Question Of The Day: Cardiovascular Disorders

Q. A client with chronic heart failure is receiving digoxin (Lanoxin), 0.25 mg by mouth daily, and furosemide (Lasix), 20 mg by mouth twice daily. The nurse instructs the client to notify the physician if nausea, vomiting, diarrhea, or abdominal cramps occur because these signs and symptoms may signal digoxin toxicity. Digoxin toxicity may also cause:

A. visual disturbances.
B. taste and smell alterations.
C. dry mouth and urine retention.
D. nocturia and sleep disturbances.

Correct Answer: A


Explanation: Digoxin toxicity may cause visual disturbances (such as, flickering flashes of light, colored or halo vision, photophobia, blurring, diplopia, and scotomata), central nervous system abnormalities (such as headache, fatigue, lethargy, depression, irritability and, if profound, seizures, delusions, hallucinations, and memory loss), and cardiovascular abnormalities (abnormal heart rate and arrhythmias). Digoxin toxicity doesn't cause taste and smell alterations. Dry mouth and urine retention typically occur with anticholinergic agents, not inotropic agents such as digoxin. Nocturia and sleep disturbances are adverse effects of furosemide — especially if the client takes the second daily dose in the evening, which may cause diuresis at night.

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Question Of The Day: The Neonate

Q. During the first feeding, the nurse observes that the neonate becomes cyanotic after gagging on mucus. Which of the following should the nurse do first?

A. Start mouth-to-mouth resuscitation.
B. Contact the neonatal resuscitation team.
C. Raise the neonate's head and pat the back gently.
D. Clear the neonate's airway with suction or gravity.

Correct Answer: D


Explanation: If a neonate gags on mucus and becomes cyanotic during the first feeding, the airway is most likely closed. The nurse should clear the airway by gravity (by lowering the infant's head) or suction. Starting mouth-to-mouth resuscitation is not indicated unless the neonate remains cyanotic and lowering his head or suctioning doesn't clear his airway. Contacting the neonatal resuscitation team is not warranted unless the infant remains cyanotic even after measures to clear the airway. Raising the neonate's head and patting the back are not appropriate actions for removing mucus. Doing so allows the mucus to remain lodged causing further breathing difficulties.

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Question Of The Day: Postpartum Period

Q. On the second postpartum day a gravida 6, para 5 complains of intermittent abdominal cramping. The nurse should assess for:

A. endometritis.
B. postpartum hemorrhage.
C. subinvolution.
D. afterpains.

Correct Answer: D


Explanation: In a multiparous client, decreased uterine muscle tone causes alternating relaxation and contraction during uterine involution, which leads to afterpains. The client's symptoms don't suggest endometritis, hemorrhage, or subinvolution.

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Question Of The Day: Substance Abuse, Eating Disorders, Impulse Control Disorders

Q. Which of the following is a priority during the first 24 hours of hospitalization for a comatose client with suspected drug overdose?

A. Educate regarding drug abuse.
B. Minimize pain.
C. Maintain intact skin.
D. Increase caloric intake.

Correct Answer: C


Explanation: Maintaining intact skin is a priority for the unconscious client. Unconscious clients need to be turned every hour to prevent complications of immobility, which include pressure ulcers and stasis pneumonia. The unconscious client cannot be educated at this time. Pain is not a concern. During the first 24 hours, the unconscious client will mostly likely be on nothing-by-mouth status.

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How to Maintain Positive Attitude in Nursing Profession

A Positive Attitude in Health Care: Mark it the thumb Rule

Your knowledge and aptitude landed you an excellent job. However these possible weren’t the one belongings that received you employed. Chances are high your enthusiasm and perspective performed a task, too. In a financial system with plenty of job seekers, employers are searching for individuals who can carry first-rate abilities to the desk, with a persona to match. In health care, that is very true a constructive perspective in health care actually counts. Your angle, because the care giver, could make a distinction in how your sufferers really feel. It’ll assist them really feel they're being cared for with compassion. A positive perspective will be infectious!

A positive attitude in health care professions can even impression your precise job efficiency. From coping with stress of the job, to managing your interpersonal relationships with co-workers, having a constructive demeanor is advantageous on many ranges. We are usually extra productive and inclined to do our greatest when we now have a constructive perspective—even in direction of undesirable assignments. What employer doesn’t respect that?

And, when you’re self-employed, you understand how vital a constructive perspective is to the success of your small business. It’s key!

However let’s be truthful. Sustaining a positive and upbeat angle always is tough to do—and that’s wonderful—so long as bouts of misery or negativity aren’t your norm. If you end up feeling destructive as a rule, it’s time to investigate the state of affairs and discover a resolution.

Causes of Negative Attitude Towards Nursing Profession

➨ Your first step is to get to the foundation of what’s inflicting your unhappiness at work.
➨ Are you continually disagreeing with a co-worker, or vice versa?
➨ Do you might have job burn-out?
➨ Did a patient say one thing that bothered you and also you’re having a tough time shaking it?
➨ Are you coping with a personal challenge that has nothing to do along with your job?
➨ Attempt to isolate the causes of your poor temper and search methods to alter these instigators.
➨ Your expectation versus actuality.

You may uncover that health care is unquestionably the place you’re speculated to be, however you simply haven’t discovered the proper job match but. Greater than possible, whenever you started your education to change into a health care skilled, you knew precisely what you needed to do upon your commencement…or so that you thought. Hopefully you probably did your homework and investigated the specifics of the job atmosphere and the place that job would take you. For those who didn’t, you may discover your expectation was a bit grander than the fact turned out to be. 

Earlier than you settle for a place in a health care facility, it’s necessary to ensure that you clearly perceive the expectations and necessities of the job. Some variant out of your preliminary expectation is suitable, but it surely attainable that different variations might be more durable to accommodate. In these instances, you would find yourself with a strained working relationship together with your employer, a nasty angle, and the potential to have a unfavorable impact on the care you give to your sufferers. To beat the problem, you’ll have to talk together with your boss to resolve the problems. Solely you'll know what changes will assist ease your discontentment.

