Nursing Crib http://nursingcrib.com Student Nurses' Community - Nursing Board Exam Results, Nursing Care Plans (NCP), Case Studies Fri, 06 Nov 2009 01:42:00 +0000 http://wordpress.org/?v=abc en hourly 1 http://creativecommons.org/licenses/by/2.0/http://creativecommons.org/licenses/by/2.0/http://creativecommons.org/images/public/somerights20.gifSome Rights Reservednursingcribhttp://feedburner.google.com Types of Abortion http://feedproxy.google.com/~r/nursingcrib/~3/ldviYT5dVzg/ http://nursingcrib.com/types-of-abortion/#comments Fri, 06 Nov 2009 01:28:59 +0000 Admin http://nursingcrib.com/?p=3183

An abortion is the termination of a pregnancy by the removal or expulsion from the uterus of a fetus or embryo, resulting in or caused by its death.

Causes of Abortion

Abortion may be occur due to various factors such as fetal, placental, or maternal.

  1. Fetal Causes – The most common cause of early spontaneous abortion is abnormal development of the zygote, embryo or fetus. These abnormalities are incompatible with life and would have resulted in severe congenital anomalies had pregnancy not been aborted spontaneously.
  2. Maternal Factors – These are congenital or acquired conditions of the mother and environmental factors that had adversely affected pregnancy outcome and led to abortion. Such conditions include diabetes mellitus, incomplete cervix, exposure to radiation and infection.
  3. Placental Factors – Placental factors usually cause abortion around the 14th week of gestation. These factors includes premature separation of the normally implanted placenta and abnormal placental implantation.

Abortion Types

Characteristics

Management

Threatened Abortion
  • occurring before the 20th week of gestation
  • characterized by cramping and vaginal bleeding with no cervical dilation.
  • it may subside or an incomplete abortion may follow.
  1. Bedrest
  2. No coitus up to 2 weeks after bleeding stopped
Imminent or Inevitable Abortion
  • membranes rupture and the cervix dilates
  • characterized by lower abdominal cramping and bleeding.
  1. Hospitalization
  2. D and C
  3. Oxytocin after D and C
  4. Sympathetic
  5. Understanding and emotional support
Incomplete Abortion
  • is characterized by expulsion of only part of the products of conception (usually the fetus).
  • severe uterine cramping
  • bleeding occur with cervical dilation.
  1. D and C
  2. Oxytocin after D and C
  3. Sympathetic
  4. Understanding and emotional support

Complete Abortion
  • characterized by complete expulsion of all products of conception
  • light bleeding
  • mild uterine cramping
  • passage of tissue
  • closed cervix
  1. There is no treatment other than rest is usually needed.
  2. All of the tissues that came out should be saved for examination by a doctor to make sure that the abortion is complete.
  3. The laboratory examination of the saved tissue may determine the cause of abortion.
Missed Abortion
  • intrauterine pregnancy is present but is no longer developing normally
  • the cervix is closed, and the client may report dark brown vaginal discharge.
  • pregnancy test findings are negative.
  1. Usually treated by induction of labor by dilation (or dilatation) and curettage (D & C).
Recurrent or Habitual Abortion
  • characterized by spontaneous abortion of three or more consecutive pregnancies
  1. Trace the cause of recurrent abortion
Septic Abortion
  • abortion complicated by infection
  • foul smelling vaginal discharge
  • uterine cramping
  • fever
  1. Antibiotics as prescribed by your Obstetrician

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]]> http://nursingcrib.com/types-of-abortion/feed/ 0 http://nursingcrib.com/types-of-abortion/ Pathophysiology of Myocardial Infarction http://feedproxy.google.com/~r/nursingcrib/~3/zMWs7edow2g/ http://nursingcrib.com/pathophysiology-of-myocardial-infarction/#comments Wed, 04 Nov 2009 04:30:52 +0000 Admin http://nursingcrib.com/?p=3182

pathophysiology of Myocardial Infarction In Myocardial Infarction, inadequate coronary blood flow rapidly results in myocardial ischemia in the affected area. The location and extent of the infarct determine the effects on cardiac function. Ischemia depresses cardiac function and triggers autonomic nervous system responses that exacerbate the imbalance between myocardial oxygen supply and demand. Persistent ischemia results in tissue necrosis and scar tissue formation, with permanent loss of myocardial contractility in the affected area. Cardiogenic shock may develop because of inadequate CO from decreased myocardial contractility and pumping capacity.

Learn more about Myocardial Infarction
Nursing Care Plan – Myocardial Infarction

]]> http://nursingcrib.com/pathophysiology-of-myocardial-infarction/feed/ 0 http://nursingcrib.com/pathophysiology-of-myocardial-infarction/ Nursing Test III http://feedproxy.google.com/~r/nursingcrib/~3/ttTXZ3Bhu1o/ http://nursingcrib.com/nursing-test-iii/#comments Mon, 02 Nov 2009 02:57:44 +0000 Admin http://nursingcrib.com/?p=3179

The scope of  this Nursing Test III is parallel to the NP3 NLE Coverage:

  • Medical Surgical Nursing

If you want to get more nursing practice test to enhance your critical thinking skills in preparation for the November 2009 Nursing Board Examination, get a copy of our Nursing Board Exam Reviewer v1.0 and Nursing Board Exam Reviewer v 2.0 Ebook for only P149 each.

