Top 10 highest paying nursing specialties – Repost

Top 10 highest paying nursing specialties (via http://scrubsmag.com/)

After you finish nursing school, or if you’re considering going back for more training, choosing the right nursing specialty becomes your chief focus. With so many specialties to choose from, many prospective nurses find it difficult to just pick…

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NCLEX Success: Test Day Advice Busters!

Ok so lets talk a little bit about that dreaded day. Most people are really nervous, they have itchy pants or just feel nauseous. Well that’s to be expected. When the day finally arrives you better be ready for it, although guaranteed you won’t feel ready! So now I’m going to tackle some of those test day cliches!

Things you’ve probably been told to do:

• Get a good nights sleep – well that is easier said than done. The likelihood is that you will toss and turn all night. The alternative is to take some melatonin or NyQuil the night before and have a family member or a friend AND an alarm clock set to wake you up. It’s true that a good nights sleep will help you, but don’t beat yourself up if you struggle to get some zzzz’s the night before.
• Eat a healthy meal the night before and a good breakfast the day of – This is dependent on what kind of eater you are. Do you binge eat under stress? Or do you lose your appetite? The fact is your mind is focused on the test, just eat whatever you want! One healthy meal isn’t going to help  you the night before. The day of, it is important to have something in your stomach, but if you are too nauseous then just stick to water.
• Don’t study the day of the test – Yeah, I was told that too; what a load of crap! My exam was at 2pm in the afternoon, and you’re damn right I studied before it. I didn’t go hardcore and freak out over the things I didn’t know. I simply went over the rationales of the mock test I took the day before. I felt like it got me in the groove without freaking me out. At the end of the day there will be questions that you just don’t know, but NCLEX know that, which is why they keep evaluating you with each question and will shut off when you have proved yourself.
• Aim to pass in 75 questions – This is a stupid notion; you should not expect or hope to be done in 75Q. Mentally prepare yourself to go the whole way. If you get to question 75 and it doesn’t shut off it doesn’t mean you failed – it means you still have to prove yourself, so take the challenge!!! Don’t freak out when questions 76 pops up, I had a friend that passed and it shut off after Q76. It is important to just take each question at a time, if you are clueless, then go with your gut and just pick one, you have to keep pace.
• You can always take it again – This isn’t a bad thing to keep in mind. We put a lot of pressure on ourselves; we don’t want to be the ones who fail, BUT, life is full of set backs and the fact that you can take it again if necessary should relieve some of that pressure. If you fail it doesn’t make you stupid, there are so many factors involved in taking the test, you just have to draw up a new study plan and start over.

You can do it, NCLEX isn’t a monster, just a bridge to cross! Best of luck to you!

Cardiac Tamponade

This has nothing to do with tampons in the heart ok! Just an FYI.

When blood or fluid accumulate in the sac which surrounds the heart it exerts pressure against the heart, making it harder for the heart to pump. As you can imagine, if the ventricles cannot fill fully or contract effectively then cardiac output decreases. Decrease cardiac output is not good news!

So how do you know if someone has this?

Well the symptoms are nothing unusual: chest pain, restlessness, quick shallow breathing, palpitations, pallor, tachycardia, weak peripheral pulses, pulsus paradoxical, distended neck veins, low BP… (do these all sound a little familiar? MI anyone?) Well causes of cardiac tamponade can be MI, Dissecting aortic aneurysm (thoracic), end-stage lung cancer, heart surgery, Pericarditis caused by bacterial or viral infections, or direct wounds to the heart.

How do we diagnose? Echocardiogram is the usual diagnostic tool, but MRI, CT, CXR or EKG can also highlight or confirm this.

Can you see the halo of fluid around the heart?

This is an emergency! The fluid must be drained to reduce damage to the myocardium and reestablish cardiac output.

Pericardiocentesis is a procedure that uses a needle to remove fluid from the pericardial sac, the tissue that surrounds the heart. The patient will be hyperoxygenated, given fluids to maintain blood pressure. It is important to note that a pericardiocentesis may have to be repeated because cardiac tamponade can return. With fast treatment the outcome is usual good, without treatment death is immanent.

A pericardial draining tube may be placed during surgery to keep in place postop. The drainage will be measured every shift and documentation on the color, amount and consistency is very important! The tube will usually be removed slowly over the postop recovery weeks at the discretion of the cardiologist.

NCLEX Success: Maslow’s Hierarchy of Needs

Maslow is a great tool to narrowing down or answering NCLEX questions. Those pesky priority questions are the ones in which Maslow can lend a helping hand. Here is how you use the Maslow Strategy:

1. Look at the answer choices. Determine if the answer choices are both physiological and psychosocial, if they are – apply the Maslow strategy.
2. Now, eliminate all psychosocial answer choices.
3.  If the answer choice is physiological, don’t eliminate it. Maslow states that physiological needs must be met first. Although pain certainly has a physiological component, it is considered a psychosocial need on Nclex.

Great Little Story to Remember Those AV Heart Blocks!

❤The Sad Story of a Struggling Marriage…❤

1st Degree AVB
Husband comes home late every night at the same time, but he
ALWAYS comes home!!!

** P waves aren’t on time but always present! Prolonged PRI

2nd Degree AVB Type 1 (Mobitz 1 or Wenckebach)
Husband comes home later and later and later until one night he
doesn’t come home at all, then the pattern starts all over again!!!

**P wave “Going, going, gone”, PRI gets longer & longer till P is dropped

2nd Degree AVB Type 2 (Mobitz 2)
Husband comes at the same time every night, but there are some
nights that he just doesn’t come home!!!

**P wave is on time but randomly drops

3rd Degree AVB (Complete)
Husband and wife are finally divorced but can’t afford to move out of
their house because of the bad economy. As a result, they are still
living under the same roof, but leading two separate lives!!! It
appears as if they’re still married, but they’re not! There is no
communication between them!!!

** P waves, PRI are not in sync with Ventricular activity (QRS) and its a hot mess!

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This guide will help you in providing therapeutic communication when your patient is grieving (could also be useful in coming to terms with Nursing School! lol)