For those who’re on the other finish of the spectrum and have been working for years, job burn-out can simply be the perpetrator. It's worthwhile to be recharged! Set yourself a objective to realize. Take a unbroken schooling class or attend a seminar to boost your experience, or study one thing new. Search for methods to enhance upon a course of that would profit your crew and decide find out how to greatest implement these adjustments. Lastly, discuss along with your boss or Human Assets in regards to the chance for development or openings in one other division. Generally it solely takes a small change to get again on monitor and motivated.

Advantages of a positive attitude

No matter what allied health care career you're employed in, a positive attitude could make a big effect in your profession and your success. It could actually assist to:

➨ Enhance the chance of optimum and constant efficiency. While you carry out at your greatest, you’re in a position to obtain the last word purpose in health care serving to your patients discover therapeutic and keep a wholesome life-style.
➨ Scale back accidents or unintentional incidents. In the event you’re in a foul temper, there’s an excellent likelihood that you simply’re mentally distracted by what’s bothering you, and you could not even notice it. While you aren’t targeted, you’re extra possible to offer less-than-your-best care. This will invite errors, damage and even accusations that you must’ve not delivered the care the patient anticipated.
➨ Earn a superb repute and advance in your profession. People with good attitudes are higher capable of deal with job stress and are extra constructive in approaching tough conditions. These are basic traits employers search for when contemplating workers for promotions and developments. It’s additionally a surefire method to get a glowing reference when you determine to vary jobs.
➨ Finally you're answerable for your attitude, and may select to be an optimist or a pessimist. You need to resolve how you'll let the world round you affect your perspective. Hopefully, you’ll discover pleasure in what you achieve this that a positive perspective is the rule, not the exception. As a result of a constructive angle in health care actually does matter.

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Question Of The Day: Psychotic Disorders

Q. A client with chronic undifferentiated schizophrenia is admitted to the psychiatric unit of a local hospital. During the next several days, the client is seen laughing, yelling, and talking to himself. This behavior is characteristic of:

A. delusion.
B. looseness of association.
C. illusion.
D. hallucination.

Correct Answer: D

Explanation: Auditory hallucination, in which one hears voices when no external stimuli exist, is common in schizophrenic clients. Such behaviors as laughing, yelling, and talking to oneself suggest such a hallucination. Delusions, also common in schizophrenia, are false beliefs or ideas that arise without external stimuli. Clients with schizophrenia may exhibit looseness of association, a pattern of thinking and communicating in which ideas aren't clearly linked to one another. Illusion is a less severe perceptual disturbance in which the client misinterprets actual external stimuli. Illusions are rarely associated with schizophrenia.

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What is the Need of Nursing Care Plan?

In nursing college, there may be probably no more hated class assignment than the nursing care plan. They’re assigned to each kind of sophistication, for intensive care sufferers, in psychological health, and even for neighborhood care. Nursing college students keep up all night time making ready patient-specific care plans for the following day’s scientific, however, why is that this agony inducing instrument nonetheless used so universally?

The Objective of the Written Care Plan

➨ Care plans a present route for individualized care of the shopper. A care plan flows from every affected person’s distinctive checklist of diagnoses and ought to be organized by the person’s particular wants.
➨ Continuity of care. The care plan is a method of speaking and organizing the actions of an always altering nursing workers. Because the affected person’s wants are attended to, the up to date plan is handed on to the nursing workers at shift change and through nursing rounds.
➨ Care plans assist train documentation. The care plan ought to particularly define which observations to make, what nursing actions to hold out, and what directions the consumer or members of the family require.
➨ They function information for assigning employees to look after the consumer. There could also be features of the affected person’s care that have to be assigned to workforce members with particular expertise.
➨ Care plans function information for reimbursement. Medicare and Medicaid initially set the plan in motion, and different third-party insurers adopted go well with. The medical report is utilized by the insurance coverage corporations to find out what they are going to pay for the hospital care obtained by the consumer. If nursing care is just not documented exactly within the care plan, there isn't proof the care was offered. Insurers won't pay for what just isn't documented.
➨ The aim of students creating care plans is to help them in pulling info from many alternative scientific disciplines as they are taught to assume critically and use the nursing course of to downside remedy. As a nursing pupil writes extra plans, the talents for pondering and processing info like knowledgeable nurse turn into extra successfully ingrained of their follow.

Care Plan Formats

The precise format for a nursing care plan varies barely from place to position. They're usually organized by 4 classes: nursing diagnoses or drawback listing; targets and consequence standards; nursing orders; and analysis.As outlined by the North American Nursing Analysis Group-Worldwide (NANDA-I), nursing diagnoses are scientific judgments about precise or particular potential person, household or group experiences or responses to well-being issues or life processes. A nursing prognosis is used to outline the fitting plan of look after the shop and drives interventions and affected person outcomes.

➨ Nursing diagnoses additionally present a normal nomenclature to be used in the Digital Medical Document (EMR), permitting for clear communication amongst care crew members and the gathering of information for steady enhancement in affected person care.
➨ Nursing diagnoses differ from medical diagnoses. A medical analysis — which refers to an illness course of — is made by a doctor and will probably be a situation that solely a health care provider can deal with. In distinction, a nursing analysis describes a shopper’s bodily, sociocultural, psychologic and nonsecular response to a sickness or potential well-being a drawback. For so long as an illness is current, the medical prognosis by no means modifications, however, a nursing analysis evolves because of the consumer’s responses change.
➨ The goal as established in a nursing care plan — when it comes to observable shopper responses — is what the nurse hopes to realize by implementing nursing orders. It's the desired end result or change within the consumer’s situation. The phrases purpose and end result are sometimes used interchangeably, however in some nursing literature, an objective is considered an extra normal assertion whereas the end result is extra particular. For instance, an objective could be that an affected person’s dietary standing will enhance general, whereas the result can be that the affected person will achieve 5 kilos by a sure date.

