Third semester Nursing Students
NCLEX-RN Nursing Review w/Sally Lagerquist, R.N., M.S.
Author of Davis’ RN-NCLEX Success
http://nclex.reviewfornurses.com/NCLEX/NCLEX_Review_Packages/Live_NCLEX_
Four Day Seminar at San Francisco State University
January 8, 9, 10 & 11, 2008
Register as part of our 3rd semester group and go for $200. This will also enable you to return in early June for a refresher or the entire course for only $75 right before our own NCLEX-RN.
Group Registration Deadline is November 2, 2007 to go for $200, after this date it goes up by $25. All Registration closes on 12/3. Please Contact: Kelly Widger @ 482-1463 or k9nurse86@comcast.net to add your name to our growing list of attendees. I will be carrying registration forms with me on campus. Do Not mail into Nursing Review or you will not get the discounted group rate. Please return completed registration form and Money to Kelly Widger the sooner the better, I would like to have everything no later than Oct.26th. At least email me so I can put you on the attendee list. I am on campus every Tue/Wed and can make arrangements to meet to turn in paperwork. If you do not have the full $200 at the time of registration you can pay the $75 registration fee to save your spot and pay the balance by Nov.1
Forms of payment are Money Order, Checks, Visa or Mastercard all made payable to Nursing Review.
2 Hotels offering discounted rates are:
Days Inn 415-665-9000 (1.8 mi) 2600 Sloat Blvd. San Francisco, Ca. 94116 (Complimentary continental breakfast) 1 King non-smoking……$70/ngt. 2 Queen non-smoking…..$80/ngt.
They do have smoking rooms call for rates.They only have 33 rooms total so book early
Hampton Inn—Daly City 650-755-7500 (2.3 mi)2700 Junipero Serra Blvd.San Francisco, Ca. 94051(Complimentary hot breakfast or continental)2 Queens non-smoking…………..$139/ngt
Sunday, August 26, 2007
BP and Cap Dynamics Questions
Factors that Affect Blood Pressure
1. What are the three main factors affecting peripheral resistance?2. What effect does vessel diameter have on peripheral resistance and blood pressure?3. What effect does sympathetic nerves have on the vessels smooth muscle layer?4. State three vasoconstrictors.5. How does viscosity affect the peripheral resistance?6. What effect does viscosity have on peripheral resistance and blood pressure?7. How does blood vessel length affect blood pressure?8. How does blood vessel elasticity affect blood pressure?9. How does blood volume affect blood pressure?10. State two behaviors that can affect blood pressure and explain how?11. Describe how changes in cardiac output affect blood pressure.12. What are the effects of autonomic stimulation on blood pressure?13. What affect does changes in stroke volume have upon blood pressure?
Blood Pressure Regulation
1. How is rising blood pressure detected by the body?2. Describe how the brain lowers blood pressure in response to signals that it is increasing?3. Describe the short term regulation of falling blood pressure.4. What are the effects of epinephrine and norepinephrine on the cardiovascular system?5. How do juxtaglomerular cells of the kidneys contribute to the long term regulation of blood pressure?6. Describe the steps of the renin-angiotensin mechanism.7. What is the secondary effect of angiotensin that causes it to raise the blood pressure?8. What is the effect of aldosterone on the kidneys?9. What is the long term effect of an increase in osmolarity?10. What is the effect of antidiuretic hormone?11. What is the short term effect of an increase in osmolarity?
Autoregulation and Capillary Dynamics
1. Explain how blood flow is controlled at the capillary bed.2. What is the effect of different concentrations of oxygen and carbon dioxide on the capillary bed?3. What is the effect of pH on the precapillary sphincters of the capillary bed?4. Name some other factors that influence blood flow through the capillary bed.5. State structural features of capillaries that aid in the transport of nutrients across the capillary wall.6. By what process does oxygen and carbon dioxide move across the capillary wall?7. What type of molecules are transported across the capillary wall by exocytosis?8. Explain why bulk fluid flows are important at capillary beds.9. What is hydrostatic pressure?10. What is the hydrostatic pressure in the capillaries?11. How does the hydrostatic pressure in the arteriole end of capillaries compare with that in the venule end.12. Why is the hydrostatic pressure in the fluid spaces normally low?13. What is the net hydrostatic pressure and how does it affect the net movement of fluid across the capillaries?14. What is osmotic pressure?15. Why does the capillary bed have a high osmotic pressure?16. Why is the osmotic pressure in the interstitial fluid low?17. Where does the fluid flow in a capillary bed because of the net osmotic pressure across the capillary walls?
