Sunday, 23 September 2018

Q. A nurse is caring for a client with lower back pain who is scheduled for myelography using metrizamide (a water-soluble contrast dye). After the test, the nurse should place the client in which position?

A. Head of the bed elevated 45 degrees
B. Prone
C. Supine with feet raised
D. Supine with the head lower than the trunk

Correct Answer: A

Explanation: After a myelogram, positioning depends on the dye injected. When a water-soluble dye such as metrizamide is injected, the head of the bed is elevated to a 45-degree angle to slow the upward dispersion of the dye. The prone and supine positions are contraindicated when a water-soluble contrast dye is used. The client should be positioned supine with the head lower than the trunk after an air-contrast study.

Saturday, 22 September 2018

Question Of The Day, Endocrine and Metabolic Disorders
Q. A client with type 1 diabetes must undergo bowel resection in the morning. How should the nurse proceed while caring for him on the morning of surgery?

A. Administer half of the client's typical morning insulin dose as ordered.
B. Administer an oral antidiabetic agent as ordered.
C. Administer an I.V. insulin infusion as ordered.
D. Administer the client's normal daily dose of insulin as ordered.

Correct Answer: A

Explanation: If the nurse administers the client's normal daily dose of insulin while he's on nothing-by-mouth status before surgery, he'll experience hypoglycemia. Therefore, the nurse should administer half the daily insulin dose as ordered. Oral antidiabetic agents aren't effective for type 1 diabetes. I.V. insulin infusions aren't necessary to manage blood glucose levels in clients undergoing routine surgery.

Friday, 21 September 2018

What is a career network (or a professional networking) and how do nurses go about networking to land that ideal job or advance your career in other ways?

You’ve heard it said “It’s not what you know but who you know” if you want to advance in life. Unfortunately, there is a lot of truth in this. Surveys show that 70% – 85% of candidates are appointed through some form of networking, and up to 70% of jobs are never advertised to the public in media or on job boards.

What is professional networking?

Nurse A and Nurse B have both applied for the same position that will be a promotion in the organization where they both work. They have the same qualifications and experience. They are both admired for the quality of their work, respected by their colleagues, and liked by their patients.

◈ Nurse A gets on with her work. She talks to her co-workers about the work to be done, but seldom chats to and laughs with them on a more informal basis. They know very little about her as a person or of her home life, she avoids social events at work and doesn’t belong to or participate in professional organizations.

◈ Nurse B often asks co-workers how they are, how things are going at home and gives support when she notices they are down. In chatting, she also shares some of her problems, dreams, and ambitions. Everyone knows Nurse B because she joins in when there is an event at work, has been asked to serve on committees, and is an active member of her local nursing association.

Who do you think is the most likely to get the promotion?

The goal of professional networking is to build real connections with others. Some even say it’s not so much who you know but who knows you. People who know what you are like as a person, what your interests, abilities, and strengths are. Who would bring you to mind if they hear about a job opening and let you know, or who would be prepared to put their reputation on the line to recommend you?

The bigger your network, the more potential opportunities could come your way. But networking involves more than just collecting contacts – as in sharing names, a business card and a few words. You have to build and maintain a connection, and this involves creating rapport as well as mutual trust and respect. This needs some work from your side by giving the other person something of value as well as linking up from time-to-time.

As a student or a newly qualified nurse, you already have a social network of family, friends, and members of groups you belong to such as your church or sports groups. You have the beginnings of a career network in fellow nursing students and colleagues. Don’t neglect this network as they can provide valuable connections now and in the future. Keep your professional and career network active.

Nursing Career, Nursing Certification, Nursing Job, Nursing Profession, Nursing Responsibilities

Keep your professional and career network active.

Professional networking is not only about potentially getting job referrals. It is also about:

◈ Building your career through gaining knowledge, including internal organizational knowledge;
◈ Staying up to date with the latest developments and trends in your workplace and the profession;
◈ Having a support system you can turn to for professional advice when you have to manage new or stressful situations in your career; and
◈ Gaining the respect and recognition that will give you a voice within your organization through which you can have a positive influence on systems and procedures.

You might feel that intentional networking is artificial, but it isn’t really if you see it as creating friendships where there is a give-and-take relationship that is work-related rather than social or recreational. As with friends, you build connections with people that you hit it off with and with whom you share common interests.

So who can you include in your professional network? Here are some suggestions:

◈ Nursing colleagues, supervisors and managers at work;
◈ Nurses who share your specialty interests;
◈ Other health care professionals including doctors and paramedical staff;
◈ Your old classmates;
◈ Your teachers and professors – past and present; and
◈ Experts in areas that you are interested in who you meet at nursing or healthcare meetings and conferences

Professional Networking Tips

1. To build a career network, you first need to meet people, and then you need to get to know them. Go out of your way to strike up conversations wherever you are. This may be difficult if you are shy but when you call others by name, ask questions and listen to what they have to say, they will immediately be attracted to you because they feel that you are interested in them.

2. Put yourself in places where you can meet people. Accept invitations. Attend events that are organized at your place of work or by nursing or other healthcare organizations. Plan to attend a few nursing conferences every year.

