Saturday 29 April 2017

Question Of The Day, School-age Child, Nursing
Q. The nurse should instruct the family of a child with newly diagnosed hyperthyroidism to:

A. Keep their home warmer than usual.
B. Encourage plenty of outdoor activities.
C. Promote interactions with one friend instead of groups.
D. Limit bathing to prevent skin irritation.

Correct Answer: C
Explanation: Children with hyperthyroidism experience emotional labiality that may strain interpersonal relationships. Focusing on one friend is easier than adapting to group dynamics until the child's condition improves. Because of their high metabolic rate, children with hyperthyroidism complain of being too warm. Bright sunshine may be irritating because of disease-related ophthalmopathy. Sweating is common and bathing should be encouraged.

Friday 28 April 2017

Nurses are integral members of a health care team. If you’ve ever come across any of the myths below, or even if you’ve perpetrated them, know that the truth is a lot more interesting than the fictions.

common nursing myth

1. Nurses are like a doctor’s assistant.

Healthcare is a team-oriented industry. While nurses may certainly lend physicians a hand from time-to-time, the majority of a nurse’s time is spent working independently taking care of patients. It’s a common myth that physicians are the nurses boss. Nurses typically answer to other nurses who are higher up in leadership positions.

2. If I get my RN, I’m stuck doing the same job forever.

With over 100 specialties and numerous advanced degree options, nurses have the ability to create their own career path and change their jobs quite often. Nurses can obtain certifications to move to different specialties or earn advanced degrees to move up into leadership positions. AmeriTech College offers a fully online Bachelor’s Degree in Nursing completion program for nurses wanting to move into leadership positions. A number of outstanding masters and PhD programs available for nurses as well.

3. Nursing is a woman’s job.

We can’t bust this myth enough! What draws people to the nursing profession is the desire to interact with people and impact patients’ lives on a daily basis. This aspiration is not unique to women; it’s universal. Over 6% of nurses are men – and this number is on the rise! Men have always played a critical role in the nursing profession, dating back to the first nursing school in 250 BC.

4. Nurses are all the same.

Even patients in hospitals are rarely aware of what nurses do. They see people in scrubs walk in and out, but that’s about it. It’s easy to start thinking that all nurses have the same duties, training, goals, and career paths. But think for a second about the fact that you see nurses in all parts of the hospital, no matter what department or specialty you’re visiting. 

5. Nurses don’t get paid well.

The federal government reports that median income for RNs in 2008 was $62,450, with earnings ranging from $43,000 to $92,000. That’s nothing to sneeze at, considering that some studies show that anyone earning more than $70k a year has already hit peak happiness in terms of salary.

6. Nursing is a dead-end job.

The Bureau of Labor Statistics pegs nursing as a hot field, with prospects for RNs listed as "excellent." Why? Well, baby boomers are getting old, and we’re also living longer in general, which means there’s going to be a glut of Americans putting a strain on the health care system.

7. Being a nurse is easy. Anyone can do it.

Being a nurse is more than just putting on scrubs and showing up for work. Read our recent blog, 5 Signs You Have the Makings of a Great Nurse. We often say to our prospective students, the skills of a nurse can be taught – the heart cannot. 

8. I won’t make any money as a nurse.

Recent nursing grads earn some of the highest starting salaries compared to recent graduates in other industries 

9. Nurses are people who couldn’t hack it in med school.

One of the ugliest myths out there. It’s not unique in assigning a weakness to a particular medical job that’s misunderstood; dentists deal with the same stuff. 

10. Being a nurse isn’t as challenging as being a doctor.

Are you serious? Being a nurse requires education, critical thinking skills, and serious amounts of medical training. Nurses perform research, participate in surgeries, administer medicine and treatments, and act as the glue that keeps the hospital running.
Q. A child, age 3, is brought to the emergency department in respiratory distress caused by acute epiglottiditis. Which clinical manifestations should the nurse expect to assess?

A. Severe sore throat, drooling, and inspiratory stridor
B. Low-grade fever, stridor, and a barking cough
C. Pulmonary congestion, a productive cough, and a fever
D. Sore throat, a fever, and general malaise

Correct Answer: A
Explanation: A child with acute epiglottiditis appears acutely ill and clinical manifestations may include drooling (because of difficulty swallowing), severe sore throat, hoarseness, a high temperature, and severe inspiratory stridor. A low-grade fever, stridor, and barking cough that worsens at night are suggestive of croup. Pulmonary congestion, productive cough, and fever along with nasal flaring, retractions, chest pain, dyspnea, decreased breath sounds, and crackles indicate pneumococcal pneumonia. A sore throat, fever, and general malaise point to viral pharyngitis.

Thursday 27 April 2017

Question Of The Day, Infant
Q. A 10-month-old child has cold symptoms. The mother asks how she can clear the infant's nose. Which of the following would be the nurse's best recommendation?

A. Use a cool air vaporizer with plain water.
B. Use saline nose drops and then a bulb syringe.
C. Blow into the child's mouth to clear the infant's nose.
D. Administer a nonprescription vasoconstrictive nose spray.

Correct Answer: B
Explanation: Although a cool air vaporizer may be recommended to humidify the environment, using saline nose drops and then a bulb syringe before meals and at nap and bed times will allow the child to breathe more easily. Saline helps to loosen secretions and keep the mucous membranes moist. The bulb syringe then gently aids in removing the loosened secretions. Blowing into the child's mouth to clear the nose introduces more organisms to the child. A nonprescription vasoconstrictive nasal spray is not recommended for infants because if the spray is used for longer than 3 days a rebound effect with increased inflammation occurs.

