Archive for the ‘NS111 – Fundamentals’ Category
Cultural Diversity Video
Posted by Laura on December 11, 2009
Posted in Day-to-Day, NS111 - Fundamentals | 2 Comments »
Osmolality
Posted by Laura on December 10, 2009
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Metabolic by Electrolytes
Posted by Laura on December 10, 2009
You can tell if a person has Metabolic Acidosis by using the Anion Gap.
The Anion Gap is a difference between the cations and anions. The anion gap indicator # you look at is > 20 mEq for Metabolic Acidosis. Cations are the positive ions in the serum. Anions will are the negatives. Na and K (sodium, potassium) are positive (cations). Cl and HCO3 (chloride and bicarbonate) are negatives (anions).
So here’s the math:
Now the Question is –
Is metabolic acidosis present (anion gap > 20 mEq/L) ?
Answer – Yes, metabolic acidosis is present with an anion gap of 24.
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Affecting Fluids and Electrolytes
Posted by Laura on December 8, 2009
Fluid and Electrolytes
Hormones regulating water retention and loss
ADH (anti-diuretic hormone) * regulates WATER excretion from the kidneys. As serum osmolality rises (>300), it stimulates osmoreceptors that stimulate thirst to ↑ H2O intake & stimulate ADH release to allow more water reabsorption in the kidney causing dilution of body fluids.
- water only, urine will be dark, scant, amber-colored,
- alcohol consumption turns ADH off and you are dehydrated the next day
- ADH & Aldosterone activate in ↓ BP
ADH keeps water from being loss through urination.
Aldosterone * Renin-Angiotensin System * regulates electrolyte balance from the kidneys by promoting Na+ & water retention and K+ loss
- with low blood volume such as internal bleeding or cut arm, kidneys kick in to reabsorb water
- this system works with salt to counteract effects of low blood volume & low BP to try to increase BP (water & salt reabsorbed)
Aldosterone, Renin-Angiotensin System keeps water and sodium from being loss through urination, though Potasium is loss.
ANP (atrial natriuretic peptide) * cardiac hormone found in atria & released when atria are stretched by increasing blood volume or BP (CHF) works to lower BP/volume through vasodilation & suppression of RAS (rennin-angiotensin system)
ANP is a marker found through testing, signifying CHF. ANP tries to lower BP/Volume that ADH and ARAS creates.
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Respiratory or Metabolic Acidosis or Alkalosis?
Posted by Laura on December 8, 2009
This is the way I see it.
pH norm = 7.4 +/- 0.05
PaCO2 norm = 40 +/- 5
HCO3 norm = 24 +/- 2
- If your pH is low and your PaCO2 is high (inverse) you have RESPIRATORYacidosis.
- If your pH is high and your PaCO2 is low (inverse) you have RESPIRATORY alkalosis
- If your pH is low and your HCO3 is low, (and your PaCO2 is normal or low) you have Metabolic acidosis
- If your pH is high and your HCO3 is high, (and your PaCO2 is normal or high) you have Metabolic alkalosis
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Daily 5 – Say What?
Posted by Laura on December 6, 2009
Starting Monday I will do a Daily 5, well… maybe starting today. My study schedule is pretty much in the order of the modules we have 1-14 (minus the last 4 tested on), so the questions will come from these areas. If you find this helpful, you must add questions of your own. Please put them in the comments so everyone can try them!
Questions & Answers
Bonus
Posted in Day-to-Day, NS111 - Fundamentals | 2 Comments »
Nurses Developing Cultural Competence
Posted by Laura on November 30, 2009
The five components of a nurse’s ability for cultural competence includes the following:
1. The nurse’s knowledge 
which is the process of learning of the different cultural backgrounds of her patients.
2. The nurse’s awareness 
or looking at self biases and prejudices.
3. The nurse’s desire 
or motivation and willingness to learn, respect and accept individual cultures.
4. The nurse’s skill 
as a framework for assessing cultural ethnic differences.
5. The nurse’s encounter 
process of interacting with diverse backgrounds thus developing cultural competence.
Skill includes –
Environmental control: how much do we belive we have control over our environment or is it just luck? Traditional western medicine vs. folk medicine
Biological variations: Scientifically any genetic factors in particular ethnic or racial groups that affects their health or high risk in diseases.
Social organization: Patrilineal or male dominated, Matrilineal or female dominated, Bilineal where male & female are dominate
Communication: assertive vs. more passive, nonverbal verbal, tone of voice, eye contact.
