question of the week

for the week of 04.27.09

A health care provider has ordered daily high doses of aspirin for a client with rheumatoid arthritis. A nurse instructs the client to discontinue the medication and contact the provider if which of these symptoms occur?

1. Infection of the gums
2. Diarrhea for more than one day
3. Numbness in the lower extremities
4. Ringing in the ears

mini-vacation

there is no class to be held on April 27, 2009 for nursing 5! :)

-mid-term grades are posted on turnitin.com!

-peer review of process recording papers is now worth 50 pts!

-only three more weeks of school!

question of the week

for the week of 04.20.09

A nurse is discussing with a new mother the proper techniques for breast feeding an infant. The nurse would identify an incorrect understanding and the need for additional instruction if the mother made which statement?

1. "I should position my baby completely facing me with my baby's mouth in front of my nipple."
2. "The baby should latch onto the nipple and areola areas."
3. "There may be times that I will need to manually express milk."
4. "I will give the baby a pacifier in between nursing."

It Don't Come Easy

It used to be easier, dealing with death.
Oh, occasionally a particularly devastating case would get to me, but I worked codes with professional detachment and took care of the surviving family members with compassion and professionalism.
It used to be easy.
It’s not so easy anymore.
*****
I knew you for a little over an hour, and the minute I saw you I knew you were dying. War had been raging inside your body for over three years; you met every battle with determination.
The enemy was pernicious. Malevolent. This particular enemy always is. Silent until its damage is irreparable, it was now ready to end its rampage.
I knew it. And so did you. In the few words we exchanged, you told me you were ready to “turn the page”; you were so exhausted.
Bone weary. Exhaustion so deep that you didn’t have the energy to even want to fight anymore.
I gave you my hand. You gave it a squeeze.
Peace was at hand.
Twenty minutes later you were gone.
*****
As I watched your monitor slowly dissolve into that undulating line of asystole, my throat tightened and my eyes burned. I made sure your family members were comfortable and I went to the nurses station to do the required paperwork. That infernal, damned paperwork.
You had just died, but God forbid that I do anything but the required paperwork. It was the most important aspect of the night.
Not the fact that I was ready to cry. I made it to the bathroom, but that made it worse so I swallowed hard, came back out and talked to your doctor, the coroner and the donor network, finished your chart and sent you to our “refrigeration unit”. That’s what the transplant coordinator called it. Guess “morgue” is no longer PC.
I didn’t even know you.
But two hours later I was crying for you on my way home from work.
*****
Why is dealing with death becoming so much harder? As a young nurse, it was what I did.
It was also something that happened to other people.
Is it my age that makes me more aware of my own mortality, making death that much harder to deal with?
Is it that I have now buried my parents-in-law, my father, three grandparents, an uncle, an aunt and two brothers-in-law, the last four within the last 18 months?
Is it because I know the feeling of the shock that sets in immediately following the split second of disbelief or the depth of the sadness that precedes the seemingly endless, painful ache?
*****
I’m not sure what it is, but the more I experience death, the more it affects me and the harder it is to control my emotions.
I wondered if maybe it was time for me to get out of this line of nursing, that maybe I had lost the ability to detach enough to remain the impartial professional.
Then I realized, after all these years I should be thankful that I can still feel for my patients and grieve their loss.
When I stop feeling for my patients, that would be the time I would need to explore another avenue of nursing.
As for now, I’ll stay right where I am.
From Kim an Emergency and Critical Care Nurse in the Bay Area

question of the week

for the week of 04.13.09

A nurse has been assigned to a group of clients who are receiving IV infusion potassium replacement. Which finding indicates that the nurse needs to advise the registered nurse (RN) to evaluate the client’s potassium replacement?

1. pain radiating down the outer part of the client's arm
2. complaints of belly pain and cramping
3. repeated dysrhythmia alarms on the monitor
4. abnormal 12 lead ECG report

AA websites

http://www.aadelta.org/

http://aasacramento.org/meeting_schedules/meeting_map.htm

students are not allowed at closed meetings!!

question of the week

for the week of 04.06.09

A nurse enters a client's room to discover that the client has no pulse or respirations. After calling for help, what is the first action the nurse should take?

1. Start a peripheral IV
2. Initiate closed-chest massage
3. Establish an airway
4. Obtain the crash cart

Spring Break! Yay! Enjoy!