What should I expect?

[SweetNSassyRN2B]

hey everyone!

i am finished with my first semester of nursing school (yay!). we just received our clinical placements for spring semester. i am on an ortho/neuro unit. has anyone else had clinicals on this type of floor? we will be giving meds this semester, so i'm a little nervous. this past semester i was on the cardio-vascular stepdown unit. it was a great experience! i'm assuming i'll have a lot of patient's with hip replacements, knee replacements, other orthopedic issues, and maybe seizures for the neuro side? what should i expect to see and learn?

as always, thanks!

amanda

[Bortaz, MSN, RN]

I imagine you'll be seeing lots of TIA's and CVA's, so study up on strokes. Also, Lovenox would be a good med to know.

[Daytonite, BSN, RN]

i started my career working on a neuro unit. i saw every kind of seizure there was. we think of grand mals when we hear the word seizure, but there are other lesser types that are most fascinating to watch when they happen. my biggest problem as a new grad was forgetting to look at my watch and note the times of onset and duration of these things as well as what seizure activity went on during them. we received all head and spine surgery and injury patients that did not go to icu or who were better and were coming out of icu and that included stroke patients. a head injury can be closed (no skull fracture or scalp laceration) or open and the brain damage can be just as severe. at the time we also used to get people who were admitted for workups for migraine headaches. that happens more on an outpatient basis these days. these patients sometimes have fluid and electrolyte issues and may be on fluid restrictions.

the pathophysiology of bone fracture is that of trauma to the body. it is actually not that hard to put together for a care plan. when the body is subjected the trauma of a cut or fracture, inflammatory responses occur and the process of healing begins immediately. bone has a particular process it follows to repair itself that you need to get from an a&p textbook.

some helpful weblinks:

• for the orthopedic surgeries, look them up for details about them on this website: encyclopedia of surgery http://www.surgeryencyclopedia.com/index.html
  
• for everything about strokes, especially aftercare: http://www.stroke.org/site/pagenavigator/home - national stroke association and http://www.stroke.org/site/pageserver?pagename=las(life after stroke)
  • http://www.strokecenter.org/prof/ems/ - stroke interactive tutorial

  [*]seizures: http://www.epilepsy.com/epilepsy/types_seizures

  • http://en.wikipedia.org/wiki/jacksonian_seizure - i actually saw a patient have one of these following her brain surgery and it was the oddest thing. it started in her face and proceeded down her body in a systematic way over the course of about 2 minutes.

things such as traction and autonomic dysreflexia (a complication of spinal injury) have been asked about and discussed on the student forums in the past.

[SweetNSassyRN2B]

thank you both for your great responses! the links are great daytonite, thank you! i'm really looking forward to this coming semester.

thanks again,

amanda