More online Interactive Nursing Test will be available soon…

1. The nurse is going to replace the Pleur-O-Vac attached to the client with a small, persistent left upper lobe pneumothorax with a Heimlich Flutter Valve.  Which of the following is the best rationale for this?





2. The client with acute pancreatitis and fluid volume deficit is transferred from the ward to the ICU.  Which of the following will alert the nurse?





3. The nurse in the morning shift is making rounds in the ward.  The nurse enters the client’s room and found the client in discomfort condition.  The client complains of stiffness in the joints.  To reduce the early morning stiffness of the joints of the client, the nurse can encourage the client to:





4. The nurse is planning of care to a client with peptic ulcer disease.  To avoid the worsening condition of the client, the nurse should carefully plan the diet of the client.  Which of the following will be included in the diet regime of the client?





5. The physician has given instruction to the nurse that the client can be ambulated on crutches, with no weight bearing on the affected limb.  The nurse is aware that the appropriate crutch gait for the nurse to teach the client would be:





6. The client is transferred to the nursing care unit from the operating room after a transurethral resection of the prostate.  The client is complaining of pain in the abdomen area.  The nurse suspects of bladder spasms, which of the following is the best nursing action to minimize the pain felt by the client?





7. A client is diagnosed with peptic ulcer.  The nurse caring for the client expects the physician to order which diet?





8. The nurse is going to insert a Miller-Abbott tube to the client. Before insertion of the tube, the balloon is tested for patency and capacity and then deflated. Which of the following nursing measure will ease the insertion to the tube?





9. The physician ordered a low-sodium diet to the client.  Which of the following food will the nurse avoid to give to the client?





10. Mr. Bean, a 70-year-old client is admitted in the hospital for almost one month.  The nurse understands that prolonged immobilization could lead to decubitus ulcers.  Which of the following would be the least appropriate nursing intervention in the prevention of decubitus?





11.  The physician prescribed digoxin 0.125 mg PO qd to a client and instructed the nurse that the client is on high-potassium diet.  High potassium foods are recommended in the diet of a client taking digitalis preparations because a low serum potassium has which of the following effects?





12. The nurse is caring for a client who is transferred from the operating room for pneumonectomy.  The nurse knows that immediately following pneumonectomy; the client should be in what position?





13. A client is placed on digoxin, high potassium foods are recommended in the diet of the client.  Which of the following foods will the nurse give to the client?





14. The nurse is assigned to care to a client who undergone thyroidectomy.  What nursing intervention is important during the immediate postoperative period following a thyroidectomy?





15. What would be the recommended diet the nurse will implement to a client with burns of the head, face, neck and anterior chest?





16. A client with multiple fractures of both lower extremities is admitted for 3 days ago and is on skeletal traction.  The client is complaining of having difficulty in bowel movement.  Which of the following would be the most appropriate nursing intervention?





17. John is diagnosed with Addison’s disease and admitted in the hospital.  What would be the appropriate nursing care for John?





18. Mr. Smith is scheduled for an above-the-knee amputation.  After the surgery he was transferred to the nursing care unit.  The nurse assigned to him knows that 72 hours after the procedure the client should be positioned properly to prevent contractures.  Which of the following is the best position to the client?





19. A client is scheduled to have an inguinal herniorraphy in the outpatient surgical department.  The nurse is providing health teaching about post surgical care to the client.  Which of the following statement if made by the client would reflect the need for more teaching?





20. Ms Jones is brought to the emergency room and is complaining of muscle spasms, numbness, tremors and weakness in the arms and legs.  The client was diagnosed with multiple sclerosis.  The nurse assigned to Ms. Jones is aware that she has to prevent fatigue to the client to alleviate the discomfort.  Which of the following teaching is necessary to prevent fatigue?





21. Mr. Stewart is in sickle cell crisis and complaining pain in the joints and difficulty of breathing.  On the assessment of the nurse, his temperature is 38.1 ºC.  The physician ordered Morphine sulfate via patient-controlled analgesia (PCA), and oxygen at 4L/min.  A priority nursing diagnosis to Mr. Stewart is risk for infection.  A nursing intervention to assist in preventing infection is:





22. Mrs. Maupin is a professor in a prestigious university for 30 years.  After lecture, she experience blurring of vision and tiredness.  Mrs. Maupin is brought to the emergency department.  On assessment, the nurse notes that the blood pressure of the client is 139/90.  Mrs. Maupin has been diagnosed with essential hypertension and placed on medication to control her BP.  Which potential nursing diagnosis will be a priority for discharge teaching?





23. Following a needle biopsy of the kidney, which assessment is an indication that the client is bleeding?





24. A client with acute bronchitis is admitted in the hospital.  The nurse assigned to the client is making a plan of care regarding expectoration of thick sputum.  Which nursing action is most effective?





25. The nurse is going to assess the bowel sound of the client.  For accurate assessment of the bowel sound, the nurse should listen for at least:





26. The nurse encourages the client to wear compression stockings.  What is the rationale behind in using compression stockings?





27. Mr.  Whitman is a stroke client and is having difficulty in swallowing.  Which is the best nursing intervention is most likely to assist the client?





