Student Nurse Laura

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

Archive for August, 2010

AD & RA

Posted by Laura on August 31, 2010

“We were pretty amazed that the treatment completely reversed cognitive impairment in 20 days,” said Tim Boyd, PhD, who, together with Steven Bennett, PhD, is a study lead author.

Wow! Can we really believe what we read? According to the Journal of Alzheimer’s Disease, a current study was done: “GM-CSF up-regulated in Rheumatoid Arthritis reverses cognitive impairment and amyloidosis in Alzheimer mice”; Journal of Alzheimer’s Disease 2010; Vol. 21:2. ( http://www.j-alz.com/press/2010/20100823.html )

It seems the study was done with mice and had used a recombinant human type of protein, which is normally stimulated in those with Rheumatoid Arthritis (RA). In the mice with Alzheimer’s Disease (AD), this protein may have stimulated the natural microglia which worked in the brain to remove beta amyloid plaques.

Currently this GM-CSF (Leukine®) protein is used with cancer patients to increase their white blood cells (WBC). This colony-stimulating factor (CSF) protein is a growth factor helping the cancer patient increase their WBCs such as neutrophils, monocytes, macrophages and the myeloid-derived dendritic cells.

Makes you think, “If I was a mouse, would I rather have AD or RA?”

(awesome image by Leukine® manufacture’s web site http://www.leukine.com/patients/benefits_leukine_therapy/cancer_therapy_immune_system.html)

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Just the class please…

Posted by Laura on August 30, 2010

Now added to flashcards exchange site is the psych meds by classification. There are so many, and quite a few I don’t know by class.

There is a Hint card with these. If you press h on your keyboard, the Trade Name will come up.

Also you can use the form below and just create your own flash cards! Just Print, fold in half, glue, and cut out!

download-able .pdf

Alprazolam* Xanax Antianxiety/Benzodiazepine
Amitriptyline* Elavil Antidepressant/Tricyclic
Amitriptyline/

Perphenazine*

Triavil Antipsychotic/ Tricyclic
Amoxapine Asendin Antidepressant/Tricyclic
Aripiprazole* Abilify Antipsychotic/ Atypical
Benztropine* Cogentin Antiparkinson Agent (EPS)
Bupropion* Wellbutrin Antidepressant (NDRI)
Busparone Buspar Antianxiety/Non-Benzodiazepine
Carbamazepine* Tegretol Anticonvulsant (Mood Stabilizing)
Chlordiazepoxide Librium Antianxiety/Benzodiazepine
Chlorpromazine* Thorazine Antipsychotic/ Typical/Conventional
Citalpram* Celexa Antidepressant (SSRI)
Clonazepam* Klonopin Anticonvulsant/Antianxiety/

Benzodiazepine (Mood Stabilizing)

Clorazepate Tranxene Antianxiety/Benzodiazepine
Clozapine* Clozaril Antipsychotic/ Atypical
Diazepam Valium Antianxiety/Benzodiazepine
Diphenhydramine* Benadryl Antihistamine
Doxepin Sinequan Antidepressant/Tricyclic
Fluoxetine* Prozac Antidepressant (SSRI)
Fluphenazine* Prolixin Antipsychotic/ Typical/Conventional
Gabapentin Neurontin Anticonvulsant (Mood Stabilizing)
Haloperidol* Haldol Antipsychotic/ Typical/Conventional
Hydroxyzine Vistaril Antianxiety/Antihistamine
Imipramine Janimine/Tipramine/Tofranil Antidepressant/Tricyclic
Isocarboxazid Marplan Antidepressant/MAOI
Lithium* Escalith Mood Stabilizing
Lorazepam* Ativan, Alzapam Antianxiety/Benzodiazepine
Midazolam Versed Antianxiety/Benzodiazepine
Mirtazapine* Remeron Antidepressant (NaSSA)
Nortriptyline Aventyl Antidepressant/Tricyclic
Olanzapine* Zyprexa Antipsychotic/ Atypical
Oxazepam Serax Antianxiety/Benzodiazepine
Paroxetine* Paxil Antidepressant (SSRI)
Perphenazine* Trilafon Antipsychotic/ Typical/Conventional
Phenelzine Nardil Antidepressant/MAOI
Quietiapine* Seroquel Antipsychotic/ Atypical
Risperidone* Risperdal Antipsychotic/ Atypical
Sertraline* Zoloft Antidepressant (SSRI)
Tranylcypromine Parnate Antidepressant/MAOI
Trihexyphenidyl* Artane Antiparkinson Agent (EPS)
Valproic Acid* Depakote/

