Thursday, March 30, 2006

Central Valley Kaiser Hiring events (FINALLY!!!!)

I am so sorry this took so long but I just got the info from her. Pass it on as you see fit.


Central Valley Hiring Event Alert: Anyone interested in joining Kaiser Permanente is encouraged to attend the following dates and times.
~Imaging, Behavioral/Mental Health, Lab, Nursing, Rehab Professionals, Respiratory
All job opportunities with Kaiser Permanente can be viewed on line at www.kp.org/jobs
April 18th, 2006 (8am to 5pm) -Stockton Medical Center
April 21st, 2006 -Manteca Medical Center (8am to 5pm)
April 26th - Modesto (Vintage Gardens/8am to 5pm)

Tuesday, March 28, 2006

N5 Students,
Does clinical start the week we return from Spring break...that is the week of the 17th?
If you are reading this and you have access to post on 3rd or 4th semester blog, please post the Kaiser info on their blog, please. Thanks.

Sunday, March 26, 2006

N5 Students- If any of you would like to borrow or purchase my book you can reach me at rdeyoung585@students.deltacollege.edu

Friday, March 24, 2006

Today I became an ICU Nurse

Hey guys! I had a job interview yesterday for the ICU at Lodi Memorial. I was officially hired as a student nurse in that department and have been assigned a preceptor who will be training me throughout the rest of the program and beyond. I am in!

Today I did my first ICU 12 hour shift and it was great! I will be going back tomorrow.
Hello there everybody! Saturday, May 27th is the Great America day. They have given us a special price of $23.00 per ticket. I am working with them right now on having a picnic lunch done. I need some input from some of you though...if we were to eat by ourselves, we would be spending alot anyways..they have lunches that range from 9.99 a piece and include all day ice cream and beverages...which sounded more economical to me. They have bigger packages that have bbq'd chicken etc...I will have a vote go out to you all two mondays from now. There will be a voting paper that will have two of the many options, you will pick one and I will collect the votes one week later....the highest amount of votes will decide which lunch option to chose from. The Monday following a flyer will be given to each of you with the price of ticket plus food option and you will tell me how many tickets you want and return the flyer to me, with your money. I hope you all will try to come, I know we will have a fun day!!!! See you all on Monday, the third with your voting options!!! :)
Mike,

Can you send me an invite to first semester blog? I wanted to give them some info. Thanks!!!

Cher
ckjt95@msn.com
FYI....
I have a close friend that is head of HR for Kaiser Permanente. They are having a job fair because they are expanding and need clinical Rn positions filled as well as externs. I will post the info if you are interested.

Cher

Thursday, March 23, 2006

Reminder:
SNA meeting
March 27th @1300 Locke 313.
Now accepting nominations for officers.

Tuesday, March 21, 2006

Does anyone want to sell their med/surg book or have an extra one? If so...here is the email of one student in first semester needing one.... aatiqa@gmail.com Also...anyone in N4 that wants to share their book with current n5 students? If so, please let Mrs. Ippolito know or bring to class on Monday...THANKS!!!!!
Let us look forward to some fun guys....I have arranged special ticket prices for us to all go to Great America for the day, the weekend after we finish up our rotations. I will have a sign up sheet going around in a few weeks so you can tell me how many tickets you want....Let us celebrate all this hard work with all the food we shouldnt eat, and all the rides that make us puke! :) So....save the date and remember we are one semester closer to graduation day!!!!!!!
Here are the Case Studies for the Respiratory System. They are not a requirement but will help you study. Please bring them to the study session on March 28th in L118.

Lewis, et al: Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 6th Edition

Chapter 26: NURSING MANAGEMENT: Upper Respiratory Problems

Cancer of the Larynx

Patient Profile
Mr. Carlson, a 60-year-old white man, was admitted for evaluation of mild pain on swallowing and a persistent sore throat over the past year.