Space: eye contact, touching how close a distance between participants
Time: future-oriented, present oriented or past oriented
laura’s thoughts generated by the article of: Flowers, Deborah. “Culturally competent Nursing Care,” Critical Care Nurse, August 2004, Pages 48-52.
Posted in Concepts, NS111 - Fundamentals | Tagged: AVC, competence, culture, curtural diversity, laura barron, nurse | Comments Off on Nurses Developing Cultural Competence
Cultural Diversity Match it
Posted by Laura on November 30, 2009
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Common Occuring Defense Mechanisms
Posted by Laura on November 28, 2009
Added to Flash Cards
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Balance of the Nurses’ Energy
Posted by Laura on November 26, 2009
I made this scale to show the balancing of the nurses’ energy. We have been taught to keep our bodies healthy, our minds nurtured and our spirit awake, but have you really thought how deep this goes? Breaking some of these areas up into mental, intuitional and emotional health lets you see where you may be missing a little tender loving care, and probably more importantly – letting go. So I ask you, is your energy balanced?
The article by D. Sherman on nurses’ stress talked about self-care nurses must do to keep from burning out. It relates the balancing of four fields: the Vital field – physical body, the Emotional field – feelings, the Mental field- thinking, visual images, ideas, and the Intuitional field – creativity, compassion, healing.
When these energies are imbalanced, stress and illness will occur.
laura’s thoughts generated by the article in Module 9 – Witt Sherman, Deborah. “Nurses’ Stress & Burnout,” AJN, May 2004, Pages 48-57
Posted in Concepts, NS111 - Fundamentals | Tagged: AJN, Deborah Sherman, energy balance, laura barron, nurse, stress | Comments Off on Balance of the Nurses’ Energy
Insulin Chart
Posted by Laura on November 24, 2009
Updated the insulin chart. Updated with Davis Drug Guide, online edition 12, 05/04/2012.
Posted in Concepts, NS111 - Fundamentals, Physiologically | Tagged: insulin | 1 Comment »
PN Math Problems from Lecture
Posted by Laura on November 23, 2009
Calculate Total Calories in One Day
TPN mixture:
40% dextrose 500 mL added to 8.25% Aminosyn 500 mL running at 100 mL per hour.
PPN mixture:
10% dextrose 500 mL added to 8.25% Aminosyn 500 mL running at 45 mL per hour
TPN mixture:
50% dextrose 500 mL added to 8.25% Aminosyn 500 mL running at 85 mL per hour, plus 500 mL of Lipsyn 20% to be run over 20 hours each day
not sure on this last one – verifying with Harmon 🙂
Harmon says correct. Hmmmm.
Posted in Day-to-Day, Math, NS111 - Fundamentals | Tagged: math problems, Nursing, PN, TPN | Comments Off on PN Math Problems from Lecture
Nutrients
Posted by Laura on November 23, 2009
Nutrients – pdf
12/3/09 Update – What is absorbed in the Large Intestine? Water, Sodium, Potassium, Vitamin K when formed by colonic bacteria.
What is absorbed in the Stomach? Water, alcohol some drugs.
Which nutrient begins digestion in the stomach? Protein with pepsinogen produced by Chief cells.
Posted in Day-to-Day, NS111 - Fundamentals, Physiologically | Comments Off on Nutrients
Week 13 Reading – Rm 114 (Last One!)
Posted by Laura on November 14, 2009
To print an 8×5 click here for .doc .pdf
| Week 13 Reading | ||||||
| NS 111 – Mod #14 Cultural Diversity | ||||||
| Book | Chapters | Pages | # pages | Min | complete | |
| F. of N.
|
2 | 30-38 | 8 | Read mod 8 | ||
| 3 | 41-61 | 20 |
|
|
||
| 36 | 1091-1119 | 30 |
|
|
||
| McKenry | 6 | 103-117 | 14 |
|
|
|
| Articles | Culturally competent Nursing Care | |||||
| American Nurse Today | ||||||
| Library Reserve | Transcultural Nursing and
Cultural Diversity in Health and Illness |
|||||
| Audio Visuals | |
| Mod
14 |
Transcultural Perspectives in Nursing: Communication, Part I (#49), Part II (#50), Assessment and Nursing Care (#51) |
| Week 13 Quiz/Exam/Other | |
| NS111 | Major Care Plan |
| NS111 | Cultural Diversity Presentation (Nov 20th or Dec 4th) |
| Week 14 Quiz/Exam/Other | |
| NS111 | Thanksgiving Break |
| NS111 | Pizza Sales, Community Day, Nov 24th 11-1 |
| Week 15 Quiz/Exam/Other | |
| NS111 | Mini Care Plan |
| NS111 | HESI evaluation |
| NS111 | Exam IV |
| Week 16 Quiz/Exam/Other | |
| NS111 | Final Exam |
Posted in Day-to-Day, NS110 - Professional I, NS111 - Fundamentals, Reading Schedule RM 114 | Tagged: AVC, reading list | 2 Comments »
What is MAO, and how come it keeps coming up in my reading of drugs?