Depakene

Anticonvulsant (Mood Stabilizing)
Venlafaxine* Effexor Antidepressant (SNRI)
Ziprasidone* Geodon Antipsychotic/ Atypical

Posted in Drugs, NS 232 - Psych, Ger, CH, Semester III | Tagged: , | Comments Off on Just the class please…

New Search Button

Posted by Laura on August 29, 2010

Student Nurse Kylie has requested a search button!

It’s now at the top Left side – Thank you Kylie!

Posted in Day-to-Day | Comments Off on New Search Button

Weekly Reading

Posted by Laura on August 29, 2010

Week 3 Reading Card  8×5 .pdf

Posted in Reading Schedule 232, Semester III | Comments Off on Weekly Reading

What does Psychotic mean?

Posted by Laura on August 29, 2010

The first time I was asked that, I thought in my little mind, that’s a bad slang word. Like calling someone fat, or stupid – a label. I grew up in a world where people would use it as a adjective to describe someone in a negative way. Of course my instructor (Psych) was standing there waiting for my answer and I couldn’t. Was I wrong? I pulled the word apart using the ‘ic’ – pertaining to. Then using the psych – that’s the mind/brain, right? So pertaining to the mind? Okay this wasn’t getting me there. Then I was thinking (while my inquirer was probably thinking – It’s so basic, why doesn’t she answer – catatonic?) perhaps if I use the word such as psychotropic….hmm psychosis…hmmm…

Then they started using the word to mean a break from reality and I wasn’t even sure that was right. So here I am trying to see my biasis and learn something.

From Tabers

Psychotic: Pert.to or affected by psychosis.

Psychosis: A mental disorder in which there is severe loss of contact with reality, evidenced by delusions, hallucinations, disorganized speech patterns, and bizarre or catatonic behavior.

Psyche: the mind and mental processes

ic: relating to

So basically – affected by a mental disorder in which there is severe loss of contact with reality, evidenced by delusions, hallucinations, disorganized speech patterns, and bizarre or catatonic behavior.

Or me – standing there doing nothing!

catatonic: stupor, inability to move or talk, studentnurselaura : )

Posted in NS 232 - Psych, Ger, CH, Semester III | Comments Off on What does Psychotic mean?

Student Nurse Flo

Posted by Laura on August 28, 2010

Posted in Student Nurse Flo | Comments Off on Student Nurse Flo

GAF

Posted by Laura on August 26, 2010

I’ve created a 4×6 card of the GAF Scale for reference. There are 2 pages for the 4×6. This is information pulled from the DSM IV-TR

4 x 6 pdf

8.5×11

Posted in NS 232 - Psych, Ger, CH, Semester III | Comments Off on GAF

Good Luck!

Posted by Laura on August 25, 2010

Funny how a short math test can stress you out!

Posted in Day-to-Day | 2 Comments »

Week 2 Reading Card

Posted by Laura on August 22, 2010

Week 2’s Reading Card 8×5 pdf

Posted in Reading Schedule 232, Semester III | Comments Off on Week 2 Reading Card

Warm-ups for TPN Calculations

Posted by Laura on August 20, 2010

Total Parental Nutrition (TPN) solutions are intravenous fluids (IVFs) that provide nutrition to clients who can’t eat normally for many different reasons. Different additives  placed in the bag are modified for the patient’s particular needs.

Dextrose & amino acids are usually the base of the fluids. They represent the carbohydrates and proteins in our normal diet. How much is in your TPN is determined by lab draws and nutrition requirements of your patient with consideration to the length of time they are on this type of therapy.

http://grey.colorado.edu/shortgut/index.php/MaxCares_TPN_Tubing

The above site provides great info on  TPN bags and tubing.

