Chest presses, not breaths, help CPR - article

By MARILYNN MARCHIONE, AP Medical Writer 1 hour, 25 minutes ago
Chest compression — not mouth-to-mouth resuscitation — seems to be the key in helping someone recover from cardiac arrest, according to new research that further bolsters advice from heart experts.

A study in Japan showed that people were more likely to recover without brain damage if rescuers focused on chest compressions rather than rescue breaths, and some experts advised dropping the mouth-to-mouth part of CPR altogether. The study was published in Friday's issue of the medical journal The Lancet.
More than a year ago, the American Heart Association revised CPR guidelines to put more emphasis on chest presses, urging 30 instead of 15 for every two breaths given. Stopping chest compressions to blow air into the lungs of someone who is unresponsive detracts from the more important task of keeping blood moving to provide oxygen and nourishment to the brain and heart.
Another big advantage to dropping the rescue breaths: It could make bystanders more willing to provide CPR in the first place. Many are unwilling to do the mouth-to-mouth part and become flummoxed and fearful of getting the ratio right in an emergency.
Sudden cardiac arrest — when the heart suddenly stops beating — can occur after a heart attack or as a result of electrocution or near-drowning. It's most often caused by an abnormal heart rhythm. The person experiencing it collapses, is unresponsive to gentle shaking and stops normal breathing.
In the new study, researchers led by Dr Ken Nagao of Surugadai Nihon University Hospital in Tokyo analyzed 4,068 adult patients who had cardiac arrest witnessed by bystanders. Of those, 439 received chest compressions only from bystanders, and 712 received conventional CPR — compressions and breaths.
Any CPR attempt improved survival odds. However, 22 percent of those who received just chest compressions survived with good neurological function compared with only 10 percent of those who received combination CPR.
"Eliminating the need for mouth-to-mouth ventilation will dramatically increase the occurrence of bystander-initiated resuscitation efforts and will increase survival," Dr. Gordon Ewy, a cardiologist at the University of Arizona College of Medicine in Tucson, writes in an accompanying editorial.
A big caveat: The combination CPR in the Japanese study was given according to the old guidelines of 15 presses for every two breaths, not the 30 presses recommended now.
The American Heart Association said the study supports a focus on chest presses, but the association does not expect its advice to change. It recommends that bystanders provide compression-only CPR if they are "unwilling or unable" to do mouth-to-mouth breathing at the same time and for emergency dispatchers to give instructions on that.
The association wants to see survival results from programs that use compression-only CPR for cardiac arrest.
"It is important to note that victims of cardiac arrest from non-cardiac causes, like near-drowning or electrocution, and almost all victims of pediatric cardiac arrest benefit from a combination of rescue breathing and chest compressions," a heart association statement says.
More than 300,000 Americans die from cardiac arrest each year. About 75 percent to 80 percent of all cardiac arrests outside a hospital happen at home, and effective CPR can double a victim's chance of survival.
Roughly 9 out of 10 cardiac arrest victims die before they get to the hospital — partly because they don't get CPR.
___
On the Net:
Lancet article: http://tinyurl.com/2fup97
American Heart Association: http://www.americanheart.org

Thank you Bonnie and Debby!!

I just wanted to thank Bonnie and Debby for taking the time to put together the workshop yesterday. This was a real eye opener, I highly recommend it to everyone, even if you have passed N4 already it will definently prepare you for the NCLEX. Once again thank you ladies!!!

I can't forget my classmates from N5!! Congrats to all for a successful completion of N5. Only 6 more nursing classes to go!!! HOORAYY!!! Enjoy the time off, because next week bright and early we start our venture through N4. See you all on Monday!!! Always Gemekia :)

Hey All!! Congrats to all that passed N4!!! Well it's time for the other half of the group to complete N4. *ahhhh!!!* My hands are sweating and my knees are shaking!! I know it's not easy, but it's not impossible either!! WE CAN DO IT!!!! I want to thank everyone that posted the wonderful resources. This will definitely help us through N4. We greatly appreciate it!!! Good Night to all and have a blast in N5. Mrs. Ippolito is wonderful!!! Always Gemekia:)

Tic-Toc-Tic-Toc-Tic-Toc..............

Does anybody else hear the clock..........only 42 more hours and N 4 is behind us. Best of luck to all.........I wish we were the class for 100% of the students to all pass!! The thought of some of our classmates leaving us at this point truly saddens me but, I know they will navigate their detour successfully and become great RN's !!

GU system questions....

Hi All,
Here are the test bank questions for GU...........have fun, last exam for N4 ;)

Male Problems
Kidneys and Cardio disease
n4-test-renalurinary-system
n4-test-complications-of-chronic
n4-test-acute-renal-failure
n4-test-urinary-problems
n4-test-interventions-for-renal disorders
n4-test-chronic-and-acute-renal failure
n4-test-urinary-system-chapter-43
n4-test-chap-44-renal-and-urologic
n4-test-chap-45-acute-renal-failure
n4-test-keeping-kidney-function
n4-gu-test

Workshop offered Thurs 3/15

Come and attend a workshop with New Grads Bonnie Boss and Deborah Vogel which will cover test and study strategies using your critical thinking skills. This will be a learn by practice session with lots of group interaction. Bring your brain, common sense and a sense of humor.

The student success program will have a room for us on Thurs 3/15 at 1300-1500ish. This should give you a chance to get some lunch after your class before attending (we will probably be a little early and plan on leaving late).

Unfortunately our schedules were not as open and available as we were hoping that they might be after graduation for lots of tutoring but we still want to help out if we can. Bring your questions for those who have been there, done that and survived.

Always be Positive!

FROGS

Once upon a time there was a bunch of tiny frogs.... who arranged a running competition.

The goal was to reach the top of a very high tower.

A big crowd had gathered around the tower to see the race and cheer on the contestants....
The race began....

Honestly:
No one in crowd really believed that the tiny frogs would reach the top of the tower.

You heard statements such as:
"Oh, WAY too difficult!!"
"They will NEVER make it to the top."
or:
"Not a chance that they will succeed. The tower is too high!"

The tiny frogs began collapsing. One by one....
Except for those, who in a fresh tempo, were climbing higher and higher....
The crowd continued to yell, "It is too difficult!!! No one will make it!"

More tiny frogs got tired and gave up....
But ONE continued higher and higher and higher....
This one wouldn't give up!

