Showing posts with label Resources. Show all posts
Showing posts with label Resources. Show all posts
Monday, October 13, 2014
Saturday, October 5, 2013
Guide To Clinical Paperwork
Clinical
Here's An Example Of A Patho That Passed
copyright Janice Silbermann :)
Diabetes
Mellitus
Disease
of deficiency or resistance to the effects of insulin. Cells use insulin for
energy needs. Insulin also promotes fatty acid storage in the adipose tissues.
Type 1 diabetes is an absolute deficiency in insulin and type 2, which has a
later onset and is related to diet and life-style choices, is insulin resistance.
Diabetes
has a hereditary component in both types and along with obesity is a risk
factor. High cholesterol, triglycerides and high BP also constitute risk
factors
Diabetes
puts a patient at risk of multisystem complications including peripheral
vascular disease, heart disease and renal disease
Hyperglycemic
symptoms include polyuria, polydipsia, weight loss, fatigue, weakness and
frequent skin complications such as infections
Tests
include fasting plasma glucose levels. A reading of > 126 mg/dL is
considered high. Random blood glucose testing may reveal a level of >200
mg/dl. Oral dextrose (75g) is given in the third test and a BG level is
obtained 2 hours later. A reading of >200mg/dL is indicative of DM.
Treatment
includes changes in diet and exercise. Type 1 requires insulin replacement as
the body is not manufacturing insulin. Type 2 may be treated with oral
anti-diabetic drugs which will stimulate the body to produce insulin or increase
sensitivity at the cellular level. Injected insulin may also be used in Type 2.
Dietary measures include a consistent carbohydrate diet, which is calorie controlled
to maintain optimal weight. The diet is carefully calculated to keep BG levels
in optimal range.
Insulin
can be characterized by its rate of onset, peak and duration. Rapid (lispro),
for example has an onset of fewer than 15 minutes, while Lente has an onset of
1-3 hours, but lasts 18-24 hours in contrast with Lispo’s 3-4 hours duration.
LeMone, P., K.
Burke, and G. Bauldoff. Medical-surgical
nursing: Critical thinking in patient care. Fifth. Upper Saddle River, NJ:
Pearson Education,Inc., 2011. Print.
Here's An Example Of A Physical Assessment That Passed
Neurological: Not oriented to person, place and
time. Unresponsive to verbal commands. Withdraws from stimuli. Pupils equal,
round, reactive to light. Sluggish pupil response, 6cm bilaterally,
accommodation present. Unable to assess hand grips. Bilateral ankle
dorsificaton and plantar flexion, equal, weak.
Pulmonary: Trach present. control assist
ventilator, Vent Settings: Mode: assist
control FiO2:40% Rate:14
TV:420mL Vmax:50L/min Respiratory rate between 17-26 during 8 hour
shift. Tachypnea. Breathing labored and shallow, bilateral, equal use of
accessory muscles, no retractions. Chest rise equal bilaterally. Rhonchi
present upper left, upper right, lower left and lower right lobes. No cough.
Moderate
secretions, thick, blood-tinged.
Cardiac: Apical pulse 0800 -108bpm,
1000-119bpm, 1200-107bpm,1400-96, strong, regular. S1 and S2 present. No
murmurs heard. Sinus tachycardia. HR between 97-140 during 8 hour shift.
BP:
0800-141/74 1000-134/61 1200-101/42 1400-11/48-automatic cuff, left arm, taken
supine.
Radial
pulses, equal 3+ bilaterally. Doralis pedis pulses equal, 3+ bilaterally, tibial
pulses equal 3+ bilaterally. Cap refill right hand <3sec, left hand <3
sec, right foot <3 sec, left foot < 3sec.
Pitting edema
4+- bilateral hands, feet, thighs, ankles. Pitting edema 1+ above knee. Pitting
edema 1+ above elbow. Facial edema present.
No JVD
present.
GI/GU: Abdomen soft, round. Bowel sounds
heard immediately in all four quadrants. No rebound tenderness or masses. Bowel
movement 0930 1-28-13, soft, formed, brown, no foul odor. zero residual in
g-tube. Auscultation shows correct placement.
Urine clear,
dark yellow. Foley catheter. Tube feeding with Nova Source Renal 30 mL/hour.
NPO.
