The responses have been both entertaining and informative!

  11. Hi, so I am going through a lecture about trauma and I began wondering what nurses are allowed to do in emergency situations in "the field" or life outside the hospital? If your assessments of a person says they have a tension pneumothorax, their trachea is already shifted and etc, and you can tell time is running out, do you have the ability to create a hole into the person's lungs to save them? What if they are aware and nod in acceptance of receiving that care knowing it is outside the "usual" scope of a nurse but may possibly be their only chance of survival? What would you do? What is allowed? How far would you go to help someone live if you know that immediate action is required? What is the legal course of action?

  12. Good day everyone!

    I am posting after many hours trying to figure out how exactly to do a portion of an assignment I have. I am doing care plans from a psych ward rotation for the different Axis. So, the problem I am encountering is trying to write a pathophysiology for Axis I and Axis IV. The reason for this is that it is not an obvious "path". My biggest concern is for my Axis IV. Here I have a nursing diagnosis of "hopelessness r/t social isolation 2° being disowned by family." I have the picture in my head of how it works, but I am having one heck of a time trying to put it into words that is appropriate for a patho in a care plan.

    Please, can anybody help?

    The other patho I'm having a hard time with (although I have a sense if I am able to do the Axis IV this one would finally be able to be worded-it's often a issue of getting started that I have troubles with) is "disturbed thought process r/t hallucinations 2° Schizophrenia with psychosis."

    This is due in the morning, and I have tried for nearly a week to put these into words and have miserably failed. Thank you in advance for any and all help!

  13. Thank you both. The OBGYN nursing diagnosis (mama and baby) were difficult for me initially because we were not allowed to use the things that were normal happenstance which made it even more difficult when you have a healthy pair. Haha. And AliNajaCat I really appreciate the detail in which you broke things down. It helped me immensely.

  14. Thank you! And I apologize for the delayed response. It is frustrating, the roles are not well defined in my state and is rather confusing. I suppose it is a judgment call in a lot of cases.

  15. So, I'm trying to figure out what exactly* is in the scope of practice for an LPN? I am finding conflicting information regarding things such as IV push (for example morphine). I also cannot find any information regarding the ability for LPNs to do such things as heparin drips.

    I've been looking at the definitions of scope of practice for RNs vs LPNs and I'll be honest, it has left me more confused than before. I know RNs make "assessments" while LPNs "collect data" to contribute to assessments, contribute to care plans, et cetera. My questions are more in application of delegations.

    Any help in clarifying would be greatly appreciated!

  16. Hi. I was just getting interested in looking at options now that after this quarter I become an LPN as to whether or not I want to continue to my RN through this school or do an online program. So with that said, does anyone know good online programs? I'm open to either LPN to RN or LPN to BSN programs currently. I've been looking a little bit at the options but wanted to know what you guys think? Are there ones to avoid? Ones you recommend?

    Thank you

  17. It is those who are humble and can admit their mistakes, take accountability (a major character requirement in nursing!) who go on and become greater. You are new and will make mistakes. This does NOT mean you will be a bad nurse. . In fact it may make you a BETTER nurse because you had this moment. You won't make this mistake again.. and I'd bet money you would never continue, rather stop and fix that mistake when you do make a mistake again, regardless of what the colleague/nurse says! Don't quit. You've got the makings of a great nurse.

  18. Remember that passing is still passing. The scores you have are passing. There's a saying in my program: C is passing. C's make RN's. In my second and third quarters I dealt with having a pretty bad concussion where I could barely remember things immediately after I read them (if at all). I still have remnants of this concussion (my eyesight is forever altered, and I cannot test in a group), but I'm pulling myself out of it. I'm not sure how far into your semester you are, but you will gain a stride. In the meantime, do not be too hard on yourself (I'm famous for that too, but having the concussion taught me to relax and be happy with my hard work even if it meant I did not receive an A). Nursing programs are much harder than traditional college so realize.. you are passing! You are making it happen. Look at you go! You got this. You can do this. Make little cards and put it on your mirror saying "I am successful" "I pass this quarter easily" et cetera (however you want to say your self-affirmations). Look at them every day. Start by looking at them and saying it out loud to yourself every morning. Do it before bed... and do it when you are feeling down. You will feel a little bit of self-empowerment. Try it, it at least worked for me.

    Study wise: try something different. Do something to switch it up, perhaps you are getting bogged down by too much of the same. Change the venue, or give yourself a treat. Change the music in the background... I feel myself get into a rut and I stop being able to learn as much. When I change the environment and approach studying differently (maybe you always read first then do videos and notes... maybe switch it up and do videos first then read for example). I'd need to know more about your learning style to really make specific to you recommendations. Also, try to go over NCLEX style questions before and after studying and before and after class. This will help adapt your mind to how to use the information.

  19. Sounds like, from chare's post that both have been considered measurements. Now, I am currently in nursing school and was taught the first method mentioned (to the xiphoid process). If this question is in regards to your program, I would recommend talking to your teacher to discuss that you found there are two ways of measurement, discuss what they are, then ask when it comes to their curriculum which do they want you to use (unless it is in your book, then go by your book's description). This will show that you have the information, you aren't asking them to tell you the answer you are coming to them with two possibilities of answers that are both correct and clarifying what they want. This will help you appear informed but wanting to learn and be accurate. It would be hard to say which one is most accurate as they need to teach what are in the books/on the NCLEX so most likely it will still be the first method for testing reasons but can open the floor for an interesting conversation with your teacher.

  20. So I am 34 and just about to graduate LPN section this December. I will graduate with my RN next December. You are not too old. In fact, I think those who come into nursing later sometimes have a different perspective that can be quite valuable to a nursing team. We will all have our experiences that will help us be better in some areas, and there will be areas that is not our strongest aspects. This is ok! It allows us to work as a team. Your previous experiences will apply even if you don't see how right now.

    If it a matter of money, you should be able to pay off any school loans in a reasonable time frame. If it is your passion do it. If it is not your passion though... I would recommend spending some time volunteering and shadowing or working as a CNA so that way you know what you are getting yourself into.

  21. So I have a primigravida patient who has completed full prenatal care. Has a medical background. Rh negative. SROM. Clear fluid. Late 20's. GBS negative. 37w6d. I have to figure out 3 antepartum* NANDA nursing diagnoses for this patient. It says specifically that it cannot be intrapartum. So far these are my thoughts but I am questioning my self, so any help would be greatly appreciated!

    Risk of Maternal Injury R/T Rh incompatibility

    Knowledge deficit R/T primigravida

    I was thinking of doing something r/t cardiac output or increased blood volume but cannot think of how to put it together.

    Thank you in advance!


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