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cupcakern: PE “Highway” Walking your patient as soon as possible after surgery, using SCDs, applying Ted hoses, etc… these are all important interventions to PREVENT pulmonary embolisms. Key point: pulmonary embolisms are preventable.  Side note:This may be common sense to some but when I learned about PE’s I pictured a small clot, no bigger than maybe a quarter size… so wrong!I took care of a patient in ICU that had a PE that was almost the whole length of his GSV! 
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cupcakern:

PE “Highway”

Walking your patient as soon as possible after surgery, using SCDs, applying Ted hoses, etc… these are all important interventions to PREVENT pulmonary embolisms. Key point: pulmonary embolisms are preventable. 

Side note:
This may be common sense to some but when I learned about PE’s I pictured a small clot, no bigger than maybe a quarter size… so wrong!
I took care of a patient in ICU that had a PE that was almost the whole length of his GSV! 

TEST SMART: HOW TO PASS NCLEX I. Prioritizing - Means ranking the client’s problems in order of importance depending on: Issue of the question Clinical setting Client’s condition Needs/problems that require immediate attention A. Priority High priority - life threatening conditions if untreated would result in harm/injury Intermediate priority  Low priority B. Guides for prioritizing Keywords or key phrases Maslow’s Heirarchy of Needs Theory Physiological needs are the first priority (Airway, Breathing, Circulation) Pain Safety     3. Steps of the Nursing Process Assessment vs. Implementation (Assess first) Expected outcome C. Other priorities Most acute/least stable patient Complication of the disease condition (not an expected outcome) II. Delegation and Assignment-making A. Principles and Guidelines Ensure client safety Focus on what the question is asking for Determine which activity can be delegated safely and legally. Match the activity on the basis of the nurse practice act. Provide adequate supervision (supervise RNs who are new grads.) B. Who can do that? Unlicensed personnel - Noninvasive tasks and basic client care activities that include the following: Ambulation Bathing Client support Grooming Hygiene measures Positioning Range-of-motion exercises Skin care Some specimen collection, such as urine or stool.    2. Licensed Practical or Vocation Nurse - Certain invasive tasks and client care activities that include the following: Administering oral medications Administering intramuscular and subcutaneous injections Changing dressings Irrigate wounds Monitoring an intravenous flow rate Suctioning Urinary catheterization    3. Registered Nurse - Some of the tasks and client care activities that only the registered nurse can perform are as follows: Administering intravenous medications Leading others and managing the client care environment Teaching Using the nursing process: assessment, analyzing data, planning client care, implementing care and evaluating care III. Test-taking Techinique A. Identify the parts of a question Case situation Question stem B. Read the question carefully. Look for keywords or phrases in the case situation and stem the question Examples: What is an early sign of shock? What is the initial nursing action? Indicates that options are correct and you have to prioritize. Which statement by the client indicates understanding of the instruction? Indicates a true response questions Which statement by the client indicates the need for additional teaching? Indicates a false response question C. Identify the issue. (What is the problem asking?) D. Use the process of elimination. Involves reading each question and removing options that are incorrect and do not address the issue of the question. E. Avoid asking yourself “what if?” or “reading into the question”. Means that you are considering issues beyond information presented in the question. Moves you off track with regards to what the question is asking. F. Additional tips and strategies Eliminate options that contain absolute words e.g. all, always, never, none, only Focus on nursing rather than medical interventions. Ensure that all parts of an option are correct. Look for an umbrella option. (more comprehensive answer) Visualize the information (arrange in sequence/order) Look for the option that relates to the question. Don’t expect the test to end after 75 questions! Source: (Nocturalnurse)
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TEST SMART: HOW TO PASS NCLEX

I. Prioritizing - Means ranking the client’s problems in order of importance depending on:

  • Issue of the question
  • Clinical setting
  • Client’s condition
  • Needs/problems that require immediate attention

A. Priority

  1. High priority - life threatening conditions if untreated would result in harm/injury
  2. Intermediate priority 
  3. Low priority

B. Guides for prioritizing

  1. Keywords or key phrases
  2. Maslow’s Heirarchy of Needs Theory
  • Physiological needs are the first priority (Airway, Breathing, Circulation)
  • Pain
  • Safety

    3. Steps of the Nursing Process

  • Assessment vs. Implementation (Assess first)
  • Expected outcome

C. Other priorities

  1. Most acute/least stable patient
  2. Complication of the disease condition (not an expected outcome)

II. Delegation and Assignment-making

A. Principles and Guidelines

  1. Ensure client safety
  2. Focus on what the question is asking for
  3. Determine which activity can be delegated safely and legally.
  4. Match the activity on the basis of the nurse practice act.
  5. Provide adequate supervision (supervise RNs who are new grads.)

B. Who can do that?

  1. Unlicensed personnel - Noninvasive tasks and basic client care activities that include the following:
  • Ambulation
  • Bathing
  • Client support
  • Grooming
  • Hygiene measures
  • Positioning
  • Range-of-motion exercises
  • Skin care
  • Some specimen collection, such as urine or stool.

