My friends....

Please join me on Thursday, November 10th at 12 pm to help plan the welcome reception. There are alot of ideas floating around, and I have information to share. I know that some of you will be going away for your much deserved winter break, but I would still love to hear your imput!

We have invitations that need to be folded and little things that can be done at home to help us prepare if you are not one of the speak in public types :).

Also...a HUGE HUGE favour I need from each of you...I would like to prepare some sort of food for the new people coming in...is 5 dollars a piece feasable for each of you?

Thank you all so much!

Let us create a nice welcome for those coming in

-Christine :)

More for you future nurses,

Several people have requested a "Test Taking Statagies class", on how to read nursing test questions. I will be having a one class on Monday, November 7, 2005 9:00 - 10:00 am in L228. See you there.
Caralee

Dear SJDC Future Nurses,

We are in the process of evaluating new software for the computer lab and would like to get your input.

The online preview of Learning System, Nurse Logic, Dosage & Calculations, Pharmacology and Skill Building from Meds publishing has been set up. You have free access until December 1, 2005. Please follow the instructions on the attached student login document and use the following class activation code to access the exams.


7566fly680house669


You’ll first want to go to http://online.medspub.com/medsonline/sec-support.html and click “Check My Computer Settings.” That will walk you through six easy steps to make sure your computer is ready for Meds. Steps 2 and 3 even have places to click for FREE Internet Explorer and FlashPlayer upgrades if needed. Those two things are a must in order to run Meds online.

After you have reviewed the program, please send your comments to cbromme@deltacollege.edu

Identify was it easy to access and use?
Did it help you in your studies?

I look forward to your input.
Caralee

End of life care summary and free NCLEX questions...scroll down to the end of the article and click "take the test"End-of-Life Care - continuing education course for nurses, physical therapists, occupational therapists, paramedics, EMTs and...


:)

Does anybody know what's up with the "Question of the Week" on learningext.com ? It's been on the same question since 10/17 .... ?

Would you like your name/initials on your Delta Nursing jacket, sweatshirt, poloshirt?? I dont have a cost right now, but I need 25 items to place the order. If you sign up, and then if the price is not what you want to pay, then you can remove your name.... I just need an estimate of the #'s. Please send me an email : RDeYoung585@students.deltacollege.edu

I will post on the BLOG when I get the price :)

I was thinking white lettering, script style -- don't know if we have other options so if there is something different you would like, let me know & I'll find out

Does anyone have shelbas email?????
I have her hours that she is available and her phone number but not her email.
If someone could post that, it would be great.

Mike,

Hi there..please email me. I need to ask your help with a possible slide show presentation for the welcome reception...and your group's cultural thing was so good...please email me at rnstudychris@aol.com thanks so much!! :)

Everyone...there is a new shirt available from the SNA with the Delta ADN logo...Polo shirts! How fun! ;)Now available for $20.00 a piece in grey and navy blue.....guys I know you will like these, I suggested we get them..so y'all should buy one, so I dont look bad haha..Let me know if anyone wants one! :)

N2 Cancer drug considerations
Lilley: Pharmacology and the Nursing Process, 4th Edition
Multiple Choice Review Questions Chapter 46
1.
The term nadir refers to:
A. The average number of days it takes the bone marrow to recover from a dose of chemotherapy
B. The average number of days it takes for the chemotherapy to have its peak effect on the bone marrow
C. The patient's tolerance to the chemotherapy's bone marrow suppressant effect
D. The maximum dose for a chemotherapy agent in reference to bone marrow suppression

2.
General adverse effects of chemotherapy include which of the following? (choose all that apply)
A. Leukocytosis
B. Thrombocytopenia
C. Alopecia
D. Urinary retention

3.
Prednisone added to a chemotherapeutic regimen contributes to all of the following except:
A. Fluid retention and risk of infection
B. Increase in blood sugar
C. Sense of well-being and euphoria
D. Decrease in bleeding tendency

4.
Combinations of chemotherapeutic agents are frequently used for all of the following purposes except:
A. Preventing drug resistance
B. Providing a synergistic action
C. Decreasing cost of treatment
D. Decreasing the severity of adverse effects

5.
When a patient is receiving cyclophosphamide (Cytoxan), he or she should be advised to drink plenty of water/fluids to:
A. Prevent renal failure
B. Prevent hemorrhagic cystitis
C. Prevent liver dysfunction
D. Increase the red blood cell count

