“Desire is the key to motivation, but it is determination and commitment to an unrelenting pursuit of your goal – a commitment to excellence – that will enable you to attain the success you seek.”

-Mario Andretti

Tuesday, August 26, 2008

Monday, August 25, 2008

THE SCOPE OF RN PRACTICE --BRN

http://www.rn.ca.gov/pdfs/regulations/npr-b-03.pdf

Hey guys here is "AN EXPLANATION OF THE SCOPE OF RN PRACTICE
including standardized procedures" that I came across on the BRN web site. Check it out when you have some "free time."

N10 Final Advance Directives

"Advance Directives – Terminology from LMH Website

Artificial Nutrition and Hydration is when food and water are given to a person through a tube or needle because the person is no longer able to swallow.

Autopsy is an examination done on a body to find out the cause of death.

Comfort Care is care that helps to keep a person comfortable and control pain.

CPR (Cardiopulmonary Resuscitation) is emergency treatment that tries to restart a person's breathing or heartbeat after they have stopped. CPR can include pushing on the chest, putting a tube down the throat, and other emergency steps.

Health Care Appointment is an advance directive in which you appoint someone to make medical decisions for you if the time ever comes when you cant make them yourself. It is also called a "Health Care Proxy" or a "Durable Power of Attorney for Healthcare."

Life Sustaining Treatment is any medical treatment that is used to keep a person from dying. A breathing machine, CPR, and artificial nutrition and hydration are examples of lifesustaining treatments.

Health Care Directive is an advance directive in which you say what forms of medical treatment you do or do not want if you become terminally ill or are in a persistent vegetative state.

Organ and Tissue Donation is when a person permits his/her organs (such as eyes or kidneys) and other parts of the body (such as skin) to be removed after death to be transplanted to another person or used for education or research.

Persistent Vegetative State is when a person is unconscious with no hope of regaining consciousness even with medical treatment. The body may move and eyes may be open, but as far as anyone can tell, the person can't think or respond.

Being Terminally Ill means having an injury or illness that has no cure and from which doctors expect the person to die, even with medical treatment.

Link to '06 Blog Check it Out...

http://deltarnstudents.blogspot.com/search?updated-max=2006-10-22T21%3A34%3A00-07%3A00&max-results=20

This is the page on the '06 blog that has info on the N10 FINAL

A few N8 Tips ('06 Blog)

"Hey all you 2nd rotation OB peeps....greetings and good luck in N8! The theory lecture goes verbatim with the syllabus so you don't have to take class notes from stratch (yeah!). Ms. Batson's tests are not just all multiple choice. There are a lot of fill-in and short answer questions; know your interventions and rationales (as always!). The third test was the hardest and longest because it had the most writing involved. There's a lot of busy work in clinical but the 3 most time-consuming things are: 1) drug worksheet that has to be filled out before your first clinical day, 2) the neonatal theory worksheet (what's normal in a head-to-toe newborn assessment v. what's not normal)...this has to be filled out before your assigned day in the nursery and 3) the oral presentation (because you have to include recent/pertinent research related to your topic). If anyone has any questions, post them on the blog....have fun!"

Genogram Software

http://www.smartdraw.com/


Colorful and fairly easy. Only three prints with watermark on the trial version. But we only need to print two items.

-Debbie

NCLEX Questions ('06 Blog)

Worried about passing the National Council Licensure Examination (NCLEX), the test from the National Council of State Boards of Nursing (NCSBN) that your state board of nursing will use to determine whether you are ready to practice nursing? The more practice questions you do, the more confident you'll feel. Try these, then review the answers and rationales that follow. Experts recommend taking many practice questions before the NCLEX, so take advantage of review courses, books, and other products to help you succeed and pass the NCLEX.

1. The surgeon orders cefazolin (Ancef) 1 gram to be given intravenously at 7:30 a.m.; the client's surgery is scheduled at 8:00 a.m. What's the primary reason to start the antibiotic exactly at 7:30?

a. Legally, the medication has to be given at the ordered time.

b. The antibiotic is most effective in preventing infection if it's given 30 to 60 minutes before the operative incision is made.

c. The postoperative dose of Ancef needs to be started exactly 8 hours after the preoperative dose.

d. The peak and titer levels are needed for antibiotic therapy.

2. Which of the following clients is most at risk for latex allergies?

a. A woman who's admitted for her seventh surgery.

b. A man who works as a sales clerk.

c. A man with well-controlled type 2 diabetes.

d. A woman who's having laser surgery.

