Tuesday, February 28, 2006
danO's ATI TEST PREP Session Notes
ATI test will count for 50pts of your grade.
It is 60 questions and will take 1-hour.
Questions will cover everything we've covered in N1
To get comfortable with the ATI testing style and logic, login and take the ATI's self-paced, unproctored fundamentals exam here. Your username is your SS# and the password is the last four digits of your SS#. The tests are 100 questions long and give instantaneous feedback, but keeps track of only your first answer (right/wrong). You can stop anytime and come back, and it will remember where you left off. I think there are two tests you can take. I'm not sure if you can repeat them.
Everything you need to know is in the ATI study guides which look thick, but shouldn't take more than 2-3 hours to review. It may cover some things we haven't covered yet. If so, refer to the textbook for answers.
Use the textbook study guide for practice questions.
Table on ATI Nursing Fundamentals, p.411 has a good overview of IV solutions
Things to know:
Growth and development:
Ericson's stages of growth
Westeroff's stages of spirituality/faith
Basic Nurisng Care
Bedbaths, chain of infection, etc...
Client Teaching
Motivation, etc...
The 6 (or 7, or 8) Rights of Medication Administration
Parenteral Medication delivery routes
IV, IM, SQ, SD, SL, etc...
Wound Care
Death & Dying
5 stages (denial, anger, bargaining, depression, acceptance)
Suctioning technique
Nasogastric tubes
Vital Signs and their significance
Percussion (I know, we're too dumb to do this yet according to FS, but we have to know about it for the ATI)
tip: if it sounds hollow, it's the stomache.
When given a choice of interventions, imagine you have ALL THE TIME IN THE WORLD, and choose the intervention that is BEST FOR THE CLIENT
Rule of thumb: Pick "GIVING OF YOURSELF" answer unless you're absolutely sure it's something else.
Heart sounds: Location and interpretation
aortic, pulmonary, [erb's point], tricuspid, mitral
A(unt) P(olly) [E(njoys)] T(aking) M(orphine)
Auscultate apical HR at M(itral)
Palpate PMI (point of maximal impulse) at M(itral)
Lung Sounds
Crackles = lower lungs, percolating fluid sounds --> Suspect CHF, Pneumonia, etc...
Wheezes = Upper respiratory constriction, heard on exhalation --> suspect asthma, anaphalaxis
Ronchi = chunks of stuff rattling around in lungs post-illness, when patient is drying out.
Okay, that's my notes. They didn't cover a lot of detail, just the broad strokes of what areas we should know thouroughly. If anyone has anything else to contribute, please post your comments.
Good luck everyone!
SJDC ADN Class of 2007
Saturday, February 25, 2006
SJDC ADN Class of 2007
1st sem ADN reimbursement
Friday, February 24, 2006
Great Job Everyone!
I am still in the tutor center on Mondays, Wednesday and after your lecture on Thurs. Come on over if you need a little help. If you need another time, let me know or drop me an email.
bboss947@sbcglobal.net
Taking the time to help others will help you most of all.
Clinicals at Dameron Hospital
Just a reminder to anyone who is going to Dameron Hospital for clinicals you have to go have those additional tests done: drug urine test, hepatits C and breathalizer. On the paper you clinical instructor gave says you need the RPR for syphillis, but that test is not needed. Make sure to make an appointment with human resources at (209) 954-5550 and ask to talk to Mona Lisa. Also don't forget to get your picture taken for your badge. You will get your badge the day of orientation. Have a good weekend everyone!
skills lab
Tuesday, February 21, 2006
For those who couldn't make it today...