1. What are the three main factors affecting peripheral resistance?2. What effect does vessel diameter have on peripheral resistance and blood pressure?3. What effect does sympathetic nerves have on the vessels smooth muscle layer?4. State three vasoconstrictors.5. How does viscosity affect the peripheral resistance?6. What effect does viscosity have on peripheral resistance and blood pressure?7. How does blood vessel length affect blood pressure?8. How does blood vessel elasticity affect blood pressure?9. How does blood volume affect blood pressure?10. State two behaviors that can affect blood pressure and explain how?11. Describe how changes in cardiac output affect blood pressure.12. What are the effects of autonomic stimulation on blood pressure?13. What affect does changes in stroke volume have upon blood pressure?
Blood Pressure Regulation
1. How is rising blood pressure detected by the body?2. Describe how the brain lowers blood pressure in response to signals that it is increasing?3. Describe the short term regulation of falling blood pressure.4. What are the effects of epinephrine and norepinephrine on the cardiovascular system?5. How do juxtaglomerular cells of the kidneys contribute to the long term regulation of blood pressure?6. Describe the steps of the renin-angiotensin mechanism.7. What is the secondary effect of angiotensin that causes it to raise the blood pressure?8. What is the effect of aldosterone on the kidneys?9. What is the long term effect of an increase in osmolarity?10. What is the effect of antidiuretic hormone?11. What is the short term effect of an increase in osmolarity?
Autoregulation and Capillary Dynamics
1. Explain how blood flow is controlled at the capillary bed.2. What is the effect of different concentrations of oxygen and carbon dioxide on the capillary bed?3. What is the effect of pH on the precapillary sphincters of the capillary bed?4. Name some other factors that influence blood flow through the capillary bed.5. State structural features of capillaries that aid in the transport of nutrients across the capillary wall.6. By what process does oxygen and carbon dioxide move across the capillary wall?7. What type of molecules are transported across the capillary wall by exocytosis?8. Explain why bulk fluid flows are important at capillary beds.9. What is hydrostatic pressure?10. What is the hydrostatic pressure in the capillaries?11. How does the hydrostatic pressure in the arteriole end of capillaries compare with that in the venule end.12. Why is the hydrostatic pressure in the fluid spaces normally low?13. What is the net hydrostatic pressure and how does it affect the net movement of fluid across the capillaries?14. What is osmotic pressure?15. Why does the capillary bed have a high osmotic pressure?16. Why is the osmotic pressure in the interstitial fluid low?17. Where does the fluid flow in a capillary bed because of the net osmotic pressure across the capillary walls?
Saturday, August 25, 2007
SNA PDA Party - Sept. 17th!!
Your Student Nursing Association will be presenting a PDA party Sept. 17th 1-3pm in Locke 314.
Bonnie Boss has agreed to come give her PDA presentation. We invite other SJDC students to be on hand to give a PDA "show and tell". Come make some suggestions for future meetings that will provide you with the info you really need to know!
All are welcome to attend, if you still have not registered for the SNA, we will be happy to register you at the door.
SNA items will be raffled and Snacks will be served!!
Your Fall 2007 SNA officers are:
Danielle Mathias-Lamb, President
Barbara Buonauro, V. President
Amanda Aguirre, Secretary
Aime Edwards, Treasurer
Mrs. Batson, SNA Faculty Advisor
Bonnie Boss has agreed to come give her PDA presentation. We invite other SJDC students to be on hand to give a PDA "show and tell". Come make some suggestions for future meetings that will provide you with the info you really need to know!
All are welcome to attend, if you still have not registered for the SNA, we will be happy to register you at the door.
SNA items will be raffled and Snacks will be served!!
Your Fall 2007 SNA officers are:
Danielle Mathias-Lamb, President
Barbara Buonauro, V. President
Amanda Aguirre, Secretary
Aime Edwards, Treasurer
Mrs. Batson, SNA Faculty Advisor
Thursday, August 23, 2007
Great resource........
Hi everyone,
I just wanted to let you all know that the website for evolve http://evolve.elsevier.com for our Thelans Critical Care Nursing Book is a GREAT resource!! There are video clips showing all kinds of physiology and it is just full of relevant info. for those of us in nursing 7.
I just wanted to let you all know that the website for evolve http://evolve.elsevier.com for our Thelans Critical Care Nursing Book is a GREAT resource!! There are video clips showing all kinds of physiology and it is just full of relevant info. for those of us in nursing 7.
Thanks Nurse Nicky and Kat!
Just wanted to say thanks for the question you ladies made! I am so glad to have you two in my class.....
