Do these quickly!

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.

Flash Cards Made Simple

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!

Psych Sites

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!

Anxiety Levels

for .pdf click here

Some images worth reviewing

Tulane University School of Medicine http://tulane.edu/som/index.cfm

Pericarditis – here you can see and imagine the pain a person would have. S/S of Pericarditis: pain, pericardial friction rub, pain aggravated by breathing, Dyspnea, Fever (it looks hot!), Decreased cardiac output (you wouldn’t want it to move!) Treatment: Antibiotics  Diagnosis: see below  Leads to:  See the pericardial effusion

Echocardiogram to confirm pericarditis or pericardial effusion

Myxoma  – what does “oma” mean?      not “coma” so …. “oma” means it is benign, this is more a cancer item, but I had to throw it in. Luckily this can be removed. Benign.

Rheumatic Mitral Valve            – when you see the obstruction of the blood flow here due to the thickening or inflammation, you can see how rhematic endocarditis can cause Mitral Stenosis.                   

Ventricular Hypertrophy  – caused by increased work of the left ventricle – increased afterload (resistance) will make the heart over work.

Infective Endocarditis – s/s: malaise, wT loss, cough, back and joint pain w/fever. Leads to deformity of the leaflets. Treatment: Antibiotics – prophylaxis (esp before dental procedures). Leads to: CHF, CVA

Aortic Valve: destructive endocarditis caused by staph aureus, with abscess cavity under the pulmonary artery (aortic valve removed)
(RCA – right coronary artery, LCA – left coronary artery, MV – mitral valve) 

http://my.clevelandclinic.org/heart/disorders/valve/sbesurgerypics.aspx

Valve Disease Chart

Reading for RNs

Yesterday we were fortunate to have Linda Secretan from the Reading Department ( #2197) in the Learning Center speak to us about time-saving and comprehension tips in our text reading. There is so much to read, and for some of the material we need to scan through, she gave us some good tools to use. 

1.  Pay Attention (don’t let you mind wander) 

2. Pre-Read (know the glossary, the back critical thinking Qs, the headings, charts) 

3. Put headers into questions (Biorhythmicity – changes to What is Biorhythmicity and why is it important?) 

4. When you read, use your hand and don’t go back over what you have already read. 

5. Don’t vocalize the words in your head. 

6. Read for 20 min at a time, take 5, then back at it. (take notes of the important things you think the teacher wants you to know in question form) 

7. Speed reading should be 400-500 words a minute. 

Linda was great.

Speech is at 250 words a minute and if you say the words in your head when you are reading- then you are reading at the same speed of speech. Interesting.

She said this type of speed reading (with no words in your head, only eye to brain) will be a little uncomfortable at first, but it will speed up our reading and Comprehension. I’m all for that!

Here is the Learning Center Workshop Schedule for Intersession 2010

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….

Blood Transfusions

We need to know something about blood transfusions for the HESI. I found this quick quiz to give a little info. Think it might help.

http://www.cetl.org.uk/learning/Blood-transfusion-quiz/quizmaker.html

PN Math Problems from Lecture

Calculate Total Calories in One Day 

TPN mixture:

 40% dextrose 500 mL added to 8.25% Aminosyn 500 mL running at 100 mL per hour.

Click for Answer

 PPN mixture:

10% dextrose 500 mL added to 8.25% Aminosyn 500 mL running at 45 mL per hour

Click for Answer

 TPN mixture:

50% dextrose 500 mL added to 8.25% Aminosyn 500 mL running at 85 mL per hour, plus 500 mL of Lipsyn 20% to be run over 20 hours each day

Click for Answer

not sure on this last one – verifying with Harmon 🙂

Harmon says correct. Hmmmm.

Patient’s Lab Tests

When looking at my paitents Lab Works, I decided I wanted a little reference/exercise for what each lab test was for.

This is some of what I have come up with.

