Michelle's Nursing Blog

All things nursing 👩🏼‍⚕️🧠🏥💉

[michellesnursingblog-blog]

The End of the Semester

The end of the semester is finally coming and although I am feeling very relieved that it will be over soon, I am also becoming very stressed about finals week. All the information we have learned over the semester is going to be crammed into three exams that could make or break our grades. I am feeling overwhelmed but I know that I just have to study everyday and use the resources that I have in order to succeed.  Also, eating a good breakfast and getting a good nights sleep prior to the exams is very important in order to have full focus. I wish everyone the best in these last few weeks of our junior year fall semester. We got this!  

[medicalbasics]

The Heart Process #nursingschool #nurse #rn #nursing #nurses #nursingstudent #resources #study #inspiration #school #tips

[lulabelleismyshihtzu]

Nursing: Post-Op Complications

[imtheregisterednurse]

DUMPING SYNDROME

[rightatrium]

[chartingnewterritory]

Hypernatremia

[bloopz]

[anaestheticroom-deactivated2015]

[michellesnursingblog-blog]

Snow Day

After being at the library all morning trying to complete all of my work and awaiting the ATI proctored exam for med surg I found out around 1 pm that it is canceled. In high school I used to get excited when class was canceled so I could sleep in but now that I am in college it doesn’t excite me because I would rather get things done and have it over with than having things postponed. I am now going to use part of my day to get some more work done and then spend the rest of my night relaxing and watching a movie because it is the perfect day to do that and it is definitely well deserved. I can not wait until Thanksgiving Break so I can relax a little… but not too much because there is two more exams when we get back. Happy Holidays!

[nurse-on-duty]

COMMON CARDIAC RHYTHMS

1. Normal Sinus Rhythm

Rate: 60-100

Rhythm: regular

P waves: similar; 1:1 with QRS

PR: 0.12-0.20 sec; constant

QRS: equal to or less than 0.1 sec

2. Sinus Bradycardia

Rate: <60

Rhythm: regular

P waves: similar; 1:1 with QRS

PR: 0.12-0.20 sec; constant

QRS: equal to or less than 0.1 sec

3. Sinus Tachycardia

Rate: 101-180

Rhythm: regular

P waves: similar; 1:1 with QRS; at very fast rates, P wave looks like T wave

PR: 0.12-0.20 sec; constant

QRS: equal to or less than 0.1 sec

4. Sinus Arrhythmia

Rate: 60-100

Rhythm: irregular; often associated with breathing

P waves: similar; 1:1 with QRS

PR: 0.12-0.20 sec; constant

QRS: equal to or less than 0.1 sec

5. Premature Atrial Contraction

Rate: variable

Rhythm: regular with premature beats

P waves: premature; 1:1 with QRS

PR: dependent on prematurity of the beat

QRS: usually <0.1 sec, but may be wide

6. Supraventricular Tachycardia

Rate: 150-250

Rhythm: regular

P waves: usually obscure but 1:1 with QRS

PR: 0.12-0.20 sec when present

QRS: usually <0.1 sec

7. Atrial Tachycardia

Rate: 150-250

Rhythm: regular

P waves: P waves appear different; may be difficult to distinguish P waves from T waves

PR: may be shorter or longer than normal; ma be hard to measure

QRS: usually equal to or less than 0.1 sec

8. Atrial Flutter

Rate: atrial 250-450; ventricular rate variable

Rhythm: atrial regular; ventricular may be regular or irregular

P waves: no P waves. Flutter (sawtooth shaped) waves observed

PR: not measurable

QRS: usually <0.1 sec

9. Atrial Fibrillation

Rate: atrial 400-600; ventricular variable

Rhythm: ventricular irregular

P waves: no P wave; fibrillatory waves may be present; erratic, wavy baseline

PR: not measurable

QRS: usually <0.1 sec

10. Premature Ventricular Contraction

Rate: 60-100

Rhythm: regular with PVCs

P waves: absent; may appear after QRS complex

PR: none

QRS: >0.12 sec; wide and bizzare

11. Ventricular Tachycardia

Rate: 150-300, typically 200-250

Rhythm: may be regular or irregular

P waves: none

PR: none

QRS: >0.12 sec

12. Asystole

Rate: none

Rhythm: none

P waves: none (“P-wave” asystole)