Practice Unit I NS07
1.)Morphine is good for cardiac pts because...
a.) It makes them feel really good
b.) It increases GFR which increases urine production which helps avoid 3rd spacing, and augments gas exchange at the cellular level.
c.) It helps with pain.
d.) both b and c
2.) When involving capillary pressures, which statement is true?
a.) Both negative and positive pressure pull.
b.) Negative pressure pushes while positive pressure pulls.
c.) Positive pressure pushes while negative pressure pulls.
3.) When figuring out the calculations for IV meds, you would use.
a.) dry weight
b.) my weight and your weight.
c.) All weight including 3rd spacing volume.
4.) What 2 meds call for lab work of potassium before administration?
a.) vicodin and viagra
b.) lopressor and metformin
c.) lasix and digoxin
5.) What increases the force or tension of the heart?
a.) cardiac output
b.) volume
c.) heart rate.
6.) What is Epinephrine?
a.) 30% alpha vasoconstriction and 70% beta increase heart rate.
b.) 60% beta increase heart rate and 40% alpha vasoconstriction.
c.) Its all alpha vasoconstriction
7.) What are inotropic agents?
a.) influence the force of muscular contractility
b.) influenc heart rate
c.) both a and b
8.) How much oxygen does the brain utilize?
a.) 20%
b.) 50%
c.) 100%
9.) What are the 2 phases of cellular damage?
a.) Ischemia and hypovolemia
b.) decrease cell production and leakage
c.) Ischemia and Necrosis.
10.) In anaerobic metabolism, we don't produce c02 like we do in the kreb cycle, but we produce what?
a.) Chocolate
b.) lactic acid
c.) urea
11.) What are scrubbers, and what do they do?
a.) o2 radicals are scrubbers that scrub the membranes so thin they tear.
b.) students nurses that give bedbaths
c.) antioxidants that counteract the o2 radicals.
1.)d 2.)c 3.)a 4.)c 5.)c 6.)b 7.)a 8.)a 9.)c 10.)b 11.)a
a.) It makes them feel really good
b.) It increases GFR which increases urine production which helps avoid 3rd spacing, and augments gas exchange at the cellular level.
c.) It helps with pain.
d.) both b and c
2.) When involving capillary pressures, which statement is true?
a.) Both negative and positive pressure pull.
b.) Negative pressure pushes while positive pressure pulls.
c.) Positive pressure pushes while negative pressure pulls.
3.) When figuring out the calculations for IV meds, you would use.
a.) dry weight
b.) my weight and your weight.
c.) All weight including 3rd spacing volume.
4.) What 2 meds call for lab work of potassium before administration?
a.) vicodin and viagra
b.) lopressor and metformin
c.) lasix and digoxin
5.) What increases the force or tension of the heart?
a.) cardiac output
b.) volume
c.) heart rate.
6.) What is Epinephrine?
a.) 30% alpha vasoconstriction and 70% beta increase heart rate.
b.) 60% beta increase heart rate and 40% alpha vasoconstriction.
c.) Its all alpha vasoconstriction
7.) What are inotropic agents?
a.) influence the force of muscular contractility
b.) influenc heart rate
c.) both a and b
8.) How much oxygen does the brain utilize?
a.) 20%
b.) 50%
c.) 100%
9.) What are the 2 phases of cellular damage?
a.) Ischemia and hypovolemia
b.) decrease cell production and leakage
c.) Ischemia and Necrosis.
10.) In anaerobic metabolism, we don't produce c02 like we do in the kreb cycle, but we produce what?
a.) Chocolate
b.) lactic acid
c.) urea
11.) What are scrubbers, and what do they do?
a.) o2 radicals are scrubbers that scrub the membranes so thin they tear.
b.) students nurses that give bedbaths
c.) antioxidants that counteract the o2 radicals.
1.)d 2.)c 3.)a 4.)c 5.)c 6.)b 7.)a 8.)a 9.)c 10.)b 11.)a
Wednesday, August 22, 2007
Practice Test
I was going over my audio, text and notes from todays lecture and I put together a little test you can practice with. Please feel free to reference my answers to your own material and pose any questions. It would be cool if someone else can post another "Self Created" test with about 10 or 15 questions on different material. It would help us all!!! See ya, next week :)
Practice Test for N7
Unit #1
1. Nasal Cannula delivers what type of gas:
A. Moist gas
B. Warm gas
C. Dry gas
2. Pavoulon a Muscle Paralyzing Agent:
A. Decrease demand and Increase supply
B. Decrease demand and Decrease supply
C. Increase demand and Increase supply
3. TPN can infuse through a peripheral line: T or F
{If answer is false give reasoning to make answer true}
Peripheral line is too small to infuse TPN. TPN contains protein and fats that are to big to transfuse through peripheral line. Also TPN is an irritant to peripheral veins.
