My Nursing Assistants

       

OB Maternity Flash Cards

http://www.flashcardexchange.com/flashcards/view/640038

OB Meds

Current meds list. Blank meds list.

I’m doing 5 meds a day. Around 40 meds…hmm.. I may step this up to 10 a day.

 Label set #1  Label set #2

to be printed on Avery 8163 a 2×2″ label for a 3×5, or 4×6 card. If you see something wrong or needs to be added, please let me know. As I start reading the maternity info, I’ll probably update the Davis info on the cards.

New Words:

Oxytocic

1 pertaining to a substance that is similar to the hormone oxytocin.

2 any one of numerous drugs that stimulates the smooth muscle of the uterus to contract. The administration of an oxytocic can initiate and enhance rhythmic uterine contraction at any time, but relatively high doses are required for such responses in early pregnancy. Oxytocic agents commonly used include oxytocin, certain prostaglandins, and the ergot alkaloids. These drugs are used to induce or augment labor at term, control postpartum hemorrhage, correct postpartum uterine atony, produce uterine contractions after cesarean section or other uterine surgery, and induce therapeutic abortion. These drugs are used with extreme caution in parturients with severe hypotension and hypertension, partial placenta previa, cephalopelvic disproportion, or grand multiparity. The risk of using these agents is much higher in mothers who have undergone recent uterine surgery or who have suffered recent sepsis or trauma. The most serious adverse reaction is sustained tetanic contraction of the uterus, resulting in fetal hypoxia or rupture of the uterus. (Mosby’s Medical Dictionary, 8th edition. © 2009, Elsevier.)

ergotism 

 

 1 an acute or chronic disease caused by excessive dosages of medications containing ergot. Symptoms may include cerebrospinal manifestations such as spasms, cramps, and dry gangrene.

2 a chronic disease caused by ingestion of cereal products made with rye flour contaminated by ergot fungus.

(Mosby’s Medical Dictionary, 8th edition. © 2009, Elsevier)

3 Davis – (signs include cold, numb figers and toes, chest pain, nausea, vomiting, headache, muscle pain,weakness)

5 Pregnancy Category Ratings – A, B, C, D, Z

According to the US Department of Health and Human Services, the FDA created pregnancy letter categories to help explain what is known about using medicine during pregnancy. This system assigns letter categories to all prescription medicines. The letter category is listed in the label of a prescription medicine. The label states whether studies were done in pregnant women or pregnant animals and if so, what happened.

Over-the-counter (OTC) medicines do not have a pregnancy letter category. Some OTC medicines were prescription medicines first and used to have a letter category.

OTC Medicines

Keep in mind that other things like caffeine, vitamins, and herbal remedies can affect the growing fetus. Talk with your doctor about cutting down on caffeine and ask which type of vitamin you should take. Never use an herbal product without talking to your doctor first.

All OTC medicines have a Drug Facts label. The Drug Facts label is arranged the same way on all OTC medicines. This makes information about using the medicine easier to find. One section of the Drug Facts label is for pregnant women. With OTC medicines, the label usually tells a pregnant woman to speak with her doctor before using the medicine. Some OTC medicines are known to cause certain problems in pregnancy. The labels for these medicines give pregnant women facts about why and when they should not use the medicine. Here are some examples:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil®, Motrin®), naproxen (Aleve®), and aspirin (acetylsalicylate), can cause serious blood flow problems in the baby if used during the last third of pregnancy (after 28 weeks). Also, aspirin may increase the chance for bleeding problems in the mother and the baby during pregnancy or at delivery.
• The labels for nicotine therapy drugs, like the nicotine patch and lozenge, remind women that smoking can harm an unborn child. While the medicine is thought to be safer than smoking, the risks of the medicine are not fully known. Pregnant smokers are told to try quitting without the medicine first.

Prescription Medicines

The FDA chooses a medicine’s letter category based on what is known about the medicine when used in pregnant women and animals.

Definition of Medicine Catogories

Pregnancy Category	Definition	Examples of Drugs
A	In human studies, pregnant women used the medicine and their babies did not have any problems related to using the medicine.	Folic acid Levothyroxine (thyroid hormone medicine)
B	In humans, there are no good studies. But in animal studies, pregnant animals received the medicine, and the babies did not show any problems related to the medicine.OrIn animal studies, pregnant animals received the medicine, and some babies had problems. But in human studies, pregnant women used the medicine and their babies did not have any problems related to using the medicine.	Some antibiotics like amoxicillin. Zofran® (ondansetron) for nausea Glucophage® (metformin) for diabetes Some insulins used to treat diabetes such as regular and NPH insulin. AVC OB Meds: Ampicillin, Ancef, Benadryl
C	In humans, there are no good studies. In animals, pregnant animals treated with the medicine had some babies with problems. However, sometimes the medicine may still help the human mothers and babies more than it might harm.OrNo animal studies have been done, and there are no good studies in pregnant women.	Diflucan® (fluconazole) for yeast infections Ventolin® (albuterol) for asthma Zoloft® (sertraline) and Prozac® (fluoxetine) for depression AVC OB Meds: Demerol, Gentamycin, Darvocet-N, Vicodin, Morphine,
D	Studies in humans and other reports show that when pregnant women use the medicine, some babies are born with problems related to the medicine. However, in some serious situations, the medicine may still help the mother and the baby more than it might harm.	Paxil® (paroxetine) for depression Lithium for bipolar disorder Dilantin® (phenytoin) for epileptic seizures Some cancer chemotherapy
X	Studies or reports in humans or animals show that mothers using the medicine during pregnancy may have babies with problems related to the medicine. There are no situations where the medicine can help the mother or baby enough to make the risk of problems worth it. These medicines should never be used by pregnant women.