28.  Following nephrectomy, the nurse closely monitors the urinary output of the client.  Which assessment finding is an early indicator of fluid retention in the postoperative period?





29. A nurse is completing an assessment to a client with cirrhosis.  Which of the following nursing assessment is important to notify the physician?





30. Mr.  Park is 32-year-old, a badminton player and has a type 1 diabetes mellitus.  After the game, the client complains of becoming diaphoretic and light-headedness.  The client asks the nurse how to avoid this reaction.  The nurse will recommend to:





31. A client is rushed to the emergency room due to serious vehicle accident.  The nurse is suspecting of head injury.  Which of the following assessment findings would the nurse report to the physician?





32. Mrs.  Moore, 62-year-old, with diabetes is in the emergency department.  She stepped on a sharp sea shells while walking barefoot along the beach.  Mrs. Moore did not notice that the object pierced the skin until later that evening.  What problem does the client most probably have?





33. A client with gangrenous foot has undergone a below-knee amputation.  The nurse in the nursing care unit knows that the priority nursing intervention in the immediate post operative care of this client is:





34. A client with a diagnosis of gastric ulcer is complaining of syncope and vertigo.  What would be the initial nursing intervention by the nurse?





35. After a right lower lobectomy on a 55-year-old client,  which action should the nurse initiate when the client is transferred from the post anesthesia care unit?





36. The nurse is providing a discharge instruction about the prevention of urinary stasis to a client with frequent bladder infection.  Which of the following will the nurse include in the instruction?





37. A male client visits the clinic for check-up.  The client tells the nurse that there is a yellow discharge from his penis.  He also experiences a burning sensation when urinating.  The nurse is suspecting of gonorrhea.  What teaching is necessary for this client?





38. A client with AIDS is admitted in the hospital.  He is receiving intravenous therapy. While the nurse is assessing the IV site, the client becomes confused and restless and the intravenous catheter becomes disconnected and minimal amount of the client’s blood spills onto the floor.  Which action will the nurse take to remove the blood spill?





39. Before surgery, the physician ordered pentobarbital sodium (Nembutal) for the client to sleep.  The night before the scheduled surgery, the nurse gave the pre-medication.  One hour later the client is still unable to sleep.  The nurse review the client’s chart and note the physician’s prescription with an order to repeat.  What should the nurse do next?





40. The nurse on the night shift is making rounds in the nursing care unit.  The nurse is about to enter to the client’s room when a ventilator alarm sounds, what is the first action the nurse should do?





41. What effective precautions should the nurse use to control the transmission of methicillin-resistant Staphylococcus aureus (MRSA)?





42. The postoperative gastrectomy client is scheduled for discharge.  The client asks the nurse, “When I will be allowed to eat three meals a day like the rest of my family?”.  The appropriate nursing response is:





43. A male client with cirrhosis is complaining of belly pain, itchiness and his breasts are getting larger and also the abdomen. The client is so upset because of the discomfort and asks the nurse why his breast and abdomen are getting larger.  Which of the following is the appropriate nursing response?





44. A client is diagnosed with detached retina and scheduled for surgery.  Preoperative teaching of the nurse to the client includes:





45. A 70-year-old client is brought to the emergency department with a caregiver.  The client has manifestations of anorexia, wasting of muscles and multiple bruises.  What nursing interventions would the nurse implement?





46. A nurse is providing a discharge instruction to the client about the self-catheterization at home.  Which of the following instructions would the nurse include?





47. The nurse in the nursing care unit is assigned to care to a client who is Immunocompromised.  The client tells the nurse that his chest is painful and the blisters are itchy.  What would be the nursing intervention to this client?





48. A client is admitted and has been diagnosed with bacterial (meningococcal) meningitis.  The infection control registered nurse visits the staff nurse caring to the client.  What statement made by the nurse reflects an understanding of the management of this client?





49. A 18-year-old male client had sustained a head injury from a motorbike accident.  It is uncertain whether the client may have minimal but permanent disability.  The family is concerned regarding the client’s difficulty accepting the possibility of long term effects.  Which nursing diagnosis is best for this situation?





50. A client with AIDS is scheduled for discharge.  The client tells the nurse that one of his hobbies at home is gardening.  What will be the discharge instruction of the nurse to the client knowing that the client is prone to toxoplasmosis?







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]]> http://nursingcrib.com/nursing-test-iii/feed/ 4 http://nursingcrib.com/nursing-test-iii/ Hypovolemic Shock http://feedproxy.google.com/~r/nursingcrib/~3/69EODVMdTdU/ http://nursingcrib.com/hypovolemic-shock/#comments Sat, 31 Oct 2009 07:08:58 +0000 Admin http://nursingcrib.com/hypovolemic-shock/

A. General information

  1. Hypovolemic shock is an emergency condition in which severe blood and fluid loss makes the heart unable to pump enough blood to the body. This type of shock can cause many organs to stop working.
  2. Hypovolemic shock reduces CO and causes inadequate tissue perfusion from loss of circulating blood volume.
  3. Inadequate tissue perfusion resulting from markedly reduced circulating volume.
  4. Surgical patient’s are at high risk because of blood loss intraoperatively and trauma from the manipulation of body tissue.