3. If you’re given the opportunity to serve on committees at work or in other organizations, don’t hesitate to get involved and stay involved. Not only will you get to know the other members very well, but you’ll also learn new skills and get a chance to showcase your abilities.

4. Join professional organizations and engage and interact with other members. Be prepared to give some of your time and expertise to advance the interests of the organization. This will get you noticed by other professionals who might help you to improve your career in the future.

5. Work on building a deeper relationship with the people you meet. Where appropriate, you can send an “it was great to have met you” or a thank you e-mail to follow up. Or you can connect on social media. Make sure to keep any promises you made during a meeting like passing on a message to a mutual friend or sending a web link that the other person was interested in.

6. Once you have a good career network going avoid losing contact when “life happens.” Keep in touch regularly even if it’s just sharing something on social media that you know the other person will be interested in or a quick phone call. Try to give more than you get. You never know when the day might come when someone passes on information about that ideal opportunity, or you need support in a work crisis.

Expertise and networks work hand-in-hand 

You’ve put a lot of work and time into building your knowledge and skills through qualifications and experience. How much effort have you put into building your nursing career network? As busy as you are, take 10 minutes here and 10 minutes there to connect with someone face-to-face or on social media and commit to attending a few professional meetings and conferences every year.
Question Of The Day, Gastrointestinal Disorders
Q. The comatose victim of the car accident is to have a gastric lavage. Which of the following positions would be most appropriate for the client during this procedure?

A. Lateral.
B. Supine.
C. Trendelenburg's.
D. Lithotomy.

Correct Answer: A

Explanation: An unconscious client is best positioned in a lateral or semiprone position because these positions allow the jaw and tongue to fall forward, facilitate drainage of secretions, and prevent aspiration. Positioning the client supine carries a major risk of airway obstruction from the tongue, vomitus, or nasopharyngeal secretions. Trendelenburg's position, with the head lower than the heart, decreases effective lung volume and increases the risk of cerebral edema. The lithotomy position has no purpose in this situation.

Thursday, 20 September 2018

Q. A young man with early-stage testicular cancer is scheduled for a unilateral orchiectomy. The client confides to the nurse that he is concerned about what effects the surgery will have on his sexual performance. Which of the following responses by the nurse provides accurate information about sexual performance after an orchiectomy?

A. "Most impotence resolves in a couple of months."
B. "You could have early ejaculation with this type of surgery."
C. "We will refer you to a sex therapist because you will probably notice erectile dysfunction."
D. "Because your surgery does not involve other organs or tissues, you'll likely not notice much change in your sexual performance."

Correct Answer: D

Explanation: Although there may not be a big change in sexual function with a unilateral orchiectomy, the loss of a gonad and testosterone may result in decreased libido and sterility. Sperm banking may be an option worth exploring if the number and motility of the sperm are adequate. Remember, the population most affected by testicular cancer is generally young men ages 15 to 34, and in this crucial stage of life, sexual anxieties may be a large concern.

Wednesday, 19 September 2018

Q. Before discharge, which instruction should a nurse give to a client receiving digoxin (Lanoxin)?

A. "Take an extra dose of digoxin if you miss one dose."
B. "Call the physician if your heart rate is above 90 beats/minute."
C. "Call the physician if your pulse drops below 80 beats/minute."
D. "Take digoxin with meals."

Correct Answer: B

Explanation: The nurse should instruct the client to notify the physician if his heart rate is greater than 90 beats/minute because cardiac arrhythmias may occur with digoxin toxicity. To prevent toxicity, the nurse should instruct the client never to take an extra dose of digoxin if he misses a dose. The nurse should show the client how to take his pulse and tell him to call the physician if his pulse rate drops below 60 beats/minute — not 80 beats/minute, which is a normal pulse rate and doesn't warrant action. The client shouldn't take digoxin with meals; doing so slows the absorption rate.

Tuesday, 18 September 2018

Q. The neonate of a client with type 1 diabetes is at high risk for hypoglycemia. An initial sign the nurse should recognize as indicating hypoglycemia in a neonate is:

A. peripheral acrocyanosis.
B. bradycardia.
C. lethargy.
D. jaundice.

Correct Answer: C

Explanation: Lethargy in the neonate may be seen with hypoglycemia because of a lack of glucose in the nerve cells. Peripheral acrocyanosis is normal in the neonate because of immature capillary function. Tachycardia — not bradycardia — is seen with hypoglycemia. Jaundice isn't a sign of hypoglycemia.

Monday, 17 September 2018

Q. The nurse is assessing a client at her postpartum checkup 6 weeks after a vaginal delivery. The mother is bottle feeding her baby. Which client finding indicates a problem at this time?

A. Firm fundus at the symphysis.
B. White, thick vaginal discharge.
C. Striae that are silver in color.
D. Soft breasts without milk.

Correct Answer: A

Explanation: By 4 to 6 weeks postpartum, the fundus should be deep in the pelvis and the size of a nonpregnant uterus. Subinvolution, caused by infection or retained placental fragments, is a problem associated with a uterus that is larger than expected at this time. Normal expectations include a white, thick vaginal discharge, striae that are beginning to fade to silver, and breasts that are soft without evidence of milk production (in a bottle-feeding mother).




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