What are good things to know by heart?

Guttercat, ASN, RN · Jan 24, 2012

Hi everyone,
I am in my second semester of a 2 year RN program and I'm starting to realize there are some things I just want to commit to memory to make things easier during my clinical life as well as in my future career as an RN. I've started by making index cards (to use as flash cards) and I have made some for normal lab results for adults and children (such as cbc, hemoglobin, BUN, etc). I was just wondering if anyone has any suggestions that they know by memory or things you think would be good for me to start commiting to memory. Thanks for taking the time to read this and for all the help everybody! I hope you all have a wonderful night!

The rule: look at the patient, not the machine.

Machines, values, results...often lie.

Commit that to memory.

DemonWings · Jan 24, 2012

My life would have been much easier had I memorized the differences between the different blood pressure meds, and exactly how they work in the body.

So my patient is on metoprolol 25 mg but her blood pressure is 112/62?? Why is she on this? OOH her heart rate is 130......

or similarly " His blood pressure is 185/97, The night nurse didnt give his atenolol! That must be why, oh wait his HR was 49, lets call the doc and get something other then a beta blocker"

I had such a hard time remembering why certain meds were used and others wernt. I would make a chart and write out the different classes of these meds and list their mechanism of action, side effects, desired use, and interventions.

Also I had a tough time with the different insulins, I could not for the life of me remember what the onset/peak/duration of the different types. I made a similar chart for these.

anotherone, BSN, RN · Jan 24, 2012

alot of it will depend on what area you work in ? do psych nurses routinely try to remember meds used in LD? I would say for a nursing student lab values, common meds and how they work, anti depressents, anti anxiety meds, ppis, pain medication, anti hypertension meds, different insulins, antibiotics.

PeepnBiscuitsRN · Jan 24, 2012

As you're a student it's hard to give specific, focused facts to know, since you have to know the whole spectrum for NCLEX and for the rest of school for now. So you have to know all about psych meds and L/D meds and cardiac meds and assessments.

I would definitely know some lab values and what is normal and what isn't and what a high or low level signifies. K+, Na+ and Mg+ are one's I'd know, and Ca+. HGB too, and maybe understand about basic kidney function values. Those are values you can take anywhere, really from cardiac to OB, and they're all pertinent.

The only other thing I'd memorize is this: look at the big picture. When I started working at the hospital, I was stuck in student mode where I was very task oriented, and doing things because the chart said to. "Ok, give this Metoprolol because it's due..."

"Wait, don't I want to look at this dude's BP? What's it been doing? Oh- it's 98/52? Well, it's a good thing we didn't give that med, isn't it?" Every facility is different- we have an hour before and an hour after a med is due to give it. In school I think they expected us to pass it within 20 minutes. I agree with looking at the patient, not the numbers and machines (although they're also pretty important). If their o2 says 84% and they're talking in complete, conversational sentences, and they're not blue...and they just washed their hands...maybe the probe needs to be changed and they don't need the rebreather...

So those are my little tips.

Been there,done that, ASN, RN · Jan 24, 2012

The way home.

hiddencatRN, BSN, RN · Jan 24, 2012

Lab value parameters can vary from hospital to hospital, so other than a general range and what you need to know for class I wouldn't worry too much about lab values to be honest. In school, depending on which textbook you looked at you got different ranges of normal (and then there were the powerpoints which were a whole other set of values). I wouldn't say ignore them completely, but just keep in mind that an abnormal from one source might be WNL in another. (THAT being said, I always remember pH, sodium and CO2 based on the chart a tutor drew for us that showed how they all end in 35-45, pH from 7.35-7.45, sodium from 135-145, and CO2 from 35-45)

One of my clinical instructors gave us a list of medication classes we should just know- how they work, general class side effects, administration concerns, important assessments. But even that....those meds were mostly geared towards the adult population, and since I work in peds I find a lot of that info I don't use. For nursing school and the NCLEX, you need a broad range of knowledge, but then once you start working, what you keep fresh and learn in depth will shift based on where you work. What I keep from nursing school that is most helpful is, as others have said, the big picture stuff, physical assessment, things to watch out for (giving a new med? how does it work, side effects, interactions, important assessments, how do I give it, AND WHERE DO I GO TO FIND THIS INFO ACCORDING TO MY HOSPITAL'S POLICY).

brownbook · Jan 24, 2012

I would memorize the words "I don't know....please teach me about it, (or).... but I will find out.)" And, "I have never done that procedure, or given that drug, please tell me what it is, how to do it."

Your idea, to have some basic facts memorized, is wonderful. But you will NEVER know it all. Better to admit to it to yourself and co-workers, and doctors. If you get report that so and so needs such and such don't fake it or try to remember what you think you memorized, or think it is dumb to say, "I don't know or understand, what is that drug or procedure."

Drugs change, procedures change, nurses of 30 plus years experience are not going to know it all, and a new grad should't be expected to.

CrufflerJJ, BSN, RN, EMT-P · Jan 24, 2012

I was just wondering if anyone has any suggestions that they know by memory or things you think would be good for me to start commiting to memory.

1) Air goes in & out

2) Blood goes round & round

3) Oxygen is good

4) All bleeding eventually stops

MattNurse, MSN, RN · Jan 24, 2012

Eriksons (for school only, especially pediatrics, I could care less about Erikson's day to day while on the floor)

lab values

interpreting vital signs (not just memorizing)

look at the end of drug names olol (beta blocker), pril (ace inhibitor), sartan (arb), prazole (PPI) etc etc

hypotonic, isotonic, hypertonic solutions (remember dextrose 5% may be isotonic in the bag, but when it hits the blood stream it becomes hypotonic)

how to give certain meds, like will you give Iron pill with orange juice or milk, or knowing about tobramycin and gentamycin, never crush extended release drugs.

PTT (Heparin), PT INR (coumadin/warfarin)

Always choose airway on your test if it's an option.

When to put people on precautions and what kind of precautions.

My peds teacher made us memorize the pediatric vaccination schedule which was a huge waste of time because 1) I can look it up, 2) I am not a peds a nurse.

I definitely would not memorize a CBC, differentials and stuff (most of the time I don't know why the doctor's run them daily on their patients). They sell a memory notebook that is useful in school. Also don't waste your time knowing certain numbers, it all depends on the lab that performs the test, some books will say normal hemoglobin for a male is 14.5, another may say 14.2, you should know that if it is below 8 he is probably getting intervention.

Scarlette Wings · Jan 25, 2012

Better words were never spoken...

Air goes in and out and blood goes round and round......amen and amen!

LMAO. Loved it!

Flo., BSN, RN · Jan 25, 2012

Know how to get help fast if your patient goes bad.