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Nursing School week 2/#4
Feb. 11th, 2012 08:51 amI didn't fail the exam. In fact, I was one of the people who got the top score...of 86.4%...which is about as well as I thought I had done after the exam, though lower than I would have liked. I'm still not crazy about the fact that they show us our rank, but I admit that this time it was a bit reassuring--"I didn't do as well as I hoped, but probably no one else did, either!"
Anyway, this week we learned about hypertension in the theory class--sooo many medications to learn. We need to know the names (generic & trade), the action, how to assess whether it's working or not, and what things to look out for (ex: some hypertension drugs can drop the blood pressure TOO much). Knowing the action of the drug means understanding that "this drug suppresses ______, which is responsible for _______ in the body." Ex:, metoprolol suppresses reception at beta-1 sites in the heart and kidneys. These sites are responsive to epinephrine, which causes the heart rate to increase and causes the kidneys to release renin (which raises blood pressure). So, I'll have a lot of studying of all of those things to do!
The other lecture topic was about Patient Teaching--nurses teach patients a lot of things while they're in the hospital, and that's becoming a focus for us. It could be as simple as showing someone how to use an inhaler, or more complicated--like showing a newly-diagnosed diabetic how to use the glucometer, understand their dosing chart for insulin, and self-inject insulin at the right time. Of course, we need to use Nursing Process to do this, which includes Assessing the patient's willingness and ability to learn, Diagnosing factors that affect their learning, Planning how to teach the material, Implementing the plan, and Evaluating the learning afterwards.
In clinical this week I had two patients on the 2nd day, which was a good challenge. (RNs on the floor are usually assigned to 4-5 patients it seems, but they rarely do the "basic care" things that we're expected to do--bathing, feeding, changing briefs. Usually the nurse aides take care of these things.)
In Lab we learned how to give medication through a "locked" IV--which just means that it's an IV that isn't in constant use. You have to check on what ran through the IV tubing before, to make sure the new medication is compatible. You have a bag of saline hanging to use as a flush, and you program the IV pump to first deliver the medication (at whatever rate has been ordered), and then program the pump to send a small amount of saline down the line as a flush. You also have to begin (as always) by assessing the site on the patient and flushing the line manually to dislodge anything that could build up on the catheter and potentially block it. It's basically a combination of the two IV skills we've already learned. Of course, the last two weeks neither of my patients has had an IV, so I haven't gotten to do it in clinical yet!
One last random thing to share with you: My patient last week was on a "pureed diet," which is exactly as appealing as it sounds. The meal trays usually have a variety of scoops of puree on them--like "eggs and toast," "butternut squash," etc. My favorite, though, was the "waffle" puree that he had one morning--it actually had a waffle-grid stamped into it, despite being the consistency of pudding!
Anyway, this week we learned about hypertension in the theory class--sooo many medications to learn. We need to know the names (generic & trade), the action, how to assess whether it's working or not, and what things to look out for (ex: some hypertension drugs can drop the blood pressure TOO much). Knowing the action of the drug means understanding that "this drug suppresses ______, which is responsible for _______ in the body." Ex:, metoprolol suppresses reception at beta-1 sites in the heart and kidneys. These sites are responsive to epinephrine, which causes the heart rate to increase and causes the kidneys to release renin (which raises blood pressure). So, I'll have a lot of studying of all of those things to do!
The other lecture topic was about Patient Teaching--nurses teach patients a lot of things while they're in the hospital, and that's becoming a focus for us. It could be as simple as showing someone how to use an inhaler, or more complicated--like showing a newly-diagnosed diabetic how to use the glucometer, understand their dosing chart for insulin, and self-inject insulin at the right time. Of course, we need to use Nursing Process to do this, which includes Assessing the patient's willingness and ability to learn, Diagnosing factors that affect their learning, Planning how to teach the material, Implementing the plan, and Evaluating the learning afterwards.
In clinical this week I had two patients on the 2nd day, which was a good challenge. (RNs on the floor are usually assigned to 4-5 patients it seems, but they rarely do the "basic care" things that we're expected to do--bathing, feeding, changing briefs. Usually the nurse aides take care of these things.)
In Lab we learned how to give medication through a "locked" IV--which just means that it's an IV that isn't in constant use. You have to check on what ran through the IV tubing before, to make sure the new medication is compatible. You have a bag of saline hanging to use as a flush, and you program the IV pump to first deliver the medication (at whatever rate has been ordered), and then program the pump to send a small amount of saline down the line as a flush. You also have to begin (as always) by assessing the site on the patient and flushing the line manually to dislodge anything that could build up on the catheter and potentially block it. It's basically a combination of the two IV skills we've already learned. Of course, the last two weeks neither of my patients has had an IV, so I haven't gotten to do it in clinical yet!
One last random thing to share with you: My patient last week was on a "pureed diet," which is exactly as appealing as it sounds. The meal trays usually have a variety of scoops of puree on them--like "eggs and toast," "butternut squash," etc. My favorite, though, was the "waffle" puree that he had one morning--it actually had a waffle-grid stamped into it, despite being the consistency of pudding!
