Student Nurse Laura

Orem – "creative effort of one human being to help another human being."

Archive for July, 2010

CPR – To Breathe or not to breathe?

Posted by Laura on July 29, 2010

It’s in the news about CPR given without the 2 breathes to 30 compressions is having the same percent or higher of survival rates for patients.

The New England Journal of medicine has a good article on it, as well as many places in the news right now. (http://www.nejm.org/doi/full/10.1056/NEJMoa0908993)

When we learned CPR, we checked the airway (the look, feel, listen), the pulse – are they breathing? Is there a pulse?

We also learned to start with the 2 breathes. The ratio is 2 to 30 at a rate of 100 compressions per min – I hope I still have all this right!

It now has now  come up through research the survival rate of adults given just the compressions has the same overall rate of survival or even better than if you gave your patient the breathes and compressions. (We are talking only 12% of patients kept alive by CPR go on to be a survivor. ) By giving the breathes you are as a health care provider at a risk for transmission of diseases – besides anything else coming up through the oral membranes. By starting compressions first and not stopping, you keep the heart pumping blood to the brain and the neurological outcome was better.

So what will the American Heart Association (AHA)  or American Red Cross recommend now? I didn’t see anything on the current AHA site though I read in various articles they support the ‘hands only’ technique.  The Red Cross fully supports it, and states so on their site. (http://www.redcross.org/portal/site/en/menuitem.1a019a978f421296e81ec89e43181aa0/?vgnextoid=629a1a8526e1a210VgnVCM10000089f0870aRCRD)

Songs to do compressions to:

Staying Alive – Bee Gees

Saturday Night Fever – Bee Gees

Nellie the Elephant – Toy Dolls (see video below)

(http://www.youtube.com/watch?v=eti21PVHXrg) (lyrics) (you do the chorus twice)

Another One Bites The Dust – Queen

Burnin’ Down the House -Talking Heads

Genius of Love –  Tom Tom Club’s

Rock Me Amadeus – Falco

Ticket to Ride – Beetles

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Peplau

Posted by Laura on July 24, 2010

Hildegard Peplau: psychodynamic nursing – interpersonal relationship between a nurse and a patient.

Four phases of this relationship:

  • orientation – the patient and  nurse mutually identify the person’s problem
  • identification – patient  identifies with the nurse, thereby accepting help
  • exploitation – patient makes use of the nurse’s help
  • resolution – the patient accepts new goals and frees herself or himself from the relationship.

Peplau identifies 6 nursing roles:

Counselor Role – working with the patient on current problems

Leader Role – directing the nurse-client interaction to facilitate goal achievement.

Surrogate Role – figuratively standing in for a person in the patient’s life

Stranger – accepting the patient objectively

Resource Person – interpreting the medical plan to the patient

Teaching Role – offering information and helping the patient learn

(Our book doesn’t list stranger as one of the main 6 nursing roles, but includes Technical Expert – which is one of the  secondary roles the nurse plays along with mediator, safety agent, researcher, tutor, and manager of environment.) – http://historicalbiographies.suite101.com/article.cfm/hildegard_peplau

The Peplau Theory taken from the students of Mt Saint Mary’s College Nursing Program (Los Angeles, CA) 2009.

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Psych Summer Reading

Posted by Laura on July 23, 2010

Psych Summer Reading 1

This reading card will be updated when we have the actual syllabus for the class. 🙂

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Flash Cards Made Simple

Posted by Laura on July 23, 2010

Paper Folding:
If you don’t want to deal with back-to-back printing the paper folding technique is a great way to go.
Try this with the schizophrenia.pdf
Set your options and print the cards Vertically fold each page in half Cut around the outermost border of the flashcards Glue together the inside edges of the folded paper Cut between each card Instant flashcards!

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Maslow, Erickson, Piaget

Posted by Laura on July 22, 2010

These are my own images of the theories to know…

Maslow

Erickson

Piaget

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Freud and Ice Cream

Posted by Laura on July 22, 2010

Can a person compare the Id, Ego, and Superego

to eating a bowl of ice cream?

The desire for immediate gratification and pleasure to have a sweet bowl of lime sherbet  smothered in dark hot fudge and nuts, comes to me once a month. I believe it may be the Id of me. Yet once I dip into the rich, sour, sweet crunchy scoopfuls, I take my time and taste it. I slow my Ego self down and relish all the beauty of it and how begin to notice the coldness in my throat and head. Not far into my bowl I start to wonder how this bowl of sherbet is going to ruin my dinner in a couple hours, not to mention how the chocolate always makes me break out. The right & wrong feed back system of my Superego has now taken over and sent the remains of the green-brown melted mess down the garbage disposal.

To live through Freud in the matter of a few sticky cold minutes…..

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DSM-IV-TR

Posted by Laura on July 21, 2010

Diagnostic and Statistical Manual of Mental Disorders, 4th ed, Text Revision.

“Standard nomenclature of emotional illness published by the American Psychiatric Association (APA) and used by all health care practitioners. It classifies mental illness and presents guidelines and diagnostic criteria for various mental disorders.”   Psychiatric Mental Health Nursing, 6th edition, Townsend

Published in July 2000 as a update to be official in 2014. The last updated DSM-IV was in 1994.

