Monday, 21 August 2017

Q. Which of the following should the nurse use to determine achievement of the expected outcome for an infant with severe diarrhea and a nursing diagnosis of Deficient fluid volume related to passage of profuse amounts of watery diarrhea?

A. Moist mucous membranes.
B. Passage of a soft, formed stool.
C. Absence of diarrhea for a 4-hour period.
D. Ability to tolerate intravenous fluids well.

Correct Answer: A
Explanation: The outcome of moist mucous membranes indicates adequate hydration and fluid balance, showing that the problem of fluid volume deficit has been corrected. Although a normal bowel movement, ability to tolerate intravenous fluids, and an increasing time interval between bowel movements are all positive signs, they do not specifically address the problem of deficient fluid volume.

Sunday, 20 August 2017

Let’s be honest, nursing school is no joke. It’s not only extremely challenging, but also extremely time-consuming. If you’re a nursing student, you know what I’m talking about.


Nursing School, Nursing Degree, Nursing Job

From an outsider’s perspective, it seems crazy. You are voluntarily giving up your social life for four years. While your friends are making their weekend plans, you’re making study plans. While their smiles come from last night’s party, your’s comes from passing last night’s test.

So why do we do it? Better yet, how do we stay so disciplined?

Confessions of a registered nurse


The answer is really quite simple - we love what we do. We know the rewards of obtaining a BSN far outway the sacrifices.

There’s no question it takes a special person to become a registered nurse. (Coffee may or may not factor into the equation as well.) I can tell you this without sounding arrogant, because every nursing student is one of those special people.

It takes far more than good memorization skills and intellect to obtain your BSN, which you’ll learn very quickly in your first clinical. A registered nurse must have special skills and unique relational abilities that can’t be taught in the classroom.

Why I chose to pursue a BSN


I first truly fell in love with nursing school during my clinical year. It was through hands-on learning and interaction with patients that I developed a true appreciation and understanding of nursing.

I can remember my senior year of college caring for a patient who was in the hospital for weeks with numerous symptoms. A team of doctors was on the case, and every test you could possibly fathom was being ordered in the hopes of coming to a diagnosis.

Through comforting this patient, as well as the family, during such a trying time in their lives, I understood the impact of what I was choosing to do with my life.

What makes a registered nurse a good nurse


As a registered nurse, you’re not only present to complete morning assessments, administer medicine, and documents in charts. Often times, you’re a pillar of support for patients. There are good days and bad days. Some days your work is truly appreciated and fulfilling, and other days you are a punching bag for patients who have no one else to express or project their anger onto.

Being able to take a step back and put the situation into perspective is a true and necessary skill. You must learn to be personable while not taking things too personally. It’s in those moments where people needed me most, that I realized this is why I love nursing and I’m here. I want to be able to provide that support for them in return.

Nursing school in a nutshell


So I suppose my message is, nursing and nursing school are hard - no doubt that about it. But my ability to step back and separate myself from difficult situations and be empathic is what has allowed me to love nursing school, from classroom to clinical, persist towards obtaining a BSN, and now to love my professional career as a registered nurse.

Saturday, 19 August 2017

Q. When assessing an elderly client, the nurse expects to find various aging-related physiologic changes. These changes include:

A. increased coronary artery blood flow.
B. decreased posterior thoracic curve.
C. decreased peripheral resistance.
D. delayed gastric emptying.


Correct Answer: D
Explanation: Aging-related physiologic changes include delayed gastric emptying, decreased coronary artery blood flow, an increased posterior thoracic curve, and increased peripheral resistance.
Any clinical rotation site can be intimidating-from meeting new staff members, working with different nurses, and getting to know your patients. However, when it comes to your clinical rotation in psych nursing, it is a whole different ballgame.

How to Manage Your Clinical Rotation in Psych Nursing
Learn what’s different about clinical rotations in psych nursing. 
Psych nursing is a wonderful sector, but not everyone is cut out for it. For those of you who have never worked in a psychiatric unit in a medical setting, this can be quite overwhelming, exciting, uncomfortable, and intimidating.