Subjective Data
· States that his symptoms worsened in the last 2 months
· Has used various cold remedies to relieve symptoms without relief
· Has lost weight because of decrease in appetite and difficulty swallowing
· Has smoked 3 packs of cigarettes a day for 40 years
· Consumes 6 cans of beer a day

Objective Data
Laryngoscopy
· Subglottic mass

Physical Examination
· Enlarged cervical nodes

Computed Tomography Scan
· Subglottic lesion with lymph node involvement

Collaborative Care
· Total laryngectomy with tracheostomy with inflated cuff
· Nasogastric tube

Critical Thinking Questions
1. What information in the assessment suggests that Mr. Carlson might be at risk for cancer of the larynx?
2. What diagnostic tests are typically performed to evaluate the extent of this problem?
3. What teaching should the nurse plan for Mr. Carlson before and after laryngectomy?
4. Discuss methods used to restore speech after laryngectomy.
5. What teaching is required to assist this patient to assume self-care after his surgery? What precautions should the patient take because of his stoma?
6. Based on the assessment data presented, write one or more nursing diagnoses. Are there any collaborative problems?

Lewis, et al: Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 6th Edition
Chapter 27: NURSING MANAGEMENT: Lower Respiratory Problems

Aspiration Pneumonia

Patient Profile
Sam, a 27‑year‑old African-American male, was admitted to the hospital because of an uncontrollable fever. He was transferred from a long-term care facility. He has a history of a gunshot wound to his left chest. Following a cardiac arrest after the accident he developed hypoxic encephalopathy. He has a tracheostomy and gastrostomy tube. He has a history of methicillin-resistant Staphylococcus aureus (MRSA) in his sputum.

Subjective Data
· Family says that they visit him regularly and are very devoted to him.

Objective Data
Physical Examination
· Thin, cachectic African American man in moderate respiratory distress
· Unresponsive to voice, touch, or painful stimuli
· Vital signs: temperature 104° F (40° C), heart rate 120, respiratory rate 30, O2 saturation 90%
· Chest auscultation revealed crackles and scattered rhonchi in the left upper lobe

Diagnostic Studies
· Serum albumin 2.8 g/dl (28 g/L)
· White blood cell (WBC) count 18,000/ml (18 x 109/L)
· Sputum specimen: thick, green colored, foul smelling; cultures pending
· Arterial blood gases: pH 7.29, PaO2 80 mm Hg, PaCO2 40 mm Hg, bicarbonate 16 mEq/L
· Stool culture positive for Clostridium difficile
· Chest x‑ray: infiltrate in left upper lobe; no pleural effusions noted

Critical Thinking Questions
1. What types of infectious disease precautions should be taken related to Sam’s hospitalization?
2. What clinical manifestations of aspiration pneumonia did Sam exhibit? Explain their pathophysiologic bases.
3. What antibiotic medication is likely to be prescribed?
4. What is his oxygenation status and metabolic state?
5. What other clinical issues need to be addressed in his plan of care?
6. What family interventions would you initiate?
7. Based on the assessment data presented, write one or more appropriate nursing diagnoses. Are there any collaborative problems?

Lewis, et al: Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 6th Edition
Chapter 28: NURSING MANAGEMENT: Obstructive Pulmonary Diseases

Asthma

Patient Profile
Mrs. S., a 30-year-old African American mother of two preschoolers, comes to the emergency department (ED) with severe wheezing, dyspnea, and anxiety. She was in the ED only 6 hours ago with an acute asthma attack.

Subjective Data
· Treated in the ED previously with nebulized albuterol and responded quickly
· Can speak only one- to three-word sentences
· Is allergic to cigarette smoke
· Began to experience increased shortness of breath and tightness in her chest when she returned home
· Used albuterol MDI (without a spacer) repeatedly at home with no relief

Objective Data
Physical Examination
· Uses accessory muscles to breathe
· Has audible wheezing
· Respiratory rate 34/min
· Auscultation reveals no air movement in lower lobes
· Heart rate 126 beats/min

Diagnostic Studies
· ABGs: PaO2 80 mm Hg, Paco2 35 mm Hg, pH 7.46
· PEFR: 150 L/min (personal best: 400 L/min)

Critical Thinking Questions
1. Why did Mrs. S. return to the ED? Explain the pathophysiology of this exacerbation of asthma.
2. What are the nursing care priorities for Mrs. S.?
3. What are the complications the nurse must be ready for based on her assessment of Mrs. S.?
4. What should be included in her discharge plan of care?
5. Based on the assessment data presented, write one or more nursing diagnoses. Are there any collaborative problems?