At the end everyone else had given up climbing the tower. Except for the one tiny frog who, after a big effort, was the only one who reached the top!

THEN all of the other tiny frogs naturally wanted to know how this one frog managed to do it?

A contestant asked the tiny frog how he had found the strength to succeed and reach the goal?

It turned out....
That the winner was DEAF!!!!

The wisdom of this story is:
Never listen to other people's tendencies to be negative or pessimistic.... because they take your most wonderful dreams and wishes away from you -- the ones you have in your heart!

Always think of the power words have.
Because everything you hear and read will affect your actions!

Therefore:
ALWAYS be....
POSITIVE!

And above all:
Be DEAF when people tell YOU that you cannot fulfill your dreams!

Always think:
I can do this!

Pass this message on to "tiny frogs" you care about.

Test Bank Questions for exam 5 M.skeletal

Here are the practice tests for Tuesday's exam for musculoskeletal System................


N4 test Chapter 60 musc Skel stuff
N4 musculoskeletal trauma
n4-test-musculoskeletal-problems
N4 bones and joints quiz
n4-test-assessment-of-musculoskeletal system
n4-test-chapter-63-joints
n4 review questions chapter 62 back probs
n4-test-musculoskeletal-chapter-61
n4-test-osteoporosis
n4-test-differences-between osteoarthritis and rheumatoid arthritis
n4-test-arthritis
n4-test-fractures-care-and-traction
n4-test-pagets-bone-disease
n4-test-hip-fractures
n4-test-fractures-and-dislocations
n4-quiz-systemic-lupus-erythematosus
n4-muskuloskeletal-pharm-quiz
n4-test-musculoskeletal-trauma
n4-test-antiinflammatory-drugs

for those who want to go to Kaiser in Modesto when we are done

We will graduate in enough time to work there when finally opens.

Kaiser Permanente has set October 2008 as the date it will open the 220-bed hospital wing of its new Modesto Medical Center.
A Kaiser official cited the organization's desire to open the hospital with its HealthConnect electronic medical records system in place and a backlog of work for outside hospital-supply vendors as reasons for the delay.
Kaiser officials announced last fall during the opening of the office wing housing 53 physicians that construction of the hospital wing would wrap up this July but the facility would not open until sometime in 2008.
However, it was not until recently that they pinpointed the opening date to the last quarter of the year, essentially mothballing the brand new building for up to 15 months.
Construction is on schedule and is not an issue.
The entire project on 49 acres at 4601 Dale Road in northwest Modesto has been estimated to cost $492 million and is intended to serve Kaiser's 265,000 members in Stanislaus and San Joaquin counties. And that number is projected to grow by 7,500 to 10,000 members this year, according to Kaiser.
The Oakland-based health-care giant operates a small, 99-bed hospital in Manteca and contracts with private hospitals Dameron in Stockton and Emanuel in Turlock to serve its area members. They also have access to larger Kaiser hospitals in Sacramento and the Bay Area.
At the time the project was announced in December 2002, Kaiser's Toni Flores said "it is imperative for us to get this medical center up and running quickly."
Kaiser officials at the time cited rapid population growth and the shortage of hospital beds and medical-specialty physicians as the reasons for selecting the site and seeking to move forward rapidly.
Corwin Harper, a Kaiser senior vice president and Central Valley Area manager, said this week that the Modesto hospital simply has to wait its turn as Kaiser opens other hospitals and medical office buildings around the state.
In Northern California alone, Kaiser expects to invest $1.6 billion into the next decade on construction projects. Together with other hospitals in the midst of expansion and construction, hospital-supply vendors are being taxed beyond their capacity.
"We're opening hospitals in Southern California and Antioch (Nov. 7), and it's putting a huge demand on our vendors," Harper said, particularly in the area of radiology where MRIs and CT scanners must be installed by trained technicians.
Also, Kaiser wants to open the new hospital with its highly touted HealthConnect system in place. HealthConnect will provide a common software for all Kaiser facilities and over the Internet covering electronic registration and scheduling, billing, clinical information systems, laboratory and X-ray information, pharmacy records and information, and online patient access.
Harper said Kaiser's schedule calls for HealthConnect to be implemented in South Sacramento, Santa Rosa and Antioch hospitals this year, followed by the hospitals in Manteca and Modesto in 2008.
Meanwhile, Harper is moving forward with hiring key personnel for the new hospital. When fully operational, the Modesto Medical Center is expected to employ more than 1,800. Kaiser currently employs close to 2,500 people at nine facilities in the two-county area, including about 315 physicians in the Permanente Medical Group.
"We have a very well-organized education department for training purposes. We do not want to hire everyone in September. We're looking at multiple different ways to staff this hospital - from existing Kaiser staff in the Bay Area to people already living here who will make the decision they want to come work for Kaiser," Harper said.
California's Office of Statewide Health Planning and Development, which regulates hospital construction, said Friday there were no problems with the delay in opening from a construction standpoint, according to spokesman David Byrnes.

Sheesh... glad that's over!!

I hope everyone got their care study in on time.

I know a few of us who did not know Fern's review time had changed. Did anyone make it?

CD Paper

Just got done with my CD Paper. Glad it's over!! Can't wait to be done with one more nusing class in a few weeks! Soon we can say we're half way!!!!!!!!

Endocrine Review Website

Hi all- Here is a website I found while writing my care study that has to do with the Endocrine System. The info is condensed and concise-hope it helps!!

http://www.rn.com/getpdf.php/585.pdf

Clinical Companion For Sale

Hi all-
I have an extra copy of the Clinical Companion to Medical Surgical Nursing that goes with our textbook if anyone is interested. It is the same edition that matches our text and has a matching cover, it is an excellent reference. It is in like new condition with no marks or folds anywhere. The only exception is that it was formerly owned by a smoker so if that is something you may be sensitive to, be aware of that. It sells for $34.95 and I am selling it for $25. Please let me know if you are interested. Hope everyone is having a good week at clinicals.
Amie

For those of you who couldn't make it....

I'm putting some pictures of the Polynesian show my daughter and I performed in. I want to thank Gemekia, Alejandra and Kimmy for coming out and cheering me on. I love you girls!!!




THE LADIES OF TAMARI'I MATAIREA

Neuro Exam Scores?

