Friday, January 16, 2009

Nclex Review at School

Today my college had a nice Lady from Drexel come in and teach us about the nclex exam Its a monster of an exam. I am going to talk about the things that struck me most.

  • Its never to early to start thinking about nclex because testing in nursing school is based on the nclex model
  • Answer as many nclex questions as possible thats the way to find out what your weaknesses are and fix the problem therefore increasing your chances of doing well at nclex and school exams
  • Nclex is checking 2 things if you can prioritize (remember the nursing process) and if you are safe (thinking critically)

These are just my thoughts on the whole nclex thing so now i will talk about what i learned from the whole class

  • Time Frame : Always look at the time frame in the question e.g pre-op, post-op, early, late. One thing she told us that is probably going to stick with me is that time frame is important because of anasthesia .It may take up to 72hrs for anasthesia to wear off. E.g client comes in 1hr post-op
  • Safety: When you see you see the word ESSENTIAL in a question its a question thats targeting safety of the patient and you answer this question using maslows hierarchy and when you see INITIAL ACTION in a question you need to use the nursing process and the INITIAL action in the nursing process is ASSESSMENT
  • Terminologies : sometimes you may have no idea what a question is about stick with whatever is familiar to you and learn terminologies they may give you an idea about whjat the answer is. We had one question in the class that had to do with costochondritis and one of the answers had chest in it. That was the one i picked because i knew the sternum and ribs have costochondrial joints and my answer was correct. Some terminologies are blph for the eyes, cephal for head and cost for chest.
  • Repeated words: words you see in the questions which are repeated in the answers. They point to the correct answer.
  • Opposite answers: If in the options you have 2 answers that are oppostites, one of them is probably right e.g increased respiration and decreased respiration.
  • Positioning: questions with nausea, drainage,swelling and pain may have answers that involve positioning. E.g clients are positioned on their sides if theres going to be nausea.
  • Therapeutic communication: When asked questions like what is the best way for the nurse to respond? For this listen to the therapeutric communication tutorial on this website. It must be open ended and not be advice or corny stuff like "you are going to be cured".
  • Odd answers: sometimes on answer just sticks out at you.That may be the right one because where all the other 3 answers aree similar this one is starkly different.
  • Umbrella answer: you probably know this one.. the answer that covers all the other answers e.g we had one question with different ways to reduce pain and one umbrella asnwer that said reduce clients perception of pain. The umbrella answer was right because it included all the other 3 answers which were ways to reduce the clients perception of pain.
  • Delegation : is important as well you need to know what can be delegated and what cannot
  • Physical exam: you need to know your health assessment because they ask you to click on areas of the body where you assess maybe the apical pulse.
  • Finally there are the words to look out for. The deadly, dangerous and safe words in the answers. Deadly words are absolute type words like never, always , all they are found in answers that are more likely to be WRONG along with the dangerous word. E.g you cannot say that ALL clients in the hospital get ROM excercises. Not every client needs ROM excercises. Safe words are found in answers that are most probably right.

  • Deadly

  • Dangerous words are
  • main
  • Safe words are

These are the stuff i remeber. Its important to remember to use ABC, ADPIE and MASLOW to prioritize. You need to know Digoxin inside out and pathophysiology and pharmacology are going to be important. Everything we learn will be tested so basic nursing knowledge is important but critical thinking within the nursing process is important. I guess everything is important!

Thursday, January 15, 2009

Links to fundamentals of nursing audio lectures

These are links to very detailed audio summaries in fundamentals of nursing from fa davis.

Unit 1: How Nurses Think

1. Evolution of Nursing Thought & Action
2. Critical Thinking & the Nursing Process
3. Nursing Process: Assessment
4. Nursing Process: Diagnosis
5. Nursing Process: Planning Outcomes
6. Nursing Process: Planning Interventions
7. Nursing Process: Implementation & Evaluation
8. Nursing Theory & Research

Unit 2: Factors Affecting Health

9. Growth and Development Through the Life Span
10. Experiencing Health & Illness
11. IllnessPsychosocial Health & Illness
12. The Family
13. Culture & Ethnicity
14. Spirituality
15. Loss, Grief, & Dying

Unit 3: Essential Nursing Interventions

16. Documenting & Reporting
17. Measuring Vital Signs
18. Communicating & the Therapeutic Relationship
19. Health Assessment: Performing a Physical Examination
20. Promoting Asepsis & Preventing Infection
21. Promoting Safety
22. Facilitating Hygiene
23. Administering Medications
24. Teaching Clients

Unit 4: How Nurses Support Physiological Functioning

25. Stress & Adaptation
26. Nutrition
27. Urinary Elimination
28. Bowel Elimination
29. Sensory Perception
30. Pain Management
31. Activity & Exercise
32. Sexual Health
33. Sleep & Rest
34. Skin Integrity & Wound Healing
35. Oxygenation
36. Fluids, Electrolytes, & Acid-Base Balance
37. Perioperative Nursing

Unit 5: Nursing Functions

38. Leading & Managing
39. Nursing Informatics
40. Holistic Healing
41. Promoting Health

Unit 6: The Context for Nurses' Work

42. Community Nursing
43. Nursing in Home Care
44. Ethics & Values
45. Legal Issues

Communicating and the Therapeutic Relationship

Communication is very important in nursing to get information from clients, for patient education and for therapeutic reasons.This podcast is a summary for the therapeutic communication chapter hope you find it helpful.

Lecture notes

Therapeutic Communication differs from normal communication in that it introduces an element of EMPATHY into what can be a traumatic experience for the patient.
It imparts a feeling of comfort in the face of even the most horrific news about the patient’s prognosis.
The patient is made to feel validated and respected.

Communication cycle includes

Types of communication
Non verbal

Communication Skills

1. USING SILENCE...utilizing absence of verbal communication.
Silence in itself often encourages the patient to verbalize if it is an interested, expectant silence. This kind of silence indicated to the patient that the nurse expects him to speak, to take the initiative, to communicate that which is most pressing. It gives the patient the opportunity to collect and organize his thoughts, to think through a point, or to consider introducing a topic of greater concern to him than the one being discussed. A positive and accepting silence can be a valuable therapeutic tool.

(1) It encourages the patient to talk;

(2) directs his thoughts to the task at hand--the consideration of his problem;

(3) reduces the pace of the interview when either the nurse or the patient is pressing or pushing too hard;

(4) gives the patient time to consider alternative courses of action, delve deeply into his feelings, or weigh a decision;

(5) and allows the patient to discover that he can be accepted even though he is silent, that even though he is shy and quiet, he has worth and is respected by another person.

Much nonverbal communication occurs during these interludes. The nurse needs to be alert to what she is communicating as well as perceiving. Even momentary loss of interest can be interpreted as indifference. Schwartz and Schockley state that the utilization of silence is often difficult for nursing personnel, since they think that nothing is happening and that they are wasting their time. In long periods of silence, they may become bored and their attention wanders from the patient. If the nurse could observe the patient and herself carefully, she might discover that a great deal happens between then at these times.

2. indication of reception.
"Yes." "Uh hmm." "I follow what you said." Nodding.
An accepting response, such as "I'm with you" or "I follow what you're saying," indicates that the nurse has heard and has followed the trend of thought. Such responses signify that the nurse is attuned to the patient, that communication is occurring, and that she is a participant rather than a passive observer. Accepting does not indicate agreement but is nonjudgemental in character. "It is simply a verbalization of the attitudes of permissiveness and acceptance of the counselor which say in effect: "Go on, it's safe, you needn't be ashamed of expressing how you really feel."

Please click here to see the rest of this document

Communicating & the Therapeutic Relationship Video Tutorial