Wednesday 26 April 2017

Question Of The Day, The Nursing Process
Q. A nurse is documenting a variance that has occurred during the shift, and this report will be used for quality improvement to identify high-risk patterns and potentially initiate in-service programs. This is an example of which type of report?

A. Incident report.
B. Nurse's shift report.
C. Transfer report.
D. Telemedicine report.

Correct Answer: A
Explanation: An incident report, also termed a variance report or occurrence report, is a tool healthcare agencies use to document anything out of the ordinary that results in or has the potential to result in harm to a client, employee, or visitor. These reports are used for quality improvement and not for disciplinary action. They are a means of identifying risks and high-risk patterns and initiating in-service programs to prevent future problems. A nurse's shift report is given by a primary nurse to the nurse replacing him or her or by the charge nurse to the nurse who assumes responsibility for continuing client care. A transfer report is a summary of a client's condition and care when transferring clients from one unit or institution to another. A telemedicine report can link healthcare professionals immediately and enable nurses to receive and give critical information about clients in a timely fashion.

Tuesday 25 April 2017

Being under treatment at any time can be a difficult, stressful and depressing experience for a patient. No one likes to feel ill, to undergo surgery or to need medication. These situations take on even more of a burden when they happen during the holiday season. Whether you’re working in an inpatient setting, an outpatient clinic or in home care, as a nurse showing extra kindness during this time of year can mean all the difference for a patient regardless of his or her age.

show kindness to patients

Many nurses have written about how they try to convey kindheartedness to their patients and clients. In nursing homes, residents often feel overlooked and forgotten. Offering simple things to the residents, such as gloves, socks or a handmade card can mean a lot. Simple things like wearing your best smile, making simple decorations at the nurse’s station and in the hallways and spending more time talking with your patients help uplift their spirits during this time of year.

Also important is to remember that not all individuals celebrate the same holiday. Christmas, Hanukkah, and Kwanzaa are all celebrated in December. Therefore, your holiday efforts have to include the many different religions of your patients so that no patient feels offended, discriminated against or overlooked because of his or her religious beliefs.Likewise, it may be that some patients do not acknowledge a religion or celebrate any of the holidays. If that is the case, these individuals should know they are welcome to participate or skip the celebration.

“Nurses, one of the few blessings of being ill.” Being generous, friendly and warmhearted are characteristics nurses display on a regular basis. However, during this time of the year, extra effort is needed to ensure your patients and clients experience your caring side on an even higher level.

Those of us who work in the health care profession and study medicine have long believed in the value of a kind, compassionate bedside manner. But now, this belief isn’t just a nice notion - it’s sound science. Reviews shows that when patients are treated with kindness - when there is an effort made to get to know them, empathize with them, communicate with them, listen to them and respond to their needs — it can lead to the following outcomes:

➨ faster healing of wounds,
➨ reduced pain,
➨ reduced anxiety,
➨ reduced blood pressure,
➨ and shorter hospital stays.

The research also shows that when doctors and nurses act compassionately, patients are more likely to be forthcoming in divulging medical information, which in turn leads to more accurate diagnoses. They are more likely to adhere to their prescribed treatments, which leads to fewer readmissions.

The review also found that patients aren’t the only ones who see better results from kind treatment — the doctors, nurses, and caregivers who provide the kind treatment benefit as well. A kinder work environment helps employees feel more engaged and less exhausted, which is incredibly important to caregivers who often work long and unpredictable hours in high-pressure jobs.

In the weeks and months ahead, we plan to build on this research, and translate the findings into practices and guidelines health care providers, doctors, nurses, and other caregivers can follow during their interactions with patients.

So often, the debate about health care in America has focused on how to cut costs without restricting people’s access or reducing the quality of their care. Well, institutionalizing kinder practices in hospitals, doctor’s offices, and care facilities across the nation is a virtually free way of improving quality and generating better outcomes that can lead to even lower costs. It’s a no-brainer.

At the very least, research review proves that in the context of health care and medicine, kindness shouldn’t be viewed as a warm and fuzzy afterthought, something nice to show after the “real” medicine is administered.
Question Of The Day, Medication and I.V. Administration
Q. To prevent development of peripheral neuropathies associated with isoniazid administration, the nurse should teach the client to:

A. Avoid excessive sun exposure.
B. Follow a low-cholesterol diet.
C. Obtain extra rest.
D. Supplement the diet with pyridoxine (vitamin B6).

Correct Answer: D
Explanation: Isoniazid competes for the available vitamin B6 in the body and leaves the client at risk for developing neuropathies related to vitamin deficiency. Supplemental vitamin B6 is routinely prescribed to address this issue. Avoiding sun exposure is a preventive measure to lower the risk of skin cancer. Following a low-cholesterol diet lowers the individual's risk of developing atherosclerotic plaque. Rest is important in maintaining homeostasis but has no real impact on neuropathies.

Monday 24 April 2017

Nursing has long been considered one of the most stressful professions.Stress in nursing is attributed largely to the physical labor, suffering and emotional demands of patients and families, work hours, shift work, interpersonal relationships (eg, inter- and interprofessional conflict), and other pressures that are central to the work nurses do. Factors that have increased stress among nurses since the 1980s include the rising use of sophisticated healthcare technologies, budget cuts, increasing workload, and constant organizational changes in some healthcare environments.

Stress in nursing profession

Stress is not inherently deleterious, however. Each individual’s cognitive appraisal, their perceptions, and interpretations gives meaning to events and determines whether events are viewed as threatening or positive.2 Personality traits also influence the stress equation because what may be overtaxing to one person may be exhilarating to another.