Have any of the other groups for N4 got their scores from the Neuro exam? Thanks and see ya Tuesday!

ENDOCRINE ?'S

TEST BANK QUESTIONS FOR ENDOCRINE

ENDOCRINE SYSTEMDIABETES I & II/PANCREAS

n4-test-chapter-46-endocrine-system
n4-test-chapter-47-diabetes-mellitus
n4-test-chapter-48endocrine-problems
n4-test-assessment-of-endocrine-system
n4-test-pituitary-and-adrenal-gland
n4-test-diabetes-mellitusA cute-pancreatitis
n4-test-gallbladder-and-pancreas
n4-pharm-quiz-pituitary-agents
n4-pharm-quiz-antidiabetic-agents
n4-pharm-quiz-adrenal-agents
n4-test-pancreas-glucose-metabolism
n4-test-adrenal-insufficiency
n4-test-adrenal-hypersecretion
n4-test-disorders-of-pituitary-gland
n4-test-endocrine-and-metabolic
n4-endocrine-quiz
diabetic-dilemma Q

ENDOCRINE........Nice Web Site

Hey, I found this web link on one of the nursing 101's in docushare...........lots of good information here for all of us in N4...........give it a looksie and see what you know already.


Endocrine site review

The NCLEX gets a little harder...

NCSBN Board of Directors voted to raise the passing standard

FOR IMMEDIATE RELEASE CHICAGO - The National Council of State Boards of Nursing, Inc. (NCSBN) voted at its Dec. 5-7, 2006 meeting to raise the passing standard for the NCLEX-RN examination (the National Council Licensure Examination for Registered Nurses). The new passing standard is -0.2100 logits on the NCLEX-RN logistic scale, 0.070 logits higher than the previous standard of -0.2800. The new passing standard will take effect on April 1, 2007, in conjunction with the 2007 NCLEX-RN Test Plan. After consideration of all available information, the NCSBN Board of Directors determined that safe and effective entry-level RN practice requires a greater level of knowledge, skills, and abilities than was required in 2004, when NCSBN established the current standard. The passing standard was increased in response to changes in U.S. health care delivery and nursing practice that have resulted in the greater acuity of clients seen by entry-level RNs. The Board of Directors used multiple sources of information to guide its evaluation and discussion regarding the change in passing standard. As part of this process, NCSBN convened an expert panel of 11 nurses to perform a criterion-referenced standard setting procedure. The panel's findings supported the creation of a higher passing standard. NCSBN also considered the results of a national survey of nursing professionals including nursing educators, directors of nursing in acute care settings and administrators of long-term care facilities. In accordance with a motion adopted by the 1989 NCSBN Delegate Assembly, the NCSBN Board of Directors evaluates the passing standard for the NCLEX-RN examination every three years to protect the public by ensuring minimal competence for entry-level RNs. NCSBN coordinates the passing standard analysis with the three-year cycle of test plan content evaluation, conducted using a practice analysis of entry-level RNs. This three-year cycle was developed to keep the test content and passing standard current with entry-level practice. A PDF of the 2007 NCLEX-RN Test Plan is available free of charge from the NCSBN Web site (https://www.ncsbn.org/RN_Test_Plan_2007_Web.pdf).

Hello Everyone

Wow, I haven't been able to interact on the Blog, since starting N4! I have a minute to breath, so I figured I would say, "Hi" to you all. It's kind of weird being without the other 40 of you, but I di-gress. Anyway, I hope you have a wonderful Valentine's Day.

Can you read this

I found this interesting. I was amazed with how fast and easily I was able to read this, probably because I have a child that spells like this. See if you can do it too.

fi yuo cna raed tihs, yuo hvae a sgtrane mnid, too. Cna yuo raed tihs? Olny 55 plepoe tuo fo 100 anc. i cdnuolt blveiee taht I cluod aulaclty uesdnatnrd waht I was rdanieg. The phaonmneal pweor of the hmuan mnid, aoccdrnig to a rscheearch at Cmabrigde Uinervtisy, it dseno't mtaetr in waht oerdr the ltteres in a wrod are, the olny iproamtnt tihng is taht the frsit and lsat ltteer be in the rghit pclae. The rset can be a taotl mses and you can sitll raed it whotuit a pboerlm. Tihs is bcuseae the huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe. Azanmig huh? yaeh and I awlyas tghuhot slpeling was ipmorantt! if you can raed tihs forwrad it.

Neuro Tests from Test Bank

Hi All, here are the Neuro tests from the Test Bank.............Hey, look at the bright side, 2 exams down and only 4 to go...........There is also some Neuro Info. on docushare I will try to include it here.

NEURO - CNS - PNS - HEAD INJURY AND SURGERY
Stimulating Coma Test
Neuro and cranial nerves quiz
Nervous System Assessment Test
Seizure Q
Test-Brain Problems
CNS trouble Test
Neuro Test
PNS Test
Seizure Test
Alzheimers and Dementia Quiz
Chronic Neuro Problems Quiz
Stroke test
ICP Neuro quiz
Another Neuro test
ICP and Head Injuries test
ICP and Cerebral Bleeding test
Brain Attack test
Cranial Conundrum test

Here is the docushare link:
http://docushare.deltacollege.edu/dsweb/View/Collection-5039

I found 4, Cranial Nerves, Epilepsy, Parkinson's Dz, and Stroke

Great Power Point on Immunology......

Hi All,

Happy Saturday reading...........for those of you who have not found it, here is a link to an awsome power point on Immunology that was put together by Caralee Bromme. There is great and easy to understand information in this presentation...........Enjoy!!

Immunity Info- This is a large file. It will take time to down load. Read the note section for more info.

ATI Books

I got a message from the nursing office in my delta email that the ATI books will be there Monday to pick up. It says that they are $79 this semester and bring your receipt. Does anyone know if you are in the grant program what we do? Do we get a receipt or note from them?

Susan

Student Nursing Association

Meeting: February 5, 2007

Locke 314 1:00pm

Nursing Success Tips & Tricks!

Come see what it takes to get through the nursing class you are in and the tricks to making it happen successfully:

Play a part and pay it forward…
Share what you know with those that are where you were.

Elections! Elections!

Now seeking interested students for the offices of:
President, Vice President, Secretary and Treasurer

Train with the current officer through this semester - take your position and train the next class through next semester.
Great leadership opportunities and looks great on your resume!