Certified Nursing Assistant

Being a Student Nurse, you can apply and test to be a Certified Nursing Assistant (CNA). 

This is what I have learned about the testing for the CNA in California.

For California, if you are presently in an RN program, you will not have to take further training and qualify to take the competency exam for an equivalency-trained nurse assistant. You must submit an original copy of your transcript of training (or a student nurses can substitute the transcript with a letter on official school letterhead listing equivalent training in at least “fundamentals of nursing”).

Submit transcript or letter, along with fingerprints using live scan (available at the college), completed application form, and a $15 application fee.

Cost of the exam is $90-105. Information of what is involved can be found in this brochure by California’s National Nurse Aide Assessment Program.

This exam can be taken over the summer after the first year of student nursing. The exam is a written test of 70 questions and a skills performance test. 24 Skills have critical steps that must be completed to pass. Some of he skills tested include hand washing, applying knee-high elastic stockings, ambulate using transfer belt, cleans upper or lower dentures, counts and records radial pulse and respirations, and feeds client who cannot feed self. The whole list is in the brochure.

iPod touch Applications for Nursing

Applications  

  

Nursing Central has:

Davis Drug Guide     

Davis’s Lab and Diagnostic Tests  

Disease and Disorders  

Medline Journals    

Taber’s  

And Favorites  This I can see using with each patient, I will just save the med or lab as a favorite and can refer back to it. Or I can save all my common OB meds to favorites….

Second Semester

During the break before 2nd semester I am reading the book Essentials of Nursing Leadership and Management for Professional 120, and I am also reading Novice to Expert: Excellence and Power in Clinical Nursing Practice, as recommended by Mrs Beatty.

I’m OB for the first 8 weeks, then Med Surg.

OB Med List  To be reviewed, OB math, Postpartum Normals and Abnormals, and Assessments.

OB Math

I also changed up the bog theme a little…

Cultural Diversity Video

 

Osmolality

Metabolic by Electrolytes

You can tell if a person has Metabolic Acidosis by using the Anion Gap.

The Anion Gap is a difference between the cations and anions. The anion gap indicator # you look at is > 20 mEq for Metabolic Acidosis. Cations are the positive ions in the serum. Anions will are the negatives. Na and K (sodium, potassium) are positive (cations). Cl and HCO3 (chloride and bicarbonate) are negatives (anions).

So here’s the math:

Now the Question is -

Is metabolic acidosis present (anion gap > 20 mEq/L) ?

Answer – Yes, metabolic acidosis is present with an anion gap of 24.

Affecting Fluids and Electrolytes

Fluid and Electrolytes

Hormones regulating water retention and loss

ADH (anti-diuretic hormone) * regulates WATER excretion from the kidneys.  As serum osmolality rises (>300), it stimulates osmoreceptors that stimulate thirst to ↑ H2O intake & stimulate ADH release to allow more water reabsorption in the kidney causing dilution of body fluids.  

1. water only, urine will be dark, scant, amber-colored, 
2. alcohol consumption turns ADH off and you are dehydrated the next day
3. ADH & Aldosterone activate in ↓ BP

ADH keeps water from being loss through urination.

Aldosterone * Renin-Angiotensin System * regulates electrolyte balance from the kidneys by promoting Na+ & water retention and K+ loss

1. with low blood volume such as internal bleeding or cut arm, kidneys kick in to reabsorb water
2. this system works with salt to counteract effects of low blood volume & low BP to try to increase BP (water & salt reabsorbed)

Aldosterone, Renin-Angiotensin System keeps water and sodium  from being loss through urination, though Potasium is loss.

ANP (atrial natriuretic peptide) * cardiac hormone found in atria & released when atria are stretched by increasing blood volume or BP (CHF) works to lower BP/volume through vasodilation & suppression of RAS (rennin-angiotensin system)

ANP  is a marker found through testing, signifying CHF. ANP tries to lower BP/Volume that ADH and ARAS creates.

 

Respiratory or Metabolic Acidosis or Alkalosis?