Nevertheless, stress has been regarded as an occupational hazard since the mid-1950s. In fact, occupational stress has been cited as a significant health problem.Work stress in nursing was first assessed in 1960 when Menzies8 identified four sources of anxiety among nurses: patient care, decision-making, taking responsibility, and change. The nurse’s role has long been regarded as stress-filled based upon the physical labor, human suffering, work hours, staffing, and interpersonal relationships that are central to the work nurses do. Since the mid-1980s, however, nurses’ work stress may be escalating due to the increasing use of technology, continuing rises in health care costs, and turbulence within the work environment.

The Physical Demands of Nursing Cause Stress

Day to day nursing is full of potential physical stressors, including frequent lifting and bending, changeable shifts or rosters, noisy work environments, and long hours. Nurses working night-shift may also suffer from disruption to their natural circadian rhythms, which in turn, can predispose them to illness. As well, many nurses face exposure to infection and toxic substances on a regular basis. The sheer anxiety of contracting a disease, especially in the face of rising resistance, can also play on a nurse’s mind. Finally, with the current median age of a nurse being 45, many are simply not as physically resilient as they were in their younger years.

Emotional Stress in Nursing

Let’s be honest, caregiving itself can be quite emotionally draining. This combined with the many interpersonal relationships that develop at work (colleagues, patients, families etc.) can also become catalysts of stress for many nurses. Difficult or tragic situations, such as caring for and communicating with a person who is dying, also present emotional challenges for nurses. While societal changes, such as the increased risk of violent or aggressive patients, has also created greater stress.
Question Of The Day, Basic Physical Care
Q. A nurse is caring for a client who required chest tube insertion for a pneumothorax. To assess for pneumothorax resolution, the nurse can anticipate that the client will require:

A. monitoring of arterial oxygen saturation (SaO2).
B. arterial blood gas (ABG) studies.
C. chest auscultation.
D. a chest X-ray.

Correct Answer: D
Explanation: Chest X-ray confirms diagnosis by revealing air or fluid in the pleural space. SaO2 values may initially decrease with a pneumothorax but typically return to normal within 24 hours. ABG studies may show hypoxemia, possibly with respiratory acidosis and hypercapnia but these are not necessarily related to a pneumothorax. Chest auscultation will determine overall lung status, but it's difficult to determine if the chest has reexpanded sufficiently.

Sunday 23 April 2017

Question Of The Day, Genitourinary Disorders
Q. When caring for a client after a closed renal biopsy, the nurse should?

A. Maintain the client on strict bed rest in a supine position for 6 hours.
B. Insert an indwelling catheter to monitor urine output.
C. Apply a sandbag to the biopsy site to prevent bleeding.
D. Administer I.V. opioid medications to promote comfort.

Correct Answer: A
Explanation: After a renal biopsy, the client is maintained on strict bed rest in a supine position for at least 6 hours to prevent bleeding. If no bleeding occurs, the client typically resumes general activity after 24 hours. Urine output is monitored, but an indwelling catheter is not typically inserted. A pressure dressing is applied over the site, but a sandbag is not necessary. Opioids to control pain would not be anticipated; local discomfort at the biopsy site can be controlled with analgesics.

Saturday 22 April 2017

Question Of The Day, Respiratory Disorders
Q. The physician ordered I.V. naloxone (Narcan) to reverse the respiratory depression from morphine administration. After administration of the naloxone the nurse should:

A. Check respirations in 5 minutes because naloxone is immediately effective in relieving respiratory depression.
B. Check respirations in 30 minutes because the effects of morphine will have worn off by then.
C. Monitor respirations frequently for 4 to 6 hours because the client may need repeated doses of naloxone.
D. Monitor respirations each time the client receives morphine sulfate 10 mg I.M.

Correct Answer: C
Explanation: The nurse should monitor the client's respirations closely for 4 to 6 hours because naloxone has a shorter duration of action than opioids. The client may need repeated doses of naloxone to prevent or treat a recurrence of the respiratory depression. Naloxone is usually effective in a few minutes; however, its effects last only 1 to 2 hours and ongoing monitoring of the client's respiratory rate will be necessary. The client's dosage of morphine will be decreased or a new drug will be ordered to prevent another instance of respiratory depression.

Friday 21 April 2017

What is a Portfolio?

If you plan to keep a portfolio as a record of your personal and professional development - and make it work for you - it's important to understand what it is, what it does and how you can use it.Don't know much about portfolios? Try working through the learning sections in order. Portfolios come in many styles and formats, to suit different needs. Take a look at some of the options open to you.

Nursing Portfolio

➠ Most nursing students and nurses create a nursing portfolio to help them keep track of their professional goals, accomplishments, competencies, and skills. For example, an artist creates a portfolio to show their work and accomplishments to future clients.
➠ Nurses in a sense keep a portfolio to show future employers who they are and what they have done. A nursing portfolio is a tool used by nurses to help them secure a nursing job.
➠ When trying to wrap your mind around a nursing portfolio, think of it as a scrapbook that contains everything you have done up to that current moment in your nursing career.
➠ A nursing portfolio does not need to be confused with a resume. A resume is a piece of paper that shows the employer a summary of the nurse’s education, other job experiences, references, and certifications. The portfolio is the supporting documentation of that information.

How to Create a Nursing Portfolio?

Most nursing schools require nursing students to create a nursing portfolio. This is a great way to help the new nurse get started with creating their portfolio. However, some nurses have never created one. Remember that if you are a new nurse your portfolio will not be as in depth when compared to a nurse who has been in the field for several years.