Musculoskeletal: Passive ROM in all extremities, unable
to move spontaneously. Unable to assess neck range of motion due to edema and
presence of trach collar. Gait and posture unable to assessed-non-ambulatory.
Integumentary: skin color normal for ethnicity. Skin warm and clammy on palpation. MM moist, pink. Not
tenting in upper extremities. Lower extremities edematous, skin tight and
shiny. Nail color pink. No clubbing observed. PICC line present right
antecubital. Dressing dry and intact, no drainage, no bleeding.
Large area of
reddened, denuded, sloughing skin both buttocks, both things, sacral area,
moist.
Tuesday, August 6, 2013
Let's Get HESI Specific
HESI/NCLEX
Studying/Testing
Resources
Study Guides
HESI questions are on a higher level than practice book questions and it helps to do questions that are HESI-specific. The NCLEX is really on the HESI level and not the Saunder's practice book level.
You have a HESI after each class and they really are a good gauge of how well you know the material and a good predictor of NCLEX readiness.
The conceptual framework used to develop HESI exams is grounded in classical test theory and critical thinking theory. The creation, administration, and interpretation of tests are accomplished through educational and psychological measurement processes.
Specialty exams are designed to measure the student's ability to apply concepts related to specific clinical nursing content areas. Typically, specialty exams consist of 50 test items. Test blueprints for these exams are developed by HESI nurse educators whose clinical practice area is congruent with the exam being developed. Test items that measure nursing knowledge and competencies within the specific clinical specialty area are selected from the HESI database.
(http://www.medscape.com/viewarticle/484343_2)
You will be taking the following HESIs:
- Dosages
- Fundamentals
- Adult Health
- Maternity
- Peds
- Psychiatry
- Management
- EXIT HESI- maybe more than once
Remember the HESI counts for 5% of your grade, and that can sometimes make the difference between passing and failing. But that being said, there is really no way to study for the end-of-class HESIs, you're supposed to know the content by then.
The grade is based on that conversion score.
The grade is based on that conversion score.
(yeah, yeah I AM proud of that one)
It can get nerve-racking to have test #3, the final and the HESI all in the same week, but you will survive.
Typical tests are 50 questions long and the questions are weighted. Don't spend too much time on any one question, the next one may be worth more.
You need above an 850 on the course HESIs and a 950 on the exit HESI.
If you do not obtain these scores, you will be sent to remediation. The Evolve site tailors remediation to your specific weaknesses and provides materials that can help you review.
It really helped me before the NCLEX to know that I needed help in basic procedures, especially the order in which things are done because there are drag-and-drop questions on the NCLEX that would have proved difficult for me otherwise.
When I click that 'View Materials' tab, here is a sampling of what is available to me. There are more practice questions available here.
You also print out a PDF file which gives you some useful information if you take time to wade through all 26 pages of it...
Evolve is obviously the main source for HESI practice:
Evolve has a video about the HESI:
There is also an Evolve Facebook page that has NCLEX practice quesitons
They also have a mobile app:
And this is available on iTunes:
I liked this site with free practice exams and the option to sign up for more if you pay
The Exit HESI
There are four versions of the exit HESI and you are given many opportunities to test if you do not pass the first time. In fact, it was only a handful of my class that passed the first time. Do not despair. This is at least the third time I am saying in this blog to worry about passing the final and THEN worry about the HESI. You will pass the exit HESI at some point. It's nice to pass the first time because you are eligible to sit the NCLEX earlier and hence have a license earlier which helps with the job search and signing up for classes should you pursue a BSN. But even people who had to take it two or three times had their licenses within a reasonable time frame.
If you do not pass the first time, remember there is a HESI/NCLEX prep course provided by the school which is extremely helpful (but extremely boring). You are given a prep book as part of the course. I used that and one other HESI-specific book to prepare for the second sitting and it was sufficient. With a week of studying, I managed to raise my score 272 points.
The exit exam is a 150-item comprehensive exam that is designed for administration near the completion of the curriculum to measure student preparedness for the NCLEX-RN . It is used to identify the strengths and weaknesses of the students and the possible need for remediation prior to taking the licensure exam
SW IS GOING TO MAKE DARN SURE THEY KEEP THEIR
NCLEX PASS RATE
Sunday, August 4, 2013
Lets Talk Textbooks
Resources
SW Business
This is a good Site:
Abebooks
and try this:
Amazon Student
AMAZON PRIME IS FREE THE FIRST YEAR WHEN SIGNED UP FOR AMAZON STUDENT!!!!