B. Causes

  1. Hemorrhage
  2. Burns
  3. Dehydration
  4. Trauma

C. Assessment findings

  1. Systolic blood pressure less than 90 mm Hg or 30 mm Hg less than baseline values
  2. Rapid weak pulse
  3. Dyspnea
  4. Tachypnea
  5. Cool, clammy skin
  6. Pallor
  7. Extreme thirst
  8. Irritability
  9. Urine output less than 30mL/hr

D. Diagnostic test findings

  1. Chest X-ray: pulmonary lesions and areas of atelectasis
  2. ABG measurements: respiratory alkalosis progressing to combined respiratory and metabolic acidosis; hypoxemia
  3. Serum chemistries: increased BUN, alkaline phosphatase, creatinine, lactate, and potassium levels; decreased HCO3, and albumin levels
  4. CBC: increased hematocrit (HCT) levels

E. Patient care management goal: restore the circulating blood volume

  1. Assess and document continuous ECG rhythm; vital signs; mental status; heart, lung, and bowel sounds; urine output; and any signs and symptoms indicating changes in these parameters
  2. Administer fluids (lactated Ringer’s solution or normal saline solution) to correct fluid deficit
  3. Obtain ABG measurements and monitor for hypoxemia and acid-base imbalance; monitor SaO2 with a pulse oximeter
  4. If a pulmonary artery catheter is in place, assess the patient’s fluid volume and document CVP, PAP, PAWP, CO, and SVR as ordered
  5. Weigh the patient daily, at the same time and on the same scale with patient wearing the same amount of clothing, to evaluate fluid balance
  6. Administer oxygen at a flow rate based on the patient’s clinical condition to relieve ischemia
  7. If gas exchange is inadequate, prepare the patient and equipment for intubation

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]]> http://nursingcrib.com/hypovolemic-shock/feed/ 0 http://nursingcrib.com/hypovolemic-shock/ New Dress Code Memo for Nursing Board Exam Takers http://feedproxy.google.com/~r/nursingcrib/~3/zEk599hIqQE/ http://nursingcrib.com/new-dress-code-memo-for-nursing-board-exam-takers/#comments Tue, 27 Oct 2009 13:39:10 +0000 Admin http://nursingcrib.com/?p=3177

A new resolution has been released by the PRC- Board of Nursing amending its previous resolution regarding the proper dress code for all nursing board exam examinees.

According to the resolution, examinees who are not in the prescribed dress code will not be allowed to take the nursing board examination.

Those who will take the November 2009 Nursing Board Exam are required to observe the following dress code:

Female
Clinical uniform with white shoes and white stockings but without nameplate, school insignia/logo, and pin or School Uniform.

Pregnant Examinees
White clinical scrub suit

Male
Clinical uniform with white shoes and white socks but without nameplate, school insignia/logo, and pin or School Uniform.

Repeaters may wear white clinical scrub suit.


Dress Code – November 2009 Nursing Board Exam

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]]> http://nursingcrib.com/new-dress-code-memo-for-nursing-board-exam-takers/feed/ 0 http://nursingcrib.com/new-dress-code-memo-for-nursing-board-exam-takers/ CHED to Close Down Worst Performing Nursing Schools http://feedproxy.google.com/~r/nursingcrib/~3/okr1plIm_Y8/ http://nursingcrib.com/ched-to-close-down-worst-performing-nursing-schools/#comments Tue, 27 Oct 2009 05:07:06 +0000 Admin http://nursingcrib.com/?p=3174

closed signA Total of 177 nursing schools in the country face closure for not producing any single graduate who passed the nursing licensure exams in the last five years.

This was according to Commission on Higher Education (CHED) Chairman Emmanuel Angeles during the launch of Ched’s partnership with the Kapit Bisig Para sa Ilog Pasig (KBPIP) Foundation for the cleanup of the Pasig River.

Angeles said CHED is currently “verifying” their data before issuing an order to the schools to phase out their nursing programs.

The agency’s crackdown on poor performing nursing schools is part of his administration’s campaign to raise the standard of education in the Philippines.

Last month, Ched announced it would close down six law schools because not one of their graduates passed the Bar exams in the last five years. Another 38 maritime schools were also being monitored for the same reason.

Angeles also announced that warnings would be issued to schools whose passing rates are above zero but below the national average.

“We are way behind our neighbors like Singapore, Malaysia, Thailand, and soon, Vietnam may even surpass our standard,” Angeles said.

“We’re starting to be identified with Cambodia, Laos, and even East Timor. Do we want our schools to be identified with the schools of these countries? Certainly not,” he stressed.