Before you start creating your nursing portfolio you need to compile supporting documents. There is no right or wrong way to compile your supporting documents. Also, keep in mind that you need to include information that highlights your competencies, educational achievements, and skills. Below are suggested documents include in your portfolio.

What type of information is included in a Nurse Portfolio?

➠ Resume
➠ College Transcripts
➠ 1-page essay on what your personal values and beliefs are on the nursing profession
➠ An outline of your plan for professional development with supporting documentation of activities and learning outcomes.
➠ Health records which include immunizations and current physical
➠ List of Volunteer Positions with Supporting Documentation➠ List of Professional Organization you are in with Supporting Documentation
➠ Your Job Description
➠ Performance Evaluations
➠ Competency Checklists
➠ Copy of your Nursing License
➠ Certifications with renewal dates
➠ Samples of Academic Work such as research
➠ Professional Conferences Attended with Supporting Documentation
➠ In-services Attended with Supporting Documentation
➠ References and Recommendation Letters
➠ Peer/Manager Evaluations
➠ Lists of Committees you are on and type of work you have contributed to it
➠ Educational Projects you have done such as in-services
➠ Awards you have received

How to Organize a Nursing Portfolio?

Once you have compiled all of the proper paperwork you need for your nursing portfolio you need to place it into a three ring binder. It is good practice to place the resume at the beginning of the portfolio because this has your name and contact information on it.

Try to organize your documentation in chronological order, if possible. For example, organize in-services based on the date they were completed and so on. However, there is no correct way on how to organize your documentation. Try to organize it in a way that will make sense to the reader.

To help your portfolio look professional to be sure to label each section with binder tabs that can be purchased at Walmart. In addition, a table of contents needs to be created and placed in the front of the portfolio.
Question Of The Day, Neurosensory Disorders
Q. The client with a hearing aid does not seem to be able to hear the nurse. The nurse should do which of the following?

A. Contact the client's audiologist.
B. Cleanse the hearing aid ear mold in normal saline.
C. Irrigate the ear canal.
D. Check the hearing aid's placement.

Correct Answer: D Explanation: Inadequate amplification can occur when a hearing aid is not placed properly. The certified audiologist is licensed to dispense hearing aids. The ear mold is the only part of the hearing aid that may be washed frequently; it should be washed daily with soap and water. Irrigation of the ear canal is done to remove impacted cerumen or a foreign body.

Thursday 20 April 2017

Question Of The Day, Musculoskeletal Disorders
Q. A client has a herniated disk in the region of the third and fourth lumbar vertebrae. Which nursing assessment finding most supports this diagnosis?

A. Hypoactive bowel sounds
B. Severe lower back pain
C. Sensory deficits in one arm
D. Weakness and atrophy of the arm muscles

Correct Answer: B
Explanation:  The most common finding in a client with a herniated lumbar disk is severe lower back pain, which radiates to the buttocks, legs, and feet — usually unilaterally. A herniated disk also may cause sensory and motor loss (such as footdrop) in the area innervated by the compressed spinal nerve root. During later stages, it may cause weakness and atrophy of leg muscles. The condition doesn't affect bowel sounds or the arms.
Skilled nursing is a Medicare covered service and is health care that is provided when skilled nursing or rehabilitative services are needed to manage, observe and evaluate the care an individual receives. Medicare skilled services are provided for a short period of time (e.g. 100 days or less).

Skilled nursing facilities are licensed by each State’s Department of Health and Human Services and are certified by CMS for the provision of Medicare services. The skilled nursing setting provides intensely skilled nursing care aimed at helping an individual regain or maintain their independence and level of functioning, to the extent possible, or to provide comfort and support for the end of life. Skilled nursing is not custodial care.

Skilled nursing facilities

Whereas, a nursing home, an Intermediate Care Facility or ICF, provides a room, meals, and help individuals with activities of daily living needs. Residents living in a nursing home usually have physical or memory problems that keep them from living on their own.

In terms of rehabilitation in skilled nursing facilities, hospitals make the arrangements for follow-up patient care after an acute hospital stay, like after a surgery. When released from the hospital, a patient transfers to the skilled nursing home to receive hands-on care from nurses. If a patient needs rehabilitation like physical of speech therapy, a patient receives the services until they're able to go home.

🔹 Nursing in the skilled setting tends to serve older/elderly individuals who
🔹 Have experienced a decline in condition
🔹 Need assistance with activities of daily living
🔹 Are sick with multiple co-morbidities
🔹 May or may not have a disability
🔹 May be recovering from surgery and are in need of rehabilitative services in a skilled nursing facility/unit
🔹 May or may not have support systems to assist them with their recovery care needs

The focus of care in the skilled nursing setting is to provide skilled nursing services (e.g. wound care, tube feedings, IV therapy, respiratory care, dialysis, anticoagulant therapy, insulin administration) and rehabilitative services.

Admission to a skilled nursing setting requires medical necessity and often follows hospitalization or is related to a decline in functioning.  The individual may be:

🔹 Recovering from surgery (e.g. hip replacement, fracture, amputation, tracheostomy placement, colostomy placement)
🔹 Experiencing an exacerbation of an illness/chronic condition (e.g. COPD, CHF, kidney failure, pneumonia, thrombosis, CVA, UTI), a progressive disease (e.g. Parkinson’s, Alzheimer’s, Huntington’s), a terminal illness (e.g. cancer)
🔹 Unable to care for him/herself.

Admission to a skilled nursing setting may be for a short stay admission (e.g. less than 100 days) for skilled services or for a long-term care admission for custodial care.  The provision of skilled nursing services is for a short period of time and usually, follows a qualifying hospital stay.