A quote from my classmate:
best part of amazon prime is you pay $40 bux for a year student subscription, and you can get a %$&*load of books and everything else in the world shipped FREE 2-day to you, or pay 3.99 and have it shipped overnight.
and try this:
Amazon Student
AMAZON PRIME IS FREE THE FIRST YEAR WHEN SIGNED UP FOR AMAZON STUDENT!!!!
A quote from my classmate:
best part of amazon prime is you pay $40 bux for a year student subscription, and you can get a %$&*load of books and everything else in the world shipped FREE 2-day to you, or pay 3.99 and have it shipped overnight.
Here's a link to the official bookstore:
You do not need a current edition of Lehne, Management or even Foundations (although it can be hard to follow if you don't- so just for the ease, I got the most up-to-date version). Another thing you can do is split the cost between you and someone taking the class in the opposite half of the semester. Get with a student from last semester. Check the bulletin boards for students selling books.
A up-to-date Med-Surg book is useful for AH1, in AH2, Mr. S. uses his slides and I barely consulted the textbook.
General consensus after polling my classmates is that the bookstore is way, way too expensive
If you can, get the electronic version. Those darn books are HEAVY. If not, buy a really good wheeled backpack.
I have exactly two texts left on my shelf- Lehne and Med-Surg.
Friday, July 26, 2013
Job Search- Interview and Resume
Obtaining Employment
Resources
I took a really long time to get a job. I was almost the last person in my class to be hired. But I learned a few things along the way. I am hoping they might help someone else through this nerve-racking experience.
I did not even start getting calls until I completely overhauled my resume. You have skills that are appealing to hiring managers even if you have never worked in the medical field in your life. Teaching was a big one for me. I also had an unusual job mystery calling psychiatric facilities- you have to be able to think on your feet to fake that kind of thing and sound convincing. A little more about unusual skills in a second...
You can overhaul your resume in many different ways. I had some friends who had been hiring managers who helped a lot and told me what they looked for in a resume.
Here are a some links to help with writing a nursing specific resume and cover letter :
SW has as service to help you build a resume:
The next thing I really needed work on was interviewing skills. I learned to play up my strengths even if they were somewhat unusual , "I have five kids and went to nursing school, you tell ME how my time-management skills are." or, "I am really good at acting and talking to people while I think on my feet pretending to need rehab and psych help." That wasn't an experience many people have had. Play up everything that is in your favor. That is VERY hard to do, it's not in a lot of people's nature to sell yourself for an hour.
Even if a skill seems to only vaguely relate to nursing, you never know what might interest the recruiter. Every interviewer was fascinated by the mystery caller job, and I would never have thought that all that relevant.
Here are a couple of sites to help with anticiapting questions you might be asked:
The University of Memphis has a service (for a charge) where you can practice interviewing
Excellent youtube video on interviewing skills:
I went on interviews simply to get practice, even if I wasn't really interested in the job. Every time you do it, it gets a little easier.
So, after being the last person to even get called, I actually got TWO job offers in two days.
Monday, July 1, 2013
Evolve Free Resources
Resources
Go to 'catalog'
Look for these free resources:
Sorted by subject:
PHARMACOLOGY
MED SURG
MENTAL HEALTH
PEDS/OB
The Library-A Guide For Nursing Students
Go to Library resources
Click databases:
Click medicine:
And you get all this:
Go to:
Electronic books
and you get:
go to cybercat online catalog and there are at least 45 NCLEX books you can check out plus other nursing books:
Go to:
ebrary book collection
and click on Medicine:
and you get access to TONS of free nursing books, including a Davis NCLEX guide.
Seriously, what I am showing you below is merely SCRATCHING THE SURFACE of what is available:
Students and faculty may use their SW
ID cards to borrow from other educational institutions. The
SW Library has cooperative borrowing agreements with the following
institutions:
Mid-American
Theological Seminary
Tuesday, June 11, 2013
Free Is Always Good
Resources
Study Guides
Amazon has some free nursing Kindle books which are actually really good resources.