Nursing orders are directions for the precise actions that may carry out to assist the affected person to obtain the well-being cared objective. How detailed the order is dependent upon the well-being personnel who will perform the order. Nursing orders will all include:

The date

To assist college students study and apply their data, educators usually add yet another class to care plans. The rationale is the scientific motive for choosing a selected nursing motion. College students could also be required to quote supporting literature for his or her plan and rationale.
Care plans train nursing college students to assume critically, look after patients on an extra care, not as an illness or prognosis. They assist educate easy methods to prioritize care and interventions. They're a vital evil of nursing college, tried and true for instructing future nurses to not care, however, methods to present care that can enhance the consumer’s well-being standing.

An action verb like “monitor,” “instruct,” “palpate,” or one thing equally descriptive
A content material space that's the place and the what of the order, for instance, inserting a “spiral bandage on the left leg from ankle to simply under the knee.”

A time component will outline how lengthy or how usually the nursing motion will happen
The signature of the prescribing nurse, since orders are authorized paperwork.
Lastly, within the analysis, the consumer’s well-being care professionals will decide the progress in the direction of the objective achievement and the effectiveness of the nursing care plan. The analysis is extraordinarily vital as a result of it determines if the nursing interventions need to be terminated, continued or modified.

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Question Of The Day: School-age Child

Q. A 10-year-old with glomerulonephritis reports a headache and blurred vision. The nurse should immediately:

A. Put the client to bed.
B. Obtain the child's blood pressure.
C. Notify the physician.
D. Administer acetaminophen (Tylenol).

Correct Answer: B

Explanation: Hypertension occurs with acute glomerulonephritis. The symptoms of headache and blurred vision may indicate an elevated blood pressure. Hypertension in acute glomerulonephritis occurs due to the inability of the kidneys to remove fluid and sodium; the fluid is reabsorbed, causing fluid volume excess. The nurse must verify that these symptoms are due to hypertension. Calling the physician before confirming the cause of the symptoms would not assist the physician in his treatment. Putting the client to bed may help treat an elevated blood pressure, but first the nurse must establish that high blood pressure is the cause of the symptoms. Administering Tylenol for high blood pressure is not recommended.

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Question Of The Day: Preschooler

Q. After discussing asthma as a chronic condition, which of the following statements by the father of a child with asthma best reflects the family's positive adjustment to this aspect of the child's disease?

A. "We try to keep him happy at all costs; otherwise, he has an asthma attack."
B. "We keep our child away from other children to help cut down on infections."
C. "Although our child's disease is serious, we try not to let it be the focus of our family."
D. "I'm afraid that when my child gets older, he won't be able to care for himself like I do."

Correct Answer: C


Explanation: Positive adjustment to a chronic condition requires placing the child's illness in its proper perspective. Children with asthma need to be treated as normally as possible within the scope of the limitations imposed by the illness. They also need to learn how to manage exacerbations and then resume as normal a life as possible. Trying to keep the child happy at all costs is inappropriate and can lead to the child's never learning how to accept responsibility for behavior and get along with others. Although minimizing the child's risk for exposure to infections is important, the child needs to be with his or her peers to ensure appropriate growth and development. Children with a chronic illness need to be involved in their care so that they can learn to manage it. Some parents tend to overprotect their child with a chronic illness. This overprotectiveness may cause a child to have an exaggerated feeling of importance or later, as an adolescent, to rebel against the overprotectiveness and the parents.

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Question Of The Day: Toddler

Q. A child with a poor nutritional status and weight loss is at risk for a negative nitrogen balance. To help diagnose this problem, the nurse anticipates that the physician will order which laboratory test?

A. Total iron-binding capacity
B. Hemoglobin (Hb)
C. Total protein
D. Sweat test

Correct Answer: C

Explanation: The nurse anticipates the physician will order a total protein test because negative nitrogen balance may result from inadequate protein intake. Measuring total iron-binding capacity and Hb levels would help detect iron deficiency anemia, not a negative nitrogen balance. The sweat test helps diagnose cystic fibrosis, not a negative nitrogen balance.

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Question Of The Day: Infant

Q. Which of the following should the nurse use to determine achievement of the expected outcome for an infant with severe diarrhea and a nursing diagnosis of Deficient fluid volume related to passage of profuse amounts of watery diarrhea?

A. Moist mucous membranes.
B. Passage of a soft, formed stool.
C. Absence of diarrhea for a 4-hour period.
D. Ability to tolerate intravenous fluids well.

Correct Answer: A

Explanation: The outcome of moist mucous membranes indicates adequate hydration and fluid balance, showing that the problem of fluid volume deficit has been corrected. Although a normal bowel movement, ability to tolerate intravenous fluids, and an increasing time interval between bowel movements are all positive signs, they do not specifically address the problem of deficient fluid volume.

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Question Of The Day: The Nursing Process

Q. A nurse is caring for a client with a diagnosis of Impaired gas exchange. Based upon this nursing diagnosis, which outcome is most appropriate?

A. The client maintains a reduced cough effort to lessen fatigue.
B. The client restricts fluid intake to prevent overhydration.
C. The client reduces daily activities to a minimum.
D. The client has normal breath sounds in all lung fields.

Correct Answer: D

Explanation: If the interventions are effective, the client's breath sounds should return to normal. The client should be able to cough effectively and should be encouraged to increase activity, as tolerated. Fluids should help thin secretions, so fluid intake should be encouraged.

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Question Of The Day: Basic Psychosocial Needs

Q. A worried mother confides in the nurse that she wants to change physicians because her infant is not getting better. The best response by the nurse is which of the following?