1. No RED meat
2. Check for allergies to Shellfish and iodine
3. Use STERILE container, sterile syringe w/ sterile needle, clean port with anitmicrobial swab, clamp below port, collect sample
4. Peaceful and dignified death. Keyword: Autonomy. allow the pt to make as many decisions as possible
5. wipe front to back (female, clean to dirty (male), sterile container, start stream and catch 30-60mL
6. Provide pt with as much info to make a reasonable decision when donating organs
7. Assess activity/strength/tolerance, orthostatic hypotension- check pulse and BP when pt is laying down, sitting up, and standing
8. Under STERILE conditions: open pkgs, apply sterile gloves, open all the pkg, check equipment (inflate and lubricate), drape and cleanse pt, identify orifice, insert, and check urine
9. Change in bowel movements, bleeding
10. Keep bag below waist, equipment management- do not let the bag get full, empty it
11. increase fluids, diet: high fiber, low fat, exercise, medication education
12. assess, ROM/motor/strength of extremities--. atrophy/musclemass, CV (decrease Cardiac output), Resp. (decrease Tidal volume), GI (decrease motility, bowel sounds, peristalsis--> constipation), Pain level
13. prepare for loss, prepare to cope, Helps to move on, find inner peace, Have a healthy mental outlook and wellness in life
14. Give self (sit with pt)
15. Skin care (clean/dry), equipment management
16. SUBJECTIVE: pain, frequency, urgency, amount (oliguria, anuria, polyuria, nocturia), OBJECTIVE: Amount (30mL/hr or 1500-1700mL/24hrs), odor, color
17. 1-denial, 2-anger, 3-bargain, 4-depression, 5-acceptance
18. FVD (decreased fluid and electrolytes: K should be 3.5-5.0), Skin breakdown, altered mental status
If I missed something, feel free to add it to this...
Monday, February 20, 2006
Quiz 5 # 15
Can someone post directions for adding to a post? That seems to keep everybody's notes together but I don't know how... Thanks!
Sunday, February 19, 2006
Comparison
Saturday, February 18, 2006
Friday, February 17, 2006
MESSAGES – 17 February 06
For next week’s quiz, in calculating dosages, please review Ch. 3, Reading Medication Labels, in Curren. Know drug name, dosage strength. Be able to calculate a medication dosage by reading the label. Have a good weekend. Remember, Monday is a holiday.
I also double checked my numbers regarding Q#4. I did add that point #20 to all of your scores already. So no more points. Sorry
A student left a cell phone in the Forum. I have it. If it is yours, come to my office. Student of cell phone found.
Okay. You guys convinced me. I will have a study session on Monday, 2/21 at 1400-Room will be posted on either L228 or in front of my office. Can someone announce it on your BLOG to notify the other students.
Tragedy in the Philippines
http://www.comcast.net/news/index.jsp?cat=GENERAL&fn=/2006/02/17/328433.html
Rupert
Thursday, February 16, 2006
N1 Quiz#5
789321Thanks for your help Rupert, it was great to compare answers. My question is regarding #11. I interpret the question as how to alleviate it. Found answer in tx 1393 under interventions and in lecture "bowel" pg 11 - From Kkc
Here is an update to Rupert's list For #2) Page 1340 under "Diagnostic examinations" and table 44-4For #15) Urinary pages 1327-1330, specifically the bottom of page 1329Number 14: I would read pages 1217-1222 becuase it discusses factors for acute to long term care with sleep problems - From Austin
18 February, 2006 12:35 1. Discuss the education necessary for obtaining a stool specimen for occult blood. (Txt 1386-87 , Box 45.3)
2. Discuss the assessment of the client undergoing a radiographic exam using radiopaque contrast media. (Txt 1389, Box 45.5) RADIOPAQUE CONTRAST - A radiopaque substance (e.g. metal) will be highlighted (appear white) on a plain x-ray. The use of iodine containing radiopaque contrast dyes allow enhancement of the anatomy demonstrable with conventional x-ray. (http://www.medhelp.org/glossary2/new/gls_3945.htm)
3. Discuss the procedure for obtaining a sterile urine specimen from a urinary catheter. (Txt 1335, Box 44.2)
4. Discuss the primary goal(s) for the dying client. (pg.8 lec/dying)(Txt 580)
5. Discuss instructions necessary for the client to obtain a "clean catch midstream" urine specimen. (Txt 1336-37)
6. Discuss the nursing interventions for the client regarding organ donation. (Txt 588-89)
7. Discuss the nursing interventions for the bedfast client beginning to ambulate. (Txt 1476, Box 46.11)
8. Describe the procedure for urinary catheterization. (Txt 1351, Box 44.2)
9. List the warning signs for colon cancer. Pg 1388 Box 45-4 - from Jaylyn
10. Discuss the necessary information to provide to assistive personnel when caring for the client with a urinary catheter. (Txt 1359, Box 44.3)