3. The nurse receives the preoperative blood work report for a client who's scheduled to undergo surgery. Which of the following laboratory findings should she report to the surgeon?

a. Red blood cells, 4.5 million/mm³

b. Creatinine, 2.6 mg/dL.

c. Hemoglobin, 12.2 g/dL.

d. Blood urea nitrogen, 15 mg/dL.

4. When the nurse administers intravenous midazolam hydrochloride (Versed), the client shows signs of an overdose. Which of the following interventions should the nurse be prepared to implement first?

a. Ventilate with an oxygenated Ambu bag.

b. Defibrillate the patient.

c. Administer 0.5 mL 1:1000 epinephrine.

d. Titrate flumazenil (Romazicon).

5. A client who had a thoracoscopy sustained an injury secondary to the surgery position. Which of the following injuries would he demonstrate?

a. foot drop

b. knee swelling and pain

c. tingling in the arm

d. absence of the Achilles reflex
Posted by Bonnie Boss at 19:39 1 comments

N8 Textbook Quizes Chapters 4-6 ('06 Blog)

From the Evolve website
Wong, et al.: Maternal Child Nursing Care, 3rd Edition
icon Review Questions

Chapter 04

1.
A 42-year-old woman asks the nurse about mammograms, now that she is "getting older." The nurse should tell her that:


A. The American Cancer Society recommends mammograms every 1 to 2 years for women ages 40 to 49.
B. The best time to perform a mammogram is just prior to a menstrual period.
C. Regular mammograms reduce the need to perform BSE.
D. Mammograms can confirm the diagnosis for breast cancer.


Chapter 05

1.
When obtaining a reproductive health history from a female patient, the nurse should:


A. Limit the time spent on exploration of intimate topics
B. Avoid asking questions that may embarrass the patient
C. Use only accepted medical terminology when referring to body parts and functions
D. Explain the purpose for the questions asked and how the information will be used

2.
The nurse should include questions regarding sexuality when gathering data for a reproductive health history of a female patient. Which of the following principles should guide the nurse when interviewing the patient?


A. An in depth exploration of specific sexual practices should be included for every patient
B. Sexual histories are optional if the patient is not currently sexually active
C. Misconceptions and inaccurate information expressed by the patient should be corrected promptly
D. Questions regarding the patient's sexual relationship is unnecessary if she is monogamous

3.
The nurse should refer the patient for further testing if which of the following were noted upon inspection of the breasts of a 55-year-old woman:


A. Left breast is slightly smaller than the right breast
B. Eversion (elevation) of both nipples
C. Bilateral symmetry of venous network which is faintly visible
D. Small dimple located in the upper outer quadrant of the right breast

4.
The nurse is assessing a woman's breast self-examination technique (BSE). Which of the following actions indicate that a woman needs further instruction regarding BSE?


A. Performs every month, on the first day of her menstrual period
B. Uses the pads of her fingers when palpating each breast
C. Inspects her breasts while standing before a mirror and changing arm positions
D. Places a folded towel under right shoulder and right hand under head when palpating right breast

5.
Which of the following is correct concerning the performance of a Papanicolaou (Pap) smear?


A. The woman should not douche, use vaginal medications, or have intercourse for at least 24 hours prior to the test
B. It should be performed once a year beginning with the onset of puberty.
C. A lubricant such as Vaseline should be used to ease speculum insertion.
D. The specimen for the Pap smear should be obtained after specimens are collected for cervical infection

6.
A 65-year-old woman, G 6 P 6006 is complaining of increasing stress incontinence and pelvic pressure and fullness. Pelvic examination reveals a bulging in the anterior vaginal wall. This woman is most likely experiencing:


A. Uterine prolapse
B. Rectocele
C. Cystocele
D. Vesicovaginal fistula


Chapter 06

1.
An effective relief measure for primary dysmenorrhea would be:


A. Reduce physical activity level until menstruation ceases.
B. Begin taking prostaglandin synthesis inhibitors on the first day of the menstrual flow
C. Decrease intake of salt and refined sugar about one week before menstruation is about to occur
D. Use barrier methods rather than the oral contraceptive pill (OCP) for birth control

2.
Self-care instructions for a woman following a modified radical mastectomy would include that she:


A. Wear clothing with snug sleeves to support her affected arm.
B. Use depilatory creams instead of shaving the axilla of her affected arm.
C. Expect a decrease in sensation or tingling in her affected arm as her body heals.
D. Empty surgical drains once a day or every other day.