A. "This doctor has been on our staff for 20 years."
B. "I know you are worried, but the doctor has an excellent reputation."
C. "You always have an option to change. Tell me about your concerns."
D. "I take my own children to this doctor."

Correct Answer: C

Explanation: Asking the mother to talk about her concerns acknowledges the mother's rights and encourages open discussion. The other responses negate the parent's concerns.

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Question Of The Day: Basic Physical Care

Q. A nurse takes informed consent from a client scheduled for abdominal surgery. Which of the following is the most appropriate principle behind informed consent?

A. Protects the client's right to self-determination in health care decision making.
B. Helps the client refuse treatment that he or she does not wish to undergo.
C. Helps the client to make a living will regarding future health care required.
D. Provides the client with in-depth knowledge about the treatment options available.

Correct Answer: A

Explanation: Informed consent protects the client's right to self-determination in health care decision making. Informed consent helps the client to refuse a treatment that the client does not wish to undergo and helps the client to gain in-depth knowledge about the treatment options available, but the most important function is to encourage shared decision making. Informed consent does not help the client to make a living will.

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Question Of The Day: Gastrointestinal Disorders

Q. A client who has a history of Crohn's disease is admitted to the hospital with fever, diarrhea, cramping, abdominal pain, and weight loss. The nurse should monitor the client for:

A. Hyperalbuminemia.
B. Thrombocytopenia.
C. Hypokalemia.
D. Hypercalcemia.

Correct Answer: C


Explanation: Hypokalemia is the most expected laboratory finding owing to the diarrhea. Hypoalbuminemia can also occur in Crohn's disease; however, the client's potassium level is of greater importance at this time because a low potassium level can cause cardiac arrest. Anemia is an expected development, but thrombocytopenia is not. Calcium levels are not affected.

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Question Of The Day: The Nursing Process

Q. When developing a care plan for a client with a do-not-resuscitate (DNR) order, a nurse should:

A. withhold food and fluids.
B. discontinue pain medications.
C. ensure access to spiritual care providers upon the client's request.
D. always make the DNR client the last in prioritization of clients.

Correct Answer: C

Explanation: Ensuring access to spiritual care, if requested by the client, is an appropriate nursing action. A nurse should continue to administer appropriate doses of pain medication as needed to promote the client's comfort. A health care provider may not withhold food and fluids unless the client has a living will that specifies this action. A DNR order does not mean that the client does not require nursing care.

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Question Of The Day: Gastrointestinal Disorders

Q. Which of the following laboratory findings are expected when a client has diverticulitis?

A. Elevated red blood cell count.

B. Decreased platelet count.

C. Elevated white blood cell count.

D. Elevated serum blood urea nitrogen concentration.

Correct Answer: C

Explanation: Because of the inflammatory nature of diverticulitis, the nurse would anticipate an elevated white blood cell count. The remaining laboratory findings are not associated with diverticulitis. Elevated red blood cell counts occur in clients with polycythemia vera or fluid volume deficit. Decreased platelet counts can occur as a result of aplastic anemias or malignant blood disorders, as an adverse effect of some drugs, and as a result of some heritable conditions. Elevated serum blood urea nitrogen concentration is usually associated with renal conditions.

  

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Safety Issues In Nursing Profession

The protection of nurses from workplace-induced injuries and diseases is common in the nursing profession, nurses get infections in addition to the patients they serve. The presence of wholesome and well-rested nurses is vital to offering monitoring, empathic affected person care, and vigorous advocacy. Many office stressors that may produce illnesses and accidents are current in nursing work environments. These stressors include factors associated with the rapid work context, traits of the organization and modifications which might be occurring exteriorly to the group however all through the health care business.

Nurses expertise important bodily and psychological calls for throughout their day, in addition to a piece security local weather that may be opposed. Pressures inside organizations to downsize, use nurses employed underneath various preparations (pool and touring workers), and the turnaround time for affected person care (early discharge, larger affected person hundreds) are examples of things which are decided at an organizational degree. The exterior context inside which nurses observe contains lean managed care contracts, growing used of advanced technological improvements, an older nurse workforce, and growing numbers of very sick aged sufferers (aging inhabitants). Elements at every of those ranges can produce threats to nurses’ security whereas on the job.

The hazards of nursing work can impair health care each acutely and in the long run. These health care outcomes embody musculoskeletal accidents/problems, different accidents, infections, modifications in psychological health care, and in the long run, cardiovascular, metabolic, and neoplastic illnesses.


These stressors embrace features of the best way work is organized in nursing (e.g., shift work, lengthy hours, and additional time) and psychological job calls for, comparable to work tempo. As well as, elements of direct care work that affect nurse security will probably be mentioned, together with the influence of bodily job calls for reminiscent of affected person lifting and awkward postures, protecting units to stop needle sticks, chemical occupational exposures, and a potential for violence. The place potential, interventions which have demonstrated effectiveness to scale back the danger of sickness and harm will likely be introduced, in addition to gaps in data that may spur new traces of analysis inquiry.

Healthcare expertise evolving, however, nurses stay burdened by legacy bodily challenges, in line with the latest survey.60 % of nurses fear their jobs are negatively impacting their total well-being, and 12 % of nurses have been injured on the job before now 12 months. These are of some of the statistics revealed at the moment in Ergotron’s first survey, exploring challenges nurses face on the job.