   2. Licensed Practical or Vocation Nurse - Certain invasive tasks and client care activities that include the following:

  • Administering oral medications
  • Administering intramuscular and subcutaneous injections
  • Changing dressings
  • Irrigate wounds
  • Monitoring an intravenous flow rate
  • Suctioning
  • Urinary catheterization

   3. Registered Nurse - Some of the tasks and client care activities that only the registered nurse can perform are as follows:

  • Administering intravenous medications
  • Leading others and managing the client care environment
  • Teaching
  • Using the nursing process: assessment, analyzing data, planning client care, implementing care and evaluating care

III. Test-taking Techinique

A. Identify the parts of a question

  1. Case situation
  2. Question stem

B. Read the question carefully. Look for keywords or phrases in the case situation and stem the question

Examples:

  1. What is an early sign of shock?
  2. What is the initial nursing action? Indicates that options are correct and you have to prioritize.
  3. Which statement by the client indicates understanding of the instruction? Indicates a true response questions
  4. Which statement by the client indicates the need for additional teaching? Indicates a false response question

C. Identify the issue. (What is the problem asking?)

D. Use the process of elimination. Involves reading each question and removing options that are incorrect and do not address the issue of the question.

E. Avoid asking yourself “what if?” or “reading into the question”. Means that you are considering issues beyond information presented in the question. Moves you off track with regards to what the question is asking.

F. Additional tips and strategies

  • Eliminate options that contain absolute words e.g. all, always, never, none, only
  • Focus on nursing rather than medical interventions.
  • Ensure that all parts of an option are correct.
  • Look for an umbrella option. (more comprehensive answer)
  • Visualize the information (arrange in sequence/order)
  • Look for the option that relates to the question.
  • Don’t expect the test to end after 75 questions!

Source: (Nocturalnurse)

(Source: rightatrium)

Help Kids in Africa

Hey, I’m Melanie. I’m a nurse graduate from the Philippines who just moved here in United States. This year I have decided to pursue something I have been dying to for years and that is to work with and help the children in any way they need. Many children at the projects don’t receive the level of affection and education that they deserve, and volunteers therefore play an important role in working alongside local staff to improve the educational, emotional, and hygiene conditions among the children. Now I am asking for your help. I am trying my hardest to accumulate the funds, but cannot do it alone. I am hoping you can see how this act I am pursuing is worthy of some support from you.

Who, when, where? I will be volunteering in Africa with ‘International Volunteer HQ’. Established in 2007, IVHQ assists developing countries by providing volunteers to work in a variety of jobs such as teaching, orphanage assistance, medical work, HIV/Aids awareness, women empowerment, sports education, construction work, conservation work, panda conservation, surf and swim schools and agricultural work. For more information visithttp://www.volunteerhq.org/ 

How can you donate to my volunteer fund? You can donate simply by clicking on the ‘Help Kids in Africa’ button and following the instructions. Any donation will help, however big or small! Thank you for your support! :-)


Help Kids in Africa - Donate with WePay

nurse-with-a-smile: Action Block calcium access to the cells, causing decreased heart contractility and conductivity and leading to a decreased demand for oxygen Uses Angina HTN Dysrhythmias (verapamil and diltiazem) Contraindications Nifedipine: hypersensitivity Verapamil: severe left ventricular dysfunction, decreased BP, cardiogenic shock, or heart block diltiazem: sick sinus syndrome, heart block, decreased BP, acute MI, or pulmonary congestion Precautions Renal or hepatic insufficiency may develop Avoid giving verapamil or diltiazem with beta blockers and digoxin Side Effects Decreased BP, edema of the extremities, headache Constipation (verapamil), nausea, skin flushing Dysrhythmias  Nursing Implications Administer before meals; may be taken with food if needed Do not crush or allow patient to chew sustain-released medication preparations Monitor vital signs and watch for low blood pressure Check liver and renal function studies Weight patient; report any peripheral edema or weight gain Teach patient about postural hypotension Teach patient to avoid grapefruit and grapefruit juice Tach patient that constipation can be minimized by increasing dietary fiber and fluid
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nurse-with-a-smile:

Action

  • Block calcium access to the cells, causing decreased heart contractility and conductivity and leading to a decreased demand for oxygen

Uses

  • Angina
  • HTN
  • Dysrhythmias (verapamil and diltiazem)

Contraindications

  • Nifedipine: hypersensitivity
  • Verapamil: severe left ventricular dysfunction, decreased BP, cardiogenic shock, or heart block
  • diltiazem: sick sinus syndrome, heart block, decreased BP, acute MI, or pulmonary congestion

Precautions

  • Renal or hepatic insufficiency may develop
  • Avoid giving verapamil or diltiazem with beta blockers and digoxin

Side Effects

  • Decreased BP, edema of the extremities, headache
  • Constipation (verapamil), nausea, skin flushing
  • Dysrhythmias 

Nursing Implications

  • Administer before meals; may be taken with food if needed
  • Do not crush or allow patient to chew sustain-released medication preparations
  • Monitor vital signs and watch for low blood pressure
  • Check liver and renal function studies
  • Weight patient; report any peripheral edema or weight gain
  • Teach patient about postural hypotension
  • Teach patient to avoid grapefruit and grapefruit juice
  • Tach patient that constipation can be minimized by increasing dietary fiber and fluid
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