Most people pay for skilled nursing care with Medicare or Medicaid benefits, health insurance plans.

Many patients who live in nursing homes permanently exhaust their personal finances at some point. When this happens, Medicaid pays for the nursing home care. Know: Medicaid does not pay all costs.

Medicare pays for skilled nursing care when:

🔹 The patient has a qualifying hospital stay
🔹 The doctor decides you need daily skilled care.
🔹 The nursing home's certified by Medicare.

Wednesday 19 April 2017

Question Of The Day, Endocrine and Metabolic Disorders
Q. The best indicator that the client has learned how to give an insulin self-injection correctly is when the client can:

A. Perform the procedure safely and correctly.
B. Critique the nurse's performance of the procedure.
C. Explain all steps of the procedure correctly.
D. Correctly answer a posttest about the procedure.

Correct Answer: A
Explanation: The nurse should judge that learning has occurred from evidence of a change in the client's behavior. A client who performs a procedure safely and correctly demonstrates that he has acquired a skill. Evaluation of this skill acquisition requires performance of that skill by the client with observation by the nurse. The client must also demonstrate cognitive understanding, as shown by the ability to critique the nurse's performance. Explaining the steps demonstrates acquisition of knowledge at the cognitive level only. A posttest does not indicate the degree to which the client has learned a psychomotor skill.
Nursing students must take classroom theory to real-life practice. That happens during nursing internships. At some point in a nursing education, all the textbooks, lectures, labs, and clinical converge on an internship experience. The nurse’s internship is one of the most important phases of a nursing degree program since it helps to establish the nursing career. Here’s what you can expect.

Nursing internship

Surprise. No article, video tutorial, or personal conversation can prepare you for the experiences you will face as a nurse intern. Once your education hits the hospital floor, you’re in for a series of surprises-some pleasant, some not so pleasant that will make you into the nurse you need to become.

Routine. In spite of the initial surprise phase of your internship, it will likely wear off into routine after a little while. Much of a nurse’s responsibilities revolve around repeat action after repeat action. Just like any other job, there will be routine.

Excitement. You’ll learn to savor the routine when excitement hits. Hospitals have high-stress moments, and as a nurse intern, you will be part of those intense events. During the adrenalin rush of an emergency surgery, an ER event, or a baby delivery in the hallway, you’ll learn what preparation, reflexes, and training are really all about. It’s all part of a nursing career.

Discovery. The event of a nursing internship, albeit filled with surprise, routine, and excitement will be a time of discovery for you as a nurse in training. The internship is time for you to decide, “Is this what I want to be doing?” As you come into contact with body fluids, get bogged down in paperwork, handle hospital politics, and get tired during a twelve-hour shift, you’re learning about the reality of a nursing career. More importantly, you’re building skills for one of the most important careers on the planet-helping other people.

Benefits of Internships

● You get to work one on one with a nurse - Nurses usually volunteer to be preceptors, and they gladly share their know-how, while promoting a safe space for learning. Anytime there is a learning experience on the unit, preceptors will try to get you involved in some way or allow you to observe.
● At the end of your internship, if you have done well, the nurse preceptor could end up being a great reference for your future job pursuits.
● You will gain confidence in the clinical setting – You will have the opportunity to practice and perfect clinical skills. During my internship, I learned how to use an infusion pump and stayed on the unit until I mastered the skill. Nurse preceptors may even allow you to perform certain procedures that you practiced only in the skills lab.
● You will practice interprofessional collaboration skills - During my internship, I had the opportunity to give a report, join hurdles, and work with physical and occupational therapists and pharmacists. Working with a broader healthcare team has helped me to understand each profession’s roles and responsibilities.
● It may result in your first nursing job  -  An internship will, at the very least, allow you to familiarize yourself with the acute care environment. The experience also may help you home in on what specialties and settings interest you.

Mostly internship was called a long-term, 357-hour interview. During your internship, your managers, supervisors, and staff will notice your talents and perseverance. They might ask you to come back as soon as you graduate or even work as a nurse’s aide during the school year.

Tips for a standout internship application. Given the benefits of an internship, you’ll want to make sure you have plenty to write and brag about on your applications. 

In your clinical, go above and beyond what is expected of you as a student. Inquire if staff needs assistance or if you can observe during special procedures or patient care. A recommendation from a clinical instructor or nurse preceptor is usually required with an internship application, so make sure your faculty and preceptor are familiar with you and what you’re capable of.

Know your strengths and weaknesses in the clinical setting. Be ready to explain the details of your clinical experiences on an application and to answer questions about how your patient care has benefited others or how you overcame difficult situations in the clinical setting.
Teamwork in healthcare is essential. When you are being interviewed, you should talk about your clinical experiences as a member of the healthcare team.

As a nursing student, it is important that you get involved in your school organization. Participate in community service activities, school improvement committees, school program initiatives or volunteer abroad. And make sure your resume and internship application reflect what you have learned.

We recommend you start looking for summer internships right now. Apply to as many as possible to expand your choices. If you are already gainfully employed

Tuesday 18 April 2017

Nurses are the backbone of the healthcare industry. Doctor’s offices, clinics and hospitals all depend on a qualified nursing staff in order to adequately serve the public.

Currently, too many communities in the United States are suffering from critical shortages of certified professional nursing personnel. This places a large strain on the American healthcare industry. Efforts to expand the pool of qualified nurses across the country are being made by both federal and state governments, as well as colleges, universities and professional associations.

scholarship for nursing courses

The American Association of Critical-Care Nurses (AACN) offers continuing professional developmental scholarships to students. This scholarship is intended for those who want to go beyond their academic education and continue to learn. Students will have the ability to travel and experience other avenues of nursing, picking up valuable life lessons along the way. Those that apply to this scholarship may also receive a travel fund to help assist in paying for travel-related activities.