Special Guest: 24 Hour Fitness representative Brandon will be at the meeting to offer a special SNA discount!!
It’s difficult to schedule time for PE classes with the Nursing schedule;
Make sure that you keep your physical health a priority.

All nursing students welcome
Pizza and free Raffles for SNA Gear!!

a little immunology info

http://docushare.deltacollege.edu/dsweb/Get/Document-61672/Immunity%20information.doc

another source for oxy-hemogl. curve.......

I found this helpful in addition to our Text........


http://www.ccmtutorials.com/rs/oxygen/page06.htm

GREAT INFO........

Hey There, me again I found this information on the recently graduated nurses blog..........Bonnie Boss had posted it getting ready for the resp. exam in N4.

N4 Random thoughts on Acid Base
These are just little thought trails.
It can make it easier to see cause and effects of abnormal findings.
It can sometimes help to break down difficult concepts.
If you want to know why you see S/Sx, break them down until it make sense.

Resp. Alkalosis Seen in bloodIncreased ventilation (hyperventilation)= decreased CO2 decreased CO2 = reduced H2CO3,
reduced H2CO3 = reduced HC03 and H+,
reduced HC03 and H = increased pH,
increased pH = Alkalosis,
reduced H+ in blood causes H+ to leave cells (down concentration gradient)
= increased H+ In blood, causes K+ to enter cells to maintain electrical balance results = Hypokalemia,
decreased CO2 = hypocapnia, hypocapnia causes cerebral and peripheral vasoconstriction, cerebral and peripheral vasoconstriction = reduced cerebral and peripheral blood flow,
reduced cerebral and peripheral blood flow = reduced Ca2+ ionization,
reduced Ca2+ ionization= hypocalcemia,
hypocalcemia = dizziness, decreasing LOC, hyperreflexia, carpo/pedal spasm, tetany, arrhythmias, seizure, coma,
Hypocapnia overexcites medulla, pons and parts of ANS (autonomic NS)
= increasing anxiety, diaphoresis, dyspnea, alternating periods of apnea and hyperventilation, dizziness, tingling of fingers and toes
Hypocapnia stims carotid & aortic bodies and medulla
= increased Heart Rate, Respiratory Acidosis,
Hypercapnia = increased CO2, increased CO2 = increased H+,
increased H+ = cerebral vasodilation,
cerebral vasodilation = increased cerebral blood flow,
increased cerebral blood flow = cerebral edema,
cerebral edema = headache, CNS depression, confusion, lethargy, nausea, vomiting Hypoventillation = increased CO2,
increased CO2 (+H2O) = increased H2CO3,
increased H2CO3 = increased H+ and HCO3,
increased H+ and CO2 causes hemoglobin to buffer by dumping O2 and picking up CO2 and H+ (2,3 DPG) = decreased O2 SAT ( saturation of hemoglobin)etc..........

Fluid Shift Document.......

Hi Again,

I found this document on fluid shifts and thought it simplified it nicely without all the "Fluff".........See if you like it !

http://faculty.ccri.edu/pmoberg/fluid_facts.htm

pix of dameron

Tutor Session Today ??

Hi All,

I was just wondering if any body was aware of a tutor session today for Monday's exam?? I know that Fern's session for today was cancelled.......but, I also heard that one was scheduled for today from the tutor center people?? Anyone else hear anything about this??????

Thanks............Hey only 7 weeks to go for all of us N4's, what a difference in clinicals!!

HEB B titre

Just a friendly reminder to get your HEP B titre, just got mine done today and thought there may be people out there that may have forgot about it.

All You Can Eat CRAB

Hey everyone, my daughter is selling tickets for a crab feed dinner on Saturday Feb 3rd at 5:30 pm.
Lots of food, silent auction (way cool stuff like dinners, vacations, etc.) and raffle prizes.
Tickets are $40 per person all you can eat crab. If anyone is interested call me at 209.369.5683
or email me at jenn@telnetcom.us. Karly (my daughter) would love for you to come. Thanks.

If you want a little break.....

Hey all, well some of you already know that I do Polynesian dancing as one my hobbies. Just wanted to inform you guys and gals that my dance troupe Tamari'i Matairea will be having a Luau on Sat February 17 from 6-12. Tickets are $35.00 and include dinner, polynesian show, and a dance afterwards. If anyone is interested in going please feel free to email me at drea878rn@yahoo.com or call me at 209-610-8454. It will be a fun night filled with music and great food!!! Don't miss out!

Fern's Study Session

If you look on Fern's Docushare her calender for Review Sessions is up. The first review on Respiration will be held tomorrow at 12:00. I e-mailed her and she doesn't know which classroom it will be in yet.

RESP. INFO

THIS IS A LINK FOR RESP INFO THAT WAS POSTED IN LAST SEMESTERS BLOG. IT'S LONG THAT'S WHY I DIDN'T JUST COPY AND PASTE. IT HAS INFO AND PRACTICE QUESTIONS WITH ANSWERS...
http://docushare.deltacollege.edu/dsweb/Get/Document-47833/The%20Respiratory%20System.doc
HERE'S A LINK FOR ABG'S...
http://rnbob.tripod.com/arterialgasses.htm
AND A LINK FOR LAB VALUES...
http://docushare.deltacollege.edu/dsweb/Get/Document-49473/Lab%20Values.doc

Great info on Fern's docushare

Well organized and concise info and tutorials by body system... see see more by clicking on Fern's N4 link on our blog

here is an example of the respiratory system:
http://www.mc.maricopa.edu/dept/d31/nur/learning_objects/_systems/Respiratory.html

Nursing 4 Review Session with Fern Sison

Hey there future nurses of America!!!
I am not sure if you are aware that Fern Sison is holding review sessions for Nursing 4, but I will tell you anyways!! Fern will begin the first review session on January 23rd. If you need more info about the time and place please contact Fern on her delta e-mail. Future review sessions will be posted on the office and skills lab window. This is a message from 2 of your fellow Nursing 5 classmates. Good Luck with Nursing 4!!!

Gemekia and Kimberly

A couple of ABG tutorials with practice quest.

http://web.indstate.edu/mary/abgdemo.html

http://maagnursing.com/ABG/basic_questions.php

New Blog

Hey Danielle, I love what you have done with the new blog and your own! Is it possible to send an invite to me to get onto the blog and then admin status to send out more helpful invites and tech support please? Do you know how many admins there are yet for the new semester? I want to make sure that they get plugged into all of the other blogs as admins too.

