Archive for the ‘Nursing procedures’ Category

2nd Birth Handle 01/22/99

Wednesday, December 16th, 2009

Leila N. 26 y.o, G2P2, delivered baby girl “ Hannah Paula”at 01:43am, a small baby, , apgar score 8/9, 250cc, with hemoglobin of 9. delivered by LP, ZG, AT, with patient’s mom. # 1637

Liela came in the clinic fully and the BOW was already ruptured clear. The baby was out after 13 minutes. The baby was given free-flow oxygen due to cyanosis but the color pinked up after few seconds. I was very fast birth with no complications. She has a 1st degree laceration that needed no suturing. It was good she did not hemorrhage considering she was very anemic. She just lost a very minimum amount of blood at birth.
It was a very exciting birth. Liela has a twin sister that I got to see. They really looked alike. After few months we visited them at their house and Leila cut my hair. It was fun.
1st stage = 3 hr 35 min
2nd stage = 54 min
3rd stage = 07 min
Total admission = 4 hr 54 min

CNA’s role

Wednesday, June 3rd, 2009

As nurses we need to know the CNAs role and the scope of their responsibilities. They are a big part in our team. CNAs have instinct we, nurses, rely on them as our ears and hands but they can’t make Nursing diagnosis. They do not solve patient’s problems, not evaluate the patient, not provide health counselling, not do sterile invasive procedures, no medicine administration those are nurses’ responsibilities. They can do NGT tube feedings, can put oxygen on but can’t turn the oxygen on.

CVP Monitoring

Wednesday, June 3rd, 2009

Nurses should know what are our responsibilities with regards to CVP Monitoring. We should be knowledgeable enough about the procedure.

A catheter is inserted to the right atrium of the heart to determine fluid balance. The normal functioning of the heart, all the fluids that come to the heart is pump out from the heart. If it does not happen you’ll have Congestive Heart Failure. We try to figure out how the heart handles the volume of blood coming in.
The measuring point of the CVP is in the right atrium. What you should do is level up the right atrium with the manometer. Make sure that the manometer is the same level with the right atrium. Use a lever to balance it out.

NCLEX Q – CVP pt if the head of the bed is adjusted you have to adjust the manometer otherwise you will get a false reading.
Normal CVP reading 5-10 cm H20. More than 10cm is indicative of overload. Less than 5cm patient is dry or dehydrated.
Always check the lever of the manometer. Check the insertion site of the catheter for bleeding and other complication like pneumothorax or hemothorax. Signs and symptoms is shortness of breath.

KUB ultrasound result

Sunday, March 15th, 2009

Today, my mom went with me to the hospital for my KUB ultrasound (kidney, ureters, urinary bladder). Though I do not have severe pain anymore in my left side, I just want to have a check with my kidneys. I want to know if I have 2 because my mom only one kidney is functioning. Her other kidney is very small according to the doctor it is inborn. I am glad every thing was normal. Thank you Lord. I was so relieved.
This is my result : Left Kidney measures 8.8 x 4.8 x 1.4 cm, Right kidney measures 8.7 x 4.1 x 1.6cm. there is no significant disparity in the sizes, shapes and locations of both kidneys. No evident mass, calculus nor any abnormality in the scans obtained. Both ureters were not visualized (not significantly dilated). There is a good filling of the urinary bladder, showing regular contours and smooth walls with no intraluminal echoes.
IMPRESSION : Normal study

Moody day

Tuesday, February 3rd, 2009

Today I do not feel good. I was moody. I do not know why but may be due to hormonal changes. Lol. Anyways, someone got me to insert an IV (intravenous) to the patient. I prayed that God would still help me to insert it successfully even I am not in the mood. God really did not disappointment. I got it in one try. To God be the glory.

MICU orientation schedule

Tuesday, January 27th, 2009

I learn today that our hospital MICU orientation will be in two weeks. I thought it would be sooner. I think I am just excited. It is okay though I still have time to study and review some nursing procedures and common diseases in the Medicine ICU. At the same time I can do the things I needed to do because I know when I start the training I only have limited time. For now, I list all the things that need to be done.

What if patient becomes unresponsive?

Monday, January 26th, 2009

This must be hard for a newbie ICU nurse like me. I ask this question so that I will be prepared to know what should I do when my patient becomes unresponsive. Nursing process should always be utilized. What should be done first? First thing that needed to be done is assessment. The thing to focus on here is pretty simple- keep in mind the basic question: “What’s wrong with my patient?”. The goal as a new ICU nurse is to try to figure out what the patient is doing- but when the patient does something happened unexpected, there is just no substitute for experience. So go get some help: get the resource nurse, and get the team. This points up the most basic principle of ICU nursing: it is a group process. As a new nurse, we should know where we stand, what are our roles and most of all always communicate what is happening to the patients with the resource nurse.

Excited for MICU training

Sunday, January 25th, 2009

In the next two weeks my training in MICU (Medicine Intensive care unit). I am very excited and at the same time kind of nervous as to what to do. This will be my first exposure to that unit. I know this is one of the busiest and toxic nursing units in the hospital. I am very excited to learn and to care for sick patients. I know in the beginning I need to observe, learn and familiarize things. At first, I think I will feel like it seems as though there is an endless stream of emergent situations that crop up in the unit, may be sometimes it clearly in response to some prior event, sometimes all by themselves, and they can be genuinely terrifying. Experienced ICU nurses may be a lot more nervous than a newbie trainee nurse simply because they know what to be afraid of. A key rule of ICU: any patients is capable of doing anything at any time. I know where to put myself though. When there will be cases that needs an experience then I need to call the experienced ICU nurse and I need to back up myself and let them do what is needed to be done. I can help them handing the things they needed. In that case, I should be a keen observer so if that case will happen again I know what to do. It is good to know that later on in my training I will improve and function or do what the unit staff do. I cannot wait for that time.

How to read ECG in seconds

Saturday, January 24th, 2009

My sister who is also a nurse told me that there will be a seminar to be held on January 29, 2009 on Reading ECG in seconds and ABG interpretation. I am so glad to know it because, I really wanted to be really good at reading ECGs. I am very much curious about this seminar because of the how can someone read an ECG in just seconds. I cant wait to attend. I am familiar though about how to interpret ABG (arterial blood gas) but it is always good to have a review and another technique of interpreting it easier. The registration is very cheap so I am sure there will be a lot of nurses will attend.

Called for IV insertion

Thursday, January 22nd, 2009

I was once again called up in the middle of the night to insert an IV to a laboring patient. The staff in the Lying clinic where I worked before needed help for it. So I went there and of course, I prayed and ask God to guide my hand and be able to insert the IV cannula successfully in one try since the patient had couple of poke already. God did answered my prayer. I was able to insert it without any problems. I used to insert it in the cephalic vein. I like that site because it big compare to the other veins. At the same time, it is not hard for the patient since she can move her hand without dislodging the IV cannula. There is no need for a splint which make her hand immobile.
The laboring patient needs to be induced for her labor did not progress so I she needs one so that medication will be given to her via IVTT (intravenous through tubing). After the insertion I went back home feeling good about myself that I was able to help someone.