An excessive amount of insulin in the body. It may be caused by administration of an insulin dose greater than required or the presence of an insulin-secreting tumor in the islets of Langerhans or insulin reference. If there is hypoglycemia symptoms include hunger, shakiness, and diaphoresis.
Thursday, November 26, 2009
Nursing Phrase of the Day
From Maternal and Child Health Nursing:
The nurse should suggest ambulation to a postpartum patient who has gas pain and flatulence.
Saturday, November 21, 2009
Word of the Day
Empathic
Pertaining to or involving the entering of one person into the emotional state of another while remaining objective and distinctly separate.
Nursing Phrase of the Day
From Medical-Surgical Nursing:
The antidote for magnesium sulfate is calcium gluconate 10%.
Tuesday, November 17, 2009
Nursing Phrase of the Day
From Fundamentals of Nursing:
Signs of accessory muscle use include shoulder elevation, intercostal muscle retraction, and scalene and sternocleidomastoid muscle use during respiration.
Monday, November 16, 2009
Nursing Case: Myocardial Infarction
Before my shift ended today, a patient came in the ER with the chief complaint of chest pain 2 hours prior to admission. He came in at around 6 am. He was transferred to a stretcher. Initial Vital Signs were: T= 36.5 degrees Centigrade per axilla; CR = 70 bpm; RR = 23 cpm; BP = 110/70 mmHg. We immediately called up the the technician to do a 12-leads ECG. We then administered oxygen via nasal cannula at 3 liters per minute(LPM). He was also attached to a pulse oximeter. Initial Oxygen Saturation was around 89%.
The Resident on Duty(ROD) immediately ordered for the oxygen to be administered via face mask and at 10 LPM. The oxygen saturation then went up gradually up to 96%. The 12-Leads ECG result was as expected - a myocardial infarction. The doctor ordered Plain Normal Saline Solution 1 liter for the patient's IV line. I inserted the IV at the left cephalic vein using a gauge 20 needle. A fast drip or "volume challenge" of 100 mL was done. The BP was then rechecked but it was now at 70 palpatory. The ROD then ordered to start Dopamine drip at 5 ugtts/min which was attached as piggyback to the above mainline IVF.
The patient also experienced vomiting to a whitish vomitus in small amounts. The chest pain he experienced just by his facial expression was excruciating. Tramadol 1 amp IVTT now was also ordered and given. Patient also complained of defecating and was allowed to do so but with precautions to do it slowly and avoid straining. He defecated to a brownish formed stool in moderate amount. The doctor also ordered for the insertion of a Foley Catheter which was also done successfully with immediate output of approximately 200 cc. Dobutamine drip was also attached as ordered starting at 5 ugtts/min to titrate for BP <90.
The patient also had an order for a chest XRAY PA view and was done. He was then fixed and brought to the ICU for close monitoring. There was also a pending order for starting another IV line for a Heparin drip of D5w 86 cc + 10,000 cc via soluset. The patient is now in the ICU for further care and management.
Nursing Phrase of the Day
From Fundamentals of Nursing:
Word of the Day
Brow Presentation
An obstetric situation in which the brow, or forehead, of the fetus is the first part of the body to enter the birth canal. Because the diameter of the fetal head at this angle may be greater than that of the mother's pelvic outlet, a cesarean section may be recommended.
*All Terms used in Word of the Day is from Mosby's Pocket Dictionary of Medicine, Nursing and Health Professions 2006.
Sunday, November 15, 2009
Word of the Day
Hacking Cough
A short, weak repeating cough, often caused by irritation of the larynx by a postnasal drip.
Saturday, November 14, 2009
Nursing Phrase of the Day
From Psychiatric Nursing:
Confrontation is a communication technique in which the nurse points out discrepancies between the patient's words and his nonverbal behaviors.
Friday, November 13, 2009
Drug Guide 101: Pantoprazole
Last night I had a chance to give Pantoprazole(Pantoloc) 40 mg/vial, 1 vial via IVTT(Intravenous through tube) as ordered by the resident on duty at the emergency room. I am currently assigned in the Operating room but we had no case so every time this happens we go to the ER per hospital policy.
The patient was suffering from intense epigastric pain 1 day prior to admission. Pantoprazole was the only medication given to the patient in the ER. I prepared the powdered medication in a vial by combining it with 10 cc of normal saline which is 0.9% Sodium Chloride, an isotonic solution. Pantoprazole is a proton pump inhibitor(PPI). Proton pump inhibitors act to reduce gastric acid secretion mainly by blocking the gastric proton pump system of the gastric parietal cell. The drug is given in an inactive form and is only protonated and rearranges itself when exposed in an acid environment.
According to one article from sciencedaily.com there are adverse effects on weight when one is under long term treatment of PPI's. Check out this article to know more. http://www.sciencedaily.com/releases/2009/10/091023092130.htm.
Adverse effects: rash, itch, flatulence, constipation, anxiety, depression. Decreased vitamin B12 absorption may occur with long-term use.
The drug is contraindicated for patients with hepatic impairment and pregnant patients.
