Saturday, October 17, 2015

Nursing Drug Calculations~ Mass to Liquid

Ms. Suzanne Bomber Wacker was admitted into the hospital this morning. The physician ordered Morphine Sulfate 6mg IVP every 3-4 hours. You only have 10mg/mL of Morphine Sulfate on hand. How much would you administer to Ms. Suzanne Bomber Wacker? 


Show me how
Ordered dose mg/Have on hand mg X Volume =Amount administered 
6mg/10mg X 1mg= 0.6 mL administered IVP every 3-4 hours



What's What?: You will have to convert a mass to a liquid when there is a powder form. You will have to reconstitute it with a liquid solution such as Normal Saline. If you don't know how much solution to add read the label on the bottle. 

Do you remember what you should assess when giving Morphine Intravenous push
  • Assess level of consciousness 
  • Morphine will depress the respiratory system so check respirations Q2h
  • Always check the IV site  
Do you know how to draw up 0.6 mL? What syringe would you use? What size needle gauge




Saturday, October 3, 2015

Medical Surgical Nursing ~A BROKEN TICKER! What is CHF (Congestive Heart Failure)?

CHF is when the heart can't pump blood to the body efficiently to meet the body's needs. 




The heart doesn't literally implode upon itself. The heart does not pump well enough to get enough blood and oxygen to the body. 



Terms: Heart failure (HF) and Congestive Heart Failure (CHF) are the same things. Heart failure is the inability of the heart to pump enough blood to meet the oxygen demands of the tissue. Acute and Chronic heart failure have been replaced with CHF.  Acute HF is, the short-term condition, and Chronic HF, is the long-term condition. 

What are the Primary Causes of Heart Failure? 

  • Coronary Artery Disease
  • Hypertension/High Blood pressure
  • Rheumatic Heart Disease
  • Pulmonary Hypertension
  • Cardiomyopathy 
  • Hyperthyroidism
  • Valvular Disorders (mitral stenosis) 
  • Myocarditis

What are conditions that can trigger Heart Failure?

  • Anemia
  • Infection
  • Hypothyroidism
  • Dysrhythmia
  • Bacterial Endocarditis
  • Pulmonary Embolism
  • Paget's disease
  • Nutritional deficiencies
  • Hypervolemia

Types of Heart Failure? 

Heart failure happens when ventricles of the heart fail. Usually, both ventricles of the heart will pump in a synchronized way and produce blood flow through the body. When a patient has heart failure the ventricles of the heart won't pump properly and the body won't get sufficient blood flow. 

  • Left-Sided Heart Failure
  • Right-Sided Heart Failure 

What are some signs and symptoms of Heart Failure? 

First you must know if it is left or right sided heart failure. The symptoms will vary. If the patient has left sided heart failure they will have lung problems with the patient has right sided heart failure they will have problems all over the body. 

Think of the flow of blood through the heart. 
Blood Flow Through the Heart
Veins-takes blood to the heart because it needs oxygen
Arteries- take blood away from the heart to give the body oxygen
Valves- prevent back flow of blood


Deoxygenated blood comes from the veins and enters the right atrium then goes through the tricuspid valve to the right ventricle then through the pulmonary valve and bifurcates into the left and right pulmonary arteries and picks up oxygen and carbon dioxide from the lungs.


Blood comes back into the left atrium to through the mitral or Bicuspid valve into the left ventricle and through the aortic valve and through the aorta to the rest of the body 

Left-Sided HF Signs 
  • Pulmonary congestion (excess pressure in the lungs)  
  • Pulmonary Edema (fluid in the lungs) 
Right-Sided HF Signs
The primary cause of right-sided HF is left-sided HF. 
  • Jugular vein distention (JVD) 
  • Hepatomegaly (enlarged liver) 
  • Splenomegaly (enlarged spleen) 
  • Peripheral edema (swelling over the entire body) 

Awesome Facts about the Heart! 

  • The heart does the most work more than any other muscle in your body throughout your lifetime
  • A woman's heart naturally beats faster than a man's 
  • A woman is more likely to get heart disease in her later years
  • People with a college education are less likely to get heart disease
  • The heart valves opening and closing is what makes the beating sound





Friday, October 2, 2015

See the Signs!