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]]> http://nursingcrib.com/ched-to-close-down-worst-performing-nursing-schools/feed/ 0 http://nursingcrib.com/ched-to-close-down-worst-performing-nursing-schools/ Job Opportunity Awaits Graduates of NARS Program http://feedproxy.google.com/~r/nursingcrib/~3/E80Ap5D6mQU/ http://nursingcrib.com/job-opportunity-awaits-graduates-of-nars-program/#comments Mon, 26 Oct 2009 23:57:08 +0000 Admin http://nursingcrib.com/job-opportunities-awaits-graduates-of-nars-program/

Name of Hospital

  1. Al Essra Hospital, Amman, Jordan — POEA Accreditation No. 10146010
  2. Al Khalidi Medical Center, Amman, Jordan— POEA Accreditation No. 10146100
  3. International Dental Clinic, Amman, Jordan – POEA Accreditation No. 10146004
  4. King Hussein Cancer Center, Amman, Jordan – POEA Accreditation – under process

Place and Date of Selection of Nurses

  1. Al Essra Hospital — Oct 10 & 11 at Legend Villa Hotel, Mandaluyong City
  2. Al Khalidi Medical Center — Oct.. 16 & 17 at Legend Villa Hotel, Mandaluyong City
  3. International Dental Clinic – No Interview needed
  4. King Hussein cancer Center – To be Announced shortly

Requirements for both hospitals

  1. Female
  2. Licensed Nurses
  3. Age — 20 -30 yrs. old

Documents Needed to be Submitted by the Applicant (Original and Xerox)

  1. Resume
  2. 2×2 pictures, 6 pcs.
  3. Diploma
  4. Transcript of Records
  5. PRC ID
  6. Board Rating
  7. Board Certificate
  8. Passport
  9. NBI Clearance
  10. Certificate of Employment (if available)
  11. Certificates of Trainings, Seminars and Attendance

Where to apply:

Japan Maruko International Corporation
Unit 3 & 4 ESC Building
153 San Francisco St.
Mandaluyong City, Philippines

Phone No.  (632)532-9264/532-7371
Email Add : info@japanmaruko.com
Website      www.japanmaruko.com

For more information visit http://bonphilippines.org/index.php?option=com_content&task=view&id=295&Itemid=1

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]]> http://nursingcrib.com/job-opportunity-awaits-graduates-of-nars-program/feed/ 0 http://nursingcrib.com/job-opportunity-awaits-graduates-of-nars-program/ Emergency Nursing http://feedproxy.google.com/~r/nursingcrib/~3/lpsezww72As/ http://nursingcrib.com/emergency-nursing/#comments Sun, 25 Oct 2009 21:25:54 +0000 Admin http://nursingcrib.com/?p=3172

emergency nursingA. General information

  1. Emergency nursing deals with human responses to any trauma or sudden illness that requires immediate intervention to prevent imminent severe damage or death
  2. Care is provided in any setting to persons of all ages with actual or perceived alterations in physical or emotional health.
  3. Initially, patients may not have a medical diagnosis.
  4. Care is episodic when patients return frequently, primary when it is the initial option for health or preventive care, or acute when patients need immediate and additional interventions.
  5. Emergency nursing is a specialty area of the nursing profession like no other.
  6. Emergency nurses must be ready to treat a wide variety of illnesses or injury situations, ranging from a sore throat to a heart attack.

B. Historical Development of Emergency Nursing

  1. Florence Nightingale was the first emergency nurse, providing care to the wounded in the Crimean War in 1854
  2. The Emergency Department Nurses Association (EDNA) was organized in 1970
  3. A competency-based examination, first administered in 1980, provides Certification in Emergency Nursing; certification is valid for 4 years
  4. EDNA developed Standards of Emergency Nursing Practice, published in 1983, to be used as a guideline for excellence and outcome criteria against which performance is measured and evaluated
  5. In 1985, the Association name was changed to Emergency Nurses Association (ENA), recognizing the practice of emergency nursing as role-specific rather than site-specific.
  6. Originally ENA aimed at teaching and networking, the organization has evolved into an authority, advocate, lobbyist, and voice for emergency nursing. It has 30,000+ members and continues to grow, with members representing over 32 countries around the world.

C. Emergency Care Environment

  1. Prehospital care by emergency medical services (EMS), emergency medical technicians, and paramedics provides initial stabilizations and transport of patients; personnel communicate with the emergency department during patient transport
  2. The national emergency telephone number 911 is the result of an effort to improve access to EMS
  3. The concept of the emergency room has expanded to that of the emergency department, which provides various levels of care
  4. Specialized electronic technology and techniques are used to monitor patient status continuously; these may pose safety hazards to patients, such as possible exposure to electric shock

D. Triage

  1. Triage classifies emergency patients for assessment and treatment priorities
  2. Triage decisions require gathering objective and subjective data rapidly and effectively to determine the type of priority situation present
  3. Emergent situations are potentially life-threatening; they include such conditions as respiratory distress or arrest, cardiac arrest, severe chest pain, seizures, hemorrhage, severe trauma resulting in open chest or abdominal wounds, shock, poisonings, drug overdoses, temperatures over 105°F (40.5°C), emergency childbirth, or delivery complications
  4. Urgent situations are serious but not life-threatening if treatment is delayed briefly; they include such conditions as chest pain without respiratory distress, major fractures, burns, decreased level of consciousness, back injuries, nausea or vomiting, severe abdominal pain, temperature between 102 and 105°F (38.9 and 40.5° C), bleeding from any orifice, acute panic, or anxiety
  5. Nonemergency situations are not acute and are considered minor to moderately severe; they include such conditions as chronic backache or other symptoms, moderate headache, minor burns, fractures, sprains, upper respiratory or urinary infections, or instances in which a patient is dead on arrival