“Nurses play an important function within the supply of affected person care, and their insights assist us higher perceive the state of nursing at this time and what may be accomplished to enhance scientific affected person care and confidence transferring ahead,” mentioned Steve Reinecke, MT (CLS) CPHIMS, AVP of Healthcare at Ergotron. Whereas U.S. healthcare continues its radical digital transformation, with nurses typically on the forefront particularly relating to using digital health care data (EHRs), little else has modified on the bodily facet of day-to-day, real-time nursing care.
Nurse injuries have been properly documented, however, what is usually not addressed is how their accidents and bodily discomfort immediately impacts affected person care. The findings present:

• They're much less pleasant or partaking with their sufferers (22 p.c)

• They've to change or restrict their exercise/motion on the job (22 %)

• They wanted extra help from different workers (14 %)
Nurses report seeing some great benefits of EHRs within the survey, and nearly all of them really feel snug utilizing know-how. Nevertheless, the most important problem is creating an atmosphere that caters to the wants of the nurse. When requested what they might change:
• 54 p.c stated they might improve nursing workers to alleviate workloads

• 28 % would instate a devoted ergonomics workforce to assist guarantee tools is ergonomically supportive to the workers

• 28 p.c would re-design the bodily house inside affected person rooms and on flooring to higher align with scientific workflow and affected person wants

• 25 % would replace the furnishings on the nursing station

• 24 % would replace medical tools and furnishings within the affected person room

• 22 p.c would implement extra point-of-care options all through the ground with sit-to-stand performance.

These findings challenge healthcare organizations to implement options to guard the wellbeing of nursing sources whereas creating the sort of surroundings that brings the affected person and caregiver collectively for elevated interplay, satisfaction, safety, and efficiency.

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Question Of The Day: The Nursing Process

Q. The nurse is caring for a client with asthma. The nurse should conduct a focused assessment to detect which of the following?

A. Increased forced expiratory volume.
B. Normal breath sounds.
C. Inspiratory and expiratory wheezing.
D. Morning headaches.

Correct Answer: C


Explanation: The hallmark signs of asthma are chest tightness, audible wheezing, and coughing. Inspiratory and expiratory wheezing is the result of bronchoconstriction. Even between exacerbations, there may be some soft wheezing, so a finding of normal breath sounds would be expected in the absence of asthma. The expected finding is decreased forced expiratory volume [forced expiratory flow (FEF) is the flow (or speed) of air coming out of the lung during the middle portion of a forced expiration] due to bronchial constriction. Morning headaches are found with more advanced cases of COPD and signal nocturnal hypercapnia or hypoxemia.

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Question Of The Day: Gastrointestinal Disorders

Q. A home health nurse who sees a client with diverticulitis is evaluating teaching about dietary modifications necessary to prevent future episodes. Which statement by the client indicates effective teaching?

A. "I'll increase my intake of protein during exacerbations."
B. "I should increase my intake of fresh fruits and vegetables during remissions."
C. "I'll snack on nuts, olives, and popcorn during flare-ups."
D. "I'll incorporate foods rich in omega-3 fatty acids into my diet."

Correct Answer: B

Explanation:  A client with diverticulitis needs to modify fiber intake to effectively manage the disease. During episodes of diverticulitis, he should follow a low-fiber diet to help minimize bulk in the stools. A client with diverticulosis should follow a high-fiber diet. Clients with diverticular disease don't need to modify their intake of protein and omega-3 fatty acids.

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Question Of The Day: The Nursing Process

Q.  A nurse is developing a nursing diagnosis for a client. Which information should she include?

A. Actions to achieve goals
B. Expected outcomes
C. Factors influencing the client's problem
D. Nursing history

Correct Answer:  C


Explanation:  A nursing diagnosis is a written statement describing a client's actual or potential health problem. It includes a specified diagnostic label, factors that influence the client's problem, and any signs or symptoms that help define the diagnostic label. Actions to achieve goals are nursing interventions. Expected outcomes are measurable behavioral goals that the nurse develops during the evaluation step of the nursing process. The nurse obtains a nursing history during the assessment step of the nursing process.

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How to Prepare for NCLEX – RN Exam

We are all responsible for delaying in exam preparations, right? Properly, you'll be able to research for the NCLEX-RN in a single week however I wouldn’t suggest it as a procedure for success.  With the intention to take the NCLEX-RN, the applying course of and test scheduling can take a few weeks to some months depending on what state you might be in.  You've loads of time from the once you apply to whenever you truly take the test to set up a preparation schedule that can suit your wants. However, let’s simply say that you must've to delay finding out and now your check is every week away. Hope for your best. Listed here are some ways for NCLEX-RN preparation…FAST!

1. When should I begin studying?

The typical USA nursing scholar begins finding out 2-3 months previous to the NCLEX, with a lot of the effort being spent a month or so previous to the check. There are some college students who solely examine for 1-3 weeks and nonetheless go. However, this places you at an enormous threat for failing. We don't advocate this strategy however we all know just a few college students who've made it work. Worldwide college students taking the NCLEX often start learning 5-6 months previous to their examination however there may be vast variability relying on your background.

2. What's the finest methodology for studying?

Everybody prepares a bit completely different however there are some key issues to recollect when finding out for the NCLEX: - When finding out for the NCLEX, don't reread all of your nursing college notes. You don’t want that a lot of info to go, the NCLEX is common information. Simply obtain an app like NCLEX Mastery to observe NCLEX model questions. - Deal with key topics that you simply wrestle with. If you're glorious at medical/surgical nursing, however, don't have any expertise with labor and supply, then give attention to labor and supply. This can be extra painful. However, it's going to repay in the long run. - It's a lot simpler to check a small quantity every day for a pair months than to try to cram proper earlier than. Not solely is it much less aggravating, however, for a similar quantity of labor you'll have way more long run retention and check efficiency. Discover a research software you'll be able to use conveniently. - Different format questions are showing extra often within the check plan, particularly “choose all that apply” kind questions. Be sure you observe these, as they are typically harder than regular NCLEX questions.

3. Do I need to master every part to cross? What's the go/fail percent? How tough is the test?

The NCLEX is a troublesome examination with tens of hundreds of doable questions that could be requested. It isn't life like or good to attempt to study everything. As an alternative, do follow questions or use an up-to-date examine support that focuses on excessive yield subjects? Most questions are detailed and particular, not common or broad concepts/ideas.