Unfortunate circumstance where a woman chose to be blind but she had a medical disorder called BIID ( body integrity identity disorder).  They believe they are meant to be disabled. 





Nurses often spend the most time with patients getting to know them while they care for them. Not only do nurses have to be aware of the physical disorders psychological disorders. Look for cues such as, "I don't like" "I wish I had" or "this doesn't feel right". This could save someones life. Although this condition is rare you must be aware.

Tuesday, September 29, 2015

Test Study Tips!

Prioritize 
A lot of the questions will ask you prioritize nursing actions. What should you do first?  

  • Does your patient have a clear airway, can they breathe, do they have a pulse? Always take care of these issues first.  
  • Use Maslow's Hierarchy of Needs (physiological needs, safety and security, love and belonging, self-esteem and self-actualization needs)  
  • Use the nursing process. Assess first, diagnose, plan, implement care and evaluate.  

Wednesday, September 23, 2015

A Single Mom in Nursing School

A Single Mom In Nursing School


How to Cope?  

Being a single mother in nursing school is a challenging journey. I realized helping people was my passion in life, and I must complete nursing school and become a registered nurse but to do this it would take hard work and effort. I found myself trying different things to manage my time better. I visited the college counselors, nursing remediation specialist, and instructors got a life coach to get advice on how to manage my life properly. Great life changing tips have been given to me and others I learned along the way. I will show you how to manage your time to continue nursing school successfully. 


Organize Your Calendar

Monday, Tuesday & Thursday 
0530-Wake-up (morning grooming) 
0645-Take daughter to school 
0700-Take son to school 
0800-1200-Class/Theory 
1200-1400-Study Group 
1500-1600-Workout 
1600-1630-Pick up kids from moms
1700-1730-Cook dinner 
1730-1900-Study at home 
1900-2200-Work from home (beach body) 
2200-2230-Shower and get ready for bed 



Wednesday Game Day
0530-Wake-up (morning grooming) 
0645-Take daughter to school 
0700-Take son to school 
0800-1200-Class/Theory 
1200-1400-Study Group 
1500-1600-Workout (Insanity) 
1600-1630-Pick up kids from moms
1700-1730-Cook dinner 
1730-1900-Football game (listen to audio book for nursing) 
1900-2200-Work from home (beach body) 
2200-2330-Shower and get ready for bed


Friday's Errand Day 
0530-Wake-up (morning grooming) 
0645-Take daughter to school 
0700-Take son to school 
0800-1400- Complete Errands (pay bills and finish loose ends) 
1400-1500-Workout (Insanity)
1500-1600-Cook Dinner 
1600-1630-Pick up kids from moms
1700-1830-Study group via Skype 
1730-1900-Study at home 
1900-2200-Work from home (beach body) 
2200-2330-Shower and get ready for bed 
Saturdays –Business, mommy time and family time
Sundays-Church, business and care plan day


I would like to add… if you are a full-time student, then you must have a part-time job and work on the weekends or have your own business that allows you flexibility. I am a Beach Body coach, and this allows me the freedom to schedule my days accordingly. 



Find A Support System 


You need help. Do not try to tackle everything alone. My support system consists of my parents whom help out tremendously with my children, life coach who has helped me become whole and keeps me on track, friends who support me through good and bad times and even instructors who also help me in every aspect of my life to stay on track with nursing by being an advocate for me. My parents are especially helpful with my children. When you have to change your schedule unexpectedly, it can be helpful to have family and friends to help you with your children this cuts back on the cost of babysitters or daycare. My mom and dad are awesome. Also, do not take your family and friends for granted. They are doing you a huge favor so if you have the extra money pay them what you have. They'll be grateful. 


Cooking  

Cooking was a challenge until I began to order dinners online. Before you turn your nose up at this idea the idea… I save $200.00 a month on my grocery bill, it only takes me 30 minutes' average to cook the meals from start to finish, they are healthy meals about 500 calories per meal, and my children love it. Lastly, I save time and money because I am not going back and forth to the grocery store for ingredients. Find a company that will send you groceries in a box and this will be a huge time and money saver. I only cook breakfast on the weekends and my children eat breakfast at school. Although I do not eat breakfast, this does not stop me from living a healthy lifestyle. I drink the meal replacement, Shakeology in the mornings for breakfast. 


