Thursday, September 24, 2009

NCLEX cheat sheet

are you ready for it???

well i know a lot of ppl out there are doing nursing so i thought i would share my dun dun dun dun - nclex cheat sheet i made. it has all the essential things i cant remember on my own and i memorized up to the very last minute and then ran in and sat down and wrote all the things i could remember onto the whiteboard. so here it is hope it helps someone out. obviously if you dont understand it i dont blame you but i encourage you to make something of your own before you go into nclex bc it helped a ton! happy studying! and as an NClex side note - im not saying these things were on the test just that they help to know in all nursing ;-)

Blood pH 7.35 - 7.45
PaCo2 35-45
Na 135-145
K 3.5 - 5
Albumin 3.5-5
Cl 95 - 105
Mg 1.5 - 2.5
platlets 150(000) - 400(000)
WBC 4(000) - 11(000)
Cholesterol 140 - 200
Ca 9 - 11
BUN 10 - 30
Creatinine 0.5 - 1.5
BiCarb 22-26
Hgb 12 - 18
Hct 38-54
Lithium 0.5 - 1.2
Dig 0.5 - 2
L/S 2:1
APTT (2) hep (15 - 35)
PT (2-3) warfarin ( 10 - 15)
Glasgow Coma <8 = Coma

SIADH - Too Much ADH - Hold on to water

hot and dry = sugar high
cold and clammy = need some candy

intolerant to heat, bulging eyes, big thyroid, increase bp, wt. loss, tremors

hypothyroidism - intolerance to cold, angioedema, anorexia, dry skin, jair loss, apathy. constipation, muschele aches and weakness

addisons (decreased cortisol)
brown skin, hypoglycemia, wt. loss, low sodium, HIGH potassium, weak, renal shutdown

Cushings (steroids)
buffalo hump, osteoporosis, immunosuppression, moon face, thin extremeties, thin skin, brusises, hyperglycemia, high Na, LOW potassium

COPD - pulmonary emphesema - pink puffers - right heart failure
chronic bronchitis - blue bloaters - heart enlargement
asthma - co2 retnetion
Croup - - stridor, night, cold, increase Temp

TB - airborne - productive cough, night sweats, low grade fever

increase BP
decrease Pulse
Decrease REsp

Decrease BP
increase pulse
increase resp

Ulcerative colitis - 10 - 20 bloody diarrhea
Crohns - 20 -40 - diarrha, N/V - SEGMENTS

RSV - bad cold - PNA

O - universal d0nor
AB - receipient

CVP - 3-12 - ability of Right heart to push fluid load

R heart failure
peripheral edema
distended veins
GI distress

Left sided heart failure
S3 gallop
Pulm edema
blood tinged sputum

IVP - dye, allergy, Iodine shellfish, burning or salt, xray kidney
myelogram- NPO 4 - 6 hours prior, hold CNS depressant, encourage fluids 48 hours prior

Meniere's disease - dizzy


dark leafy greens - increase vit K

fruits, dairy , fish 0- increase potassium

cured meats, chocolate, ETOH, cheeses - increase Tyramine

dairy, beans, nuts and veggies - increase CA

Wednesday, September 23, 2009

nursing or marriage nurssing or marriage. i cant decide which i want to write first about. well lets go with nursing. so i worked the past 2 days i have two days off then i work 3 , 1 off, 3 on. ugh. so much. i switched with a girl bc she needed the day so that why my schedule is kinda packed. its not too too bad. but i feel like i am still trying to get used to working. i have had this discussion more than a few times with thomas and my dad and others but it still bothers me. i guess i never really had to work when it wasnt super flexible and someone that i knew. now i have the responsibilites of things like sick days or PTO and scheduling, benefits, taxes blah blah blah. lucklily when i moved into this job meeting people wasnt too hard to do. both of my preceptors (from new grad and sem 8 were great and introducing me to others. And nursing is crazy. you have to talk and interact with other nurses in order to survive in the nursing unit. especially being a student you have to ask a lot of questions and i say have to because if you dont and keep things in the dark and just go ahead like you know something it will only get worse when you mess us and have to tell someone instead of just asking in the first place.

anyways, i think it was great to start off as a new grad in the night shift. lucky for me i did my sem 8 rotation at the same unit and got to do day shift so i got to see what day shift was like. i worked night shift 12 hours 7pm to 7 am for about 3 months. it was a good shift to start because i think you work more as a team with the other nurses as well as do things for yourself more because you dont have your own nursing assistant. now on PM's i have my own nursing assistant who follows me and another nurse. on nights you have one for the whole unit plus they are supposed to give bed baths to at least 3 patients ( which can take awhile).

so on nights you take your own vitals, ambulate your patients, take them to the bathroom, clean up your patients, turn your patients in addition to medications, charting, and hourly rounding. thats the other thing about night shift. i was always a little more unsettled because your patient's arent awake and there are not others checking in on your patients or workign with them like massage therapists, CNA's. Physical therapy, resp therapy... so it is your job to make sure they are breathing. which makes sense when you only need to hourly round and you tend to go into their room 3 or 4 times just to watch them sleep and make sure their chest is rising and falling. not everyone sleeps though either - you hear the tv running in someone's room, the call for pain meds, or the call for a sleeping pill oh and the bathroom. then you also get the patients who are confused or have dementia and here the bed alarm go off and you run to find them sprawled across the bed with their head and legs hanging off the sides. they definetly keep you on your toes.