The check is tougher than most anticipate so don't take it evenly or assume that passing can be straightforward. As talked about earlier than the questions are very particular and detailed. A big chunk of candidates strolls out feeling like they failed. However, a majority move the take a look at (90.35%).

4. What's the test structure like? How a lot of time do I've for the test and are there breaks?

The NCLEX is a variable size computerized adaptive take a look at, having wherever from 75 to 265. 15% of the questions are pretest objects that aren't scored. Loads of the questions ask the scholar to use data from some disciplines. Practice with online sample questions, together with a brief tutorial, two elective breaks, and any unscheduled breaks chances are you'll take. The ending is usually not an issue until you get greater than 200 questions.

5. When and the way do I register for boards? Can I reschedule?

Click on this hyperlink to view the candidate bulletin, it would give you all the knowledge you want: https://www.ncsbn.org/1213.htm

6. What are the test requirement and what am I allowed/not allowed to convey for the NCLEX?

The amenities are extremely strict and prohibit all private objects resembling cell telephones, luggage, purses, coats, hats, gum, drink, watches, and many others. See the candidate bulletin hyperlink above for extra info.

7. How early ought to I arrive on the take a look at the facility?

The very best thought is to get there 30-40 minutes early so you may get settled in and really feel as comfy as doable earlier than the take a look at. There's typically a big line of individuals on the facility.

8. How do I get into peak situation on taking a look at day?

We suggest making ready to your examination like runners put together for a marathon with correct vitamin, sleep, and coaching to simulate the situations you might be about to place your physique via.

➠ Eat nutritious meals - advanced carbohydrates, greens and protein optimize power ranges for the lengthy day of focus.

➠ Have a small quantity of caffeine - Scientific research persistently present that reasonable consumption caffeine improves efficiency, however, extreme consumption has a destructive impact.

➠ Keep away from sugary meals - Refined sugars are related to a spike in vitality, adopted by a pointy decline in cognitive capability.

➠ Apply concentrating for a prolonged time period - It's sensible to extend your research length within the days previous to the take a look at in an effort to deal with the fatigue positioned in your mind by concentrating for therefore lengthy.

➠ Train the morning of the check - Train improves blood stream to the mind thus optimizing your capabilities on check day.

9. How I get my results, what happen if I fail?

Assessments are scored in batches so you may anticipate attending a variable period of time after you are taking your examination to see your result. Sometimes, you possibly can anticipate attending about one month. You can even get your “unofficial” result after 48 enterprise hours by the fast result service out there on the NCLEX Candidate web site at www.pearsonvue.com/nclex

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Question Of The Day: Antepartum Period

Q. The nurse has discussed sexuality issues during the prenatal period with a primigravida who is at 32 weeks' gestation. She has had one episode of preterm labor. The nurse determines that the client understands the instructions when she says:

A. "I can resume sexual intercourse when the bleeding stops."
B. "I should not get sexually aroused or have any nipple stimulation."
C. "I can resume sexual intercourse in 1 to 2 weeks."
D. "I should not have sexual intercourse until my next prenatal visit."

Correct Answer: B

Explanation: This client has already had one episode of preterm labor at 32 weeks' gestation. Sexual intercourse, arousal, and nipple stimulation may result in the release of oxytocin which can contribute to continued preterm labor and early delivery. The client should be advised to refrain from these activities until closer to term, which is 6 to 8 weeks later. Telling the client that intercourse is acceptable after the bleeding stops is incorrect and may lead to early delivery of a preterm neonate. The client should not have intercourse for at least 6 weeks because of the danger of inducing labor. There is no indication when the client's next prenatal visit is scheduled.

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How to Cope-up with the Challenges in Nursing Profession?

Healthcare professionals are challenged each day with quite a lot of stressors as they look after patients. These job-related stresses can take a toll on the thoughts and physique of those professionals, which in flip might have an effect on the standard of affected person care and outcomes. Work-related stress might also influence job satisfaction, workforce stability, and security within the healthcare setting.

Nurses, for one, have to feel stress and overwork as considered one of their prime issues throughout the occupation. Work schedules that embody lengthy shifts and inadequate staffing are two components recognized by nurses that improve stress ranges. Nurses and different professionals want to concentrate on the stresses related to intense scientific settings and difficult work schedules.

Healthcare professionals work in demanding conditions, maintain excessive expectations for themselves, and imagine they need to be capable of deal with something it doesn't matter what the problem. Thankfully, job-related stress is each “treatable” and preventable. Professionals can be taught to deal with stress and burnout by gaining an understanding of stress and stressors, recognizing the indicators and signs of job burnout, buying abilities to handle it is harmful results, and stopping its incidence sooner or later.

WHAT IS STRESS?

“Stress” is the term used to explain a wide range of physiological and psychological stimuli that trigger a physiological response. The thought of stress started with the pioneering work of Walter Cannon (1871–1945). He investigated the sympathetic nervous system because it reacted to the warmth and seen that the physique responds in a predictable sequence.

The stress response was first described in 1956 by Hans Selye. In his analysis, he separated the bodily results of stress from different bodily signs, observing that patients suffered bodily results not prompted instantly by their illness or by their medical situation. Selye discovered that stressors could also be bodily (resembling an infection, damage, and ache) or psychological (similar to concern, anger, and disappointment).He recognized what he referred to as a basic adaptation syndrome, whereby the physique seeks to take care of homeostasis, or stability. He divided his basic adaptation syndrome into three phases:

➠Alarm response, the place the physique detects the exterior stimulus
➠Adaptation, the place the physique engages defensive countermeasures towards the stressor
➠Exhaustion, the place the physique begins to expire of defenses

Stress can have a significant effect on the bodily functioning of the human physique. It raises the extent of adrenaline and corticosterone, which in flip will increase the guts price, respiration, and blood stress and places extra bodily stress on bodily organs. Within the quick time period, this permits an individual to carry out at ranges past their regular limits. However, as soon as exhaustion is reached, even the strongest motivation loses its impact.