Monday, March 20, 2006

N4's
There is a shortage of N5 textbooks at the bookstore. Is there anyone thats willing to sell their N5 textbook or loan their book please let me know.
Thanks
Mosby's Box o'cards

I heard there is a new edition out...Anyone have the new ones yet?
Someone mentioned they'd be at the Barnes and Noble across from school. Anyone know?

Thanks!!
-Lisa

Saturday, March 18, 2006

I found these links to be helpful for N5:

For Chemical Dependence (when you make your "drug chart")
www.streetdrugs.org
Street Terms: Drugs and the Drug Trade

I found these sites to be interesting concerning the use of antipsychotic drugs and patient's rights:
http://www.mindfreedom.org/
PSYCHRIGHTS

Also, I just wanted to share this poem with all you guys...

To Be a Mental Patient by Rae Unzicker (1948-2001)

To be a mental patient is to be stigmatized, ostracized, socialized, patronized, psychiatrized.
To be a mental patient is to have everyone controlling your life but you. You're watched by your shrink, your social worker, your friends, your family. And then you're diagnosed as paranoid.
To be a mental patient is to live with the constant threat and possibility of being locked up at any time, for almost any reason.
To be a mental patient is to live on $82 a month in food stamps, which won't let you buy Kleenex to dry your tears. And to watch your shrink come back to his office from lunch, driving a Mercedes Benz.
To be a mental patient is to take drugs that dull your mind, deaden your senses, make you jitter and drool and then you take more drugs to lessen the "side effects."
To be a mental patient is to apply for jobs and lie about the last few months or years, because you've been in the hospital, and then you don't get the job anyway because you're a mental patient. To be a mental patient is not to matter.
To be a mental patient is never to be taken seriously.
To be a mental patient is to be a resident of a ghetto, surrounded by other mental patients who are as scared and hungry and bored and broke as you are.
To be a mental patient is to watch TV and see how violent and dangerous and dumb and incompetent and crazy you are.
To be a mental patient is to be a statistic.
To be a mental patient is to wear a label, and that label never goes away, a label that says little about what you are and even less about who you are.
To be a mental patient is to never to say what you mean, but to sound like you mean what you say.
To be a mental patient is to tell your psychiatrist he's helping you, even if he is not.
To be a mental patient is to act glad when you're sad and calm when you're mad, and to always be "appropriate."
To be a mental patient is to participate in stupid groups that call themselves therapy. Music isn't music, its therapy; volleyball isn't sport, it's therapy; sewing is therapy; washing dishes is therapy. Even the air you breathe is therapy and that's called "the milieu."
To be a mental patient is not to die, even if you want to -- and not cry, and not hurt, and not be scared, and not be angry, and not be vulnerable, and not to laugh too loud -- because, if you do, you only prove that you are a mental patient even if you are not.
And so you become a no-thing, in a no-world, and you are not.

Rae Unzicker © 1984
Dear N5,
As part of the Chemical Dependence module you'll need to attend a 12-step meeting. Here's a Meeting Locator from Narcotics Anonymous so you can find a meeting where/when it's convenient for you.
Congratulations to everyone for passing n4/n5. To those that did not make it through to the end, remember that we will always be here to help you...if you decide to take n4 again, we will be available to you as resources and stand by you 150%. You will have the knowledge to be ahead of the game next time around, and you will get through it. Never more did I realize how much of a benefit we can be to each other than this semester, we have to all work together and supporting eachother. Confucius says, "Our greatest glory is not in never falling, but in rising every time we fall. "

Thursday, March 16, 2006

Woo Hoo!!!!

N4 is over and we made it through. Aren't you proud of yourselves??? I know I am. I just wanted to say congrats. That was a challenge was it not?

Monday, March 13, 2006

To any N5'ers: Which books did you actually use for the class. I don't want to buy any books that I don't really need and that will just get added to "the pile". I would appreciate any input!!! Thanks and Good Luck in N4!
Hi! This is Anton and I'd like to know if there is any of you who would like to exchange clinical sched with me for Nursing 4. I am supposed to have it at the county hospital with Prieto on a Thurs. & Wed. from 6:30 am -4:00 pm. I would like to swap hopefully with someone who is taking it at St. Joe evening clinical. I know it's kinda late for me to realize I'm not a morning person but just in case let me know through my email bmena1023@yahoo.com. Thanks

Friday, March 10, 2006

EKG Class Grades

The grades for the EKG class have been posted.