11. Discuss the education necessary for the client with constipation. (Txt 1379, Box45.1)
12. Discuss the nursing interventions for the client with impaired mobility. (Txt 1446)
13. Discuss the purpose of anticipatory grief. (Txt 571)
14. Discuss the nursing interventions for the client with sleep pattern disturbance. (Txt 1216-17)
15. Discuss the nursing interventions for the client with urinary or bowel diversions.
(Txt 1380/Bowel) (Txt 1377/Urinary, bottom of page)
16. Discuss the data necessary to evaluate a client's urinary status. (Txt 1331/Assessment)
17. Describe and discuss Kubler-Ross's Stages of death. (Txt 570, Box 29.2)
18. Discuss the nursing diagnoses for the client with severe diarrhea. (Txt 1379)
Wednesday, February 15, 2006
Quiz #4 emphasis
#1 Know drainage types, and where/when it would be found.
#2 Secondary is usually infected
#3 How does the pain affect activities of daily living?? AND know the difference between acute and chronic pain (duration)
#4 immobility-->ischemia->lack of blood supply
#6 foley insertion, and trach suctioning...anytime skin integrity is broken or something is inserted to a sterile cavity.
#7 know PQRST, AND use of pain scale/rating. Medicate according to pain level.
#8 Handwashing!!! Procedure, disinfection, mishandling of equipment
#10 Turn the patient q2h
ALSO!!! Know the calculations DA... We can use calculators...
1000mcg/mg, 1000mg/1g, 5mL/1tsp, 65mg/1grain
Test Taking strategies
To help insure success I just was to give some test taking hints. Remember to focus on Mrs Semillo's lectures and use the book as back up for what you don't understand. She take a lot directly out of her lecture.
Identify who the client of the question, (It could be the patient or the family); is it a positive or negative question, ( the appropriate or inappropriate intervention) and remember that when choosing a response the nurse always has the time to do the most appropriate intervention' what ever it is. ( Don't bring real life into answering the question). Look for similar words in the question and response.
When you come down to two answers, Look for the global answer it will always be the best answer. It will encompass every step or intervention listed as an answer.
And always trust your gut feeling unless you read the question wrong. Do not read into the question. Take it for face value.
More of these test taking strategies are on the computer program in L231. I highly recommend everyone go through the program. It takes about 1 1/12 hours.
I am also willing to work with any one who would like assistance. Good Luck.
Caralee
Special study session for quiz 4
Sunday, February 12, 2006
Pharm Answers
Hello Everyone, We will start class with the exam. I will provide the Scantron. You will need to bring a number 2 pencil. Below are the answers to the sample questions:
1. C 2. A 3. C 4. C 5. C 6. D 7. C 8. A 9. C 10.A See you all tomorrow evening Richard
Also go to his docushare and print out the lecture outline for exam 2
http://docushare.deltacollege.edu/dscgi/ds.py/View/Collection-5817
PDA Suggestions
Friday, February 10, 2006
Update to Austin's quiz #4 study guide
#1 Describe the various types of wound drainage. text p.1494 table 47-2 , p.5 lecture notes
#2 differentiate between primary and scondary wound healing. text 1492
#3 Discuss the assessment of a client with chronic painLook on page 1234 and page 1241 and in box 42-5 on same pagep. 3,9 lecture notes
#4 discuss the etioloty of pressure ulcers. text 1487 p. 12 lecture notes
#5 discuss the assessment of a client with infection or inflammation. text p. 780-783, lecture notes p.6
#6 Give examples of sterile proceduresPage 802 803-816 under sterile procedures. Also include skills 33-2, 33-3, and 33-4
#7 discuss goals of the terminally ill client in the variuos stages of pain. text p. 586t
#8 Discuss potential risks for developing nosocomial infectionsPg 779-780 and box 33-2 on page 780, also look on page 11 in the infection section from the lecture notes
#9 Describe and discuss the components of pain assessmentPg9-10 in pain section of lecture notes, also pages 1242-1245 in fundamentals
#10 discuss the nursing interventions for the immobile client to prevent skin breakdown. text p. 1430-1431
#11 Discuss the education necessary for the client with an infection Page 19 under "infections" in the lecture book, p.11 lecture notes table 35-2, text p. 787
#12 discuss the purpose of wound irrigation. text p.1543
#13 discuss the evaluation of the client with an infection. text p.816-818
#14 Discuss the health education necessary to prevent the transmission of infectionsPg 776-777, Table 33-2, Pages 788-789 788-794
Mr. Svilla's Study Guide and practice q's (convenient format)