4. ART lines need to be counteracted with how much pressure:
A. 150 mmHg of counter pressure
B. 300mmHg of counter pressure
C. 425mmHg of counter pressure
5. Nitro is a potent coronary artery dilator and a vasodilator. What is the priotity after administraiotion of Nitro:
A. Monitor B/P for low blood pressure
B. Monitor every 15 minutes for pt’s report of headache
C. Monitoring pt’s appetite
6. What is a intervention for Nipride:
A. Observe pt for paralyses, due to Nipride high incidence of paralyzes 1 hour after administration of medication.
B. Store med in a plastic bag, due to photosensitivity
C. Never Administer with Dopamine
7. What is the first indicator a patient is suffering from hypoxia:
A. Patients’ respiratory rate increases
B. Patients’ has a change in LOC
C. A marked decrease in urine output
8. When patient is suffering a nitrogen imbalance:
A. Serum Albumin increases
B. Serum Albumin remains unchanged
C. Serum Albumin decreases
9. Dilantin must not be pushed greater than:
A. 25 mg/min
B. 40mg/min
C. 250mg/min
10. Your patient states “I have this ringing in my ear and it’s never happened to me before this morning after I took all of my morning meds”. From your knowledge of meds, you know that of the meds listed one cause a feeling of “ringing in the ear”:
A. Regular Insulin
B. Heparin
C. Lasix
11. You notice MD ordered a insulin drip containing Lantus, you:
A. Question the order, knowing that only Regular insulin is to be used as a IV drip
B. Give the med as ordered
C. Refuse to give the medication
12. Morphine Sulfate should never be pushed faster than:
A. 1.0 mg/min
B. 2.0 mg/min
C. 3.0 mg/min
13. Your preceptor states, “His central line has been in for two weeks and that’s good, we won’t have to worry about it, because central lines are good for a month”. You:
A. Agree, because central lines are intended to be in place for 30 days
B. Disagree, knowing that central lines are only good for 72 hours
C. Disagree, knowing that central lines are intended to be in place for 7-10 days
14. You Instructor gives you a verbal warning when she sees you:
A. Check the K+, of your patient prior to administering a loop diuretic
B. Push 25mg/min of Dilantin
C. Give pt a med via his central line without flushing line with heparin
15. Mrs. Antran knows you know your stuff when you:
A. Raise you hand to say, “K+ must be diluted in 100ml of NS for 20 meq or less
B. Digoxin is to be given 1.25 mg within one hour
C. Dilantin increases heart rate
Answers: 1c, 2a, 3F, 4b,5a, 6b, 7a,8c,9a,10c,11a,12b,13c,14c,15a
Practice Test for N7
Unit #1
1. Nasal Cannula delivers what type of gas:
A. Moist gas
B. Warm gas
C. Dry gas
2. Pavoulon a Muscle Paralyzing Agent:
A. Decrease demand and Increase supply
B. Decrease demand and Decrease supply
C. Increase demand and Increase supply
3. TPN can infuse through a peripheral line: T or F
{If answer is false give reasoning to make answer true}
Peripheral line is too small to infuse TPN. TPN contains protein and fats that are to big to transfuse through peripheral line. Also TPN is an irritant to peripheral veins.