Test	Definition
Auto Diff	looks at the types of white blood cells present. There are five different types of white blood cells, each with its own function in protecting us from infection. The differential classifies a person’s white blood cells into each type: neutrophils (also known as segs, PMNs, granulocytes, grans), lymphocytes, monocytes, eosinophils, and basophils.
BUN	The BUN test is primarily used, along with the creatinine test, to evaluate kidney function in a wide range of circumstances, to help diagnose kidney disease, and to monitor patients with acute or chronic kidney dysfunction or failure. It also may be used to evaluate a person’s general health status when ordered as part of a basic metabolic panel (BMP) or comprehensive metabolic panel (CMP).
Calcium	involved in bone metabolism, protein absorption, fat transfer muscular contraction, transmission of nerve impulses, blood clotting and cardiac function. Regulated by parathyroid.
Carbon Dioxide	The CO2 level is related to the respiratory exchange of carbon dioxide in the lungs and is part of the bodies buffering system. Generally when used with the other electrolytes, it is a good indicator of acidosis and alkalinity.
Chloride, serum	Elevated levels are related to acidosis as well as too much water crossing the cell membrane. Decreased levels with decreased serum albumin may indicate water deficiency crossing the cell membrane (edema).
Creatinine	The creatinine blood test is used along with a BUN (blood urea nitrogen) test to assess kidney function. Both are frequently ordered as part of a basic or comprehensive metabolic panel (BMP or CMP), groups of tests that are performed to evaluate the function of the body’s major organs. This test is also known as: Creat, Blood creatinine, Serum Creatinine, Urine creatinine
Glucose	The blood glucose test is ordered to measure the amount of glucose in the blood right at the time of sample collection. It is used to detect both hyperglycemia and hypoglycemia, to help diagnose diabetes, and to monitor glucose levels in persons with diabetes
HCT	measures the percentage of red blood cells in a given volume of whole blood.
HGB	measures the amount of oxygen-carrying protein in the blood.
MCH	is a calculation of the average amount of oxygen-carrying hemoglobin inside a red blood cell. Macrocytic RBCs are large so tend to have a higher MCH, while microcytic red cells would have a lower value.
MCHC	is a calculation of the average concentration of hemoglobin inside a red cell. Decreased MCHC values (hypochromia) are seen in conditions where the hemoglobin is abnormally diluted inside the red cells, such as in iron deficiency anemia and in thalassemia. Increased MCHC values (hyperchromia) are seen in conditions where the hemoglobin is abnormally concentrated inside the red cells, such as in burn patients and hereditary spherocytosis, a relatively rare congenital disorder.
MCV	is a measurement of the average size of your RBCs. The MCV is elevated when your RBCs are larger than normal (macrocytic), for example in anemia caused by vitamin B12 deficiency. When the MCV is decreased, your RBCs are smaller than normal (microcytic) as is seen in iron deficiency anemia or thalassemias.
MPV	is a machine-calculated measurement of the average size of your platelets. New platelets are larger, and an increased MPV occurs when increased numbers of platelets are being produced. MPV gives your doctor information about platelet production in your bone marrow.
Platelet count	is the number of platelets in a given volume of blood. Both increases and decreases can point to abnormal conditions of excess bleeding or clotting.
Potassium	is the major intracellular cation. Very low value: Cardiac arrhythmia.
RBC	is a count of the actual number of red blood cells per volume of blood. Both increases and decreases can point to abnormal conditions.
RDW	a calculation of the variation in the size of your RBCs. In some anemias, such as pernicious anemia, the amount of variation (anisocytosis) in RBC size (along with variation in shape – poikilocytosis) causes an increase in the RDW
Sodium	is the most abundant cation in the blood and its chief base. It functions in the body to maintain osmotic pressure, acid-base balance and to transmit nerve impulses. Very Low value: seizure and Neurologic Sx.
WBC count	is a count of the actual number of white blood cells per volume of blood. Both increases and decreases can be significant.

Laboratory – Chemistry

BASIC METABOLIC

• SODIUM, serum
  • Normal Adult Range: 135-145 mmol/L
    Optimal Adult Reading: 140.5
• POTASSIUM, serum
  • Normal Range: 3.5 – 5.0 mmol/L
    Optimal Adult Reading: 4.5
• CHLORIDE, serum
  • Normal Adult Range: 101-111 mmol/L
  • Optimal Adult Reading: 103
• Carbon Dioxide (CO2)  
  • Normal Adult Range: 20-29 mEq/L 
• Glucose
  • Normal Adult Range: 70-110 mg/dl
• BUN (Blood Urea Nitrogen)
  • Normal Adult Range: 6-20 mg/dl
• Creatinine, serum
  • Normal Adult Range: 0.5-1.2 mg/dl
• CALCIUM, serum
  • Normal Adult Range: 8.5-10.5 mg/dl
    Optimal Adult Reading: 9.4