  1. You have mixture of Glucose (200 g) Fat (55 g) and Protein. The mixture provides 2000 kcal, how many grams of protein are in the mixture?
  2. If the daily calorie requirements for your patient is 2600 kcal, and they have a daily intake of 300 g glucose and 200 g protein, how much fat is needed to meet the requirements?
  3. What is your intake of fat if you were to consume 10 g, then 20g, then 30g of fat in one day?
  4. How many calories will your patient receive if you infuse 2.5 liters of 5% dextrose?
  5. With 8% fats, 10% protein and 15% dextrose, how many calories are in 1 Liter?
  6. What would the kcals be of a liter of 10% dextrose and 8.5% amino acids?
  7. Your patient receiving TPN has a solution consisting of 500mL of 25% dextrose and 500mL of 10% amino acids. What are the total calories in the preparation?
  8. Your patient received 1000mL of the following mixture every 8 hours: 50% dextrose in water 500mL and 8.5% Fre-Amine 500mL. Calculate the glucose calories per day. What are the grams of protein received per day?

9. A 250mL solution of 2% fat, 5.5% protein, and 25% dextrose will give ___ calories?

10. How many mL of 20% dextrose solution or 5% protein are required to get 50kcals of energy?

11. What is the protein-calorie percentage of a 500 mL solution of 10% dextrose and 20% protein?

12. What is the protein in a solution , whose protein-calorie percentage is 20% and which contains 400 g of dextrose?

Posted in Day-to-Day, Math | Comments Off on Warm-ups for TPN Calculations

Psych Drugs

Posted by Laura on August 20, 2010

Here are my drug cards for Psych. I’m sure there will be updates as I go. This information is from the Davis Drug Guide 2010 and the Townsend book.

4×6 cards .pdf  10/29/10 – updated!

Posted in Drugs, NS 232 - Psych, Ger, CH, Semester III | Tagged: , | Comments Off on Psych Drugs

Do these quickly!

Posted by Laura on August 19, 2010

Don’t read these simple math equivalents yet!! Set your timer to 4 minutes and do these quickly! Ready, set, go!

__ g =

1 oz

__ mL =

1 pt

__ mg =

1 gr

__ Tbsp =

1 oz

__ mL =

1 tsp

__ mL =

1 fl. Oz

__ lb =

1 kg

__ tsp =

1 Tbsp

__ Tbsp =

3 tsp

__ tsp =

5 mL

__ fl oz =

30 ml

__ kg =

2.2 lb

__ oz =

2 Tbsp

__ gr =

60 mg

__ oz =

30 g

__ pt =

500 mL

the answers are in the problems.

Posted in Math, Resources | Tagged: , , | Comments Off on Do these quickly!

Week 1 Reading Card

Posted by Laura on August 18, 2010

8 x 5 .pdf Reading Card

Posted in Reading Schedule 232, Semester III | Comments Off on Week 1 Reading Card

Fall 2010 Schedule

Posted by Laura on August 18, 2010

My next 8 week schedule in the ADN Program…

8 Week Calendar

Fall 2010, 1st 8 weeks

Professional Nursing Course III NS 230

Psychiatric/ Geriatric/ Community Nursing NS 232

.pdf

WEEK/DATE TOPIC COMMENTS
Week 1

Aug 25


Aug 26

Aug 27

*Welcome

*Review Syllabus

*Module #1 Community/Teaching

*Introductions and Overview

*Module 1:  Introduction to Psychiatric Nursing

*Module 2:  Overview of Psychopharmacology

Clinical – APL

Clinical –  

Bring Syllabus

Math Test

Week 2

Sept 1


Sept 2

Sept 3

*Module #1 continued

*Module 2:  Overview of Psychopharmacology (continued)

*Module 3:  Therapeutic Nurse-Patient Communications

Clinical – AVH

Clinical – AVH

Week 3

Sept 8

Sept 9

Sept 10

*Module #1  continued

*Module 4: Nursing Process and Therapeutic Approaches In Mental Health Nursing

Clinical – AVH

Clinical – AVH

Week 4

Sept 15

Sept 16

Sept 17

*Module #2 Professional and Legal Issues

*Module 5:  Schizophrenia

*Module 6:  Mood Disorders

Clinical – AVH

Clinical – AVH

NS230 Written assignment

NS232 Exam1

Modules 1 – 4

Week 5

Sept 22


Sept 23

Sept 24

*Module #2  continued

*Module 7:   Geriatrics and Mental Health

*Module 8:   Legal, Ethical and Community Issues in Mental Health and  Geriatric Nursing

