Nursing for Newbies

A blog for nursing students and new nurses that YOU can relate to Follow me on Twitter!

[nursing4n00bs]

As of this week I have accepted a position in telemetry at Long Island Jewish Medical Center. It's been a long time coming, I've been looking for a job since September - but it was worth the wait! The North Shore-LIJ healthcare system has a national reputation for their patient outcomes and satisfaction. 

I have to relocate for this job and my start date is in one week, so my life has gone from the slow pace of unemployment to super busy and complicated. I have decided to take a hiatus from this blog for a few weeks until things settle down. 

I wanted to thank all of my followers for their positive feedback - I have loved learning with you and when I come back I'll have tons of fresh material and a different perspective to share. 

PS - If anyone works at LIJ or lives in the area, let me know! I could use some friends in my new town :)

[nursing4n00bs]

YOUR WEEKEND NCLEX TIP

After hip replacement surgery, the patient should avoid these three positions until fully recovered:

Bending more than 90 degrees at the waist (for example, bending over to pick something up)

Internally rotating the leg

Adducting the legs (including crossing one's legs)

The device seen above helps to prevent the latter two positions from occurring during sleep

[nursing4n00bs]

FACTOID FRIDAY

Diabetes is the leading cause of blindness in the United States. 

The above image depicts how diabetic retinopathy first manifests. 

[nursing4n00bs]

TRICKY THURSDAY

The ABCD side effects of Barbituates

A - Ataxia

B - Behavioral disturbances

C - decrease in Concentration, Coma

D - Depression, Drowsiness, Diplopia

[nursing4n00bs]

WOMEN'S HEALTH WEDNESDAY

Uterine Fibroids. What the heck are those, right?

They are benign tumors that grow in and around the uterine walls. In extremely rare cases (less than .1%) they lead to cancer. They come in all sizes (from the size of a pea to the size of an orange) and grow in all areas of the uterus - so their symptoms and treatments are dependent on size/location. 

Smaller fibroids are usually asymptomatic. They may never have to be treated. In other cases, the fibroid may place pressure on the bladder/bowel causing urinary retention/frequency or painful defecation and constipation. They may cause other symptoms such as back pain or painful/heavy menstruation. Rarely, they can interfere with ovulation which can lead to infertility. 

Fibroids are fairly common, especially in the African-American population and women in their later reproductive years. There is a correlation between patients with fibroids and patients with hypertension. They can be diagnosed by use of ultrasound or MRI and may even be palpated during a gynecological exam. Like with reproductive cancers, there's no surefire prevention. 

As stated before, treatment varies on severity. Tumor-shrinking medications may be prescribed. One method of treatment is cutting off the blood circulation to the fibroids. Radiation can be used. Unfortunately, hysterectomies are typically the go-to treatment and may even be suggested for patients with asymptomatic fibroids - although I hope that in coming years this trend dies down and alternative, less invasive treatments take over. 

[nursing4n00bs]

TUTORIAL TUESDAY

How to insert eyedrops

[nursing4n00bs]

MED REVIEW MONDAY

Naloxone aka Narcan is an opioid antagonist, it works by blocking the opioid receptor and therefore can counteract the depression of the CNS and respiratory system caused by opioids. This is the drug you push when you suspect a morphine overdose (I believe the guideline is less than 8 respirations per minute). It is often made available by public health agencies to heroin users in case of accidental overdose. The drug also blocks pain-lowering endorphins which register in the same receptor as opioids. Narcan is used in a combination pill that aids in the detox of opioid users. 

[nursing4n00bs]

Raritan Bay Medical Center in New Jersey has invented a new role for the registered nurse. Named the Nurse Navigator, these nurses act as a liaison between the patient and the entire medical center. They help the patient and their family "navigate" through multidisciplinary healthcare from diagnosis to follow-up by scheduling appointments, providing advice and patient education ranging from pre-operative teaching, prevention methods and explanation of the disease process. RBMC, a Magnet Hospital-recognized facility, has seen improvements in patient outcomes and satisfaction since the implementation of this coordinating role.

