What you need to know before clinicals

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hi everyone,

so i know there are a lot of threads discussing clinicals and how nervous people are but i was hoping to start a new thread of everything you need to know before you start clinicals. so far my list consists of:

rbcs (hgh, hct, mcv, mch, mchc, esr)

wbcs (% neutro, % lymph, % monos, % eosino, % basos)

platelets (mpv)

troponin-t, troponin-i

glucose -

sodium - 135-146

chloride - 98-106

potassium - 3.5-5.0

phos - 3.0-4.5

albumin - 3.5-5

bilirubin - 0.3-1.0

protein - 6.4-8.3

cholestoral

triglycerides - 400-160m, 35-135f

bun - 10-20

creatinine 0.6-1.2 male, 0.5-1.1 female

uric acid 4.0-8.5 male, 2.7-7.3 female

ua - clear, amber, yellow, aromatic

specific gravity - 1.005-1.030

ph 4.6-8.0

creatinine clearance 107-139 male, 87-107 female

any thoughts on other values, procedures, standards or other items we should have perfected before clinicals? thanks for your input!

Specializes in Psychiatry, ICU, ER.

Oh, and of course drug allergies as part and parcel of the past medical history. Important one.

Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

Forget memorising lab values. Firstly the lab value slip will tell you what is abnormal. You are not going to have time to remember and memorise all that stuff.

Secondly, you are going to be too busy caring for real people to go through charts and all the lab values. You will not have time to sit in front of computers and philosophise re stuff.

Find out as much as you can re the unit/ward/department you are going to. Work out what the routine of the ward it, try to talk to some more senior nurses there and ask them what they do. A trip to the ward b4 clinicals start is an excellent idea.

For example if it's a cardiac ward, what is their routine on a morning shift? Well they will probably do their ECGs/rhythm strips in the morning, patients will be wearing continuous telemetry (holter monitors) so they can't shower - you have to work out how they are going to bathe that day, find out re your common ECG ryhthms, what they mean, common cardiac conditions, what to do in an emergency (ie: patient in the shower, gasping for breath, chest pain), update your DRABCD and CPR. Learn all your drugs - the ins and outs as much as possible, and about common cardiac procedures, ie: your angiograms, care of patient pre and post cardiac procedures, what to do for chest pain and SOB, ie: do you give GTN routinely on that ward? check what meds you can and can't give as a student as well - very important to know your boundaries and duties as a student. DO NOT overstep your boundaries and always get a senior RN to help out with anything if unsure.

There's lots else but try to find out the basic routine of the ward firstly and always ask experienced staff members for help for ANYTHING. Also do not be shy or timid - try to be a bit more aggressive and forward and ask lots of questions - even if they sound stupid.

Specializes in LTC, home health, addiction, hospice.

A tiny dab of vicks vapor rub will do wonders for the array of "smells" you may encounter, put a little bit in a contact lens case and carry it in your pocket!! Good Luck!!

I agree with most of the posters. Don't waste your time trying to memorize the lab values for clinical. Of course you need to know them, but just keep your cheat sheet with you for now. I spent a lot of time writing down lab values and trying to memorize them during 1st semester and then "Surprise", each hospital had a different set of values than what my book had. Each facility also flagged them as High or Low.

I agree with the poster about learning some of the common meds and there are several threads relevant to that on this site.

Other than that, just make sure that you come prepared with everything that is required (stethoscope, name bagde, hospital issued passwords, drug book, penlight, etc.). Make sure that you know exactly where to park. I had one clinical instructor that issued U's to students parking in what appeared to be employee parking, but wasn't. If they give you a map of the facility and indicate where to park, then follow it. I would say too, make sure that you can perform a head to toe assessment blind-folded. That tends to be the focus in first semester. Your instructor wants to know that you saw that the patient had +3 pitting edema in the left leg. They want to know that you were aware that the patient was wearing a fentanyl patch AND that it needed to be removed before you placed the next one. First semester is all about the assessment though, in my opinion.

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