E. Roles of the Emergency Nurse

  1. Care provider: provides comprehensive direct care to the patient and family.
  2. Educator: provides patient and family with education based on their learning needs and the severity of the situation and allows the patient to assume more responsibility for meeting health care needs
  3. Manager: coordinates activities of others in the multidisciplinary team to achieve the specific goal of providing emergency care
  4. Advocate: ensures protection of the patient’s rights

F. Functions of the Emergency Nurse

  1. Uses triage to determine priorities based on assessment and anticipation of the patient’s needs
  2. Provides direct measures to resuscitate, if necessary
  3. Provides preliminary care before the patient is transferred to the primary care area
  4. Provides health education to the patient and family
  5. Supervises patient care and ancillary personnel
  6. Provides support and protection for the patient and family

G. Legal issues affecting the provision of emergency nursing

  1. Negligence
  2. Malpractice
  3. Good Samaritan Laws (these statutes may protect private citizens but usually do not apply to emergency personnel on duty or in normal emergency situations)
  4. Informed consent
  5. Implied consent
  6. Duty to report suspected crimes to the police
  7. Duty to gather evidence in criminal investigations; be aware of hospital policy and state laws for evidence collection
  8. Advanced directives, including durable power of attorney and living wills

H. Qualifications of an Emergency Nurse

  1. An emergency nurse is a registered nurse with specialized education and experience in caring for emergency patients.
  2. Emergency nurses continually update their education to stay informed of the latest trends, issues, and procedures in medicine today.
  3. Many take a special examination that proves their level of knowledge. After successful completion of this exam they are certified in emergency nursing.
  4. Some emergency nurses also acquire additional certifications in the areas of trauma nursing, pediatric nursing, nurse practitioner, and various areas of injury prevention
  5. Many emergency nurses acquire additional certifications in the areas of trauma nursing, pediatric nursing, nurse practitioner, and various areas of injury prevention

I. Recommended Books

  1. Emergency Nursing Made Incredibly Easy! (Incredibly Easy! Series) Emergency Nursing by Springhouse
  2. Lippincott’s Q&A Certification Review: Emergency Nursing (LWW, Lippincott Q&A Certification Review) Emergency Nursing

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]]> http://nursingcrib.com/emergency-nursing/feed/ 0 http://nursingcrib.com/emergency-nursing/ Fewer Pinoy Nurses Seeking Employment in the US http://feedproxy.google.com/~r/nursingcrib/~3/ouoaelTwLu0/ http://nursingcrib.com/fewer-pinoy-nurses-seeking-employment-in-the-us/#comments Fri, 23 Oct 2009 05:35:46 +0000 Admin http://nursingcrib.com/?p=3169

american dreamAccording to TUCP secretary- general and former senator Ernesto Herrera, the number of Filipino nurses who took the US Nursing Licensure Examination has plunged.

From January to September this year, only 11,854 Pinoy nurses took the National Council Licensure Examination (NCLEX), compared to the 15,079 nurses who took the test in the same period last year 2008.

From July to September of this year alone, Herrera said only 3,582 Filipino nurses took the NCLEX for the first time, down by 1,660 from the 5,242 that took the test in the same quarter last year.

Despite the fact that NCLEX testing center was established in Manila (opened last July 2007) to make it easier for nurses to take the exams, there was still a sharp decline in the number of Filipino nurses who want to take the NCLEX.

“The recession in the US might have discouraged nurses from applying there”, Herrera said.

He also noted that according to US Department of Labor, 7.6 million Americans have lost their jobs since the start of the US recession in December 2007. The number of unemployed Americans has doubled to 15.1 million, with the national jobless rate at 9.8 percent.

But Herrera said Filipinos still account for four out of every 10 foreign nurses seeking to enter the US nursing profession.

Last year, a total of 20,746 Filipino nurses took the NCLEX for the first time, a 3.5- percent decrease from the   21,299 Filipino nurses who took the test in 2007.

View NCLEX Passing Rate – 3rd Quarter 2009

Source: http://www.philstar.com

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]]> http://nursingcrib.com/fewer-pinoy-nurses-seeking-employment-in-the-us/feed/ 0 http://nursingcrib.com/fewer-pinoy-nurses-seeking-employment-in-the-us/ Critical Care Nursing http://feedproxy.google.com/~r/nursingcrib/~3/T1t_ZW75JOo/ http://nursingcrib.com/critical-care-nursing/#comments Wed, 21 Oct 2009 05:05:17 +0000 Admin http://nursingcrib.com/?p=3168

critical care nursing A. General information

1. Critical care nursing deals with human responses to life-threatening problems and includes the critically ill patient, the critical care nurse, and the critical care environment.
2. It is the field of nursing with a focus on the care of the critically ill or unstable patients.

3. Care is provided to patients of all ages with alterations in physical or emotional health.
4. The critical care nurse coordinates interventions aimed at resolving life-threatening problems.

5. Critical care nurses can be found working in a wide variety of environments and specialties, such as emergency departments and the intensive care units.

B. Critically Ill Patient

1. Critically ill patients are defined as those patients who are at high risk for actual or potential life-threatening health problems.

2. The critically ill patient is at high risk for developing life-threatening problems and requires constant, intensive, multidisciplinary assessment and intervention to restore stability, prevent complications, and achieve and maintain optimal responses

3. The more critically ill the patient is, the more likely he or she is to be highly vulnerable, unstable and complex, thereby requiring intense and vigilant nursing care.

