Student Nurse Laura

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

Archive for September, 2010

Geriatric Nursing Resources

Posted by Laura on September 27, 2010

From Hartford Institute for Geriatric Nursing – a good site with lots of information. The list below has videos. They take a little while to load, but some of them are interesting.

Dementia Series

Focused on tools and strategies in the assessment of older adults with dementia.

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Difference between Postural and Orthostatic Hypotension

Posted by Laura on September 27, 2010

My understanding is when a patient has orthostatic hypotension they have a fall in blood pressure occurring when they stand up quickly after lying or sitting down. This is due to a temporary shortage of blood to the brain. The decrease in required blood, causes dizziness. 

When you have postural hypotension, it has a similar end effect on the brain – loss of blood and dizziness, but the cause is a little different. The cause is usally from blood pooling in dilated blood vessels, such as in an athlete after a good work out. Because the blood is pooling into these dilated/warm blood vessels as a person is just standing there, there is little blood returning to the heart. If they sit, it helps the blood perfusion back to the heart and therefore to the brain.

Orthostatic Hypotension is a side effect from Psychotropic drugs such as anitpsychotics: Phenothizaines

According to Tabers a way to determine orthostatic hypotension is by taking the BP:

“The measurement of blood pressure and pulse rate first in the supine, then in the sitting, and finally in the standing position. A significant change in both of these vital signs signifies hypovolemia or dehydration. A positive test result occurs if the patient becomes dizzy or loses consciousness; or if the pulse increases by 20 or more beats per minute and the systolic blood pressure drops by 20 mm Hg within 3 min of arising from supine to sitting position or from sitting to standing position.”

♥ ↑ 20+, or ↓ Sys BP 20+ w/in 3 min

Posted in Concepts, Day-to-Day, NS 232 - Psych, Ger, CH, Semester III | 1 Comment »

Week 7 Reading

Posted by Laura on September 26, 2010

Week 7 Reading 230&232

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Dementia vs Delirium

Posted by Laura on September 25, 2010

We have been studying about Dementia and Delirium.The difference of acuteness or chronic. So it was interesting to read AJN’s article from Off the Charts called No Country for Old Women.

In this article the author shares a personal experience with her mother who has dementia, but turns into a suspected bi-polar personality. The author who sees this isn’t her mother’s norm, rightly questions the extremely hard situation and treatment from various doctors. This critical eye of knowing how there must be something else going on, proves to be the case.

To me, it restated the idea that people – all people, can have situations which are different than their chronic diagnosis. Various disease processes can cover up new, acute situations. Even with personalities.

As nurses, we need to always think about what is the main focus. In this particular situation it was the delirium. Delirium can be the symptom to many things – and not just the “Shes getting older” ideation.

Good timely article.

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Geriatric & Aging Exercise

Posted by Laura on September 24, 2010

This slideshow requires JavaScript.

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My Clinical Group NS232

Posted by Laura on September 24, 2010

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Statutory and Common Law

Posted by Laura on September 23, 2010

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Glaucoma

Posted by Laura on September 20, 2010

Image found at:  http://www.medrounds.org/glaucoma-guide/2006/06/section-4-d-angle-closure-glaucoma.html

More on Glaucoma at on-line Merck Manual

Posted in Day-to-Day, NS 232 - Psych, Ger, CH, Semester III | Comments Off on Glaucoma

Module 7 Drugs

Posted by Laura on September 20, 2010

These Drug cards have information from Davis Drug Guide.

Disclaimer – this is only as a reference tool for my use while in nursing school. Any use of these otherwise (to get an A on your test – etc.), should be done so at your own risk. Please let me know if you see any update needed : )

drug cards mod 7 4×6  as .pdf

Mod 7 drugs in table

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Caffeine Drug Card

Posted by Laura on September 20, 2010

caffine drug card

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Psych cards updated

Posted by Laura on September 20, 2010

psychotropic drug cards 102910

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Week 6 Reading

Posted by Laura on September 19, 2010

Week 6 Reading 230&232

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Dystonia vs Dyskinesia

Posted by Laura on September 17, 2010

Our class in Psych requires you to know the difference between Dystonia and Dyskinesia. Sure – everyone studies transference vs countertransference, neurosis vs psychosis, empathy vs sympathy… but this one is hard.

click on image to go to Dystonia Association of Kentucky

Medline Plus says “Dystonia is a movement disorder which causes involuntary contractions of your muscles. These contractions result in twisting and repetitive movements. Sometimes they are painful.

Dystonia can affect just one muscle, a group of muscles or all of your muscles. Symptoms can include tremors, voice problems or a dragging foot. Symptoms often start in childhood. They can also start in the late teens or early adulthood. Some cases worsen over time. Others are mild.”