2. The 6 rights to medication administration
3. The 3 safety checks before giving a medication
4. Pharmakokinetic and Pharmakodynamic principles and terminology
5. Defining terms from your drug guide (mechanism of action, indication, etc)
Here are some sample questions...I'll post the answers by Sunday
1. A patient is in severe pain. Which of the following routes of administration would be the most expeditious?
a. Oral
b. Intramuscular
c. Intravenous
d. Transdermal
2. Therapeutic index is the ratio of a drugs LD50 to its ED50. A large therapeutic index means that:
a. a drug is relatively safe.
b. the drug is not safe
c. there is overlap between the therapeutic dose and the lethal dose.
d. the drug is too toxic for 50% of the population.
3. A drug with a strong attraction to albumin would have a distribution that is:
a. higher than the distribution of a drug with a weaker attraction.
b. no different than the distribution of a drug with a weaker attraction.
c. lower than the distribution of a drug with a weaker attraction
d. decreased by the presence of a drug that displaces the drug from the albumin.
4. On Monday a patient begins taking a daily dose of a drug with a half-life of 1 day. If he takes the same dose every day, on what day will his plasma drug levels reach plateau?
a. Wednesday
b. Thursday
c. Friday
d. Saturday
5. The binding of a drug to its receptor is ____ reversible.
a. never
b. rarely
c. usually
d. always
6. A patient is receiving warfarin, a drug with a strong attraction to albumin. While taking the warfarin, the patient begins to take a second drug that also has a strong attraction to albumin. The nurse would assess for:
a. decreased effects of the warfarin
b. therapeutic effects of the warfarin.
c. subtherapeutic levels of warfarin.
d. toxic levels of warfarin.
7. When one drug alters the absorption of a second drug taken at the same time, the drug interaction would be classified as:
a. a direct chemical reaction.
b. pharmacodynamic.
c. pharmacokinetic.
d. combined toxicity.
8. Your patient is taking a drug that has been determined highly hepatotoxic. You should counsel him to:
a. avoid alcohol and acetaminophen.
b. come in for a liver biopsy on a monthly schedule.
c. avoid strenuous activity and contact sports.
d. notify you immediately if his appetite increases.
9. The ED50 indicates the dose required to produce a:
a. minimal response in half of the population.
b. toxic response in half of the population.
c. therapeutic response in half of the population.
d. sustained response in half of the patients.
10. Which of the following statements is most correct in regards to the placebo effect?
a. It is caused by psychologic factors rather than physiologic ones
b. When it occurs, indicates that the patient is malingering
c. It is a rare effect, only seen with psychotropic medications
d. It always serves a beneficial purpose
Pharm. Test on Monday !
More for Quiz #4
Also try grouping the questions that relate to the same subject. That way you don't have to go back and forth and can get a real sense of the subjects. Use your Critical Thinking skills to apply this information to a nursing situation; assessment, nursing diagnosis, planning, implementation and evaluation. Remember that the written test is an evaluation of our understanding of the subjects and that we need the additional information to pass the real test which is application of the subject in a clinical setting. I rewrote the study guide and added what I look for...
1. Describe the various types of wound drainage. Also: Why does a wound need to drain? What equipment is needed and how is it used?
2. Differentiate between primary and secondary wound healing. Why would one wound need primary and another need secondary? What is the expected outcome of each?
4. Discuss the etiology of pressure ulcers. Look for causes, manifestations, prevention, client education, delegation of care and goals/outcomes.
10. Discuss the nursing interventions for the immobile client to PREVENT skin breakdown. What are the causes? What are the risks? What is the difference in prevention of a mobile client vs immobile client? What can a nurse do to decrease the incidence of skin breakdown?
12. Discuss the purpose of wound irrigation. Why is it done? Who can do it? How is it done? What are the risks if it is done incorrectly?