4. ART lines need to be counteracted with how much pressure:
A. 150 mmHg of counter pressure
B. 300mmHg of counter pressure
C. 425mmHg of counter pressure
5. Nitro is a potent coronary artery dilator and a vasodilator. What is the priotity after administraiotion of Nitro:
A. Monitor B/P for low blood pressure
B. Monitor every 15 minutes for pt’s report of headache
C. Monitoring pt’s appetite
6. What is a intervention for Nipride:
A. Observe pt for paralyses, due to Nipride high incidence of paralyzes 1 hour after administration of medication.
B. Store med in a plastic bag, due to photosensitivity
C. Never Administer with Dopamine
7. What is the first indicator a patient is suffering from hypoxia:
A. Patients’ respiratory rate increases
B. Patients’ has a change in LOC
C. A marked decrease in urine output
8. When patient is suffering a nitrogen imbalance:
A. Serum Albumin increases
B. Serum Albumin remains unchanged
C. Serum Albumin decreases
9. Dilantin must not be pushed greater than:
A. 25 mg/min
B. 40mg/min
C. 250mg/min
10. Your patient states “I have this ringing in my ear and it’s never happened to me before this morning after I took all of my morning meds”. From your knowledge of meds, you know that of the meds listed one cause a feeling of “ringing in the ear”:
A. Regular Insulin
B. Heparin
C. Lasix
11. You notice MD ordered a insulin drip containing Lantus, you:
A. Question the order, knowing that only Regular insulin is to be used as a IV drip
B. Give the med as ordered
C. Refuse to give the medication
12. Morphine Sulfate should never be pushed faster than:
A. 1.0 mg/min
B. 2.0 mg/min
C. 3.0 mg/min
13. Your preceptor states, “His central line has been in for two weeks and that’s good, we won’t have to worry about it, because central lines are good for a month”. You:
A. Agree, because central lines are intended to be in place for 30 days
B. Disagree, knowing that central lines are only good for 72 hours
C. Disagree, knowing that central lines are intended to be in place for 7-10 days
14. You Instructor gives you a verbal warning when she sees you:
A. Check the K+, of your patient prior to administering a loop diuretic
B. Push 25mg/min of Dilantin
C. Give pt a med via his central line without flushing line with heparin
15. Mrs. Antran knows you know your stuff when you:
A. Raise you hand to say, “K+ must be diluted in 100ml of NS for 20 meq or less
B. Digoxin is to be given 1.25 mg within one hour
C. Dilantin increases heart rate
Answers: 1c, 2a, 3F, 4b,5a, 6b, 7a,8c,9a,10c,11a,12b,13c,14c,15a
Tuesday, August 21, 2007
Helpful information for N 7
Hi All,
Here is some helpful information I found on the blog of our upper- classmen that helped them with Nursing 7.
Sunday, August 20, 2006
Some Helps for N7 Ok you N7 SNs. I also recommend that you check out this site!Critical Care TutorialsThese tutorials are short and sweet and break all of the difficult concepts of N7 into easy to understand packets.I read the respiratory section the night before our test and scored really high. (hint, hint)Do yourself a favor and check it out!
Posted by Bonnie Boss
Here are the Shock Key Points from the Critical Care Tutorials
1. Blood Pressure is Cardiac Output multiplied by Peripheral Resistance.
2. Cardiac Output is Heart Rate times Stroke Volume.
3. Hypotension is caused by either inadequate Cardiac Output or inadequate Peripheral
Resistance
4. Heart Rate, Stroke Volume and Total Peripheral Resistance exist in dynamic equilibrium: these interactions maintain blood pressure. If one of the three becomes abnormal, the other two compensate. This represents the cardiovascular physiologic reserve.
5. Hypotension is an indication of 1) an abnormality of Heart Rate, Stroke Volume or Peripheral Resistance, & 2) failure of the others to compensate.
6. Shock is acute circulatory failure leading to inadequate tissue perfusion and end organ injury: it classified as being due to malfunction of 1) the Pump (cardiogenic), 2 ) the Tubing (distributive), or 3) the Fluid (hypovolemic).
7. The heart rate is a fundamental element of hypotension both in terms of cause (tachyarrhythmias / bradyarrhythmias) and compensation – hypotension should be accompanied by a tachycardia.
8. Low Stroke volume is caused by a problem with reception or a problem with ejection.
9. Problems with reception are: inadequate venous return or cardiac inflow obstruction.
10. Fluid loss is caused by either absolute hypovolemia (e.g. blood loss) or relative hypovolemia ("third spacing").
11. Cardiac inflow obstruction is caused by a pericardial (tamponade) or intrathoracic process (PEEP), or a lesion within the heart itself (mitral stenosis).
12. Problems with ejection include pump failure (ischemia, overload, contusion, inflammation) and outflow obstruction (embolism, aortic stenosis, aortic crossclamps).
13. Shock caused by low peripheral vascular resistance is caused by loss of tonic vasoconstriction (vasoplegia), due to sympathectomy, anaphylaxis or sepsis, leading to relative hypovolemia.
14. Vasodilation associated with septic shock occurs due to increased synthesis of nitric oxide, activation of ATP-sensitive potassium channels in vascular smooth muscle, and deficiency of vasopressin.
Here is some helpful information I found on the blog of our upper- classmen that helped them with Nursing 7.
Sunday, August 20, 2006
Some Helps for N7 Ok you N7 SNs. I also recommend that you check out this site!Critical Care TutorialsThese tutorials are short and sweet and break all of the difficult concepts of N7 into easy to understand packets.I read the respiratory section the night before our test and scored really high. (hint, hint)Do yourself a favor and check it out!