This is the original DSM-I

My diagram of the Diagnostic and Statistical Manual shows the 5 Multi-axial system.

There are 3 Components of the DSM:

Diagnostic Classification – list of the mental disorders
Diagnostic Criteria –  description of each disorder
Descriptive Text accompanies each disorder with descriptions under the following headings: Diagnostic Features *  Subtypes and/or Specifiers * Recording Procedures * Associated Features and Disorders * Specific Culture, Age, and Gender Features * Prevalence * Course * Familial Pattern * Differential Diagnosis

Multi-axial system

The DSM-IV organizes each psychiatric diagnosis into five levels (axes) relating to different aspects of disorder or disability:

  • Axis I: Clinical disorders, including major mental disorders, and learning disorders. Common Axis I disorders include depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, phobias, and schizophrenia.
  • Axis II: Personality disorders and mental retardation. Common Axis II disorders include personality disorders: paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, histrionic personality disorder, avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder, and mental retardation.
  • Axis III: Acute medical conditions and physical disorders. Common Axis III disorders include brain injuries and other medical/physical disorders which may aggravate existing diseases or present symptoms similar to other disorders.
  • Axis IV: Psychosocial and environmental factors contributing to the disorder.
  • Axis V: Global Assessment of Functioning or Children’s Global Assessment Scale for children and teens under the age of 18

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Psych Sites

Posted by Laura on July 21, 2010

I’ve added a blog link category called Psych for different Psychiatric sites which may be useful during our 3rd semester. If you know of any other good ones I should add, please let me know!

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Types of Anxiety Disorders

Posted by Laura on July 20, 2010

Types    S/S     Nursing Assessment     Nursing Diagnosis     Management

2 page .pdf

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Anxiety Levels

Posted by Laura on July 19, 2010

for .pdf click here

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CNSA Annual Convention

Posted by Laura on July 15, 2010

2010 CNSA Annual Convention

October 15 – 17

Marriott Hotel and Conference Center
2000 East Convention Center Way
Ontario, Ca 91764Phone: 909.937.3000
Fax: 909.937.3080

Hotel Reservations

Exhibitor Packet

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Precepting in ED

Posted by Laura on July 14, 2010

Summer Precepting has provided me with over 100 hours on the floor working with many patients and team health care providers of different personalities. As with many things in life, the unknown can be scary and the only way to take that fear away is to make the unknown a friend.

With many successful IV starts,  OG tube insertions, Foleys, EKGs, blood draws, iSTATs, UAs, IVFs and IVPBs, Meds by PO, IM, R, SQ, charting, assessments, restraints, and Accu-Cheks, I have gained a great deal of clinical skill. I found by working closely with the other team members such as the RTs, Lab Techs, EMTs, Radiology and even EVS I have a better understanding of what makes their job easier and quicker if the nurse uses certain techniques. This ensures the overall safety of the patient, making the nurses job better with less time lost and better communication. Sometimes a simple thing like the way a lab draw is labeled will ensure the patient doesn’t need to be poked again delaying the results for treatment.

I asked questions always. To the nurses who were busy saving lives on the floor, I think it just showed my inexperience, but after I knew the answer I know I had one more piece of information to help me next time. I also found I prefered to stay busy. When there was a lull in the ED, I sanitized, restocked supplies, did “sit and chats” with the patients. I didn’t see the other nurses do this. They found chairs to sit in and talk about their schedules. I wrote notes to look up when I get home, or found some tech to follow and watch how they did their procedures.

I suppose both ways are stress relieving techniques and after I know all the answers I may be more interested in my schedule, but for now its the same as when I started the program – the more I learn, the more I realize I don’t know 🙂

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What do Walnuts, Tea and Vit D have in Common?

Posted by Laura on July 12, 2010

According to the Alzheimer’s Association, there is research showing a direct connection to those who develop dementia and Alzheimer’s disease. A recent conference of the Alzheimer’s Association International Conference on Alzheimer’s Disease was recent held in Honolulu, Hawaii. At this event, new evidence based research was released on just what percentages these dietary modifications have on the brain along with moderate to heavy exercise.

Vitamin D has had a lot of press lately on the deficit found in many people, and I have noticed quite a few of my patients who are on regular Vitamin D prescribed supplements now. I’m also aware on how Vitamin D is synthesized from cholesterol with the help of the sun. Makes you wonder if we shouldn’t be having our breakfast of walnuts and tea under the morning sun.
Find out more about these studies at:

http://www.alz.org/icad/2010_release_large_071110_1200pm.asp

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Summer Blogging

Posted by Laura on July 10, 2010

A month of summer has gone by and I finished my 30 days of pre-formed posts to give a little break to the blogging site. Now I need to step my game back up. So Psych wise:

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30 Student Nurse Success Secrets

Posted by Laura on July 8, 2010

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30 Student Nurse Success Secrets

Posted by Laura on July 7, 2010

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30 Student Nurse Success Secrets

Posted by Laura on July 6, 2010

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30 Student Nurse Success Secrets

Posted by Laura on July 5, 2010

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30 Student Nurse Success Secrets

Posted by Laura on July 4, 2010

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30 Student Nurse Success Secrets

Posted by Laura on July 3, 2010

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