Monday, November 9, 2009
Nursing
Nursing is a way of life for most people nowadays. Everybody in the Philippines almost always end up taking nursing as their course in college. Even doctors took up nursing because of desperation to go abroad and because it's a faster ticket when you're a nurse. Everybody has their dream of a greener pasture after graduating and working as a nurse abroad. Their main target - the United States of America or somewhere where they have a residing relative. Some would even settle for other Asian countries just to get out of the country and earn foreign currency.
The sad thing is it's not always a green pasture for most of the Filipino Nurses here in the Philippines. With the current situation of the country, some can't even practice their profession due to an overflow of nurses every year. The Nursing Licensure Examination passing rate is less than 50% but still thousands and thousands more are still honored to pledge as a nurse. Some hospitals have now implemented a system wherein if you want to volunteer in their institution, you need to pay them from Php 3000 up to Php 5000 so you can get a certification and the most important one - EXPERIENCE.
Experience will always be the best teacher - no one can argue with that. The mistakes you commit when you are practicing nursing will be crucial in your growth as a nurse and as a professional. You must learn from your short comings or else you will end up wasting the time you spent in college not to mention all the expenses as nursing is not a cheap course. Your growth can be a rough road or a smooth slide. Your knowledge, skills, and attitude during college can drastically affect you when you are already a nurse.
Everything you learn during college days is very important. During college, you might just take some of your lessons and subjects but what you don't know is that the knowledge you missed because you were busy texting or talking to your seatmate could've been the key to a greener pasture. The school that you are in is also a big factor to your success but it will always be up to you whether you become either a nurse or one who will be nursed.
The time you made a decision to become a nurse either by heart or for profit should've been a firm and stable decision. If you were unsure then you'll be wasting your time and your parent's money. This happened to some people I knew. One quit during our first year to become a cop but from what I heard she never got in because her IQ was too hight(?). One was too intelligent but also uninterested that he got addicted to playing computer games. He was always absent so the outcome was that he failed. His father was called and was explained the reason why his son failed. He was down in tears when he knew nothing could be done. Another one shifted to another course. The last time I saw him he was in a call center and he was good at it.
Speaking of call centers, nurses are also invading this scene. I was one of them and so was 1/4 of my 170 batchmates. Another fourth went into tutoring Koreans. Some nurses today are still in call centers and some are even team leaders or trainers. They can't leave the scene because of practical reasons. They need to earn to live and they can't do this if they volunteer without assurance they'll be absorbed. So they choose to be in jobs where the pay is good and sufficient enough for them to contribute money to their family.
This blog will be of great help to fellow nurses. This blog will be all about nursing and all about us nurses. Feel free to comment and correct me when I'm wrong or even right. Be holistic! Be a nurse!
The sad thing is it's not always a green pasture for most of the Filipino Nurses here in the Philippines. With the current situation of the country, some can't even practice their profession due to an overflow of nurses every year. The Nursing Licensure Examination passing rate is less than 50% but still thousands and thousands more are still honored to pledge as a nurse. Some hospitals have now implemented a system wherein if you want to volunteer in their institution, you need to pay them from Php 3000 up to Php 5000 so you can get a certification and the most important one - EXPERIENCE.
Experience will always be the best teacher - no one can argue with that. The mistakes you commit when you are practicing nursing will be crucial in your growth as a nurse and as a professional. You must learn from your short comings or else you will end up wasting the time you spent in college not to mention all the expenses as nursing is not a cheap course. Your growth can be a rough road or a smooth slide. Your knowledge, skills, and attitude during college can drastically affect you when you are already a nurse.
Everything you learn during college days is very important. During college, you might just take some of your lessons and subjects but what you don't know is that the knowledge you missed because you were busy texting or talking to your seatmate could've been the key to a greener pasture. The school that you are in is also a big factor to your success but it will always be up to you whether you become either a nurse or one who will be nursed.
The time you made a decision to become a nurse either by heart or for profit should've been a firm and stable decision. If you were unsure then you'll be wasting your time and your parent's money. This happened to some people I knew. One quit during our first year to become a cop but from what I heard she never got in because her IQ was too hight(?). One was too intelligent but also uninterested that he got addicted to playing computer games. He was always absent so the outcome was that he failed. His father was called and was explained the reason why his son failed. He was down in tears when he knew nothing could be done. Another one shifted to another course. The last time I saw him he was in a call center and he was good at it.
Speaking of call centers, nurses are also invading this scene. I was one of them and so was 1/4 of my 170 batchmates. Another fourth went into tutoring Koreans. Some nurses today are still in call centers and some are even team leaders or trainers. They can't leave the scene because of practical reasons. They need to earn to live and they can't do this if they volunteer without assurance they'll be absorbed. So they choose to be in jobs where the pay is good and sufficient enough for them to contribute money to their family.
This blog will be of great help to fellow nurses. This blog will be all about nursing and all about us nurses. Feel free to comment and correct me when I'm wrong or even right. Be holistic! Be a nurse!
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