No tablet/ipad? No problem-
The Basics
KINDA COOL-
Florence Nightingale
Applied Psychology For Nurses
The RN Course Book
Kaplan Content Review Guide
Wednesday, June 5, 2013
Tiger PAWS
Resources
(Oh, sorry, wrong school...)
No, I mean PAWS. Guess what? It's got TONS of resources on it. Each of your teachers has uploaded many documents and links that are really helpful. Most of them have a discussion board. It's a great way to organize study groups. There are videos of nursing procedures. All kinds of stuff. Take some time to explore what's there.
PINK STAR- This is your email tab. Remember you have TWO SW emails. I call this one the PAWS email, but there is another general SW email. Some teachers use both and some use one or the other. make sure you ask your teacher which one he or she is using and which one you should use or you will miss something.
BLUE STAR- This is where you can set up a profile. I was the only person in my class who had a picture by her name. It was a picture of my kids. It reminded me why I was doing all this.
GREEN STAR- This is where you click to find your course content and clinical content.
YELLOW STAR- This is the link to the nursing convocation. SNGA stuff and general nursing announcements go here. It also has the emails of every student and faculty member in case you want to email someone in a different semester. You course content link will have the email of every student in your semester. We used PAWS email to each other quite a lot. Just let your friend know to look for an email there. It's easier than trying to get everyone's outside email.
YOUR HOMEPAGE
PINK STAR- This is your email tab. Remember you have TWO SW emails. I call this one the PAWS email, but there is another general SW email. Some teachers use both and some use one or the other. make sure you ask your teacher which one he or she is using and which one you should use or you will miss something.
BLUE STAR- This is where you can set up a profile. I was the only person in my class who had a picture by her name. It was a picture of my kids. It reminded me why I was doing all this.
GREEN STAR- This is where you click to find your course content and clinical content.
YELLOW STAR- This is the link to the nursing convocation. SNGA stuff and general nursing announcements go here. It also has the emails of every student and faculty member in case you want to email someone in a different semester. You course content link will have the email of every student in your semester. We used PAWS email to each other quite a lot. Just let your friend know to look for an email there. It's easier than trying to get everyone's outside email.
COURSE CONTENT
PINK ARROW- This is the link to the Nursing Student Handbook. You want info and to not have to bother a teacher- well, here you go.
RED ARROW- Encyclopedia Of Nursing- this is where you can find skills videos. There are also written pages to print out or make into a document you can carry around on your ipod, tablet or smartphone. I suggest this app for doing that. It allows you to upload Microsoft Word documents:
GREEN ARROW- This is where you and your teacher can post discussions. In AH2, the discussion board is where you can ask questions of your teacher and post your links to helpful resources. If there is not a similar group set up in your class, ask your teacher if you can set it up. This is a wonderful place to share resources beside the Facebook group. You can send an email to all your classmates in PAWS letting them know something new has been posted.
BLUE SMILEY FACE- LOOK!!! TCPS STUFF!!! This is also where powerpoints are located.
PURPLE SMILEY FACE-So what do we have? Also another way to access content, another way to see who is in your class and email them, the discussion board, the DROPBOX-below is a tutorial on how to use the dropbox. The quizzes tab will probably not be used. The most important tab of all- your GRADES.
RED FLOWER- Instructor information. They made it easy to contact them. No excuses if something is not going right and you didn't contact the correct person. Remember-they ARE there to help you.
PINK FLOWER- Class announcements. That could be slightly important, don't you think?
Then the green 'student email' tab. Remember you can also access PAWS this way as you see below.
PURPLE SMILEY FACE-So what do we have? Also another way to access content, another way to see who is in your class and email them, the discussion board, the DROPBOX-below is a tutorial on how to use the dropbox. The quizzes tab will probably not be used. The most important tab of all- your GRADES.
COURSE HOMEPAGE
RED FLOWER- Instructor information. They made it easy to contact them. No excuses if something is not going right and you didn't contact the correct person. Remember-they ARE there to help you.
PINK FLOWER- Class announcements. That could be slightly important, don't you think?
CLINICAL CONTENT
This picture is just to show you that your clinical content page is going to look very similar to your class content page.
THE OTHER EMAIL
This is the other email I referred to earlier. Remember some teachers like to use this one. Click on "My Southwest Online Services"
Then the green 'student email' tab. Remember you can also access PAWS this way as you see below.
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