the emergency calls that get called on our unit are kind of different on nights too. there are a lot of low blood sugars like in the 20's because they get their sugars checked at 9 and are given insulin and are suppposed to eat something but ppl are confused or they fall asleep or they dont like the food yadda yadda yadda and then their sugar comes crashing down and you have to get it up.

we tend to have a few more falls at night. people try to go to the bathroom when they think they can make it but forget about their iv being hooked up or slip. we had a few bad instances where that happened. unfortunately one of the guys was already slowly bleeding into his brain and that fall might have rattled it a little bit more and he passed away a couple days after. so we are super careful about patients and falling. bed alarms, frequent checks, constant reminding the patients to call us if they wanna get up.

anyways but like i was saying although you have to do a lot of things on your own, the other nurses know that its sometimes hard doing things by yourself. so when someone needs to turn a patient you offer to help them so they dont hurt their back. i tried turning a patient by myself once bc i didnt want to bother anyone and a nurse came in and told me she would slap me with a wet noodle if i ever tried to do it by myself again :). or if you have an er admit as soon as they come up you get up and help the nurse bc its too hard to try and transfer the pt, assess, release orders, and get vitals for one nurse. i liked working as a team on nights. one of my night shift nurses asked if i wanted to come back to nights and i said maybe sometime and she asked why - i said i missed them and i feel that they are more bonded. its quiet during the hours of 2 - 5 so you have to talk with others so you can stay awake. plus getting that hour nap (lunch break) was pretty nice too. i didnt think i would be able to sleep for an hour , wake up and do nursing but i got the hang of it and really if you dont sleep i just feel groggy the rest of the night. the only thing was i was always super warm when i woke up and i would be freezing cold when i woke up so i bought a coupe long sleeve shirts and would change into them after i woke up.

well anyways, thats my take on night shift for now. i think ill add more later. well see. and ill add a pm shift note too so you can see the difference.

xoxo you know you love me

Sunday, September 20, 2009

Santa Clara art festival

so today was a great day. thomas put me to sleep real early last night because he said we were gonna have a great happy day and we indeed did. we woke up late at 1pm when our projected time was 10 am. whoops. well anyways we woke up and then got ready and left in our car for the Santa Clara Art and Wine festival. First parking was crazy and Thomas was getting frustrated so we ended up just paying 5 dollars to park. we entered the festival and of course one of the first things i see is "Ring around the Toezees" booth which is a booth where you can get toe rings put on and they basically never come off.

ive had a plain silver one put on from hawaii when i visited my sister last year and have loved it since. so i got another one today a silver bubbley one on my other foot. how those girls can sit there and touch ppls feet all day long - YUCK ;(. i mean i know where my feet have been and they are pretty clean and well taken care of but what about all those other peoples feet. ugh. even when i have to assess my patients toes i try to do it through their socks or where gloves. ugh. well moving on after i got my toe ring which took forever and thomas was so nice because he was like the only guy and stood by me the wholle time in the heat. we moved on to the food part and got tri tip sandwiches and lemonade. mmm. lemonade was a bummer though cuz it was definetly a mix not real. we walked to find thomas' parents at the santa clara christian school booth. we sat around for awhile then i got tired and had to move again.

we walked to see the other booths and we passed by the POOCH booth. its this new doggie hotel right by our house that looks so cute. get this they are opening next weekend and we were telling them about boba and the guy gave us free $10 gift card for our puppy to try it so she can socialize. i looked at their brochure and what they offered. get this pawdecures ( pedicures so cute), treadmills both land and water, private sleeping rooms if they have to stay overnight, facials, aromatherapy baths mmm, and facial coloring for your pets graying muzzle!! freaking awesome. thomas isnt sure if he wants boba hanging out with pooches that go there but either way at least boba can visit and get cultured - itll be like her visit to santan row is for us. haha. our once a 4 month visit. :)

then we almost passed by this awesome booth but luckily we stopped. its called aromatheraputty. its so awesome. thomas said he was surprised i didnt create it first bc i love yummy smelly things and i always have playdoh to play with. then talked about how i should invest in her business and then went on to talk about how we should start investing ::blah blah blah::: haha jk. anywyas. i freaking bought two!!! its putty that have lovely aromatherapy scents. i bought the green exhilirating eucalyptus peppermint putty and the purple lavendar putty. ive already loved the lavender one smells so good!

then after that we got some quick dinner at mcdonalds bc we were both starving and dehydrated and then went to target got some new night gowns, some new silverware, and thomas got some deoderant. oh and we got this awesome storage ottoman for only 13.98 that we will definetly use a ton! Target is the place to be for super on sale collegey or summer stuff. then we came home and had a good night in. thomas playing the guitar singing amazing grace and me playing on the computer looking at random blogs. blogs about cupcakes, iphones, dogs, cats, crafts, and even cheese! well thats all for now folks

you know you love me xoxo

squiddle post Day #1

hello fellow squiddles. my husby thomas told me i should start keeping a diary again. i liked having a diary but when i wanted to journal i was always frustrated because my hand couldnt write as fast as my thoughts came. so typing seems the way to go. unfortunately i dont how long this journal will stand against the times like a journal found in the attic, but we shall see. anyways i named this blog squiddle post because...well its sort of a long story. in monsters and aliens the animated movie that little suid thing walks and makes a found squiddle noise. i think of that noise everytime i see something or someone walking or moving funny. it really does make life more entertaining. you should try it. ok well thats the end of my intro blog. i shall end in the best of ways.

You know you love me xoxo