Clinical – AVH

Clinical – AVH

NS232 (Aging Eye and Ear)

Self-Study

Week 6

Sept 29


Sept 30

Oct 1

*Module #3 Ethics and Values

*Module 8:   Legal, Ethical and Community Issues in Mental Health and Geriatric Nursing (Continued)

*Module 9:   Anxiety

Clinical – AVH

Clinical – AVH

Week 7

Oct 6


Oct 7

Oct 8

*Module #4  NCLEX

*Module 10:  Psychosomatic Disorders

*Module 11:  Adolescent Disorders

Clinical – AVH

Clinical – AVH

NS232 Exam 2

Modules 5 – 9

Week 8

Oct 13


Oct 14

Oct 15

* Final Examination

*Module 12:  Substance-Related Disorders

*Module 13   Personality Disorder

Clinical –

Final  1100 in T503-A

NS230 Comprehensive Final

NS232 Final

Posted in Reading Schedule 232, Semester III | Comments Off on Fall 2010 Schedule

Units

Posted by Laura on August 16, 2010

Unit Calculations

  • When charting never use ‘U’, always write out ‘Units’.

1A.  The doctor orders heparin of 800 units/hr.  The solution available is 40,000 units in 1000/mL of D5W. (40,000U/1000mL of D5W). Calculate the flow rate.

1B.  What are the heparin units infusing when an IV bag of 1000 mL D5W containing 40,000 units has been ordered, and you notice it is infusing at 30 mL and hour?

1 C.  Is the amount infusing an hour within normal limits?

2.  Laura was told to give 2500 units of heparin to her patient in an IV solution. After checking the doctor’s order she went to get the medication and found she needed to prepare her syringe with the correct amount first. The vial said 5000 units/ml for IV or SC use. In large letters it says 10 mL, multiple dose vial. How many mLs does she need to pull in order to give 2500 units to the IV solution running at 40 mL/hr? The drop rate is 60gtt/min.

3. Brandi is preparing a solution for her patient. She has a multiple dose vial labeled 5,000,000 units. The directions say “add 3.2 mL diluent to make 1,000,000 units per mL”. After she prepares this correctly, and we know she will, she gives her patient 1.7 mL of this solution. How many units did she give?

answers

Posted in Math | Comments Off on Units

For those going into Pediatrics

Posted by Laura on August 11, 2010

Pediatric Medication Calculations

  1. Sam weighs 15.4 kg and is to receive a drug with a dosage range of 5-7.5 mg/kg/dose. The solution bag is labeled 100 mg. What is the dosage range and what is your ‘soon to be’ expert opinion of the correct amount? (too low, in range, or too high)

For the following questions, state the dosage range and your opinion on the dose to be given (too low, in range, too high)

  1. Nora weighs 13.1 kg and the dosage range is 15-20 U/kg/dose. The doctor ordered 200 U in 75 mL for Nora.
  2. Sally has a dosage of 1.5 mg in 20 mL bid. Her weight is 27.28 lbs. The normal dosage range is 0.1 to 0.3 mg/kg/day in two divided doses. What is the dosage range per day, daily dosage ordered and your assessment?
  3. Brandi is at 27.9 kg. She has a medication to be infused q 8 h of 400 mg in 75 mL.  The normal range is 15-45 mg/kg/day. What is the dosage range per day, daily dosage ordered and your assessment?
  4. Lisa has a solution bag of 250 ml infusing at a rate of 50 mL/hr. This bag contains 350 mcg. The normal range is 3-7 mcg/kg. She weighs 15.7 kg.  What is the dosage range per hr, dosage infusing per hr and your assessment of the correct amount?

answers

Posted in Day-to-Day | Comments Off on For those going into Pediatrics

Okay, I lied.

Posted by Laura on August 11, 2010

Really, didn’t mean to. Did you see the movie with Bob Hope  the other night on saying the truth for one day?

Its just I’m doing a little math everyday now until our test. So – Maybe a little math.