Posted by Bonnie Boss
Here are the Shock Key Points from the Critical Care Tutorials
1. Blood Pressure is Cardiac Output multiplied by Peripheral Resistance.
2. Cardiac Output is Heart Rate times Stroke Volume.
3. Hypotension is caused by either inadequate Cardiac Output or inadequate Peripheral
Resistance
4. Heart Rate, Stroke Volume and Total Peripheral Resistance exist in dynamic equilibrium: these interactions maintain blood pressure. If one of the three becomes abnormal, the other two compensate. This represents the cardiovascular physiologic reserve.
5. Hypotension is an indication of 1) an abnormality of Heart Rate, Stroke Volume or Peripheral Resistance, & 2) failure of the others to compensate.
6. Shock is acute circulatory failure leading to inadequate tissue perfusion and end organ injury: it classified as being due to malfunction of 1) the Pump (cardiogenic), 2 ) the Tubing (distributive), or 3) the Fluid (hypovolemic).
7. The heart rate is a fundamental element of hypotension both in terms of cause (tachyarrhythmias / bradyarrhythmias) and compensation – hypotension should be accompanied by a tachycardia.
8. Low Stroke volume is caused by a problem with reception or a problem with ejection.
9. Problems with reception are: inadequate venous return or cardiac inflow obstruction.
10. Fluid loss is caused by either absolute hypovolemia (e.g. blood loss) or relative hypovolemia ("third spacing").
11. Cardiac inflow obstruction is caused by a pericardial (tamponade) or intrathoracic process (PEEP), or a lesion within the heart itself (mitral stenosis).
12. Problems with ejection include pump failure (ischemia, overload, contusion, inflammation) and outflow obstruction (embolism, aortic stenosis, aortic crossclamps).
13. Shock caused by low peripheral vascular resistance is caused by loss of tonic vasoconstriction (vasoplegia), due to sympathectomy, anaphylaxis or sepsis, leading to relative hypovolemia.
14. Vasodilation associated with septic shock occurs due to increased synthesis of nitric oxide, activation of ATP-sensitive potassium channels in vascular smooth muscle, and deficiency of vasopressin.
Monday, August 20, 2007
From Afghanistan...
As we start our final year....I wanted to share a story that was just emailed over from my best friend, whose sister is serving in the Airforce in Afghanistan as an ER Nurse. Wow, truly amazing. Good luck and happy studying to all in our final semesters!
From Afghanistan...
The last few days have been very exciting here. Not only b/c we are allgetting ready for the end of August, but our patient tempo has picked upalso.We've been busy since I have been here. I have touched a lot of lives, butI have to tell you about one story in particular that literally made my deployment worth it this week!!
Friday (17th) we were pretty busy in the ER. We had normal ER patients,but we also got a few traumas in. One patient we were waiting on was an American who was severely injured when a sniper hit him with a bullet. The story is this soldier was wearing all his protective equipment, but the sniper picked the one spot that wasn't covered by his kevlar vest. Thebullet pierced the R side of his chest and played pin ball with his insides until it exited out his back. We were expecting him for many hours. We had to extend our time b/c we were told that at the place he was at, he began to crash (b/c of internal bleeding) and they had to take him back into the OR to save him. We weren't even sure he was going to make it here alive.
A few hours later, we got the call that he was coming and he was extremely critical. He had already received 32 blood products down range, he had 4 chest tubes, already lost a kidney and he was bleeding from his liver.
As soon as the medevac landed, we rushed him into the trauma bay. The directions were, "get blood and get him to the OR!" I was working at thebedside and he looked awful. He was intubated, had blood all over him andhad so many tubes coming out of him. He was in and out of our department in 10 minutes and onto the OR. I held 15 bags of fluids/blood etc andraced to the OR with him and the OR staff. At the doors of the OR, the labtech came to me and said, "do you think he is going to need more blood?" Isaid "definately!" He told me that we only had 8 more units of O+ blood in the hospital and he would need to make a call for blood donors. I told himto start making the calls.
Once I got back to the ER, I looked down at my scrub top and I had some ofhis blood on it. I was praying he would make it through the surgery, but Iwas worried b/c he was pretty bad!
A few hours went by and I finished up my shift. Chris (that's his name)was still in the OR. I had already been called to donate blood, but I wasstill working so I told them I would be down once I got off shift. So, Igot off work, went over to the blood donation area expecting only a few folks to be there. There were at least 20 people in line to donate blood.My eyes began to swell with tears. I stood in line and started filling out my paperwork just as a soldier came in to the hospital. He said he was amedic and would like to help. The blood donation folks were overwhelmed with patients, so they had him take vital signs.
I waited for 2 hours until I could donate my blood. I was #125. Once Iwas finished donating, I checked on Chris. He was still in the OR andstill alive. I passed one of the OR nurses on the way out and asked how he was doing. She told me that he was still holding his own, but had more damage than what the surgeons expected. That one bullet did so muchdamage! i asked her how much blood product they had gone through and she told me they were up to 40+!