Shakeology

Shakeology


The Meals in a box I order online


Exercise

You do not have to compromise your health because you are a full-time student and single mom. The best option is to workout from your home. I am a Beach, body coach. Therefore, I save money when I purchase products; I make money by working from home, and I lose weight. I also motivate the people around me to become healthy as well. As a nursing student, you learn that you must lead by example. If you are teaching health and wellness, then you must make and effort to be healthy and well. This way you not only feel great about educating your patients on diet and exercise, but you also lead by example. 
My parents early morning bike ride


Tips get started click the link http://challenge.gettingfittogether.com/CoachTheresaC00/?bypass_cookie



Keep a Great Attitude

At times, things get rough especially when you have to push out an awesome care plan that takes 20 hours of your precious time to complete and you don't see how you're going to do it. Nursing school is demanding, and this causes stress and anxiety. To make it through your days stay positive. Know that at the end of all of this you will become an awesome nurse making a difference in others lives. 


Save Time for Yourself

My favorite things to do are gardening, walking in the park, going to catch a good movie or staying home playing video games with my children or having a movie night with them. Whatever makes you happy take the and spend it with yourself. 
Basil from my garden













Tuesday, September 22, 2015

Assisting Your Patent with Ambulation

Assisting Your Patient With Ambulation 


  1. Assess the patient's ability to walk before standing. Are they a fall risk? (this will be posted outside the door of the room) Have they fallen in the past?  Do you need another nurse, gait belt, cane or walker? Do they have an IV attached? Does the IV pole move easily? Are they on oxygen? 
  2. Explain to the patient what is being done. Describe the distance required to walk, furniture the patient needs to be aware of and ask the patient to tell you when they feel weak or dizzy. 
  3. Look at the body language. If they look at their feet this is a sign they are fearful to walk probably because a previous fall. 
  4. Have the patient sit erect and dangle their legs off the edge of the bed before ambulating. With prolonged bedrest, they could feel faint. 
  5. Before the patient persists make sure they have on non-skid shoes or socks.
  6. Before moving make sure the patient is steady. 
  7. Always stand on the patients weaker side and place both hands at the waist. 
  8. If you're not certain if you could handle the patient alone, then get a two-person assist. 
  9. Ensure your patient stands with their weight evenly distributed. A cane is held on the patient's stronger side. 
  10. If using a gait belt, grasp the belt from behind the patient and walk slightly to the side of the patient. 
  11. Ask questions. Ask how the patient is feeling throughout ambulation. If you suspect weakness then stop and rest. 

Sunday, September 20, 2015

The Fastest way to get Tossed out of Nursing School


The Fastest Way To Get Tossed Out Of Nursing School 


HIPAA or the Health Insurance Portability and Accountability Act

I have personally seen students put out of the nursing program for not following HIPAA guidelines such as taking home patients information they have printed from their charts, talking about patients in the elevators of hospitals and even telling people who ask about patients their information. You must take HIPAA laws seriously because this is the quickest way to get put out of nursing school with hardly any questions asked.
The Federal Health Insurance Portability and Accountability Act means that the patient’s information is protected by law without compromising the care you give. The patient must authorize any and all information given unless you are collaborating with physicians, physical therapists or any other health care providers of the patient. Always ensure the patient signs a statement and explain to them their information is protected.
Example 
Let’s say you are sitting at the nurses station and a young man introduces himself to you as the son of patient X in Room 1 and asks how his mother is doing.  Never! Never! Never! Give away patient information. Direct him to a nurse as a student. Let’s say you are a nurse then you would ask the mother if it is ok to share her health information with him. Also, do not answer the phone as a nursing student if you can help it. You are learning the ropes and it is better safe than sorry.

Application
Look at your environment. Are there people around? Does the patient share a room? Is the room sound proof? Are you asking for information that is not relevant to their disease process? Asking yourself these questions will help you keep your patients information safe.

In general during clinical, if you do not have the facts or training, if it breaks any policies or laws, if it is not evidence based practice, if you have never heard of it then do not do it. Simply be an observer and ask your instructor.