I liked this reference next at Medical News Today:

“TERMINOLOGY

There are two major classifications of movement disorders, dystonias and dyskinesias. There are also two time frames used to classify the onset of symptoms. Dystonias are spasms of individual muscles or groups of muscles. They can be sustained or intermittent, sudden or slow, painful or painless. They can affect any of the body’s voluntary muscles including those of the vocal cords. The movements of dystonias can appear very bizarre and deliberate but are involuntary.

Dyskinesias are involuntary, often hyperkinetic movements of various types that have no purpose and are not fully controllable by the patient. Some are random, some rhythmic, most are very odd looking and socially stigmatizing.

They can affect the ability to initiate or stop a movement as in Parkinson’s. They can affect the smooth movement of a joint resulting in a jerky articulation. Abrupt and seemingly violent movements of a limb are common as are gyrations of any body part. Tics and involuntary vocalizations are related to dyskinesias.”

Tardive means “characterized by lateness,  esp. pert. to a disease in which the characteristic sign or symptoms appear late in the course of the disease” (Tabers).

So even though both processes includes the unusual movements, dytonia is often recognized as slow and is involuntary where there is no pt control. Dykinesia is a later process of dystonia(?? still not too certain here), but is a more often a  ‘rapid’ movement and is sometimes controllable by the patient, yet still involuntary. When you have Tardive before either process, it means it is the late onset of.

more:

The word dyskinesia (dis-ki-ne´ze-a) is logically derived from two Greek roots: dys-, trouble + kinesis, movement = trouble moving.

dystonia is from dys- + -tonia from Greek tonos tension, from teinen to stretch = trouble tension/stretch

So do they both include the tongue? yes.

Here is a good site American Association of Neurological Surgeons

It shows dystonia, dykinesia, parkinsons, ataxia, myoclonus, tourette syndrome….. There are links also to many organizations for resource information.

Bachmann-Strauss Dystonia & Parkinson Foundation
Huntington’s Disease Society of America
International Rett Syndrome Foundation
Michael J. Fox Foundation for Parkinson’s Research
National Multiple Sclerosis Society
National Parkinson Foundation
Tardive Dyskinesia
Tourette Syndrome Association, Inc
Tourette Syndrome Online

Posted in Day-to-Day, NS 232 - Psych, Ger, CH, Semester III | Tagged: , , , , | 3 Comments »

S & S booklet

Posted by Laura on September 17, 2010

I’m going to update the little S&S booklet with Hypertensive Crisis and Agranulocytosis.

I had printed mine on paper, but a friend did hers on card stock which made it a better product.

If you did one and want to send a picture – I’ll post it here!

So look for an update.  –

Finally Updated ! 100310

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Week 5 Reading

Posted by Laura on September 12, 2010

Reading Card for Week 5

in Psych and Proff III

8 x 5 pdf   updated 092010 Week 5 Reading 230&232

Posted in Reading Schedule 232, Semester III | 1 Comment »

Signs & Symptoms

Posted by Laura on September 10, 2010

click here for a pdf of 4 pages (8×5)   – updated 10/03/10

If you get creative, you can use spray adhesive and create a small booklet to stick in your pocket for reference or studying.

Posted in Day-to-Day, NS 232 - Psych, Ger, CH, Semester III | Tagged: , , , , , , , , , , , | Comments Off on Signs & Symptoms

Family Support

Posted by Laura on September 9, 2010

That family support structure during nursing school can be so important. It doesn’t have to be family, but when it comes from someone you love and admire, it makes a lot of difference.

My husband always makes me feel better when I critique my short comings. He doesn’t need to, he just does. And for him, he relates so much of my learning to learning to fly airplanes ( he was in the airforce for over 26 years). When I say, I felt slow for not knowing what the next step was or why the light bulb didn’t come on, he tells me some story about how the pilots will be all ready to go on their flight only to sit for an hour playing with the radar because they were sure it wasn’t working. Then, after calling maintenance who gets there and just turns up the brightness, they realize they should have tried that.

According to him, when you are stressed in a new situation, you will rely on previous habit patterns to get you through. If your experience is limited, you won’t have much to pull from and get stuck. Him relating it to a position that has such critical skills and instruction makes me realize, I will do better next time.

Have you read From Novice to Expert yet? Same thing in there. They find the experienced nurses are the ones who can pull the critical thinking and really make the difference. But it takes experience to get there. Some of us have it, the rest of us will get there.

I also liked watching the NASCAR race with him one night and the reporter asked the driver how he felt before the race. “Butterflies!” he said. Well, if he has butterflies after years of racing around a high speed track, I guess I can have butterflies before going to clinical too.

Sometimes your loved ones are just the thing to help. : )

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Antipsychotics

Posted by Laura on September 7, 2010

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antidepressants

Posted by Laura on September 7, 2010

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Antianxiety

Posted by Laura on September 7, 2010

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