3. Discuss the assessment of a client with chronic pain. Compare chronic/acute pain. What are the causes and manifestations? How can you tell if a client has chronic pain: subjective/objective?
7. Discuss goals of the terminally ill client in the various stages of pain. What are the stages? Options? What are the CLIENT CENTERED goals/outcomes?
9. Describe and discuss the components of pain assessment. What are the components? For each component: causes, manifestations, signs/symptoms, interventions, goals/outcomes.
5. Discuss the assessment of a client with infection or inflammation. Compare infection vs inflammation. What are the causes, manifestations, interventions and goals/outcomes? Compare local vs systemic. How would you document?
8. Discuss potential risks for developing nosocomial infections. What are the causes? Who is susceptible? What is prevention? What is the risk to clients, health care workers?
11. Discuss the education necessary for the client with an infection. Again, local vs systemic. What is the most important thing they need to know. How would you educate your client if they were young, old, confused?
13. Discuss the EVALUATION of the client with an infection. Local vs systemic. What goals/outcomes were successfull? What interventions would need to be adapted? What would you need to prioritize?
14. Discuss the health education necessary to PREVENT the transmission of infections. Name the parts of the Chain and describe each in detail; give examples. Who is responsible for prevention/education? How would you educate you client (young, old, confused, etc)? What is the priority?
6. Give examples of sterile procedures. What is sterile vs clean? Why would you need sterile? What are the "rules" of a sterile procedure (ie: keep sterile equipment above waist level or else it is considered contaminated)?
Dig deep! You may not need to write it all down as answers but if you keep the extra questions in mind while you are looking, it will help you to realize the application of the information. I know it is a lot more work but you can be a nurse or a good nurse. To be a good nurse it takes initiative, persistance and perseverance. We have all done well enough to make it this far... and that was hard work too!
Don't get discouraged. I always remember a saying that I think was quoted from Henry Ford: "The person that thinks they can and the person that thinks they can't are both right. Which one are you?"
ATI Testing
Mr. Sevilla's Email
Hello Everyone,
"We will still have the exam scheduled for Monday. I will have further information and study tips by Friday afternoon." - Richard
Thursday, February 09, 2006
Question #2 for Study guide 4
Page 233 in the ATI "fundamentals of Nursing" explains the differences very well
Link to Mr.Sevilla's Docushare
I tried to post the comment on your message but the link wasn't working. As of 22:16, there is no study guide posted.
http://docushare.deltacollege.edu/dscgi/ds.py/View/Collection-4940
Study Guide # 4
Look on page 1234 and page 1241 and in box 42-5 on same page
#6 Give examples of sterile procedures
Page 802 under sterile procedures. Also include skills 33-2, 33-3, and 33-4
#8 Discuss potential risks for developing nosocomial infections
Pg 779-780 and box 33-2 on page 780, also look on page 11 in the infection section from the lecture notes
#9 Describe and discuss the components of pain assessment
Pg9-10 in pain section of lecture notes, also pages 1242-1245 in fundamentals
#11 Discuss the education necessary for the client with an infection
Page 19 under "infections" in the lecture book
#14 Discuss the health education necessary to prevent the transmission of infections
Pg 776-777, Table 33-2, Pages 788-789
Need help finding the answers to number 13 if someone is willing to give input
SJDC ADN Class of 2007
Maybe if we come at this a different way we will see better results. If there is anyone that has it together and some way has found a method of studying that has shown positive results there are many of us out there that could use the advise so please help and post it on the blog. Thanks.
Types of wound drainage: table 47-2 pg. 1506-1507
Serous: clear, watery plasma
Purulent: thick, yellow, green, tan or brown
Serosanguineous: Pale, red, watery: mixture of clear and red fluid
Sanguineous: Bright red:indicates active bleeding
Wednesday, February 08, 2006
Don't wait until Thursday!
Share the Work
There is no grade curve to compete for.
This is a virtual study group blog.
If everyone posts 1 answer to the study guides you will be sharing the work. Comment on each other's answers. That way everyone will be on the same page. You each have your own unique thoughts. Someone else will always come up with a thought that never occured to you. Everyone benefits, the learning is easier when it is interactive.
If you are able to explain a concept OUTLOUD to someone else (even if it is your dog), then you have really learned it.
We are being trained to be teachers, start with each other.