 This is the way I see it.

pH  norm = 7.4  +/-  0.05

PaCO2 norm = 40  +/-  5

HCO3 norm = 24  +/-  2

 

• If your pH is low and your PaCO2 is high (inverse) you have RESPIRATORYacidosis.  
• If your pH is high and your PaCO2 is low (inverse) you have RESPIRATORY alkalosis
• If your pH is low and your HCO3 is low, (and your PaCO2 is normal or low) you have Metabolic acidosis
• If your pH is high and your HCO3 is high, (and your PaCO2 is normal or high) you have Metabolic alkalosis

Daily 5 – Say What?

Starting Monday I will do a Daily 5, well… maybe starting today. My study schedule is pretty much in the order of the modules we have 1-14 (minus the last 4 tested on), so the questions will come from these areas. If you find this helpful, you must add questions of your own. Please put them in the comments so everyone can try them!

Questions & Answers

Set 1 Questions  Set 1 Answers 

Set 2 Questions  Set 2 Answers

Set 3 Questions   Set 3 Answers

Set 4 Questions   Set 4 Answers

Set 5 Questions   Set 5 Answers

Bonus

Drug Questions   Drug Answers

Pot Luck Images!

   

And The Winner Is……..

Yea Lisa!

 Fund Raising is Great!!!!

Nurses Developing Cultural Competence

The five components of a nurse’s ability for cultural competence includes the following:

1. The nurse’s knowledge  which is the process of learning of the different cultural backgrounds of her patients.

2. The nurse’s awareness   or looking at self biases and prejudices.

3. The nurse’s desire  or motivation and willingness to learn, respect and accept individual cultures.

4. The nurse’s skill as a framework for assessing cultural ethnic differences.

5. The nurse’s encounter process of interacting with diverse backgrounds thus developing cultural competence.

Skill includes –

Environmental control: how much do we belive we have control over our environment or is it just luck? Traditional western medicine vs. folk medicine

Biological variations: Scientifically any genetic factors in particular ethnic or racial groups that affects their health or high risk in  diseases.

Social organization: Patrilineal or male dominated, Matrilineal or female dominated, Bilineal where male & female are dominate

Communication: assertive vs. more passive, nonverbal verbal, tone of voice, eye contact.

Space: eye contact, touching how close a distance between participants

Time: future-oriented, present oriented or past oriented

 

laura’s thoughts generated by the article of: Flowers, Deborah. “Culturally competent Nursing Care,” Critical Care Nurse, August 2004, Pages 48-52.

 

Cultural Diversity Match it

Mod 12 Match it.
match it answers

Common Occuring Defense Mechanisms

Added to Flash Cards

http://www.flashcardexchange.com/tag/avc

Gary’s Student Nursing Tips Blog

Gary Appel has created a new blog on gaining knowledge from sudent’s experiences in clinical situations. http://srnblog.wordpress.com/

He has also created a medication card he uses. Check it out!

“I print this Excel doc out on 3×5 index cards, punch a hole in the corner, and attach them to one of those cords that retract. I clip the cord thing onto a loop in my uniform pocket so these cards are attached to me, stored in my pocket, and within easy reach.

In the morning when I get my patient meds that I have to administer for the day I write down all the info from the drug guide onto this card, then reference the card when the instructor quizzes me about the drug or as I need to during my shift. I formatted the card so after class you can cut the top portion off at the dotted line and then use the drug card as a future study aid. The back of the card can be used for writing notes as well.”

Gary’s Med Info

Thanksgiving Mini Care Plan

Click Image for Thanksgiving Mini Care Plan

Balance of the Nurses’ Energy

I made this scale to show the balancing of the nurses’ energy. We have been taught to keep our bodies healthy, our minds nurtured and our spirit awake, but have you really thought how deep this goes? Breaking some of these areas up into mental, intuitional and emotional health lets you see where you may be missing a little tender loving care, and probably more importantly – letting go. So I ask you, is your energy balanced?

The article by D. Sherman on nurses’ stress talked about self-care nurses must do to keep from burning out. It relates the balancing of four fields: the Vital field – physical body, the Emotional field – feelings, the Mental field- thinking, visual images, ideas, and the Intuitional field – creativity, compassion, healing.

When these energies are imbalanced, stress and illness will occur.

 

laura’s thoughts generated by the article in Module 9 – Witt Sherman, Deborah.  “Nurses’ Stress & Burnout,”  AJN, May 2004, Pages 48-57

Oral Temperature with Thempadot

  How to Obtain Accurate Readings:

• Wait at least 15 minutes before taking temperature when patient is exposed to cold weather (all assessment methods) or smoking, eating or drinking (oral assessment).

• For oral assessment, place in heat pocket under tongue. Be sure mouth is closed for 60 seconds.

• For axillary assessment, be sure device is against torso, parallel to length of body and completely covered for 3 minutes.

• For rectal assessment, be sure device is completely in sheath and device is inserted into rectum with all dots covered for 3 minutes.

• Allow 10 seconds for the device to ‘lock in’ before reading.

• Read the last blue dot and ignore any skipped dots.

• Retake temperature with new device:

- If left in mouth longer than 2 minutes.

- If left under arm or in rectum longer than 5 minutes.

Download 3M pdf on readings.  tempadotinstructions