6.
The nurse would anticipate administering which of the following medications to patients receiving high-dose methotrexate?
A. bleomycin
B. cisplatin
C. leucovorin
D. dactinomycin

7.
Nausea and vomiting are frequent adverse effects associated with antineoplastic therapy. Patients who are experiencing this unpleasant effect should be advised:
A. To avoid eating any food during chemotherapy
B. That there is nothing that can be done for this effect and it will pass with time
C. To try to maintain hydration and nutrition, which are very important during treatment
D. To use antacids to relieve the irritation to the stomach, which should stop the nausea

8.
When teaching a patient receiving paclitaxel (Taxol), the nurse needs to prepare the patient for which of the following?
A. Weight gain
B. Vertigo
C. Arthralgias
D. Hypertension

9.
When assessing a patient for adverse effects related to cisplatin (Platinol), the nurse will monitor for which of the following? (choose all that apply)
A. Nephrotoxicity
B. Peripheral neuropathy
C. Hepatoxicity
D. Severe nausea/vomiting

10.
A major dose-limiting side effect of doxorubicin (Adriamycin) is:
A. Hemorrhagic cystitis
B. Cardiomyopathy
C. Hepatoxicity
D. Nephrotoxicity

11.
Which of the following laboratory results would cause the nurse to question administration of cyclophosphamide (Cytoxan)?
A. White blood cell count of 8000
B. Platelet count of 450,000
C. Hemoglobin of 15
D. Thrombocyte count of 8000

12.
The nurse would suspect which type of cancer in a patient receiving tamoxifen?
A. Lung cancer
B. Renal cancer
C. Breast cancer
D. Colon cancer

Hello everyone!!

Just a reminder for those that are interested...this Thursday at 10 am is the dimensional analysis review with Fern, then at 11 is the NCLEX review question session with Bonnie.

There are many sweatshirts available for those interested...they are 30 for pullovers and 35 for zip-up.

One more thing...I need speakers for the tea so far I have...

Christine Moles welcome and introduction

Mike speaking about PDA'S

Fazia will pass on the blog torch

Robyn will help with graduation letter

and Dan is making the invitations

Chuck will speak on the importance of sitting at the end of the row and speed reading (haha)


ANY ideas on speakers, handouts etc...Send em to my email rnstudychris@aol.com or talk to me on the break Thursday...later nurses to be

Congratulations Sarah Coots on the delivery of your first grandbaby!!!!!

Christine, If you haven't received any other offers, I would be happy to help you with invitations. I wasn't able to go to the reception so I missed out! Please email me at rdeyoung585@delta..... and we can exchange phone #'s or something if you want. Thanks for taking this on!

Complimentary and alternative medicine.
http://nccam.nih.gov/health/

Just thought I should say this...

To those that have decided that nursing is not the path for you...

We wish you all the best with your future endeavors. We offer our encouragement and honor your decsions to go on another path aside this one of nursing. Many of you had to make the very difficult decision to go another way, some feeling very sad for those of us remaining. Don't be sad for us, for this is the choice we have made. Let each of us rejoice in the bravery of one straying from the pack to lead another. You all will do tremendous things, we are proud of you, wish you all the happiness and health in the world.



(Ps..thanks Julie K...for opening my eyes, and being able to share with others :)

Check out this link to a former student, now RN
http://www.nursingstudio.net/
Her website is full of NCLEX RN questions and links to everything of interest to nursing students.

Hi everybody....A few things for you all..

1. Thank you Julie Kay. We are going to be able to use Locke 231 on Fridays as a quiet study room. The key word for this room is.....QUIET. So, if you are interested in coming in here...please be interested in being quiet haha. Thank you.

2. Beginning next Thursday, the 27th of October Bonnie has graciously offered her services to us as a tutor. She will be providing NCLEX questions that are relating to what we are learning about in N2. I have a request in with Julie Kay to be able to use the empty room on Locke 3 (I dont know the number, it is the one with the desks and supplies in it, the same place where Fern does her Monday meetings with us).

3. BONNIE...please send me an email with your email so that I dont have to keep asking you little things on this blog haha. Thank you...my email is rnstudychris@aol.com

Hi All,
I was just wondering what time the make up Math test is and where?
Thanks,
Tami

End-of-Life Care
http://www.criticalcareceu.com/courses/103/index_ccare.html
1.
More than 2.4 million people die each year in the United States. Of those:
a. Ninety percent die at home.
b. Less that 25% die at home.
c. Twenty percent die in hospitals.
d. Most die suddenly in an accident.