BTW can you set up that helpful link section in all of the other blogs ( or show me) so that I won't need to keep updating the test bank and resource posts for quick access?

Thanks Danielle, I hope that I am not bogging you down with busy work.

more cranial nerve sources

cranial nerve info and quizes:
http://www.gwc.maricopa.edu/class/bio201/cn/cranial.htm

how to assess cranial nerves (i heard...we have to be able to do...possibly at skills lab):
http://www.jcjc.cc.ms.us/faculty/adn/jmcmillan/cranial.htm

interesting case

IM SURE MANY OF YOU HAVE HEARD ABOUT THIS CASE BUT I THINK THAT IT IS VERY INTERESTING AND MAKES YOU THINK ABOUT RIGHT VS. WRONG AND ETHICAL VS. UNETHICAL AND THINK ABOUT WHERE YOU MAY STAND IN A SITUATION LIKE THIS...YOU NEVER KNOW ANY OF US COULD COME ACROSS A CASE LIKE THIS IN OUR CAREERS.

Surgery to stunt disabled girl's growth raises ethical questions

CHICAGO, Illinois (AP) -- In a case fraught with ethical questions, the parents of a severely mentally and physically disabled child have stunted her growth to keep their little "pillow angel" a manageable and more portable size.
The uterus and breast tissue of the bedridden 9-year-old girl were removed at a Seattle hospital, and she received large doses of hormones to halt her growth. She is now 4-foot-5; her parents say she would otherwise probably reach a normal 5-foot-6.
The case has captured attention nationwide and abroad via the Internet, with some decrying the parents' actions as perverse and akin to eugenics. Some ethicists question the parents' claim that the drastic treatment will benefit their daughter and allow them to continue caring for her at home.
University of Pennsylvania ethicist Art Caplan said the case is troubling and reflects "slippery slope" thinking among parents who believe "the way to deal with my kid with permanent behavioral problems is to put them into permanent childhood."
Right or wrong, the couple's decision highlights a dilemma thousands of parents face in struggling to care for severely disabled children as they grow up.
"This particular treatment, even if it's OK in this situation, and I think it probably is, is not a widespread solution and ignores the large social issues about caring for people with disabilities," Dr. Joel Frader, a medical ethicist at Chicago's Children's Memorial Hospital, said Thursday. "As a society, we do a pretty rotten job of helping caregivers provide what's necessary for these patients."
The case involves a girl identified only as Ashley on a blog her parents created after her doctors wrote about her treatment in October's Archives of Pediatrics & Adolescent Medicine. The journal did not disclose the parents' names or where they live; the couple do not identify themselves on their blog, either.
Shortly after birth, Ashley had feeding problems and showed severe developmental delays. Her doctors diagnosed static encephalopathy, which means severe brain damage. They do not know what caused it.
Her condition has left her in an infant state, unable to sit up, roll over, hold a toy or walk or talk. Her parents say she will never get better. She is alert, startles easily, and smiles, but does not maintain eye contact, according to her parents, who call the brown-haired little girl their "pillow angel."
She goes to school for disabled children, but her parents care for her at home and say they have been unable to find suitable outside help.
An editorial in the medical journal called "the Ashley treatment" ill-advised and questioned whether it will even work. But her parents say it has succeeded so far.
She had surgery in July 2004 and recently completed the hormone treatment. She weighs about 65 pounds, and is about 13 inches shorter and 50 pounds lighter than she would be as an adult, according to her parents' blog.
"Ashley's smaller and lighter size makes it more possible to include her in the typical family life and activities that provide her with needed comfort, closeness, security and love: meal time, car trips, touch, snuggles, etc.," her parents wrote.
Also, Ashley's parents say keeping her small will reduce the risk of bedsores and other conditions that can afflict bedridden patients. In addition, they say preventing her from going through puberty means she won't experience the discomfort of periods or grow breasts that might develop breast cancer, which runs in the family.
"Even though caring for Ashley involves hard and continual work, she is a blessing and not a burden," her parents say. Still, they write, "Unless you are living the experience ... you have no clue what it is like to be the bedridden child or their caregivers."
Caplan questioned how preventing normal growth could benefit the patient. Treatment that is not for a patient's direct benefit "only seems wrong to me," the ethicist said.
Dr. Douglas Diekema, an ethicist at Children's Hospital and Regional Medical Center in Seattle, where Ashley was treated, said he met with the parents and became convinced they were motivated by love and the girl's best interests.
Diekema said he was mainly concerned with making sure the little girl would actually benefit and not suffer any harm from the treatment. She did not, and is doing well, he said.
"The more her parents can be touching her and caring for her ... and involving her in family activities, the better for her," he said. "The parents' argument was, `If she's smaller and lighter, we will be able to do that for a longer period of time."'

Schedule for Next Week??

Hi Everyone,
I was just wondering if anybody knows the schedule for N4 next week?? I know that Tues. is lecture, but what about Wed/Thurs.? I heard that Thurs. was our all day clinical w/checkoffs does anybody have any other info........or know our hours on Wed.??

Free pants

First come first serve
I have a medium size pair of flare bottom scrubs
call me if you want them 209-369-5683
there is nothing wrong with them I just don't like them
Jenn Stevens

Posting

I was unaware that we had to log in and change our account over to the new blogger. Blogger beta is no longer being used it said. So if you want to be under contributor and be able to make new posts you need to go to the right hand corner and log in and it will direct you into creating your account. At least that's what I had to do this morning. Happy last minute studying all before our big first day of class next week.

Susan

Congratulations all on a very, very nice job with your tea! Chuck C and I came by to support you all, and were very impressed! You all worked well together getting the tea set up for the incoming class, and the slide show was INCREDIBLE. Keep taking lots and lots of pictures guys...you will use them all at your graduation slide show. Best of luck, you will all be there before you know it.

Rumor has it

N4 students need to get busy re: cranial nerve info.

Here's a link to docushare info
http://docushare.deltacollege.edu/dsweb/Get/Document-50528/Cranial%20Nerves.doc

and I LOVE this site
http://rad.usuhs.mil/cranial_nerves/timrad.html

Thank you

The Nursing Tea was A HUGE SUCCESS

I would like to thank everyone who came to help out. We had a huge turn out, there was a lot of support, and many thank yous to you all.