Posted by Laura on November 9, 2009
Since there is great risk for patients on MAO inhibitors, I know I need to understand this area better. Here is what I found out:
MAO stands for monoamine oxidase. Monoamine oxidases are enzymes that catalyze the oxidation of monoamines. In other words, these enzymes oxidize or use oxygen to remove an amine group from a molecule.
Starting off we have a monamine molecule. The one above is a base (R) with 2 hydrogen and one ammonia component, plus water and oxygen. We then used MAO (the oxidase) to pull the amino group from the molecule resulting in the amino, 1 hydrogen and 1 oxygen plus the ammonia and water molecules.
Okay, so we know what MAO is. Now a MAO inhibitor would keep this from happening, right? To know why we want it to be inhibited, we need to understand why it normally happens. From what I have read, the normal MAO which happens in our body functions to monitor how many neurotransmitters get to function. If MAOs are increased, then they will be lowering the neurotransmitters activity such as serotonin, norepinephrine, epinephrine and dopamine. Depending if MAO is overworking, or under-working a patient could have depression, schizophrenia, substance abuse, ADD, and migraines.
So now I understand why having our MAOs working correctly is important. If a person is on MAO therapy, then any other drug that may also depress these neurotransmitters – or increase them, will obviously counter act with the MAO drugs and create problems.
Not only other drugs but food also. This example is given in the Tabers (p. 1485) An MAO inhibitor (MAOI) is used to treat depression and Parkinson’s disease. A tyramine-containing food such as cheese can upset this balance.
If you have a MAO excess, then you will have an increased breakdown of catecholamines in your bloodstream. Catecholamines are serotonin, dopamine, metanephrine, norepinephrine, and epinephrine. They are derived from the amino acid tyrosine.
In the Taber’s example, taking an MAO inhibitor will help to not form the tyrosine base by itself. But if you eat certain cheeses (and are using certain MAOI) you just re-establish the high load of tyrosine in your body canceling out the effect of the MAOI.
Posted in Concepts, NS111 - Fundamentals | Tagged: AVC, MAO, student nurse laura | Comments Off on What is MAO, and how come it keeps coming up in my reading of drugs?
Erickson’s Table
Posted by Laura on November 8, 2009
I re-did our Erickson’s Table to show a positive outcome at each stage vs. a negative outcome. I used the video below, and our F. of N. book for my chart.
Posted in Concepts, NS111 - Fundamentals | Tagged: AVC, developmental, erickson, psychosocial, stages | Comments Off on Erickson’s Table
Week 12 Reading – Rm 114
Posted by Laura on November 8, 2009
To print an 8×5 click here for .doc .pdf
| Week 12 Reading | |||||
| NS 111 – Mod #9 Maintenance of Self-Concept | |||||
| Book | Chapters | Pages | # pages | Min | complete |
| F. of N. | 18 | 399-400 | 1 | ||
| 31 | 923-951 | 28 | |||
| 32 | 953-979 | 26 | |||
| Articles | Stress Busters and Sanity Savers | ||||
| Nurses’ Stress & Burnout | |||||
| Audio Visuals | |
| Mod#9 | One Nation Under Stress #47Taking it in Stride |
| Week 12 Quiz/Exam/Other | ||
| NS111 | Research Paper | |
| Week 13 Quiz/Exam/Other | ||
| NS111 | Major Care Plan | |
| NS111 | Module #14 Cultural Diversity | |
| NS111 | Cultural Diversity Presentation | |
Posted in NS110 - Professional I, NS111 - Fundamentals, Reading Schedule RM 114 | Comments Off on Week 12 Reading – Rm 114
Enteral and Parenteral Feeding Notes
Posted by Laura on November 1, 2009
A Good site for more information on enteral /medication administration is: (they even talk about Phenytoin -Dilantin)
http://www.ascp.com/publications/tcp/1999/jan/tubes.shtml
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Student Nurse Laura 