Today I Held A Beating Heart !!!!!!

What a way to spend the last day of N7 clinical,
Shoulder to shoulder between 2 doctors performing a triple bipass (CABG).
After the chest was opened and the pericardial sac opened, I was allowed to reach inside, sliding my hand between the pericardial sac and the pericardium, until I was underneath, and then I lifted this warm and heavy heart up from the cavity while it continued to beat, and I held it in my hand!!!!
WAY COOL!!
I am still in awe of the whole experience.
This is how Jane G. and I spent our last clinical day!
It took over an hour to get the patient prepped and the room ready. The doctors came in at 0800 and the heart was in my hand at 0845.
The surgery was completed at 1200.

Good Luck to all on your finals!!!!!!!!
the ekg summer class holds on wed/thurs from 9-11.
summer ekg class>>>>course code number 90838 from June5-22nd I will post meeting time when I get it.
oopsie daisy...LOCKE guys (Thanks Kris) also...what is the schedule in N5 guys? Do we get the first three weeks off of clinicals, so our clinical days are free then until we start yes? I am trying to plan work schedule..thanks so kindly...see you all soon;)

Thursday, March 09, 2006

ATTENTION ATTENTION.....information n4/n5 swap aka the "Sharing circle" ;)...will be next Friday....The 17th (LUCKY DAY) we will be meeting at the circle pond outside at the end of the stairs of Shima ( by Java Jitters) at 12 pm....I will send Julie Kay an email and ask if we can go inside to the skills lab, if not...we will find somewhere to go. SEE YOU ALL THERE!!!!

Sunday, March 05, 2006

N5ers...
I need some help.
The chemical dependency modules...are those turned in to our clinical instructor or Mrs. Ippolito?
Gracias!
-Lisa
Animation Activities guys this is a GOOD animation site..there are 2 renal animations with post tests...check it out if you are visual like me..this is awesome!
NurseWeek: Service with a Smile I just thought I would prove to all those doubting my dream of being a Disneyland nurse..the job does exist...work as an RN Monday through Friday in Disneyland and work one weekend a month as Cinderella in the parade, can it get any better than that? Just curious if anyone has any other interesting RN jobs that they have heard of??? Let's keep us all motivated with laughter!

Friday, March 03, 2006

National Kidney Foundation
N4
Those of you going to N5 with course code 63875, can one of you tell where our clinicals are???
When I looked it up, it says TBA.
Thanks
Attention all n5's and n4's (so I guess that would be all of us ;)....shall we plan an hour meeting to share hints and helps for the swapping of classes soon? I know we have lots of hints, tips, and THE note CD.....I am sure ya'll got some stuff for us too....when is a good time guys? The Friday after finals from 11-1? Let me know if you guys are interested, I will be there...hopefully you guys remember the pact we made in nursing one haha....see you all soon!!!

Thursday, March 02, 2006

Wandering Post from Fazia
N4
Can someone tell me where to turn in the care plan. I know its shima but don't recall the room. So much for paying attention to details huh........
See you monday
Nine more days Yeah!!!!!!

Fazia, I have found and returned your post to its rightful home LOL. Good luck on your finals!!!!!!
Would anyone who's in N4 be willing to share the study guides for at least the first test - any others would be greatly appreciated?! (Or is there a place I can find it?)

THANKS!
-Lisa Stephenson

Care Plan Helps

Here are some links that can help you with your Nursing Diagnoses and Care Plans.
RN Central
Care Plan Constructor

Critical Care Tutorials

Hey all,
These tutorials really helped out in N7. Even though they say Critical Care, they still have the basics backed up with simple physiology and easy to understand concepts. It's a lot easier reading than our text books so check these out for N4 too. They get right to the point and will not take a ton of time to read.
Sorry this is so late for you just finishing N4 but I only just found this site. There are some good pictures and flow charts.

Critical Care Tutorials