C. History of Critical Care Nursing 

1. Critical care began as a component of recovery rooms before expanding into coronary care units in the 1960s
2. The American Association of Critical-Care Nurses (AACN) was organized in 1969
3. A competency-based examination was developed in 1975 to provide certification in critical care nursing; certification is valid for 3 years; available for adult, neonatal, and pediatric certification
4.The AACN developed Standards for Nursing Care of the Critically Ill in 1981 to explain the role of the critical care nurse in ensuring quality care for critically ill patients and their families

C. Critical care environment

1. Units may be specially designated as medical, surgical, coronary, pediatric, neonatal, recovery, or postanesthesia or may encompass other areas in some institutions
2. Adequate resources (emergency equipment, supplies, and support systems) are necessary for safe care
3. A management and administrative structure is required to ensure effective care through all phases of the patient’s hospital stay, from emergency department to discharge
4. Legal, regulatory, social, economic, and political trends must be monitored to promote the early recognition of problems and a timely response
5. Specialized electronic technology and techniques are used to monitor patient status continuously; these may create safety hazards for patients, such as possible exposure to electric shock

D. Roles of the critical care nurse

1. Care provider: provides comprehensive—and at times highly technical—direct care to the patient and family in response to life-threatening health problems
2. Educator: provides patient and family with education based on their learning needs and the severity of the situation and allows the patient to assume more responsibility for meeting health care needs as health condition stabilizes or improves
3. Manager: coordinates the care provided by various health care workers to achieve the specific goal of providing optimal nursing care to critically ill patients
4. Advocate: protects the patient’s rights

E. Functions of the critical care nurse

1. Assesses and implements treatment for patient responses to life-threatening health problems
2. Provides direct measures to resuscitate, if necessary
3. Uses independent, dependent, and interdependent interventions to restore stability, prevent complications, and achieve and maintain optimal patient responses
4. Provides health education to the patient and family
5. Supervises patient care and ancillary personnel
6. Supports patient adaptation, restores health, and preserves the patient’s rights, including the right to refuse treatment

F. Legal issues affecting the provision of critical care nursing

1. Negligence
2. MALPRACTICE
3. INFORMED CONSENT
4. Implied consent
5. Advanced directives, including DURABLE POWER OF ATTORNEY and living wills

G. Qualifications of a Critical Care Nurse

1. To become a registered nurse (RN), an individual must earn a diploma in nursing, an associate’s degree in nursing (ADN) or a bachelor’s degree in nursing (BSN) and pass a national licensing exam.

2. Requirements vary and are dictated by each state’s Board of Nursing. Many nursing schools offer students exposure to critical care, but most of a critical care nurse’s specialty education and orientation is provided by the employer. Advanced practice nurses must earn a degree at the master’s or doctoral level.

3. Although certification is not mandatory for practice in a specialty like critical care, many nurses choose to become certified. Some employers prefer to hire certified nurses because they have demonstrated acquisition of a specific high level of knowledge in their specialty through successful completion of a rigorous, psychometrically valid, job-related examination.

4. Certification examinations test critical care knowledge primarily at the application/analysis level, which indicates strong critical thinking abilities.

5. A required number of clinical hours in the specialty are also an examination prerequisite. Certified nurses validate their continuing knowledge of current practices in critical care nursing through a renewal process every three years, which includes meeting extensive continuing education and clinical experience requirements.

6. Certified critical care nurses (CCRN) must have been in critical care practice for a minimum of two years to be eligible for the examination.

Recommended Books:

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Choking thumb First Aid for Choking and Swallowed Objects Each year nearly 2,000 deaths occur in the United States due to asphyxia caused by obstruction of breathing. Two-thirds of the deaths reported apply to children under the age of 4.

I. Causes

A. A small child investigates an object by placing it into his mouth.

B. A child chew well until dentition is sufficient.

C. An inedible substance can become caught in the throat.

D. Objects can be aspirated into lower air passages.

E. Obstruction may occur in adults when swallowing unchewed meat or food containing splinters of bone or shell.

F. Persons with dentures are prone to choke on food, since normal chewing sensation is diminished.

G. Eating without dentures is hazardous.

H. Alcoholic beverages before a meal decrease sensation in the mouth and normal vigilance and caution in eating, thus increasing the danger of choking.

II. Signs and symptoms

A. Violet choking

B. Alarming attempts at inhalation (stridor or crowing sounds)

C. Discoloration (cyanosis) of the face, neck, and hands

D. Cessation of breathing

E. Unconsciousness

III. First Aid

The objective of first aid for a person who is choking is to allow the victim to assume a comfortable position and encourage him to cough. If breathing fails, administer artificial respiration and, if necessary, attempt to expel the object. Obtain immediate medical attention.

A. Swallowed objects in food passages

1. Give nothing by mouth until advised by a physician.

2. Do not give any cathartic or laxative drug to person who has swallowed a foreign object.

3. If the object is small and not sharp, observe the victim’s feces to determine whether the object has passed safely through the digestive tract.

4. Remove a foreign object that is accessible to your fingers but take great care in removing it. A foreign object lodged in the back of the victim’s throat should not be removed with your fingers, because either the pressure on the object or the swallowing efforts may force the object more deeply into the victim’s throat.