(Seen above: the Magnet model graph)

Source Article

[nursing4n00bs]

YOUR WEEKEND NCLEX TIP 

RNs can delegate tasks to other RNs and LPNs - CNAs are assigned tasks to do. The language is very subtle yet important here. In addition, tasks that you cannot delegate include: assessments, judgements and patient education. 

[nursing4n00bs]

FACTOID FRIDAY

There is a disease that is thought to have been the origin of vampire or werewolf myths. Symptoms of porphyria include anxiety/paranoia, hallucinations, seizures, red urine, jaundice, an increase in hair growth (especially on the forehead) and instead of "sparkling in the sunlight" - skin will erupt in boils, blisters and even become necrotic when exposed to the sun. 

[nursing4n00bs]

TRICKY THURSDAY

SMART helps you remember the symptoms of Parkinson's Disease

S - Shuffling Gait

M - Mask-like Face

A - Akinesia

R - Rigidity 

T - Tremors

[nursing4n00bs]

WOMEN'S HEALTH WEDNESDAY

Another hot topic in women's health news this week: A university in Pennsylvania has begun to offer the "Morning After" pill or Plan B to it's students through vending machines. 

I wasn't too crazy about when they changed this form of contraception from prescription to non-prescription. I think there's a fair deal of counseling/patient education that should be given by a healthcare professional when a patient is considering ingesting this high dose of hormones. For example, how did the unprotected sex happen - did the condom break or was it sexual assault that needs to be reported? Also, the pill is not intended for frequent use but you can't count on everyone to read the warning labels on the box. 

Does this actually make Plan B more accessible? I'm not sure if feeding money into a publicly located vending machine is less discreet than speaking with a nurse or pharmacist.

What do you think?

[nursing4n00bs]

TUTORIAL TUESDAY

Informed Consent: Why it exists and what you need to obtain it

Note: I don't know why but this video references a verbal agreement in relation to informed consent. Wrong. 

[nursing4n00bs]

MED REVIEW MONDAY

Vancomycin is an antibiotic that is used to treat gram-positive infections. It works by inhibiting cell wall synthesis in bacteria. It is used prophylactically during surgery, if a MRSA or C. dif infection is suspected, and commonly with catheter infections. It is mainly given through IV. The drug can cause pain and thrombophlebitis during administration so it is given very slowly (10 mg/min) and ideally through a central line, PICC or infusion port. 

One side effect that is essential to know is red man syndrome: a rash that can occur on the face, neck and upper torso of a patient receiving Vanco - as seen in this picture. For this reason, the med is almost always ordered with an antihistamine such as Benadryl. 

[nursing4n00bs]

In honor of Black History Month, I wanted to tell you about a personal hero: Mary Mahoney. She was the first African American to be trained as a professional nurse. After graduating from nursing school in 1905, she was one of the original members of the American Nurses Association and in 1908 co-founded the National Association of Colored Graduate Nurses. After she retired from nursing, she worked to gain support for the women's suffrage movement and in 1920 was one of the first women to registered to vote in Boston. 

Today Mary Mahoney serves as a symbol of inspiration for minority nurses and student nurses facing adversity.

[nursing4n00bs]

YOUR WEEKEND NCLEX TIP 

Chronic is more stable than acute. This gets tricky when you're trying to prioritize your care and there's a chronically ill patient involved. For example, even though COPD is an airway issue, it's a chronic one - therefore it's lower on the priority list than caring for any acutely sick patients. 

[did-you-know]

Source

[nursing4n00bs]

FACTOID FRIDAY

This incident should serve as a reminder to nurses that DVTs can develop even in young, healthy patients. It's important to take the proper precautions such as ambulation, SCDs and TEDs, range of motion exercises and checking Homan's sign.