PR: none

QRS: absent

13. Ventricular Fibrillation

Rate: cannot be determine - no discernible waves or complexes to measure

Rhythm: rapid and chaotic - no pattern

P waves: none

PR: none

QRS: not discernible

14. First-Degree AV Block

Rate: usually normal 60-100

Rhythm: regular

P waves: similar, 1:1 with QRS

PR: prolonged (>0.20 sec) but constant

QRS: usually equal to or less than 0.10 sec

15. Second-Degree AV Block, Type I

Rate: atrial>ventricular

Rhythm: atrial regular; ventricular irregular

P waves: similar, more P waves than QRS

PR: lengthens with each cycle until a P wave appears without a QRS

QRS: usually equal to or less than 0.10 sec; QRS cycle is periodically dropped

16. Second-Degree AV Block, Type II

Rate: atrial > ventricular

Rhythm: atrial regular; ventricular rhythm irregular

P waves: similar, more P waves than QRS

PR: may be normal or prolonged; remains constant

QRS: usually equal to or greater than 0.10 sec; QRS cycle may be absent after P waves

17. Third-Degree AV Block

Rate: atrial > ventricular; usually slow ventricular rate between 30-60

Rhythm: atrial and ventricular; no relationship between the 2

P waves: similar; more P waves than QRS

PR: non; atria and ventricles beat independently of each other

QRS: may be narrow or wide depending on level of the block

[nurse-on-duty]

ACID-BASE IMBALANCES

[nurse-blog]

They always have a question like this, about teaching elderly how to properly use a cane. REMEMBER, you want to have the cane on the STRONG SIDE. (opposite the weak side)

NCLEX SAMPLE

 The nurse teaches an elderly client with right-sided weakness how to use a cane. Which of the following behaviors, if demonstrated by the client to the nurse, indicates that the teaching was effective?

1. The man holds the cane with his right hand, moves the cane forward followed by the right leg, and then move the left leg.

2. The man holds the cane with his right hand, moves the cane forward followed by his left leg, and then moves the right leg.

3. The man holds the cane with his left hand, moves the cane forward followed by the right leg, and then moves the left leg.

4. The man holds the cane with his left hand, moves the cane forward followed by his left leg, and then moves the right leg.

Answer: 3 

[nurse-blog]

Erikson’s Stages of Psychosocial Development are super super super important to memorize. (mostly the years and the basic conflict) i’ve had a ton of these questions in KAPLAN so far. 

[michellesnursingblog-blog]

Juggling Responsibilities

Do you ever feel like there is just not enough time in the day to accomplish everything you want to get done! Or finding it hard to manage your money? Or not being able to relax because you are thinking about the million other things you should be doing? I miss when my mother used to pay for all my bills and now I feel like all my money goes to my phone bill, gas, food, toll, credit card bills, etc. Its like I work and then all of the money disappears! Nursing school is starting to consume my life and I can never just focus on other things that don’t involve my grades because I feel like that is the most important thing in my life right now. My room is always mess, I’m always broke, and I barely get to go out anymore. I really need to take into account all the other aspects of my life instead of letting my study habits take up all of my time. Although it isn’t necessarily a bad thing, I think it is important to take breaks and relax or else your brain will just explode!

[wellbreakmywalls-deactivated201]

[ca-nursing-blog]

NCLEX tip of the day

KNOW KNOW KNOW!

TRANSMISSION-BASED PRECAUTIONS:

AIRBORNE

My - Measles Chicken - Chicken Pox/Varicella Hez - Herpez Zoster/Shingles TB

or remember… MTV=Airborne Measles TB Varicella-Chicken Pox/Herpes Zoster-Shingles

Private Room - negative pressure with 6-12 air exchanges/hr Mask, N95 for TB

DROPLET

think of SPIDERMAN! S - sepsis S - scarlet fever S - streptococcal pharyngitis P - parvovirus B19

P - pneumonia P - pertussis I - influenza D - diptheria (pharyngeal) E - epiglottitis

R - rubella M - mumps M - meningitis M - mycoplasma or meningeal pneumonia An - Adenovirus

Private Room or cohort Mask

CONTACT PRECAUTION

MRS.WEE M - multidrug resistant organism R - respiratory infection S - skin infections * W - wound infxn E - enteric infxn - clostridium difficile E - eye infxn - conjunctivitis

SKIN INFECTIONS VCHIPS V - varicella zoster C - cutaneous diphtheria

H - herpez simplex

I - impetigo P - pediculosis

S - scabies 

[ca-nursing-blog]

knowing the reversals and opposites of meds is IMPORTANT!