American Assembly for Men in Nursing also offers a worthy scholarship for those men that attend nursing school. The student must be a member of the organization, and they must be enrolled in a licensed nursing program. Also, they must have completed at least one year of school before this type of scholarship will be awarded. They offer quite a few different scholarships, but each is worth a close, in-depth look to seek where you save money on your education.The ongoing initiative is meant to address the nation’s nursing shortage on a number of different fronts, including:

● providing grants to support existing nursing programs that are understaffed and underfunded
● providing government funds to schools for the updating of teaching facilities
● providing grant money for programs to hire and retain a highly trained nursing faculty
● providing grants, scholarships, and loans for eligible nursing students

In addition to existing federal programs, many state governments have developed their own grants and scholarships designed to encourage and support both undergraduate and graduate level nursing students. The availability of financial aid for nursing students does not end with federal and state governments, however, and extends into the private sector with a multitude of grants and scholarships being supported by colleges, universities and professional organizations.

Students interested in pursuing a career in nursing will want to refer to section on Grants for Nursing Students.Nursing students are encouraged to investigate the possibility of obtaining a grant for college before considering any alternative or private loans. Grants can help to defray a sizable portion of your education costs, and the funds never have to be repaid.

Undergraduate Nursing Scholarships using grants and scholarships:

Universities, technical schools, and community colleges typically offer undergraduate nursing programs that include courses for Licensed Practical Nurses (LPN) and Certified Nursing Assistants (CNA). These 2 to 4-year courses are designed to train a front-line nursing workforce that is prepared to fill the immediate needs of the healthcare industry. Many nursing students will want to continue their education beyond this level, to become Registered Nurses (RN), or to receive their Bachelors in the Science of Nursing.

Nursing scholarships are typically merit-based and are available from a variety of sources including:

● The Federal government
● State and local governments
● Colleges, universities, and technical/vocational schools
● Private and professional associations

There are also a large number of nursing scholarships that have been designed to benefit specific portions of the student population, such as minorities and returning students. Many available nursing scholarships, particularly those supported by federal and state governments, will be scholarship-for-service programs. These programs require scholarship recipients to commit to a predetermined time of service in an under-served community, or at a designated critical need facility.

These scholarships are going to help you achieve your goals and dreams within the medical profession. Explore all of them and you’ll be way on your way to a successful career. Nurses are always needed in one capacity or another, and it’s vital they are educated well.
Question Of The Day, Gastrointestinal Disorders, Nursing Guide
Q. A client has a nasogastric tube inserted at the time of abdominal perineal resection with permanent colostomy. This tube will most likely be removed when the client demonstrates:

A. Absence of nausea and vomiting.
B. Passage of mucus from the rectum.
C. Passage of flatus and feces from the colostomy.
D. Absence of stomach drainage for 24 hours.

Correct Answer: C
Explanation: A sign indicating that a client's colostomy is open and ready to function is passage of feces and flatus. When this occurs, gastric suction is ordinarily discontinued, and the client is allowed to start taking fluids and food orally. Absence of bowel sounds would indicate that the tube should remain in place because peristalsis has not yet returned. Absence of nausea and vomiting is not a criterion for judging whether or not gastric suction should be continued. Passage of mucus from the rectum will not occur in this client because the rectum is removed in this surgery.

Monday 17 April 2017

Question Of The Day, Oncologic Disorders, Nursing Guide
Q. The American Cancer Society recommends routine screening to detect colorectal cancer. Which screening test for colorectal cancer should a nurse recommend?

A. Carcinoembryonic antigen (CEA) test after age 50
B. Proctosigmoidoscopy after age 30
C. Annual digital examination after age 40
D. Barium enema after age 20

Correct Answer: C
Explanation: The American Cancer Society recommends an annual digital examination after age 40 for the purpose of detecting colorectal cancer. The CEA test is performed on clients who have already been treated for colorectal cancer. It helps monitor a client's response to treatment as well as detect metastasis or recurrence. Proctosigmoidoscopy is recommended every 3 to 5 years for people older than age 50. Barium enema isn't a screening test.

Sunday 16 April 2017

Question Of The Day, Cardiovascular Disorders, Nursing Guide
Q. A client with a past medical history of ventricular septal defect repaired in infancy is seen at the prenatal clinic. She is complaining of dyspnea with exertion and being very tired. Her vital signs are 98, 80, 20, BP 116/72. She has + 2 pedal edema and clear breath sounds. As the nurse plans this client's care, which of the following is her cardiac classification according to the New York Heart Association Cardiac Disease classification?

A. Class I.
B. Class II.
C. Class III.
D. Class IV.

Correct Answer: B
Explanation: According to the New York Heart Association Cardiac Disease classification, this client would fit under Class II because she is symptomatic with increased activity (dyspnea with exertion). The New York Heart Association Cardiac Disease Classification identifies Class II clients as having cardiac disease and a slight limitation in physical activity. When physical activity occurs, the client may experience angina, difficulty breathing, palpations, and fatigue. All of the client's other symptoms are within normal limits.

Saturday 15 April 2017

Question Of The Day, The Neonate, Nursing Tutorials
Q. A client's gestational diabetes is poorly controlled throughout her pregnancy. She goes into labor at 38 weeks and gives birth. Which priority intervention should be included in the care plan for the neonate during his first 24 hours?

A. Administer insulin subcutaneously.
B. Administer a bolus of glucose I.V.
C. Provide frequent early feedings with formula.
D. Avoid oral feedings.