Here are some things you can expect during your clinical rotation in psych nursing to make the experience more enjoyable:

No scrubs


One thing that differs from other clinical rotations is your attire. You won’t be wearing your normal scrubs; you will be wearing street clothes—usually business casual (but could vary depending on your program). This is because some patients can become distressed at the sight of traditional hospital uniforms (scrubs).

Many programs will not even permit dark color nail polish, dangling jewelry, wearing your hair down, or the use of pens/pencils during clinical rotations in psych nursing. Patients can become agitated at the sight of color (especially if they have a history of trauma or abuse), or others may try and grab your hair or use your pen as a weapon.

The bottom line here is that all these restrictions are for the safety of both you and the patient. It’s important that you look professional without being distracting.

Timeout


As you go through your clinical rotation in psych nursing and start learning about your patient’s history, it’s very easy to empathize with what they have been through. This can take a toll on you, especially if you yourself have been through a traumatic experience, or have friends or family members who have mental health issues as well.

Know that it’s okay to opt out. Nursing instructors are usually understanding if you need to take a short break off the unit to get some air. It can get intense, especially when patients are agitated, and it’s normal for nursing students to get uncomfortable if a patient is screaming, yelling, or attacking another patient or staff member.

It’s also important to understand that for some of these patients, this unit is their home. It’s a safe place for them. When their routine is switched up, and nursing students are on the unit, it can cause some tension with the patients. The good thing is that some psychiatric units continuously have nursing students throughout the year, so these patients are used to the it—and for the most part, they seem to like it.

Listen and learn


Psych nursing is a great experience, but depending on your program, you can spend anywhere from 4 – 12 weeks on the unit. It’s important to experience as much as you can and interact with the patients simply by talking to them and participating in their activities.

It’s important to heed your nurse supervisor’s advice when it comes to avoiding talking about certain topics. Depending on the patient’s diagnosis, certain things may act as triggers. Reading the patient’s chart will provide you with great background history on the patient, but the real learning will come from your interactions with the patients and nursing staff.

Though challenging, psych nursing may prove to be one of your most rewarding clinical rotations, whether or not you end up pursuing it as your career. 

Friday, 18 August 2017

Have you ever wondered how a human being could run for 26.2 miles straight? They break down this large feat into small daily increments in order to build the physical and mental strength needed to cross the finish line.


Building Mental Strength for NCLEX Prep

It’s smart to approach NCLEX prep in the same way. With the potential for up to 265 questions and a full six hours, you’ll need all the mental stamina you can muster.

Here are five tips for successful NCLEX prep:


1. Consistency is key. Progress towards any goal is only achieved through consistent effort—an hour a day spread out over a few months will get you much further than day-long cram sessions the week before. Kaplan will help you develop an individualized study plan for success. If you follow this comprehensive model consistently, you’ll gain the confidence you need to conquer the NCLEX. Don’t sell yourself short by thinking a few cramming sessions will be enough NCLEX prep to get you prepared.

2. Train by priority, not fear. While it is tempting to only focus on learning more content—what you really need is to train your mind to answer NCLEX-level questions in a Computer Adaptive Testing environment. Passing-level NCLEX questions are written at the highest levels of application and analysis. They are more intense than the average nursing school exam. Refocusing your priority towards learning “how to” break down these questions and eliminate answers will have the most significant impact on increasing your score.

3. Watch your own “game films”. The time you spend reviewing completed practice questions is a critical training strategy. Kaplan teaches you how to review your questions and identify the three key areas of student errors in Computer Adaptive Testing. That way you can identify your weaker areas and learn specific strategies to overcome them. Reviewing the rationales for each of the correct and incorrect answers and thinking through how you selected your answer will provide invaluable information about your personal testing strategies.