I would also like to thank those who contributed with donations both monitary and with supplies.

We couldn't have done this tea without all of your help, and I can't thank you guys enough for the support you have give Denise and I.

Monitary donations totaled $920.00 (students $620.00) (Hospitals $250.00) (SNA $50.00)
The Cost came to a total of $954.34
Breakdown
Food $500.00
Ice $7.70
Supplies $183.18 e.g cups, plates, utensils, napkins, fuel for Chaffing dishes, coffeemaker rental
Decorations $171.45
Invitations $42.02
Cake $49.99

Thank you guys for eveything

Blogger welcome to the incoming students

Please take a moment and post a welcome comment for the incoming bloggers to see as they sign up for their own blog tomorrow.


http://futurenurses2008.blogspot.com/

Still need someone to bring

a large bowl of fruit salad. Please post here if you can help out.

Thanks

Nursing Tea

We are over Budget
We are looking for someone to donate a jug of salsa for the eggs
and 7 one gallon jugs of water for the coffee urn, because tap water is yak.
Let me know if you can help out with these items.
Thanks
Barbara

St. Joes N4

Does anyone know (maybe from last semester) where Classroom 1 is at St. Joes for the orientation next week? Thanks in advance!

TEA ALERT!!!!

We need extra chaffing dishes with fuel, serving utensils, coffee pots so we can brew the coffee. Does anyone have very large pots or crofts? If we don't find some, we are going to need some extra regular coffeemakers.

Nursing Tea Attire

This is forward from Mary Neville

I think that we can live without them. But, clean non-wrinkley would be nice, and nice clean shoes and correct hairdos, etc. All that given, I think that we can overlook the absence of the jacket. A white sweater might work if someone feels more comfortable. Mary

White Coats?

At our Tea, all of the welcoming students did not have on white coats. Only the speakers and a couple other students had on white coats. I am not trying to go against anyone, but I remeber specifically, most of the students did not have on white coats. At times such as this, (when money is short) it would suck to loss help because someone couldn't afford a jacket.

TEST BANK AND RESOURCES FOR ALL SEMESTER NURSING STUDENTS

Keep checking for new Additions!
Our class test bank will continue to grow as we add more and more tests and quizzes.
Think NCLEX!
Class test bank is sorted by systems, more or less. Good practice for all semesters. Please let me know on which subjects you would like to see more tests.
TEST BANK
ATI Testing
Nursing 101
Bulletin Board
EVOLVE TEXTBOOKS
Question of the Week
Fern's Blog
Nursing Center
Nursing CEUs
Medical Learning Links
The (CEU) continuing education courses and tests do not cost anything. The prices that you see are for nurses who need the CEUs for credit. Look through the clinical topics and pick the subject that you feel you need to know more about or want to take a practice test to see if you really understand.
SJDC Student Nurse Blogs
Pinned 12/2006
4th Semester
3rd Semester
2nd Semester
1st Semester

I will keep changing the post date on this link to keep it current and easy to access.
bboss947@students.deltacollege.edu
bboss947@sbcglobal.net

Barbara

Hey Barbara,
I will be there but I do not have a white jacket do I have to get one for the tea?
Jenn

N5

Can someone tell me what is the first reading section for nursing 5. The bookstore was all out of the syllabus and i'm going to be on a long flight so i thought i'd get a head start.
Thanks

county

anyone from county for the first half of the semester know what is going on for the first day of clinicals? Do we just go at 630 to the hospital or what?!....Sounds like dameron has been contacted about next semester anyone else....or am i just freakin' out!!!
Happy New Year everyone... just think this time next year .... we will be almost done!!!!

HAPPY NEW YEARS EVE!!

I hope everyone had a great year and are looking forward too 2007!! see u in a couple weeks:)

Cowboy Advice for the New Year

I'm headed out to the country for a few days. I'll be off-line w/ no phone until Jan. 2nd weather allowing. Have a marvelous and safe New Years folks!!



Your fences need to be horse-high, pig-tight and bull-strong.

Keep skunks and bankers and lawyers at a distance.

Life is simpler when you plow around the stump.

A bumble bee is considerably faster than a John Deere tractor.

Words that soak into your ears are whispered...not yelled.

Meanness don't jes' happen overnight.

Forgive your enemies. It messes up their heads.

Do not corner something that you know is meaner than you.

It don't take a very big person to carry a grudge.

You cannot unsay a cruel word.

Every path has a few puddles.

When you wallow with pigs, expect to get dirty.

The best sermons are lived, not preached.

Most of the stuff people worry about ain't never gonna happen anyway.

Don't judge folks by their relatives.

Remember that silence is sometimes the best answer.

Live a good, honorable life. Then when you get older and think back,
you'll enjoy it a second time.

Don't interfere with somethin' that ain't botherin' you none.

Timing has a lot to do with the outcome of a rain dance.

If you find yourself in a hole, the first thing to do is stop diggin'.

Sometimes you get, and sometimes you get got.

The biggest troublemaker you'll probably ever have to deal with, watches you from the mirror every mornin'.

Always drink upstream from the herd.

Good judgment comes from experience, and a lotta that comes from bad judgment.

Lettin' the cat outta the bag is a whole lot easier than puttin' it back in.

If you get to thinkin' you're a person of some influence, try orderin' somebody
else's dog around.

Live simply. Love generously. Care deeply. Speak kindly.

The Tea?

I am sure you both are getting bombarded with "The Tea" stuff. I just have TWO questions? Do you have people assigned to particular tasks, and also if I am assigned to a particular task can you tell me what task I am assigned to? Thank you and I hope you had a beautiful Christmas!

The End of 1st Semester

Must Haves, For "The 4Hour Final"

My Study Group, They Keep Me Focused!

YEAH, We Got To Celebrate, 1st Semester is OVER!!!

Looks Like, Someone Was Playing Hide The Noodle!?!

The Dynamic Duo, Yes They Are Virgin Drinks :)

St. Joe's Partaking In A Little Celebration!

