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Mar. 22nd, 2013

pantshead: (Transformers)
Posted at some delay--Week 9 actually ended last Friday.  This week is Spring Break, which I'm enjoying despite the fact that we get new snowfall every day and it hasn't gotten above 40°.  Mostly, it's just good to have some down-time.  I'm catching up and working ahead on some assignments; I'll study for the exam that we have coming the Tuesday we get back, etc...  I had been hoping to do some gardening-prep, but the weather has prevented any such efforts.  (PoC did mark out some new beds, which was great, and then the snow fell...I'm not digging anything up just yet!)

Anyway, in our Theory class last week we learned about endocrine system disorders.  Specifically, we learned about hyper- and hypo-thyroidism, and adrenal insufficiency/Addison's disease, and adrenal excess/Cushing's disease.  Since the hormones from the adrenal glands and the thyroid affect nearly every cell in the body (indirectly or directly), these are fairly involved disorders.  (For example, if you have adrenal insufficiency, you do not make enough aldosterone (among other hormones).  Aldosterone tells the kidneys to hold on to water and sodium.  Thus, you lose excess water (becoming dehydrated), you lose sodium (which causes neurological problems), you retain too much potassium because you're losing too much salt (potassium affects muscle function, including the heart), etc...)

This was our first week on our new clinical units.  As I mentioned, I'm on an oncology unit now, which a unit I'd been hoping to get some experience on.  The first week went pretty well, though in part that was because I only happened to have one patient (people kept getting discharged and she eventually gave up on finding me a 2nd patient).  This was great because I really got to spend a lot of time with the patient, who was getting ready for discharge after a long stay.  It was also useful academically, because one of our assignments this semester is to do a Teaching Plan.  The idea is that nurses do a lot of teaching for patients all the time, and we're expected to be doing that.  But for this Plan, we need to take a look at everything the patient needs to learn about before being discharged--medications, equipment, treatments, general understanding of their illness, referrals and followup, and diet--and present it all to the patient.  The hospital says "discharge teaching begins at admission,"--ie: we're always working toward the time when the patient will go home, even if there's no date on that yet.  But this patient was actually being discharged, which meant that s/he was very interested in learning about all the things s/he and home-care will need to do.  Having only one patient let me focus on this and have some good discussions.  By the time I wrote it all up, it was about 11 pages single-spaced!  It's graded as pass/fail, so now I just have to hope my instructor accepts it and I will have completed the assignment!

The nearness of the end of school is starting to push its way into my consciousness--I need to start applying for jobs soon; we'll be done with regular clinical at the end of April; I had to order my cap and gown the other day.  At the same time, I know I need to remain focused--we have 4 more exams (and 3 more computerized ones) and then the NCLEX to get through!  And, as usual, I won't feel really good about things until I get my evaluation from my instructor at the end of April. 


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