3.
When providing care to a young single woman just diagnosed with acute pelvic inflammatory disease, the nurse should:


A. Point out that inappropriate sexual behavior caused the infection
B. Position the woman in a semi-Fowler position
C. Explain to the woman that infertility is a likely outcome of this type of infection
D. Tell her that antibiotics need to be taken until pelvic pain is relieved

4.
The CDC recommended medication for the treatment of chlamydia would be:


A. Doxycycline
B. Podofilox
C. Acyclovir
D. Penicillin
Posted by Bonnie Boss at 22:17 1 comments

N8 Textbook Quiz 2 ('06 Blog)

From the Evolve website
Wong, et al.: Maternal Child Nursing Care, 3rd Edition
icon Review Questions Chapter 02

1.
Which statement made by the nurse would indicate that she/he is practicing appropriate family-centered care techniques? Choose all appropriate responses.


A. The nurse allows the mother and father to make choices when possible.
B. The nurse informs the family about what is going to happen. The nurse instructs the patient's sister, who is a nurse, that she cannot be in the room during the birth.
C. The nurse commands the mother what to do.
D. The nurse provides time for the partner to ask questions.

2.
Families in the launching stage of the family life cycle are involved in accomplishing which of the following developmental tasks?


A. Renegotiating the marital relationship as a dyad
B. Establishing financial independence
C. Maintaining own and/or couple functioning and interests in the face of physiologic decline
D. Negotiating tasks related to childrearing and household maintenance

3.
The term used to describe a situation in which a cultural group loses its identity and becomes part of the dominant culture is called:


A. Assimilation
B. Cultural relativism
C. Acculturation
D. Ethnocentrism

4.
A Native American woman gave birth to a baby girl 12 hours ago. The nurse notes that the woman keeps her baby in the bassinet except for feeding and states that she will wait until she gets home to begin breastfeeding. The nurse recognizes that this behavior is most likely a reflection of:


A. Delayed attachment
B. Embarrassment
C. Disappointment that the baby is a girl
D. A belief that babies should not be fed colostrum

5.
The nurse is planning care for a patient with a different cultural background. Which of the following would be an appropriate goal?


A. Strive to keep the patient's cultural background from influencing health needs.
B. Encourage the continuation of cultural practices in the hospital setting.
C. In a nonjudgmental way, attempt to change the patient's cultural beliefs.
D. As necessary, adapt the patient's cultural practices to her health needs.

6.
Which of the following is descriptive of the family systems theory?


A. The family is viewed as the sum of individual members.
B. When the family system is disrupted, change can occur at any point in the system.
C. Change in one family member cannot create change in other members.
D. Individual family members are readily identified as the source of a problem.
Posted by Bonnie Boss at 22:08 1 comments

Quiz 1 from N8 Textbook ('06 Blog)

From Evolve website
Wong, et al.: Maternal Child Nursing Care, 3rd Edition
icon Review Questions Chapter 01

1.
When caring for pregnant women, the nurse should keep in mind that violence during pregnancy:


A. Affects more than 25% of pregnant women in the United States
B. Is associated with complications of pregnancy such as bleeding
C. Increases a pregnant woman's risk for preeclampsia
D. Has decreased in incidence as a result of better assessment techniques and record keeping

2.
Examples of alternative healing modalities include which of the following?


A. Biofeedback
B. Antibiotics
C. Osteopathy
D. Acupressure
E. Dance therapy

3.
The term used to describe legal and professional responsibility for practice for maternity nurses is:


A. Evaluation
B. Accountability
C. Ethics
D. Collegiality

4.
The family structure consisting of parents and their dependent children living together is known as a(n):


A. Binuclear family
B. Reconstituted family
C. Nuclear family
D. Extended family

5.
A woman is giving birth to her third child in a setting that allows her husband and other two children to be actively involved in the process. The nurse caring for the woman must also consider the husband and family as patients and work to meet their needs. This type of setting is termed:


A. Family-centered care
B. Emergency care
C. Hospice care
D. Individual care

6.
Which of the following has had the greatest impact on reducing infant mortality in the United States?


A. Improvements in perinatal care
B. Decreased incidence of congenital abnormalities
C. Better maternal nutrition
D. Improved funding for health care

7.
The nurse admits Amanda to the labor unit. During the admission procedure, the nurse obtains Amanda's blood pressure, pulse, respirations, temperature, and fetal heart rate. The nurse is using which part of the nursing process?