Again, Virgin Drinks :)

Nursing Tea

The Tea is on January 8th from 9-11am. Set up starts at 7am.
Everyone comming to help out must be in scrubs with lab coat and patch.
I am currently out of town till January 2nd, so the best way to contact me is via the blog and i will respond to comments, or my cell at 209-401-1887.
Thank you
Barbara

Last Call for Photos

I am completing the slide presentation in the next 2 days so, if you have photos you want included, please send them now. Hehe, we have some good ones!

Reading Assignments for Nursing 4???

I know its still 2 weeks aways but I want to get a head start on the reading. Does anyone know which systems we are reviewing first? If so could I please have that info. Thanks!!

Barbara and Denise - tea talk

Hey gals,

What's up with the tea? Do you need help for decorating, setting up, serving? What's the scoop?


Everyone else - Who's planning on coming?

Dameron Clinical folk

Maria Junez with Dameron HR just phoned to let me know that HR does not have a list of the students expected for the upcoming clinical rotation. Mary Neville has been notified and we are requested to check back with the front desk (not with Maria) after January 2nd.

So, you may go ahead with the required med check items at Occupational Health, but wait until after January 2nd, then phone (209) 242-7073, identify yourself as a SJDC nursing-student and ask if they are ready for you to come take a photo. Maria Junez does not need to be on site or notified for you to do this. They just have to have a list of names from the Nursing Office of students that will be in the clinical group.

Test bank link

Test Bank

Happy Holidays from my family to yours!!!!

Merry Christmas everyone!!!!!
Have a good one and enjoy this holiday break.
See you guys next semester.

Just wanted to say that I feel so greatful to be a part of this group!!! Everyone has been so nice and helpful...I am sure that lifelong friendships are being formed...

SJDC ADN Class of 2008

More Pictures of LMH Christmas party
SJDC ADN Class of 2008

Scores and Total % are up for Pharm

Check Richard's Docushare for more info

LMH X-mas Party Pix...

Me and Cindy

Kat and Nicole

Lindsey and her boyfriend

Cindy and her husband

I'm gonna miss you guys,...Good Luck next semester!!!

&

MERRY CHRISTMAS!!!

2nd Semester

1st Semester Nursing Students, Not Us!
Second Semester YYYAAAHHHHOOOOOOOOO!

SJDC ADN Class of 2008

SJDC ADN Class of 2008 Grades are up

Take A Deep Breath!

We have fought long and hard to get to this point. For what is is worth, I am so proud of us all! This test is just an obstacle, we have studied for this test and we know the material, so "Don't freak out"! Take a deep breath, skip it if you have to. DON'T get frustrated, it will cloud your thoughts. Lastly, ladies and gentlemen it has been a pleasure to cross this bridge with you. Good luck tomorrow and may you, and your thoughts be blessed.

SJDC ADN Class of 2008

SJDC ADN Class of 2008You need to bring your text, syllabus, notes, lab book, and drug book.I will send emails to each clinical group via the campus email system, since you need the syllabus to do the evaluation of the class/skills lab/clincal also.Take care,Shelba Durston

This was Mrs. Durtson's response to the question on notes, this am.

Items allowed for Final

I was informed that these are the only things we are allowed to bring with us to the final:
Text book
Lab book
Drug book
PDA
Syllabus


No note books or anything else allowed :( Just passing along the info.

Thank You

I want to say thanks for the thoughts, well wishes and prayers. Other than using occasional eye drops and needing to get my contact lens and glasses prescriptions changed the first of January, I am back in the seeing world and am very grateful for it.

Lessons learned
Nursing school can make you blind
Studying is overrated
Friends are priceless
My husband Dave is a darned good nurse

more study resources

the main page: http://www.studystack.com/category-22

all cardio: http://www.studystack.com/menu-55428

http://www.studystack.com/menu-25757

http://www.studystack.com/menu-29698

http://www.studystack.com/menu-30671

there is more cardio and all other topics on our final...it's a good way to quiz yourself, and the info is presented in a few different ways so you kind find what works for you

Some cardio tutorials

All gleaned from this huge list:
http://www.medtrng.net/tutorials_and_simulators_part_1.htm


Some that I am using for review:
http://www.skillstat.com/ECG_Sim_demo.html

http://www.randylarson.com/acls/start.html

http://www.phschool.com/science/biology_place/biocoach/cardio1/anatomy.html

http://msjensen.education.umn.edu/webanatomy/cardiovascular/cvs_heart_conduction_1.htm

I may or may not have time to go through the list more thoroughly, if a few folk want to take a page and go through it for helpful sites, that would be great.

Does anyone want to switch Nursing 4 from county

I am looking for anyone who would like to switch from San Joaquin to St. Joes
for Nursing 4. If you are interested email me at jenn@telnetcom.us or call me
at 369-5683.
Thanks
Jenn

Does anyone want to switch N4 clinical?

Hi.
I know someone who regestered for N4 (the second half of the semester) at St. Joseph's
(in the morning one w/ Hawkins), and she wants to change her clinical schedule because of her
personal situation.
If anyone from Lodi (w/Melissa Black) or St. Joe (night class w/Dail) wants to swith the clinical,
let me know~.


-Bo

The mayonnaise jar and 2 cups of coffee

When things in your lives seem almost too much to handle, when 24 hours in a day are not enough, remember the mayonnaise jar and the 2 cups of coffee. A professor stood before his philosophy class and had some items in front of him. When the class began, he wordlessly picked up a very large and empty mayonnaise jar and proceeded to fill it with golf balls. He then asked the students if the jar was full. They agreed that it was. The professor then picked up a box of pebbles and poured them into the jar. He shook the jar lightly. The pebbles rolled into the open areas between the golf balls. He then asked the students again if the jar was full. They agreed it was. The professor next picked up a box of sand and poured it into the jar. Of course, the sand filled up everything else. He asked once more if the jar was full. The students responded with an unanimous "yes." The professor then produced two cups of coffee from under the table and poured the entire contents into the jar effectively filling the empty space between the sand. The students laughed. "Now," said the professor as the laughter subsided, "I want you to recognize that this jar represents your life. The golf balls are the important things--your family, your children, your health, your friends and your favorite passions--and if everything else was lost and only they remained, your life would still be full. The pebbles are the other things that matter like your job, your house and your car. The sand is everything else--the small stuff. "If you put the sand into the jar first," he continued, "there is no room for the pebbles or the golf balls. The same goes for life. If you spend all your time and energy on the small stuff you will never have room for the things that are important to you. "Pay attention to the things that are critical to your happiness. Play with your children. Take time to get medical checkups. Take your spouse out to dinner. Play another 18. There will always be time to clean the house and fix the disposal. Take care of the golf balls first--the things that really matter. Set your priorities. The rest is just sand." One of the students raised her hand and inquired what the coffee represented. The professor smiled. "I'm glad you asked. It just goes to show you that no matter how full your life may seem, there's always room for a couple of cups of coffee with a friend." Please share this with someone you care about. I JUST DID . :-)

GREAT INFO........