4. Make your own playbook. Another powerful NCLEX prep strategy is to keep a notebook. As you are reviewing questions and target studying content, keep the same notebook with you and write all your notes. For example, as you’re reviewing your practice question rationales, write a brief note for any content that was new or unfamiliar to you. Then make it a habit that you review this notebook daily. This is called “rehearsing” and is one of the most effective ways to transfer that content from your short-term memory (which “evaporates) to your long term memory (where you can retrieve it on the NCLEX).

5. Practice in a test-like environment. While all the above tips are certainly useful, nothing will help you quite like rehearsing the test itself—start to finish. Can you imagine an actor doing a whole show for the first time in front of an audience? Sit down at a computer, use a mouse, and time yourself. You don’t want any of these extraneous factors getting in your way on Test Day.
Q. A client is scheduled for an excretory urography at 10 a.m. An order directs the nurse to insert a saline lock I.V. device at 9:30 a.m.. The client requests a local anesthetic for the I.V. procedure and the physician orders lidocaine-prilocaine cream (EMLA cream). The nurse should apply the cream at:

A. 7:30 a.m.
B. 8:30 a.m.
C. 9 a.m.
D. 9:30 a.m.

Correct Answer: A
Explanation: It takes up to 2 hours for lidocaine-prilocaine cream (EMLA cream) to anesthetize an insertion site. Therefore, if the insertion is scheduled for 9:30 a.m., EMLA cream should be applied at 7:30 a.m. The local anesthetic wouldn't be effective if the nurse administered it at the later times.

Thursday, 17 August 2017

1. Save time with multitasking



5 Tips for First-Year Nurses
The habits you develop as a first-year nurse will serve you throughout your nursing career.

Not only is it important to perform your nursing duties correctly, but with so many patients under your care, it is just as important to do things efficiently. I found I saved a lot of time by grouping tasks together instead of doing them separately. For example, if Patient A is requesting pain medication and Patients B and C also need medications from the Pyxis, why not get all three at once? (Just remember your “rights” of medication administration, of course!)

2. Take pride in your work


This is something one of my preceptors told me in my first week on the floor. If you do something, put your name on it—be proud of your work, and document it. Moreover, if you forget to sign off on a task and that task comes into question, then it is considered incomplete. If you didn’t document it, you didn’t do it. So take credit for your efforts. Be proud of your work.

3. There’s no “I” in team


You’ve probably heard this a million times, but it’s especially true in nursing. Your patients not only rely on you to care for them, but also the health aides, the resident doctors, and attendees. You are also one of several RNs on the floor at any given time. Thus, know that you have plenty of help if you start to feel overwhelmed during your shift. You can delegate certain things to your health aides and ask for help from your fellow RNs. You can also always page your residents if you need their help. Bottom line—you’re not alone.

4. Ask, and you shall receive


Never be afraid to ask questions to any of your nursing coworkers. As a first-year registered nurse, you’ll find that your RNs and health aides alike will have years of experience that can greatly benefit you. Post-op patients, personality types, etc, though new to you, may be things they’ve seen many times. Also, it’s good to ask early. Don’t wait until you’re a couple years into your nursing career to ask basic questions that could have helped you all along. Knowing as much as possible will benefit you as well as your patients.

5. Love your work


Being a registered nurse is a unique, amazing experience. No one else has the skillset you have that allows you to take care of your patients from a clinical standpoint. Nor do they have the compassion you have for your patients from a personal standpoint. The feeling you get when your patients smile and thank you for making their day better is incomparable. Be proud that you are a registered nurse, and love what you do—your patients will love you for it!
Question Of The Day,Basic Psychosocial Needs
Q. A worried mother confides in the nurse that she wants to change physicians because her infant is not getting better. The best response by the nurse is which of the following?

A. "This doctor has been on our staff for 20 years."
B. "I know you are worried, but the doctor has an excellent reputation."
C. "You always have an option to change. Tell me about your concerns."
D. "I take my own children to this doctor."

Correct Answer: C
Explanation: Asking the mother to talk about her concerns acknowledges the mother's rights and encourages open discussion. The other responses negate the parent's concerns.

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