A. Assessment
B. Planning
C. Implementation
D. Evaluation

8.
Evidence-based practice is best described as:


A. Gathering evidence of mortality and morbidity in children
B. Meeting physical and psychosocial needs of the family in all areas of practice
C. Using a professional code of ethics as a means for professional self-regulation
D. Providing care based on evidence gained through research and clinical trials

9.
After admitting a new patient to the maternity unit, the nurse writes a plan of care. This process of determining outcomes and interventions is which stage of the nursing process?


A. Assessment
B. Planning
C. Implementation
D. Evaluation
Posted by Bonnie Boss at 22:00 1 comments

Some Stuff From the 2006 Pinned Blog

Scope of Practice for RN

Here is an exerpt from the CA Nurse Practice Acts

Article 2. Scope of Regulation 2725. Legislative Declaration; Practice of Nursing; Functions

  1. In amending this section at the 1973-74 session, the Legislature recognizes that nursing is a dynamic field, the practice of which is continually evolving to include more sophisticated patient care activities. It is the intent of the Legislature in amending this section at the 1973-74 session to provide clear legal authority for functions and procedures that have common acceptance and usage. It is the legislative intent also to recognize the existence of overlapping functions between physicians and registered nurses and to permit additional sharing of functions within organized health care systems that provide for collaboration between physicians and registered nurses. These organized health care systems include, but are not limited to, health facilities licensed pursuant to Chapter 2 (commencing with Section 1250) of Division 2 of the Health and Safety Code, clinics, home health agencies, physicians' offices, and public or community health services.
  2. The practice of nursing within the meaning of this chapter means those functions, including basic health care, that help people cope with difficulties in daily living that are associated with their actual or potential health or illness problems or the treatment thereof, and that require a substantial amount of scientific knowledge or technical skill, including all of the following:
    1. Direct and indirect patient care services that ensure the safety, comfort, personal hygiene, and protection of patients; and the performance of disease prevention and restorative measures.
    2. Direct and indirect patient care services, including, but not limited to, the administration of medications and therapeutic agents, necessary to implement a treatment, disease prevention, or rehabilitative regimen ordered by and within the scope of licensure of a physician, dentist, podiatrist, or clinical psychologist, as defined by Section 1316.5 of the Health and Safety Code.
    3. The performance of skin tests, immunization techniques, and the withdrawal of human blood from veins and arteries.
    4. Observation of signs and symptoms of illness, reactions to treatment, general behavior, or general physical condition, and (A) determination of whether the signs, symptoms, reactions, behavior, or general appearance exhibit abnormal characteristics; and (B) implementation, based on observed abnormalities, of appropriate reporting, or referral, or standardized procedures, or changes in treatment regimen in accordance with standardized procedures, or the initiation of emergency procedures.
  3. "Standardized procedures," as used in this section, means either of the following:
    1. Policies and protocols developed by a health facility licensed pursuant to Chapter 2 (commencing with Section 1250) of Division 2 of the Health and Safety Code through collaboration among administrators and health professionals including physicians and nurses.
    2. Policies and protocols developed through collaboration among administrators and health professionals, including physicians and nurses, by an organized health care system which is not a health facility licensed pursuant to Chapter 2 (commencing with Section 1250) of Division 2 of the Health and Safety Code.

    The policies and protocols shall be subject to any guidelines for standardized procedures that the Division of Licensing of the Medical Board of California and the Board of Registered Nursing may jointly promulgate. If promulgated the guidelines shall be administered by the Board of Registered Nursing.
  4. Nothing in this section shall be construed to require approval of standardized procedures by the Division of Licensing of the Medical Board of California, or by the Board of Registered Nursing.

2725.1. Dispensing Drugs or Devices; Registered Nurses; Limitations

Notwithstanding any other provision of law, a registered nurse may dispense drugs or devices upon an order by a licensed physician and surgeon when the nurse is functioning within a licensed clinic as defined in paragraphs (1) and (2) of subdivision (a) of Section 1204 of, or within a clinic as defined in subdivision (b) or (c) of Section 1206, of the Health and Safety Code.

No clinic shall employ a registered nurse to perform dispensing duties exclusively. No registered nurse shall dispense drugs in a pharmacy, keep a pharmacy, open shop, or drugstore for the retailing of drugs or poisons. No registered nurse shall compound drugs. Dispensing of drugs by a registered nurse shall not include substances included in the California Uniform Controlled Substances Act (Division 10 (commencing with Section 11000) of the Health and Safety Code). Nothing in this section shall exempt a clinic from the provisions of Article 3.5 (commencing with Section 4063) of Chapter 9.

Tuesday, August 19, 2008

What are your top 3 song choices for graduation?