2.
In the United States, end-of-life care programs:
a. Are widely used in most states.
b. Are used for far more than the 60 days considered necessary to gain maximum benefit.
c. Are available in the vast majority of hospitals.
d. Have few nurses or physicians certified in palliative care.

3.
All of the following statements about hospice care are true except:
a. Drugs for symptom control and pain relief are not covered by the Medicare hospice benefit program.
b. Most Americans do not know that hospice care can be provided in the home.
c. The Medicare hospice benefit guarantees comprehensive high-quality care at little or no cost.
d. To access the hospice benefit, the client’s doctor must certify that the client likely has six months or less of life remaining.

4.
Palliative care:
a. Seeks to hasten death once a person has been declared terminal.
b. Seeks to improve the quality of life of dying clients.
c. Should not be used in conjunction with other therapies that prolong life.
d. Is not applicable in the early stages of an illness.

5.
Which of the following statements about hospice care is true?
a. It is a specific place or facility.
b. It is only for people with cancer.
c. Anyone diagnosed with terminal illness is eligible.
d. It is only for older people.

6.
The principle of double effect states:
a. The healthcare provider has a duty to protect life and to provide the means to end life.
b. Hastening death is acceptable if it is an unintended consequence of relieving suffering.
c. A healthcare worker is not required to intervene if a client attempts to take his or her own life. d. A client can refuse medical treatments but cannot refuse artificial nutrition or hydration.

7.
Studies of death trends in American hospitals show:
a. More blacks than whites die as hospital inpatients.
b. In 2000, whites and blacks died in the hospital in equal proportions.
c. Access to pain medications is better for blacks than for whites.
d. Poor communication is not a factor when deciding on end-of-life care options.

8.
Federal law requires hospitals to inform clients that they have the right to complete an advance directive.
a. True
b. False

9.
All of the following statements about do-not-attempt-resuscitation (DNAR) orders are true except:
a. It was formerly known as do-not-resuscitate orders.
b. DNAR orders are found in over 90% of medical charts.
c. The DNAR order should be readily available in the event of an emergency.
d. Withholding CPR does not equate with letting someone die.

10.
All of the following statements about artificial nutrition and hydration (ANH) are true except:
a. Many older clients choose to end their lives by refusing food and liquids.
b. Forgoing ANH is the same as “killing” or “starving” the client.
c. Nasogastric tube feedings can lead to such complications as pain, aspiration pneumonia, and epistaxis.
d. People who choose not to have ANH do not suffer from hunger or thirst.

11.
Which of the following is an urgent indication of the need to discuss end-of-life care?
a. Discussion of the prognosis.
b. Discussing treatment with low probability of success.
c. Discussing hopes and fears.
d. Inquiries about hospice or palliative care.

12.
Discussing death explicitly helps the client express fears and concerns about the dying process and allows the clinician to address them directly.
a. True
b. False

13.
Which of the following statements about pain is true?
a. It should not be considered as a vital sign.
b. Most people in nursing homes with advanced cancer receive effective treatment for pain.
c. When pain is relieved symptoms such as depression, diminished appetite, and impaired sleep may disappear.
d. Its symptoms are generally effectively managed by clinicians.

14.
The Joint Committee on Accreditation of Healthcare Organizations (JCAHO) requires that hospitals and other healthcare facilities regularly assess, monitor and manage pain in all clients.
a. True
b. False

15.
Which of the following statements about pain is false?
a. Pain perception varies from person to person.
b. Older adults may have a higher pain threshold than younger people or children.
c. A person’s perception of pain may be affected by cultural considerations.
d. The client’s preferences should not define the goal of pain management.

16.
Drowsiness frequently occurs at the beginning of opioid therapy, not only from drug action on the brain but also because the client has been sleep-deprived due to unrelieved pain.
a. True
b. False

17.
Shortness of breath is common among dying clients. All of the following approaches are used to treat this symptom except:
a. Inhaled corticosteroids.
b. Supplemental oxygen.
c. Anti-anxiety medications.
d. Low doses of morphine.

18.
Methods such as massage, physical therapy, acupuncture, and psychotherapy can be effective in the treatment of pain.
a. True
b. False

19.
One of the most common fears expressed by a person with a terminal illness is:
a. Fear of starvation.
b. Fear of disfigurement.
c. Fear of pain.
d. Fear of dying in the presence of family members.