I left the hospital and as I was walking home, I heard over the "loud voice" 'all available blood donors to the hospital.' I wondered how many people would come. I found out the next day that there was a line out thehospital driveway and down to the street. The blood donation folkscollected over 60 units of whole blood! All for one soldier...amazing!
I woke up on Saturday praying that Chris had made it through surgery. Iwalked into the ICU for my shift and saw him in bed 1. Whew...I thought.Now, I just have to keep him alive until we can get him to Germany. Iasked if I could take him since I saw him in the ER. The charge nurse wasa bit leary b/c ...well, lets face it, I'm an ER nurse working in an ICU.BUT I told her that I could handle it, but would let someone know if Ineeded help. He was the most critical patient in the ICU.
As the day progressed, we did well together. I found out that the surgeons stopped all the internal bleeding after they found major damage. I gavehim 6 units of more blood product and found out that the OR ended up giving him 54 blood products during his surgery. that was in addition to the 32 he received down at the FOB (forward op base). As I was looking through his chart, I found multiple blood transfusion sheets and then I found blooddonor #125. I smiled b/c I realized that he had received my blood.
He went back into the OR that day to make sure that everything looked good and the bleeding was stopped. The good news was yes, everything looked fine...he was flight ready for Germany. the bad news was that the bullet demolished his T12-L1 spine...chances were slim that he would ever walkagain. Chris is 21 yo; he is married with a baby on the way.
As shitty as that is, at least he is alive; at least he will be able tohold his baby when he/she is born and at least he'll be home.
At change of shift, I reported off to the night nurse. Everyone commented how much better he looked. yes, he was still intubated and still had an open belly wound and chest tubes...but he made it...he was alive!! On my way home, I replayed the last 24 hours in my head. I reflected onthe blood he shed on my scrub top and the blood I shed to help save him. It was the most rewarding 24 hours I have ever experienced. I reallyhelped save a life!!
Until next time....
From Afghanistan...
The last few days have been very exciting here. Not only b/c we are allgetting ready for the end of August, but our patient tempo has picked upalso.We've been busy since I have been here. I have touched a lot of lives, butI have to tell you about one story in particular that literally made my deployment worth it this week!!
Friday (17th) we were pretty busy in the ER. We had normal ER patients,but we also got a few traumas in. One patient we were waiting on was an American who was severely injured when a sniper hit him with a bullet. The story is this soldier was wearing all his protective equipment, but the sniper picked the one spot that wasn't covered by his kevlar vest. Thebullet pierced the R side of his chest and played pin ball with his insides until it exited out his back. We were expecting him for many hours. We had to extend our time b/c we were told that at the place he was at, he began to crash (b/c of internal bleeding) and they had to take him back into the OR to save him. We weren't even sure he was going to make it here alive.
A few hours later, we got the call that he was coming and he was extremely critical. He had already received 32 blood products down range, he had 4 chest tubes, already lost a kidney and he was bleeding from his liver.
As soon as the medevac landed, we rushed him into the trauma bay. The directions were, "get blood and get him to the OR!" I was working at thebedside and he looked awful. He was intubated, had blood all over him andhad so many tubes coming out of him. He was in and out of our department in 10 minutes and onto the OR. I held 15 bags of fluids/blood etc andraced to the OR with him and the OR staff. At the doors of the OR, the labtech came to me and said, "do you think he is going to need more blood?" Isaid "definately!" He told me that we only had 8 more units of O+ blood in the hospital and he would need to make a call for blood donors. I told himto start making the calls.
Once I got back to the ER, I looked down at my scrub top and I had some ofhis blood on it. I was praying he would make it through the surgery, but Iwas worried b/c he was pretty bad!
A few hours went by and I finished up my shift. Chris (that's his name)was still in the OR. I had already been called to donate blood, but I wasstill working so I told them I would be down once I got off shift. So, Igot off work, went over to the blood donation area expecting only a few folks to be there. There were at least 20 people in line to donate blood.My eyes began to swell with tears. I stood in line and started filling out my paperwork just as a soldier came in to the hospital. He said he was amedic and would like to help. The blood donation folks were overwhelmed with patients, so they had him take vital signs.
I waited for 2 hours until I could donate my blood. I was #125. Once Iwas finished donating, I checked on Chris. He was still in the OR andstill alive. I passed one of the OR nurses on the way out and asked how he was doing. She told me that he was still holding his own, but had more damage than what the surgeons expected. That one bullet did so muchdamage! i asked her how much blood product they had gone through and she told me they were up to 40+!