Laboratory – Hematology

CBC w/Auto DIFF

CBC

• WBC Count (White Blood Cell Count)
  • Normal x Range: 4.8 -10.0 x1000/ul
  • Higher ranges are found in children, newborns and infants.
• RBC Count (Red Blood Cell Count)
  • Normal Adult Female Range: 3.9 – 5.2 mill/mcl
    Optimal Adult Female Reading: 4.55
    Normal Adult Male Range: 4.2 – 5.6 mill/mcl
    Optimal Adult Male Reading: 4.9
    Lower ranges are found in Children, newborns and infants
• HEMOGLOBIN (HGB)
  • Normal Adult Female Range: 12 – 16 g/dl
    Optimal Adult Female Reading: 14 g/dl
    Normal Adult Male Range: 14 – 18 g/dl
    Optimal Adult Male Reading: 16 g/dl
    Normal Newborn Range: 14 – 20 g/dl
    Optimal Newborn Reading: 17 g/dl
• HEMATOCRIT (HCT)
  • Normal Adult Female Range: 38 – 46%
    Optimal Adult Female Reading: 42%
    Normal Adult Male Range 42 – 54%
    Optimal Adult Male Reading: 47
    Normal Newborn Range: 50 – 62%
    Optimal Newborn Reading: 56
• MCV (Mean Corpuscular Volume)
  • Normal Adult Range: 80 – 100 fl
    Optimal Adult Reading: 90
    Higher ranges are found in newborns and infants
• MCH (Mean Corpuscular Hemoglobin) 
  • Normal Adult Range: 27 – 33 pg
    Optimal Adult Reading: 30
• MCHC (Mean Corpuscular Hemoglobin Concentration)
  • Normal Adult Range: 32 – 36 %
    Optimal Adult Reading: 34
    Higher ranges are found in newborns and infants
• RDW (Red Blood Cell Distribution Width)      
  • Normal Adult Range: 11.5-14.5%
• PLATELET COUNT  
  • Normal Adult Range: 130 – 400 thous/mcl
    Optimal Adult Reading: 265
    Higher ranges are found in children, newborns and infants
• MPV (Mean Platelet Volume)
  • Normal Adult Range: 7.4-10.4 fl

 

AUTO DIFF

• NEUTROPHILS and NEUTROPHIL COUNT  – this is the main defender of the body against infection and antigens. High levels may indicate an active infection.
  • Normal Adult Range: 48 – 73 %
    Optimal Adult Reading: 60.5
    Normal Children’s Range: 30 – 60 %
    Optimal Children’s Reading: 45

• LYMPHOCYTES and LYMPHOCYTE COUNT – Elevated levels may indicate an active viral infections such as measles, rubella, chickenpox, or infectious mononucleosis.
  • Normal Adult Range: 18 – 48 %
    Optimal Adult Reading: 33
    Normal Children’s Range: 25 – 50 %
    Optimal Children’s Reading: 37.5

• MONOCYTES and MONOCYTE COUNT – Elevated levels are seen in tissue breakdown or chronic infections, carcinomas, leukemia (monocytic) or lymphomas.
  • Normal Adult Range: 0 – 9 %
    Optimal Adult Reading: 4.5

• EOSINOPHILS and EOSINOPHIL COUNT  – Elevated levels may indicate an allergic reactions or parasites.
  • Normal Adult Range: 0 – 5 %
    Optimal Adult Reading: 2.5

• BASOPHILS and BASOPHIL COUNT – Basophilic activity is not fully understood but it is known to carry histamine, heparin and serotonin. High levels are found in allergic reactions.
  • Normal Adult Range: 0 – 2 %
    Optimal Adult Reading: 1

Lab Days Left

November 18 Wednesday     1 – 6 pm

November 21 Saturday     9 am – 1 pm

December 2 Wednesday 1 pm – 6 pm

December 5 Saturday 9 am – 1 pm

Pain – Acute/Chronic

Difference between Acute and Chronic Pain
Type	Acute Pain	Chronic Pain
Definition	Generally rapid in onset, varies in intensity from mild to severeProtective in nature	Pain that may be limited, intermittent, or persistent but lasts beyond the normal healing period
Length	< 6 months	> 3-6 months or longer +++
Intensity	Usually Sharp, may radiate	Poorly localized, dull, aching
Intensity	Mild to severeSubsides as healing takes place	Mild to severe
ANS response?	present	may be absent
Patient expectations	Relief of pain	Reduce pain, but expects continuation
Subdivided	no	Malignant / Nonmalignant

Student Nurse Flo

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B2 Receptor theory bronchodilation

Nursing Hairstyles

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How does one find the right hairstyle?

Never have figured it out, but now it has to be “off the collar”, and “out of the face”.

 Style and color should be fashioned to promote safety and professionalism. (Luckily the facial hair isn’t a concern yet.)

I’ve searched and find various styles – maybe not quite right. Any suggestions?

Begining Dosage Calculations

Simple Conversions – sets me up for Dosage Calculations.

Put your unknown on top, what we want below. Then place all our conversion factors on the other side of the equal sign, and solve for X.

