Tim, hey there...how many tickets did you want again? just leave the check with Julie ok? we are gonna have alot of fun!! ;)

SNA meeting coming up!

San Joaquin Delta College Student Nurse’s Association
Announces the next meeting of the SNA on

APRIL 24TH AT 1 P.M.

ROOM 313

PIZZA WILL BE SERVED
PRIZES WILL BE AVAILABLE
ELECTIONS WILL BE HELD

COME HAVE FUN, MEET NEW PEOPLE AND COMPARE CLINICAL EXPERIANCES

THE SNA NEEDS YOU!!!!

HI All!!!

Just wanted to share a funny with you. Have a great Easter/Spring Break!

Question for y'all...

I am looking to get a drug book, I have Davis Drug Guide for my PDA, but I want a book I can actually hold and turn the pages.

Which drug guide do you use? Do you like it? Why or why not.

Thanks!
-Lisa

Hey group!
Here's our pic...Finally =]

Enjoy.

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)

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.

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

Today I became an ICU Nurse

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

Reminder:

SNA meeting

March 27th @1300 Locke 313.

Now accepting nominations for officers.

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?

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

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