HOW DO WE DEAL WITH STRESS?

Lazarus (1966) expanded our understanding of stress and the methods individuals took care of it when he noticed that, when people view a brand new or evolving scenario, they first resolve whether or not it's a menace. He was known as this main appraisal. Then, as individuals additional monitor a menace, they consider their capability to deal with it by what Lazarus knew as secondary appraisal. On this second step of appraisal, people decide themselves unable to deal with the state of affairs and withdraw.

Professionals working in intense scientific areas the place the stakes are excessive are extra vulnerable to imagine they “ought to” be capable of deal with something and try to take action, regardless of how nice the fee to their physique. These people are at excessive threat of reaching the top stage of stress: exhaustion.

As a substitute of persisting till they attain the state of exhaustion, healthcare professionals can be taught simpler coping methods, turn out to be self-aware, acknowledge their very own limitations, and purchase emotion-regulation and problem-solving expertise.

Leaders can present bodily and emotional help for employee’s members as a solution to present help and acknowledge the worth of their position and perceive the nerve-racking nature of their work. Work-life steadiness packages can present a deal with wellness assets with methods to stop and handle the stress of working in intense healthcare surroundings.

CONCLUSION

Stress and burnout considerably have an effect on particular person health care professionals, the organizations for which they work, and the individuals to whom they offer care. These circumstances are particularly frequent in healthcare professionals due to the demanding nature of the work, the private traits of caregivers, and the expectations of the managers of healthcare organizations.

Job-related stress and burnout immediately have an effect on each the healthcare skilled, the standard of affected person care, and healthcare establishments. By understanding and addressing their causes, job-related stress will be decreased. Each particular person and institutional methods will also be employed to forestall burnout, thereby making a healthier atmosphere for each healthcare professionals and patients.

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Question Of The Day: The Nursing Process

Q. During the health history interview, which of the following strategies is the most effective for the nurse to use to help clients take an active role in their health care?

A. Ask clients to complete a questionnaire.
B. Provide clients with written instructions.
C. Ask clients for their description of events and for their views concerning past medical care.
D. Ask clients if they have any questions.

Correct Answer: C

Explanation: One of the best strategies to help clients feel in control is to ask them their view of situations, and to respond to what they say. This technique acknowledges that clients' opinions have value and relevance to the interview. It also promotes an active role for clients in the process. Use of a questionnaire or written instructions is a means of obtaining information but promotes a passive client role. Asking whether clients have questions encourages participation, but alone it does not acknowledge their views.

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Question Of The Day: Gastrointestinal Disorders

Q. Which of the following client statements indicates that the client with hepatitis B understands discharge teaching?

A. "I will not drink alcohol for at least 1 year."
B. "I must avoid sexual intercourse."
C. "I should be able to resume normal activity in a week or two.
D. "Because hepatitis B is a chronic disease, I know I will always be jaundiced."

Correct Answer: A


Explanation: It is important that the client understand that alcohol should be avoided for at least 1 year after an episode of hepatitis. Sexual intercourse does not need to be avoided, but the client should be instructed to use condoms until the hepatitis B surface antigen measurement is negative. The client will need to restrict activity until liver function test results are normal; this will not occur within 1 to 2 weeks. Jaundice will subside as the client recovers; it is not a permanent condition.

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Question Of The Day: Antepartum Period

Q. A client in the triage area who is at 19 weeks' gestation states that she has not felt her baby move in the past week and no fetal heart tones are found. While evaluating this client, the nurse identifies her as being at the highest risk for developing which problem?

A. Abruptio placentae.
B. Placenta previa.
C. Disseminated intravascular coagulation.
D. Threatened abortion.

Correct Answer: C

Explanation: A fetus that has died and is retained in utero places the mother at risk for disseminated intravascular coagulation (DIC) because the clotting factors within the maternal system are consumed when the nonviable fetus is retained. The longer the fetus is retained in utero, the greater the risk of DIC. This client has no risk factors, history, or signs and symptoms that put her at risk for either abruptio placentae or placenta previa, such as sharp pain and "woody," firm consistency of the abdomen (abruption) or painless bright red vaginal bleeding (previa). There is no evidence that she is threatening to abort as she has no complaints of cramping or vaginal bleeding.

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Question Of The Day: Neurosensory Disorders

Q. Which of the following statements would provide the best guide for activity during the rehabilitation period for a client who has been treated for retinal detachment?

A. Activity is resumed gradually, and the client can resume her usual activities in 5 to 6 weeks.
B. Activity level is determined by the client's tolerance; she can be as active as she wishes.
C. Activity level will be restricted for several months, so she should plan on being sedentary.
D. Activity level can return to normal and may include regular aerobic exercises.

Correct Answer:  A

Explanation: The scarring of the retinal tear needs time to heal completely. Therefore, resumption of activity should be gradual; the client may resume her usual activities in 5 to 6 weeks. Successful healing should allow the client to return to her previous level of functioning.

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Tips to Perform Night Shift: Nursing

Working in the health area, nurses understand they are at risk for a lot of issues in the event that they work late at night time or into the early morning. However for many who have been doing the evening shift for some time, they've some nice recommendation to bestow upon others on how one can maintain comfortable and wholesome regardless of the challenges in opposition to them.

“It’s about having the best angle,” stated Felicia Rasmussen of Lincoln, Neb. She lately spent two years on the evening shift as a RN on the Tabitha Nursing and Rehabilitation Middle. “If you're enthusiastic about what you do, the hours are irrelevant. It's about being the very best nurse you'll be able to and giving one of the best care to your sufferers.”

However it is usually about being the perfect you might be to your self and your loved ones, she says.

Listed below are some survival ideas for being a nurse on the night time shift.