These math problems are on the volume of diluent and the flow rate for the infusion. (round mL to tenth if over 1)

1. An IV of an antibiotic of 750 mg in 3 mL was ordered by the doctor to be diluted to a total of 25 mL of NS to infuse over 40 minutes.
What is the volume of diluent  __________ mL
What is the flow rate ___________ mL/hr
2. 1.5 grams/2mL of an antibiotic is to be diluted to a total of 40 mL of NS and administered over 40 minutes.
What is the volume of diluent  __________ mL
What is the flow rate ___________ mL/hr
3. Over 35 minutes, a dosage of 20 mg in 2 mL has been ordered and must be diluted to 30 mL.
What is the volume of diluent  __________ mL
What is the flow rate ___________ mL/hr
4. 500,000 U of an antibiotic preparation with a volume of 4 mL is ordered by the doctor. It must be diluted to 50 ML D5 ½ NS to infuse in 1 hr.
What is the volume of diluent  __________ mL
What is the flow rate ___________ mL/hr
5. 200 mg in 4 mL is to be diluted to 50 mL and administered over 70 minutes.
What is the volume of diluent  __________ mL
What is the flow rate ___________ mL/hr
6. A dosage of 25 mg in 5 mL is ordered diluted to 40 mL and needs to be administered in 50 min.
What is the volume of diluent  __________ mL
What is the flow rate ___________ mL/hr

Answers

Posted in Day-to-Day, Math | Comments Off on Okay, I lied.

Last 2 weeks of summer

Posted by Laura on August 11, 2010

I have this week and next before we start with classes again, so I have been taking a break from posting. Back in few!

Posted in Day-to-Day | Comments Off on Last 2 weeks of summer

Orientation

Posted by Laura on August 3, 2010

I’m helping with student orientation for incoming nursing students this week and was thinking about what I would say to help them know what is expected during their 1st semester.

Thinking back, I believe I thought it was to be perfect at everything I was taught and to know everything I read and was lectured to me, within a timed reference and with critical eyes watching my every move. Pretty high expectations. Most student nurses probably already have high expectations of themselves and when they don’t meet those levels, become very anxious and stressed.

I realized now, after it is all said and done, what was expected in 1st semester is to have a general overall idea of some of the basic understandings of nursing and how all the pieces will eventually fit together. It is to gain confidence, knowledge, passing grades and maybe some charting abilities.

When we are taught to place a Foley in check-offs, we are not expected then to complete this task by ourselves on the clinical floor without an instructor. They will be there guiding us with the first real person.

So, a few things I thought of – hopefully relieve some of the stress are:

For Check-offs:

  • See one (have your instructor show you, or you may learn wrong)
  • Show one (to your instructor in case you leave out a step)
  • Teach one (to your study-buddy and have them teach you)

For Math tests:

  • Relax!
  • One week prior to math exam, do some math problems every day prior to test.

For Patients:

  • Treat them as you would your father, mother, child, sister or brother and you will get along fine with them. You will respect them and won’t hurt them.

For You:

  • Stay healthy
  • Walk
  • Talk, Talk, and talk some more. Your instructors, your peers, your family. Talk it all out. Don’t hold back. Getting rid of anxiety, stress and questions will clear your mind for all the new things you need to learn.
  • Understand who you are. What do you do when you procrastinate? What are your highest priorities?

What most 1st semester students have said is “I don’t know where to start, what is the right way to study, am I studying the right things?”

My answer:  A D P I E

  • Assess: what do you need to know for school this week (break it down), for Family, for work?
  • Diagnose: What is the highest priority? What is your goal? Then stay with it.
  • Plan: Make a schedule and stick to it. Having a plan will keep you on tract.
  • Interventions: Read before lecture (done), Take notes during class – make up questions as teacher lectures (done) Review notes after lecture and write up outlines, tests, flash cards – whatever works for you to study for your exam. If something was gone over in lecture you didn’t understand, look it up! Ask your teacher.
  • Evaluate: did you pass your exam? If not change your plan / Get help / Don’t wait!

Think of it like this. If you can tell your patient isn’t breathing and you found if you give him oxygen and his O2 saturation goes up to 95% and they are breathing…. Then this is good. A good plan. If they fail to continue to breathe, well….then you need to change the plan. It isn’t working and you can’t wait to see if it will work later. Attack your school work the same. Make it work and work at it.

Posted in Day-to-Day | Comments Off on Orientation