Today, I got my feet tired again. My eight hours of duty requires me to be on my feet all day walking around from patient to another patient, back and forth. Literally there are days that I can’t even sit even in 2 minutes. My poor feet have no choice but to walk around as much. But sometimes, I do not feel them while I am still caring for patients. I usually feel the pain after my shift. I just have to elevate them. I will go to a foot spa for a great massage sometimes. It did help with cramps or strains in my feet. It is really important to pamper our feet and take care of them.
MY TIRED FEET
June 13th, 2009Exercise as a diagnostic tool
June 4th, 2009 Did you know about this? Exercise not only boosts fitness and wards off disease, it should also help you feel better. If it doesn’t , pay attention to your symptoms. The rigors of a work out function as a whole-body stress test that can reveal an array of serious medical conditions that might otherwise go undiagnosed and untreated.
For example, the headaches that plagued a 57-year-old man shortly after the start of vigorous physical activity actually signalled the presence of blocked coronary arteries. The Physician and Sportsmedicine, a professional journal, described this and an assortment of other case histories of exercise-induced red flags:
• Fatigue and poor athletic performance: a possible sign of anemia.
• A noticeable drop in speed and nimbleness: Parkinson’s disease.
• Abdominal cramping and diarrhea: inflammation of the colon.
• A severe headache or incoherence: a brain tumor.
• Repeated bouts of tendinitis: hypothyroidism.
Granted, many workout-related aches, pains, and other ailments stem from nothing more than an over ambitious attempt to cram a week’s worth of exercise into a single session at the gym. But any symptom that’s unusual, intense, or persistent merits prompt medical attention. Exercise may be intended to promote health, but don’t ignore its ability to uncover illness.
CNA’s role
June 3rd, 2009As 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
June 3rd, 2009Nurses 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.
Cardiac enzymes
March 31st, 2009It is a must for nurses to know about cardiac enzymes. There are a lot of MI cases. Having this knowledge will help the patient and prevent further complication of the case. With MI there are certain cardiac enzymes that will rise and it will indicate the diagnosis of the problem.
Increased CK-MB – indicates cardiac damage after 4-8 hours post infarcts.
Increased CK-MM – indicates muscular damage.
LDH – increase 3-6 days post MI
SGOT – increase 24-48 hours post MI
Troponin – is one enzymes that arises almost immediately. It is the most specific enzymes. If patient has chest pain 30minutes ago and went to the ER, we can see Troponin rises and it continue to rise. It gives us a good indication that probably a cardiac related incident.
Adrenaline came rushing
March 29th, 2009Today I worked Day shift 6am-2pm. I set my alarm clock at 5:30 am. My alarm went off but I think I was still half awake and turned it off without my awareness. I was dreaming that I am already prepared for my shift. Then finally I suddenly wake up and when I looked at the clock, it was already 5:56am. All my adrenaline came rushing. I jumped off the bed and was fully awake in just a moment. I was kind of confused as to what do I need to do first. Finally I figured it out. Of course, I was not able to have a full shower as I used to before my every shift. Fortunately, I arrived in the birth room 2 minutes before endorsement time. It is good that I am just staying in the clinic where I work.
The journey to well-being starts with simple steps
March 24th, 2009In my field of work, I usually get tired almost after every shift. Delivering babies is not easy. It takes all your energy especially when births have complications. I always remember, I don’t have to take fatigue lying down. There are many ways I can fight back: Eat a balanced diet. Get enough sleep as possible. Exercise regularly by walking or jogging each day. Have a positive attitude. And take multivitamins daily. It won’t just get me back on my feet. It made me feel like the world is at my feet.
My experience as a patient
March 21st, 2009I was so grateful that the hospital’s nurses and doctor were so nice with me. I was asked what is wrong with me. I told the nurse that I am having a severe pain in my left flank area and that I have a scanty urination. I was requested to have a urinalysis. So I did pee a little just enough for the U/A. while waiting, the pain still making me vomit. I vomited twice at the hospital. I ask the doctor to gave me a pain reliever because I cannot handle the pain anymore.
The doctor told the nurse to give a diclofenac – a pain reliever IM. But I informed the doctor that I am allergic to it. She asked me if I tried Ketorolac – another kind of pain reliever. I haven’t tried that one yet so I do not know if I am allergic to it. So I was injected in my right deltoid muscle. It was painful. Now I felt what my patients feel when I inject them. After about 15 minutes I felt medication took effect already. I was so glad. But my eyes started to be itchy. I thought I was just imagining it but after 5 minutes, my eyes started to swell. I immediately inform the nurse about it and the nurse informed the doctor. When the doctor saw my swollen eyes, she was so surprised. She then realized that I was not kidding when I told them about my allergy. It seems that they took my history lightly. She prescribed me with antihistamine caplet. While my mom went out and buy those, my eyes swollen to the max like a Garfield in front of the doctor. She immediately ordered antihistamine IM. So I was injected with Diphenhydramine. My mom can’t buy ice anywhere so the doctor tried to find an ice for me. She is so sweet and nice of her for finding an ice for me.
The doctor wanted me to be admitted for at least 24 hours just to observe as to what extent my allergies go. But I felt good with no chest pains and the pain in my left side was very minimal. I decided to just go home and just be back anytime if there will be a problem. I signed that I went home against medical advice. It was not that I am a hard-headed person but I felt so great and there is no point of staying in the hospital. I was confident to go home because I was already injected with antihistamine. So we went home. I still had cold compress on my eyes until I slept.
KUB ultrasound result
March 15th, 2009Today, 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