B. Aspiration of fluids and objects in the larynx or lower air passages

A foreign body aspirated into the air passages creates an immediate crisis. Foreign bodies are usually trapped by a spasm of the muscles at the level of the larynx. The victim is unable to breathe for a few seconds. The spasm then relaxes, and the object often will be coughed out. Coughing is a protective mechanism by which a foreign body is sometimes expelled from the larynx.

1. If the object cannot be expelled by the victim within a moment or so, seek medical help at once.

2. Allow the victim to assume a position most comfortable for him.

3. Do not attempt to remove the object with your fingers.

4. Encourage the victim to cough as soon as the spasm of the larynx subsides.

5. Remain calm and reassure the victim.

6. Do not give cough syrup, medicines, crackers, or bread.

C. Foreign body prohibiting ventilation

Artificial respiration should be administered only if the victim ceases to breathe or if breathing is ineffectual and death appears imminent. If unable to ventilate, seek a foreign body that may be deep in the airway, causing obstruction. Insert the index and middle fingers of one hand inside the victim’s cheek and slide them deeply into the throat to the base of the tongue. Use a sweeping motion to carry them through the back of the throat and out along the inside of the other cheek to try to remove the foreign body.

As a last resort, the first-aider should attempt to move the object blocking the air passages by turning the adult victim onto his side and using the heel of the hand to administer sharp blows between the shoulder blades over the spine. A child may be turned upside down over one arm and given two or three sharp blows between the shoulder blades. Even though relief is obtained, the victim should receive medical attention after an episode of chocking.

IV. Prevention

A. For small children

1. Keep articles that may be accidentally swallowed or aspirated out of the reach of infants and small children.

2. Caution older children not to put small objects in a baby’s mouth or within his reach.

3. Do not hold open safety pins in the mouth when changing a baby’s diaper. A pin may slip out of the mother’s mouth into the mouth of the infant. Take care not to leave safety pins within reach of the child.

4. Provide study, safe toys without small parts that might become detached.

5. Do not give small children nuts or candy containing nuts, raw carrots or other uncooked vegetables, fruits that require chewing, unchopped meat, or any foods containing seeds or pits until the age of 4.

6. Do not allow a child to play with beans, peas, hand kernels of corn, or large seeds.

7. Do not stimulate a child to laugh or cry when he has food in his mouth.

8. Do not permit a child to run about while eating.

9. Remove bones and shells from all foods given to a child.

10. As soon as he is old enough to learn, teach a child not to put foreign objects in his mouth.

B. For older children and adults

1. Eat slowly; chew food thoroughly; water for small particles of the bone, seed, or shell. Cut meat into small pieces.

2. Prepare food carefully; watch for foreign objects in the kitchen that may become mixed with food.

3. If you are chocking, remain calm. Wait until the spasm passes and then cough hard. Do not try to talk.

4. If you wear dentures, take special precautions in eating. Keep them in good repair. Do not wear defective dentures at night.

5. Do not go to sleep with chewing gum in your mouth.

6. Do not chew on objects that may be swallowed or aspirated. Aside from the danger, the practice sets a bad example for small children, who learn by imitation.

7. Do not assume that all is well if symptoms disappear. Consult a physician after an episode of choking unless the object has been definitely expelled. Make a note in a diary. Infection may develop later in the lung.

8. Do not allow anyone to slap you on your back if you choke and do not try to dislodge an object from another person’s throat by this means, except as a last, desperate effort to save his life.

Source:

Standard First Aid and Personal Safety by American National Red Cross

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]]> http://nursingcrib.com/first-aid-for-choking-and-swallowed-objects/feed/ 0 http://nursingcrib.com/first-aid-for-choking-and-swallowed-objects/ Government to Employ More Nurses to Address Leptospirosis Outbreak http://feedproxy.google.com/~r/nursingcrib/~3/I_MeGz1rfJY/ http://nursingcrib.com/government-to-employ-more-nurses-to-address-leptospirosis-outbreak/#comments Sat, 17 Oct 2009 02:21:15 +0000 Admin http://nursingcrib.com/government-to-employ-more-nurses-to-address-leptospirosis-outbreak/

According to DOH, the number of reported leptospirosis cases in Metro Manila and other areas in Luzon that were affected by floods has reached 1,027, with 89 fatalities as of October 15.

Areas with declared leptospirosis outbreaks were barangays Malanday, Tumana and Conception I in Marikina City where there are 82 cases while Quezon City suffered the most number of cases with 122 patients infected.

Malacanang has ordered the Department of Health to employ and deploy more nurses and health workers to help address the growing number of leptospirosis cases in cyclone-affected areas.

According to Press Secretary Cerge Remonde, “The Department of Health has been directed by the President to fill more health teams and even to employ additional nurses and health workers under the NARS program to address the problem.

Project NARS (Nurses Assigned in Rural Schools) is a training-cum-employment program implemented by the DOH, Department of Education, Department of Labor and Employment (DOLE) and the Professional Regulation Commission-Board of Nursing.

Launched in February this year, Project NARS (Nurses Assigned in Rural Service) aims to deploy “warriors of wellness” in poor communities. The program offers job experience to unemployed registered nurses in the country.

How to apply for the NARS Program

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