Food for Thought

It could be really easy to simply decide one thing as much as eat on the hospital every evening. However, Michelle Diederich, registered nurse on the Iowa Methodist Hospital in Des Moines, brings her personal lunch to work most nights.

“By doing this, I'm able to make more healthy decisions. I additionally attempt to restrict myself from going to the cafeteria at work to not more than twice a month. By doing this, I eat much less fried greasy meals in the midst of the night time,” she says.

Rasmussen labored the 10 p.m.- 6:30 a.m. shift. Each evening, she would eat dinner together with her household, after which eat a light-weight breakfast corresponding to toast when she acquired house within the morning earlier than heading to mattress.

“I attempted to not snack loads by my shift as a result of generally you will be extra sedentary throughout the night time shift,” she explains.

Savvy Sleeping

Investing in blackout drapes for her bed room was the most effective factor Rasmussen ever did whereas working the evening shift.

“It actually aided me in my capacity to sleep in the course of the day hours. Plus, I might go to mattress straight away once I bought house so I'd be up by the afternoon for when my children obtained residence from college,” she says.

If she needed to make appointments for her youngsters or herself, she would make them as early within the morning after she received off of her shift. This fashion, for the remainder of her day, she had time to compensate for her sleep.

Diederich wears earplugs to assist her block out daytime noises such because the canine barking and garden mowing.

“When I've to modify my sleep sample to sleep at night time after working all week, I guarantee that I stand up early within the afternoon in order that I can go to mattress at an inexpensive bedtime. I usually take melatonin to assist me sleep at night time,” she says.

By going to mattress the identical time each morning and getting up on the similar time each night, she avoids being drowsy throughout her shift. Typically, life will get in the way in which and that standard sleep sample will get interrupted.

“Broken sleep is tough to make up. It virtually tires you extra to attempt to make up for the sleep you misplaced,” Rasmussen says.

Family Affair

Diederich and her husband work completely different hours most days.“Often, we solely have a few hours a day collectively. I needed to study the mindset that high quality of time is extra vital than an amount of time collectively,” she states.She additionally permits for “me” time.“I ensure that I take a time to do issues only for myself, whether or not it will be the fitness center, studying an e-book or watching my favorite present on tv.”

Rasmussen and her husband dedicated one evening every week for a date night time whereas she labored nights.“You actually should work at your relationships. You could maintain linked and plan issues on your days off with them,” she says.
If there's a household birthday developing or another celebration, her household has simply adjusted their schedules.

“My household simply made certain that they do the celebration after I get up from sleeping that day and earlier than I went to work,” Rasmussen says. “And naturally, there are occasions I've needed to work Christmas or another vacation. We simply discovered what time everybody was out there and schedule it then. It does take a supportive household to do the evening shift.”

Needs of Night time-Patients

Typically sufferers who aren’t usually confused with the day can change into confused at evening, Diederich says.“Their households have all gone house for the evening. The lights exit for the night time and they're in a weird setting. They could want a bit extra reassurance from the nursing workers,” she reveals.
Rasmussen bumped into the identical state of affairs along with her aged sufferers at Tabitha.“There are at all times plenty of duties to do at night time. However you at all times get a little bit extra time with the sufferers and often relationships are created. We had the chance to take a seat down and speak and reminisce with them,” she says. “Should you had a hospice affected person, you can sit and maintain their hand. I am beloved working in long-term care and geriatrics. It was a possibility for me to present again and be current with them.”

Keep Close to Co-Staff

Rasmussen misses the camaraderie she discovered together with her evening shift co-workers.“Once we had time to have talks with one another about private issues and household, then that’s once we obtained very shut. We additionally would discover humor the place we might. Evening shift employees are distinctive folks,” she says.

She's always going to remember one of many nurses’ aides who was just like the mom hen of the group. She would herald snacks on a regular basis, manage potlucks and do different good issues for everybody to maintain the group cohesively.

“We might snort at one another and joke around. We'd do lunges down the hallway to maintain in form, and I used to be recognized for dancing down the hallways simply to have enjoyable with the opposite worker's members,” she says.

Diederich says she enjoys her co-workers, too, and that makes going to work a lot simpler.

“Most significantly although, I get pleasure from my job,” she says.

Balancing Beam

Attempting to get that good work/life stability whereas being an evening shifter is usually a robust haul. However, Rasmussen says it’s all about planning forward. “Simply get in a cycle of sleeping the identical hours every day. It's essential to change your physique into pondering that this is similar as different folks do however at completely different hours,” she says.

Sticking to your schedule even on the times you don’t work may help your physique and thoughts feel regular. The night time shift may cause havoc together with your social life, sleeping patterns and relationships if you happen to don’t prioritize your wants together with sleep, good meals, train, household time and open thoughts.

Rasmussen and Diederich say that engaged on the in a single day shift can be a good time to construct sturdy connections with co-workers and sufferers and be taught much more about yourself as a nurse and your targets sooner or later.

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Question Of The Day: Gastrointestinal Disorders

Q. A nurse preceptor is working with a student nurse who is administering medications. Which statement by the student indicates an understanding of the action of an antacid?

A. "The action occurs in the stomach by increasing the pH of the stomach contents and decreasing pepsin activity."
B. "The action occurs in the small intestine, where the drug coats the lining and prevents further ulceration."
C. "The action occurs in the esophagus by increasing peristalsis and improving movement of food into the stomach."
D. "The action occurs in the large intestine by increasing electrolyte absorption into the system that decreases pepsin absorption."

Correct Answer: A

Explanation: The action of an antacid occurs in the stomach. The anions of an antacid combine with the acidic hydrogen cations secreted by the stomach to form water, thereby increasing the pH of the stomach contents. Increasing the pH and decreasing the pepsin activity provide symptomatic relief from peptic ulcer disease. Antacids don't work in the large or small intestine or in the esophagus.

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