Correct Answer: C
Explanation: The neonate of a mother with gestational diabetes may be slightly hyperglycemic immediately after birth because of the high glucose levels that cross the placenta from mother to fetus. During pregnancy, the fetal pancreas secretes increased levels of insulin in response to this increased glucose amount that crosses the placenta from the mother. However, during the first 24 hours of life, this combination of high insulin production in the neonate coupled with the loss of maternal glucose can cause severe hypoglycemia. Frequent, early feedings with formula can prevent hypoglycemia. Insulin shouldn't be administered because the neonate of a mother with gestational diabetes is at risk for hypoglycemia. A bolus of glucose given I.V. may cause rebound hypoglycemia. If glucose is given I.V., it should be administered as a continuous infusion. Oral feedings shouldn't be avoided because early, frequent feedings can help avoid hypoglycemia.

Friday 14 April 2017

Nurse pay depends on some factors, including specialty area, type of work, cost of living in the local area, years of experience as a nurse, and in the chosen specialty area, and level of education (that is, an associate degree or bachelor’s degree).

nursing salary

Traditionally nurses working in hospital situations make more than their peers in home care, outpatient facilities, or long-term care facilities. For example, according to the Bureau of Labor Statistics, nurses who worked for an employment service (i.e., "agency" nurses who are essentially freelance) are on top of the RN salary heap, with an average yearly salary of $63,170 (although it should be mentioned that agency nurses are rarely provided health or medical or retirement benefits, so paying for these things will subtract from the ultimate bottom line), while the average salary for an RN who works in a general medical/ surgical hospitals is $53,450 a year, and the average for an RN employed in a nursing care (i.e., long term) facility is $50,220.

Nurse salaries vary from area to area both because of supply and demand and because of relative costs of living. The average RN (any specialty) in California makes $31.88/hour, as compared with the average Florida RN, who makes nearly one-third less at an average of $23.26 an hour.
Salaries also vary by shift; nurses who cover night shifts, weekends, and some holidays may earn a substantial amount more than nurses who work day shifts, depending on the policy of the particular facility.

Nurse's Earning Potential?

A registered nurse’s earning potential is tied to some external factors. For instance, a more seasoned RN has the potential for raises or promotions compared to a newer RN. Education also plays a role as those with BSNs are qualified to work as supervisors or in other higher-level roles contributing to a higher salary than an RN with an associate’s degree. An RN’s specialty area, like acute care or surgery, factors into how much they’re paid because certain specialties require more responsibility translating into a fatter paycheck.
The top-paying industries for registered nurses, according to the BLS are in government, general medical and surgical hospitals and home health care services.

Nursing Job Growth

The BLS anticipates registered nurse employment with grows 16 percent through 2024, which is faster than average. Be aware that National long-term projections of employment growth may not reflect local and/or short-term economic or job conditions.
Specifically, RN jobs in outpatient care centers that provide same-day procedures, like chemotherapy, some surgeries, and rehabilitation, are expected to see faster than average growth.
Additionally, new registered nurses will be welcomed with open arms as older RNs look to retire in the coming years.
 Postpartum Period, Question Of The Day, Nursing Guide
Q. After being treated with heparin therapy for thrombophlebitis, a multiparous client who delivered 4 days ago is to be discharged on oral warfarin (Coumadin). After teaching the client about the medication and possible effects, which of the following client statements indicates successful teaching?

A. "I can take two aspirin if I get uterine cramps."
B. "Protamine sulfate should be available if I need it."
C. "I should use a soft toothbrush to brush my teeth."
D. "I can drink an occasional glass of wine if I desire."

Correct Answer: C
Explanation: Successful teaching is demonstrated when the client says, "I should use a soft toothbrush to brush my teeth." Heparin therapy can cause the gums to bleed, so a soft toothbrush should be used to minimize this adverse effect. Use of aspirin and other nonsteroidal anti-inflammatory medications should be avoided because of the increased risk for possible hemorrhage. Protamine sulfate is the antidote for heparin therapy. Vitamin K is the antidote for warfarin excess. Alcohol can inhibit the metabolism of oral anticoagulants and should be avoided.

Thursday 13 April 2017

Q. A nurse is assessing a woman in labor. Her cervix is dilated 8 cm. Her contractions are occurring every 2 minutes. She's irritable and in considerable pain. What type of breathing should the nurse instruct the woman to use during the peak of a contraction?

A. Deep breathing
B. Shallow chest breathing
C. Deep, cleansing breaths
D. Chest panting

Correct Answer: B

Explanation: Shallow chest breathing is used during the peak of a contraction during the transitional phase of labor. Deep breathing can cause a woman to hyperventilate and feel light-headed, with numbness or tingling in her fingers or toes. A deep, cleansing breath taken at the beginning and end of each breathing exercise can help prevent hyperventilation. Chest panting may be used to prevent a woman from pushing before the cervix is fully dilated.

Wednesday 12 April 2017

Question Of The Day, Antepartum Period, Nursing Tutorials, Nursing Study Guide
Q. A client who is 32 weeks pregnant presents to the emergency department with bright red bleeding and no abdominal pain. A nurse should first:

A. perform a pelvic examination.
B. assess the client's blood pressure.
C. assess the fetal heart rate.
D. order a stat hemoglobin and hematocrit.

Correct Answer: C

Explanation: The nurse should assess the fetal heart rate for distress or viability. She shouldn't attempt to perform a pelvic examination because of the possibility of placenta previa, which presents as bright red bleeding without abdominal pain. The nurse should assess the client's blood pressure after attempting to hear fetal heart tones. Ordering a hemoglobin and hematocrit is a physician intervention, not a nursing intervention.