Hi All,
Just wanted to let every one know that there is some great information posted by Bonnie and other students from 4th semster in the 4th semester blog under may 2005 that all has to do with our N2 final and some great study info. and study guide questions as well. I have also posted some practice questions from the test bank and other info. I felt was useful everything below is copied from 4th semester blog when they were in N2.


Have Fun!!

Heart and Med Qs
Tachyarrhythmias and pacemakers
Chest Pain
Right Side or Left Side HF quiz
Quick HTN quiz
Heart Center Online Quizes
Cardiovascular Test
Mixed Qs for N2 Final
Practice mixed Qs
The Silent Killer
HTN's Grip

Misc. Study Comments from Final's Eve

Preload increases in left side CHF,
After load also increases because renin release and vasoconstriction (kidneys don’t care about the heart) result is a decrease in contractility.
No hair eventually on legs with CHF - perfusion problem - 02, no hair
Bronchodilation is not a mechanism of action, whereas activation of the beta 2 receptors which cause bronchdilation is.
Erythrocyte sedimentation rate (ESR) is ordered. An elevation will indicate something is going on, like an infection.

Study and Memory Aids

Angina: Pain pattern
Exertion = Pain;
Rest + Nitro = Relief
Angina Precipitating Factors - 3 E's
Eating
Emotion
Exertion (Exercise)
Unstable Angina
Occurs at rest

Myocardial Infarction: "INTENSE PAIN"
I schemia
N ecrotic cardiac tissue
T ightness in chest
E xtended duration
N ausea
S evere pain
E CG changes

P revent Valsalva manuever
A nxiety
I ntense
N ot relieved by rest

Heart Failure: "OVERLOAD"
O rthopnea
V entricular failure
E nlarged heart
R eported weight gain
L ungs congested
O utput decreased
A pprehension
D ependent edema

Pulmonary Edema: "FOWLERS"
F ailure- left ventricular
O rthopnea
W heezing
L ung congestion
E mergency
R estless
S kin- cyanotic

Diets- (Low) (High)

Angina Pectoris
L- Calories
L- Cholesterol
L- Fat
L- Gas-forming foods

Heart Failure
L- Sodium
Small frequent feedings

Pulmonary Edema
L- Sodium
L- Fluids

Hypotension Vs Hypertension
Causes
Hypotension Hypertension
Angina Esential hypertension
MI Anemias
Pericarditis Arteriosclerosis
valve defects Polycythemia
Heart Failure
Assessment
Behavior
Anxiety Nervous
Apprehension Irritable
Dec mentality Memory
Confusion Depression
Confusion
Neurologic
No diff Dec. vib sensation
reflex change
Babinski reflex
coordination change
Head and Neck
Distend neck veins Bruits over carotid
Worried expression Distend neck veins

Hypertension Study Aids
Assessment of hypertension: ELEVATEDED

E- xertional SOB
L- ack of activity
E- arly morning headache
V- ascular changes
A- nxiety increased
T- ired
E- pitaxis
D- iastolic pressure elevated

Complications: 4 Cs

CHF
CVA
CAD
CRF

DIET (LOW)(HIGH)
L-Na
L-Calories
L-Chloresterol
NO Caffeine

Arteriosclerosis
H- Vitamins B & C
L- Fat

Aneurisms
L-Cholesterol
L-Caloric Intake

Heart Meds
Chrono(time)tropic effect - change in the heart rate - change refractory length
Dromo(running)tropic effect - change in the electrical conduction speed across the myocardium
Ino(fiber)tropic - change in the strength or contractility of the heart - cardiac glycosides - Frank-Starling law -
Digoxin - Heart beat harder, slower
tropic - to influence
Sodium channel blockers - Quinidine - stabilize dysrhythmias by slowing spread of impulse conduction across the myocardium
Watch GI upset, digoxin, ekg
Potassium channel blockers - Amiodarone - stabilize dysrhythmias by prolonging duration the action potential and extending the refractory period
Watch blurred vision, light sensitivity, lung probs, GI upset, rash, digoxin, ekg
Calcium channel blockers - Verapamil are similar to beta blockers. Reduced automaticity in the SA node, slowed impulse conduction through AV node and prolonged refractory period
Watch bradycardia, digoxin, hypotension, headaches, constipation
Beta-adrenergic blockers - 'lols -propranolol - stabilize dysrhythmias by slowing heart rate and decreasing conduction velocity through AV node.
Watch hypotension, bradycardia - take pulse, dim. sex and impotence
Digoxin, (Adenosine, Ibutilide - rapid short term) are used for specific dysrhythmias, but do not act by blocking channels
Watch potassium, visual halos, GI upset, ekg
ACE inhibs - 'prils - ousts sodium and water which reduces afterload and preload by lowering blood volume and peripheral resistance
Watch cough, potassium, taste, hypotension
Diuretics - 'ides and spironolactone - reduce blood volume, edema, congestion - lowers blood pressure and workload
Watch electrolytes, hypotension, dehydrationPlease add missing info, I did this real fast to start off.

Excellent article re: Nurse shortage and wages

link to article

Thank You Ladies!!!

Thank you,
Michelle, Cindy and Krystal!!!

You ladies helped me so much, I really appreciate your IV knowledge. Michelle I owe you big! I don't even have enough words to express my thanks, my thanks to you and your hands. You are an excellent mentor.

Cindy and Krystal, thank you! Your new clinical groups are lucky to get you two. Cindy you are my first IV stick and I'll never forget you! Krystal, you talked me through like butter.

More IV Pix,.....LMH Group :)

Good Job Barb!!!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Thanks Michelle!!! :) Good Job Nurse Nickey!!

Good Job Jenn!!! I would have been so nervous!!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
My first IV, ...what a bloody mess!!