20.
Depression during end-of-life care may be due to all of the following factors except:
a. A weak support system.
b. Persistent negative thinking regarding the diagnosis.
c. The need to spend time alone.
d. Increased dysfunction related to the illness.

21.
Although depression is highly treatable in most people, it cannot be treated effectively during end-of-life.
a. True
b. False

22.
Bereavement is:
a. The period of time, approximately 6 months, before a loved one’s death.
b. Being deprived of someone through death and the feeling of desolation that follows.
c. The process by which an individual is able to move through the stages of grief and emerge from the grieving process.
d. An exaggeration of the normal process of grieving, often resulting from multiple losses.

23.
All of the following caregiver problems are common except:
a. Families may face severe economic consequences.
b. Physical exhaustion, economic worries, and disrupted routines may lead to anxiety and depression.
c. Care for the loved one often takes priority over the caregiver’s own healthcare needs.
d. Hospice benefits provide mental health services for the caregiver.

24.
Which statement about end-of-life and cancer is true?
a. Chemotherapy and radiation treatments are usually stopped several months before death.
b. Treatment of cancer clients near death becomes gradually less aggressive.
c. Hospice is often being used to manage the death rather than palliate the disease.
d. Cancer clients are usually admitted to hospice care several months before death.

25.
Clients with Alzheimer’s disease are eligible for hospice care and account for more 30% of the annual hospice census.
a. True
b. False

26.
In people with severe cognitive impairment, artificial nutrition and hydration:
a. Can be withheld if the client’s wishes have been made clear in an advance directive.
b. Is given via feeding tube to more than 18% of those with severe cognitive impairment.
c. Is sometimes given because the nursing home receives special reimbursement.
d. All of the above

27.
The availability of HAART for the treatment of HIV/AIDS has eliminated the need to provide end-of-life care to HIV positive clients.
a. True
b. False

28.
A person living with advanced AIDS may have unique issues related to the disease including:
a. Stigmatization because of HIV/AIDS.
b. Lack of traditional support systems.
c. Bereavement from multiple losses.
d. All of the above

29.
Which of the following statements about dying children is true?
a. The majority of children with cancer receive palliative care.
b. It is sometimes difficult to predict whether a life-threatening illness will end in cure or death.
c. Children do not fear death as much as adults.
d. Children are prone to addiction from pain medications.

30.
The dying child and family members need to talk with one another about death.
a. True
b. False

31.
The possibility of dying raises issues for both the child and the family. These include:
a. Fear of a painful death.
b. Fear of dying alone.
c. Fear of not being present when the child dies.
d. All of the above

32.
Signs of imminent death include all of the following except:
a. Drowsiness.
b. Extremities becoming cool to the touch.
c. Rattling or gurgling breath sounds.
d. Increased ease in controlling pain.

33.
Post-mortem care should include all of the following except:
a. Remove all equipment and soiled linen from the bedside.
b. Avoid facial discoloration by placing the body in a supine position with a pillow under the head and shoulders.
c. Avoid upsetting the family by allowing only a short viewing of the body.
d. Attach identification tags to the ankle and wrist.

34.
All of the following statements about autopsies are true except:
a. Nationally, only about 5% of deaths undergo autopsy.
b. Clinical diagnoses, whether obtained from death certificates or hospital discharge data, contain major inaccuracies compared with autopsy diagnoses.
c. The healthcare system as a whole can benefit enormously from autopsy data.
d. Autopsies disfigure the body.

35.
Questions about organ donation are best discussed with the client in the context of advance directives.
a. True
b. False

36.
Which of the following statements about bereavement is false?
a. A family’s bereavement begins when their loved one is diagnosed with terminal illness.
b. Grief can cause somatic distress, guilt, and hostile reactions.
c. Grief can cause overwhelming fatigue.
d. It is best not to form new relationships while grieving.

Next Thursday at 11 am there is going to be a group study with Bonnie. It will be sort of like an NCLEX related question/answer session. I have requested the use of Locke 230(where the meetings with Fern are). If y'all are interested in coming...please look onto the blog and I will find out where the actual room is going to be. I have also asked Kim Thompson if there is a classroom that can be used for people who like quiet study in lieu of the throng of teenage love affairs going on under the desks in the library. :) Hope everyone is doing well in clinicals...on to nursing two :) PS...Thank you Bonnie for all your support