Question – Dr wants you to give Drug X gr 1/400 sublingual  PRN chest pain.  You have a bottle labeled 0.15 mg per tablet. How many tablets will you give?

1st put the unknown on top as   X  tab, then as its denominator, put what we want (what the doctor ordered).

X tab

______

gr 1/400

Now start the conversion factors on the other side of the equal sign. We have a  bottle labeled 0.15 mg per tablet, or  0.15/1 tab. Make sure to place this on the opposite side of the equal sign with same units in same positions. In this case we have tablets. Should look like this.

X tab              1 tab

____          =    ______

gr 1/400       0.15 mg

Now tabs are same, but we need a conversion factor to get our mgs to equal grs. We know 60mg = 1 gr     Now we will add this conversion factor to the right side. Making sure to place units opposite this time!

X tab              1 tab        60 mg

____          =    ______ x  ______             

gr 1/400       0.15 mg     1 gr

Solving – We start off by working the right of the equation. Cross cancel what you can to simplify. We can cancel out the mg and we can put 0.15 into 0.15 once and into 60, 400 times.

X tab              1 tab        60⁴⁰⁰ mg

____          =    ______ x  ______

gr 1/400       0.15¹ mg     1 gr

Multiply right side, should look like this:

X tab              400 tab        

____          =    ______

gr 1/400       1 gr

Now we solve for X by cross-multiplying.

1X = 1/400(400)    or X  = 400/400  or x = 1

Our answer =         1 tablet

Simple Conversions

This is how I have set up my calculations.

Starting with conversions. Using a simple one we all know the answer to, I will set up my formula.

Question 1.      2000 mL = ____ L

First put what we want to know on the top of the equivalent line, or in the place of the numerator. We are going to use the algebraic X for the unknown.                X L

Then, for the denominator we put what we have. 2000 mL. So our equation will now look like this.

X  L

_______ =

2000 mL

Next we put all our equivalents on the other side of the equal sign. So we know 1 L = 1000 mL. When we put our equivalent or conversion factor up, make sure the same units are on the numerator or denominator side. Now the equation will look like this:

X  L                       1  L

_______ =     _________

2000 mL              1000 mL

When you have a ratio like this, you must cross multiply to get your answer. Starting with the top left you will get :

X  times 1000  = 2000 (1)          then,        1000 X  = 2000       then,    X = 2000/1000   then,    X = 2

or X = 2 Liter

This is the same way I set up my dosage calculations. Putting the question on the left of the equation, and then conversions on the right. Remember the first conversion or equivalent must line up with the left side’s units. All conversion factors after (on the left of the equation will have units opposite). On the right of the equation we will multiply straight across. Then we will cross multiply with the left side to solve for X.

So, a little harder conversion.

Question 2:    2 qt = _________  mL

X  mL               2 pt          500 mL

_____       =     ______    x    _____

2 qt                 1 qt           1 pt

Above we have the unknown in our 1st spot. Our known quantity (what we have) below it. Next on the opposite of the equal side (or our conversion side) we put our conversions to get there. We know 2 pints equal one quart. So we place this so the units are on same side. As we do this we see only one unit is the same – the quarts. We place it on the bottom and the unmatched one on top. Since we know we need to match up to mls, we find the equivalent for pts to mls.

Now any extra conversions on the right of our equation must have equal units opposite. This is different than the first fraction, and if I am going to mess up – this is it.

So we placed the 500 ml above 1 pt.

Now we solve for X.   Starting with the problem on the right of the equal sign. Here we cross out any equal units. So I would cancel the pt ‘s. Multiply straight across to get 1000 mL above 1 qt.

X  mL           2 pt 500 mL

_____      =    _____ x   ______

2 qt               1 qt         1 pt

X  mL             1000 mL

_____ =     _______

2 qt                    1 qt

Now that we have just one fraction on either side, with like units, we can cross-multiply to solve for X.

1 X  = 2 (1000)     or,       X = 2 (1000)     or,   X = 2000

So our answer is 2000 mL

Equivalents, Weights and Measures

Let’s see. 1 meow = 1 pat, 1 leg rub = 2 treat

Equivalents and Measurements – Test 2nd Week

 

My Nursing Assistants

       

Syllabus

I think I need to add to my list “get new ink for printer!”

The Syllabus is so long! I have added the following downloads to my resource pages.

Resource Manual PDF

NS 111 Fluid and Electrolytes Fall 2009 student version PDF

NS 110 Syllabus

Documentation Student Version Mod4.pdf

Self-care Theory Student Version Mod2.pdf

NS 111 Syllabus

These are only linked here as a reference to be referred to during my ADN program.

* No reproduction can be reproduced without the AVC nursing faculties permission.