I left the hospital and as I was walking home, I heard over the "loud voice" 'all available blood donors to the hospital.' I wondered how many people would come. I found out the next day that there was a line out thehospital driveway and down to the street. The blood donation folkscollected over 60 units of whole blood! All for one soldier...amazing!
I woke up on Saturday praying that Chris had made it through surgery. Iwalked into the ICU for my shift and saw him in bed 1. Whew...I thought.Now, I just have to keep him alive until we can get him to Germany. Iasked if I could take him since I saw him in the ER. The charge nurse wasa bit leary b/c ...well, lets face it, I'm an ER nurse working in an ICU.BUT I told her that I could handle it, but would let someone know if Ineeded help. He was the most critical patient in the ICU.
As the day progressed, we did well together. I found out that the surgeons stopped all the internal bleeding after they found major damage. I gavehim 6 units of more blood product and found out that the OR ended up giving him 54 blood products during his surgery. that was in addition to the 32 he received down at the FOB (forward op base). As I was looking through his chart, I found multiple blood transfusion sheets and then I found blooddonor #125. I smiled b/c I realized that he had received my blood.
He went back into the OR that day to make sure that everything looked good and the bleeding was stopped. The good news was yes, everything looked fine...he was flight ready for Germany. the bad news was that the bullet demolished his T12-L1 spine...chances were slim that he would ever walkagain. Chris is 21 yo; he is married with a baby on the way.
As shitty as that is, at least he is alive; at least he will be able tohold his baby when he/she is born and at least he'll be home.
At change of shift, I reported off to the night nurse. Everyone commented how much better he looked. yes, he was still intubated and still had an open belly wound and chest tubes...but he made it...he was alive!! On my way home, I replayed the last 24 hours in my head. I reflected onthe blood he shed on my scrub top and the blood I shed to help save him. It was the most rewarding 24 hours I have ever experienced. I reallyhelped save a life!!
Until next time....
Wednesday, August 15, 2007
NCLEX REVIEW......follow up
Hi Everyone,
It is GREAT to see all of your interest in the NCLEX review session coming up in January!!
I just received the packet of materials we will need to get everyone signed up that is interested.
All registration paper work and fees will go through me, but will be payable to Davis' NCLEX review by check, money order or credit card. If you have N 7 first rotation then I am in your lecture class and will be making an announcement one morning in class. If you are N 6 first then I am going to email your instructor to see if I can get a quick minute to come by your lecture when it is okay with her for me to talk to all of you as well. This way everyone should know what is going on and we will all have the same opportunity to sign up at the discounted price. With the interest being shown so far, it looks like our price will be $200 per student. Davis' is putting together a hotel list for us of near by hotels offering us a student/corporate discounted rate. I will get all of this info. out as soon as I get it. Our deadline for group registration will be early November.
See You Next Week!!!
It is GREAT to see all of your interest in the NCLEX review session coming up in January!!
I just received the packet of materials we will need to get everyone signed up that is interested.
All registration paper work and fees will go through me, but will be payable to Davis' NCLEX review by check, money order or credit card. If you have N 7 first rotation then I am in your lecture class and will be making an announcement one morning in class. If you are N 6 first then I am going to email your instructor to see if I can get a quick minute to come by your lecture when it is okay with her for me to talk to all of you as well. This way everyone should know what is going on and we will all have the same opportunity to sign up at the discounted price. With the interest being shown so far, it looks like our price will be $200 per student. Davis' is putting together a hotel list for us of near by hotels offering us a student/corporate discounted rate. I will get all of this info. out as soon as I get it. Our deadline for group registration will be early November.
See You Next Week!!!
Thursday, August 09, 2007
Welcome the incoming class
Hey folk,
I hope all had a wonderful summer and enjoyed the weddings, vacations, online classes and work experiences they were gifted with!
The incoming class Welcoming Tea will be held Monday 8/13 from 12 noon - 2 pm. If you have a moment, please pop over to their new blog site and welcome them. Just click on the 1st semester link and it will take you there.
I can't wait to see you all!
I hope all had a wonderful summer and enjoyed the weddings, vacations, online classes and work experiences they were gifted with!
The incoming class Welcoming Tea will be held Monday 8/13 from 12 noon - 2 pm. If you have a moment, please pop over to their new blog site and welcome them. Just click on the 1st semester link and it will take you there.
I can't wait to see you all!
Wednesday, August 08, 2007
Desperately Seeking Nurse Nickey
Please contact me ASAP.... thank ya very much!
PS I emailed you my phone #.
PS I emailed you my phone #.
Monday, August 06, 2007
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