Tuesday 11 April 2017

Professional nurses are expected to demonstrate a certain degree of altruism, personal attainment, self-sacrifice and the best perspective of their dealings. Every nurse wants to know the duties and considerations which can be integral to the nursing occupation. Working with a staff of well-being care professionals to supply take care of patients in want requires a self-discipline and inner and exterior composure that stays regular all through the day.

professional attitude in nursing

The core values which can be expected and appreciated in nurses are responsibility, honesty, integrity, the perception in human dignity, affected person equality, and the need to forestall and alleviate struggling. A nurse’s professionalism is judged primarily based on own behaviors, look, presentation, and so forth. 

1. Non-Biased Care For Patients 

Well being care facilities see sufferers of all ages, sizes, colors, races and backgrounds. A nurse’s job is to see an affected person as an affected person, and never give attention to attributes that are likely to be personally disliked. Displaying any type of prejudice will hinder the standard of affected person care, to not converse of incomes a nasty status for the hospital. A really skilled nurse would ensure excessive customary, non-biased take care of all sufferers. 

2. Integrity 

Sustaining medical information for sufferers additionally, wants a degree of professionalism. Medical information is supposed to be confidential, and a loose-mouthed nurse can inadvertently launch this secret knowledge to the incorrect social gathering. Nurses are trusted with an excessive amount of delicate data. The medical discipline counts on a nurse’s professionalism and integrity to maintain confidential issues confidentially. 

3. Respect For Patients 

Sufferers could be troublesome to take care of. However knowledgeable nurse can't lose his or her mood. It’s crucial to do not forget that the affected person is within the hospital to obtain care. Nobody likes being the receiver, topic to the moods and generosity of the giver. This makes some sufferers cranky. An expert nurse is ready to deal with all patients with the utmost respect and dignity, it doesn't matter what the provocation. 

4. Perspective 

A nurse with a horrible perspective could make issues troublesome for sufferers and workers alike. Those that behave like this are normally on the lookout for consideration. By sucking others into their very own drama, these attention-seeking folks attempt to management their atmosphere. The nursing occupation goals to assist others than to give attention to particular person issues. An expert nurse will work via his or her unhealthy perspective and can attempt to work effectively with others. 

5. Appearance 

Individuals will all the time choose you by your look; there’s no method of getting around this. Regarding nursing, a nurse’s look can both instill confidence within the affected person or whole distrust. Think about a nurse who walks in with dirty or ungroomed hair, chewed-on nails, wrinkly and tacky scrubs and junk jewelry? Such a nurse would lose respect within the affected person’s eyes. For those who look sloppy, the different workers, sufferers and their households will see you as lazy, unorganized and worse of all, uncaring. 

6. Willingness To Help Others 

An expert nurse understands that everybody wants to assist from time to time. Actually, the nurse himself or herself shall be in want of assist at occasions. Willingness to assist is part of a nurse’s skilled perspective that's most appreciated. A nurse who's prepared to assist different nurses, sufferers and affected person’s households is seen as somebody who could be trusted, and who has a core of goodness. Goodness and caring are the bottom values on which Florence Nightingale constructed the nursing occupation. Nurses within the previous century have been principally nuns who have been used to charitable considering and doings. 

7. Team Work 

An expert nurse is a staff employee; she or he understands that the whole hospital’s workers have to work as a staff to make sure final affected person care. Hospitals are within the enterprise of being profitable, and a nurse who doesn't work effectively with the staff could cause costly hassles. To be able to be an excellent staff employee, a nurse should get rid of any ‘self first’ perspective. For instance, when a hospital is full to capability, and all palms are required, a nurse can't insist on taking a trip day off. That is the type of perspective that exhibits a nurse is a staff employee and never a selfish individual. 

8. Honesty 

An excessive amount of can't be stated about this very important high quality in an actual nursing skilled. Honesty comes into place in some areas. For instance, if a nurse has over medicated a pateint by mistake and an error happens, honesty in time will assist save the affected person. Most individuals select to lie and keep away from taking the accountability however this solely results in cumulative points. 

9. Responsibility 

A nurse has to take up an excessive amount of accountability and should show worthy of it. Every part from accountable affected person care, to monitoring delicate gear to which the affected person is hooked, to accountable dealing with of treatment is the nurse’s lot. An expert nurse is one who takes this accountability very significantly and understands the results of errors, unintended or in any other case. 


Last however not the least, let’s speak about discipline. When taking good care of patients around the clock, it could be really easy to only sit again in a chair and fall asleep. But when a nurse have been to try this, treatment schedules and patient monitoring is not going to occur on time, which suggests patient care is compromised. Once more, nurses should report for obligation on the hour specified and relieve the earlier nurse. Lack of self-discipline in any space will deliver every little thing from mild annoyance to complete chaos in a hospital.
Questions Of The Day, Substance Abuse, Eating Disorders, Impulse Control Disorders
Q. A client with a history of polysubstance abuse is admitted to the facility. He complains of nausea and vomiting 24 hours after admission. The nurse who assesses the client notes piloerection, pupillary dilation, and lacrimation. The nurse suspects that the client is going through withdrawal from which substance?

A. Alcohol
B. Cannabis
C. Cocaine
D. Opioids

Correct Answer: D

Explanation: Piloerection, pupillary dilation, and lacrimation are specific to opioid withdrawal. A client with alcohol withdrawal would show elevated vital signs. There is no real withdrawal from cannabis. Symptoms of cocaine withdrawal include depression, anxiety, and agitation.



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