Share your clinical stories, hang your reading on what you see and know. Make it personal, it will help with understanding and retention. The more graphic or funny you can make it in your mind, the better.
2 for 1 Special!
Tomorrow when you get out of lecture, Debbie Vogel and I will both be standing by in the tutor center from 1630 - 1830 (Thurs 2/9), to help you with whatever is on your minds. If I am am too much of a spaz for you and cause you to feel overwhelmed (I hope not), Debbie is my anchor and is not shy about telling me to zip it and chill out.
Come with your questions. You will get 2 perspectives and tutoring styles to pick from, and hopefully we can make it click for you,
And remember,
KEEP IT SIMPLE!
Tuesday, February 07, 2006
SJDC ADN Class of 2007
pharm test?
Quiz help available
I wanted to let everyone know that I will be avalible Wed. from1-4 in Room L231 for anyone who needs assistance with studing for the quiz 3 or physical assessment. We also will be having study sessions weekly, per your request, every Monday from 5pm-6pm in the North forum starting next week.
Let us knowwhat else you need or would like. I can be reach by this blogg or email at cbromme@deltacollege.edu
Caralee
PDA info file link, and New Look.
Bonnie Boss was nice enough to generate and provide a word doc with links to FREE medical downloads for your PDA. According to Bonnie, "This site has 104 pages with 10 medical down loads on each page. I have cut and pasted the links to the free download pages with brief descriptions of what you can find there. Many pages have multiple free downloads. These are not those annoying free trial downloads that you probably regret ever trying." I've made the FREE medical downloads for your PDA available here. Give it a try and if you find it useful, be sure to thank Bonnie.
BTW: it turns out our blog was using the same template as the 2nd semester adn's, which was very confusing, so i switched to this new color scheme, with the same layout. nice and clean, don't you think? feel free to comment +/-.
I'm going to take/post some pix of the 1st semester adn's going about their business. if i get one i like, i may try to integrate it into the blog page header, like the green one had as a default. be patient.
thanks to all those have been contributing/posting to the blog and welcome to all our new members. if anyone STILL hasn't gotten an invitation to join the blog, email danO directly, a'ight?
have fun at clinicals everyone!
Friday, February 03, 2006
N1 Quiz 2 Results
http://docushare.deltacollege.edu/dscgi/ds.py/View/Collection-5401
Check Mrs. Semillo's message at the end of the results for question clarifications .
Respi. Assessment from Ms. Sison
http://docushare.deltacollege.edu/dscgi/ds.py/View/Collection-4738
The links on the document for the lung sounds doesn't work but here is the website: http://www.med.ucla.edu/wilkes/intro.html
For lung sounds link : http://www.med.ucla.edu/wilkes/lungintro.htm or http://www.rale.ca/Recordings.htm (R.A.L.E. Repository)
Thursday, February 02, 2006
Tutor Times
These are scheduled in the Tutor Center, Shima 217
N3 (N1 too) - Mondays - 1600-1800 (or longer if needed)
N1 - Wednesdays - 1300-1500 (or longer if needed)
N1 - Thursdays - 1630- 1830
I know that some of you will be in Clinicals on Wednesday. Drop in whenever if you need help. These times are not necessarily the only times available. If you live out of town, I can make times available that will fit with your commuting times.
24/7 email tutoring and advice is available at
bboss947@sbcglobal.net
cell (209)329-1369
Debbie Vogel is also tutoring, you can reach her at
shadowphoenix56@sbcglobal.net
Been There, Felt That
Blog links
2nd Semester Blog
3rd Semester Blog
Go to the Archives and click on the very first months to see how we helped each other.
Secrets to success...
Want to improve your quiz scores???
Well, if you get a chance, be sure to thank Kristine for thinking enough of her fellow 1st semester adn's to make sure you all were aware of the tutorial sessions every other Monday (before Pharmocology) in the south forum. Mrs. Semillio gives the instructors her study guides and they prepare the students for Thursday's quizes/exams. Kristine heard that they are helpful and if someone didn't get a great score on today's quiz, they might be interested in the tutor sessions. The next one is on the 13th. You can access the information by going to docushare and under faculty it's nursing sucess 101. The calander has all the sessions posted on it. "
See you there!