June 2009 Nurses Initial Registration for CEBU

Registrants are advised to go to the nearest Regional Office of the PRC or go to the PRC Central Office to file for application. So if you passed the PRC exams please register to the PRC Office, below are the requirements that you need in the initial registration.

Initial Registration
Requirements
1. Duly accomplished Oath Form or Panunumpa ng Propesyonal
2. Current Community Tax Certificate (cedula)
3. Two pcs. passport size pictures with name tag (for Oath Form and Certificate of Registration)
4. One pc. 1”x1” picture in plain background with complete name tag (for Registry of Professionals)
5. Two sets of metered documentary stamps (for Oath Form and Certificate of Registration)
6. One (1) short brown envelope with name and profession

CEBU SCHEDULE

TO-FROM / DATE

ABABA, MARY GRACE - AMPER, ANTHONY PAUL DIAZ / August 7, 2009

AMPIL, MACARIO AMAY - BANAL, FAITH MAGCUYAO / August 10, 2009

BANDIAN, BLAS JR. SARA - BRACAMONTE, JULIUS BONCALES / August 11, 2009

BRAGAT, HANNAH MARIE BORDAJE - CARRERA, MARIA JUDITH YSABEL PONTINELA / August 12, 2009

CARSON, MERCURY CHESTER INSTILL I JORGE - COSEP, MARJORIE ALLABA / August 13, 2009

COSEP, MELISSA ABEJO - DINOY, JOYNA GOMEZ / August 14, 2009

DIONG, IRISH CUEVAS - FERNANDEZ, ROSALIE BALILI / August 17, 2009

FERNIZ, JOHNNY II SABANDAL - GO, MARAVILLA SWEET ROJAS / August 18, 2009

GO, NATHANIEL JAMES ROMNEY GESALEM - JUMALON, MA. CORAZON BAYADOG / August 19, 2009

JUMALON, MARK RAYMUND MARTINEZ - LLERIN, CHRISTOPHER JOHN MONTANO / August 20, 2009

LLIDO, JERSON RANOLO - MAYO, MARIA ELENA LIBONGCOGON / August 24, 2009

MAYOL, KYLE DE LA CRUZ - NUÑEZ, MARIA SHIELA SEROT / August 25, 2009

OBANDO, KRISHNA ANGELA BULILAN - PATAJO, GLETCHEN ANNE TUAZON / August 26, 2009

PATCHO, ANGELICA DAJAO - RECAMADAS, ASHLEY MIÑOZA / August 27, 2009

RECUERDO, MARICOR EDER - SAN MIGUEL, BERNICE ANN CORTES / August 28, 2009

SANARES, KATHLEEN CAMILLE GRANALI - TABANAO, KARYL ROSE CLEMENTE / August 31, 2009

TABAR, PHOEBE JADE CABARAL - TUMALE, JOY MUGA / September 1, 2009

TUMAMAK, MARIAN MAE MEDICO - ZOZOBRADO, RAMON MICHAEL SANDMANN / September 2, 2009

How to Apply for NCLEX-RN

1. Determine which state you want to apply. There are many factors that you have to consider when choosing which state to apply, sometimes depending on your present circumstance. For example, if you have just passed the NLE and don’t have your license yet, there are states that allow you to apply and take the NCLEX without your PRC license. Then there are states that require CGFNS Exam, CES, fingerprint card, etc.

2. Visit the website of your chosen state. You can visit ncsbn.org for the complete list of State Boards’ websites. Or you can search it on the web.

3. Download/request Application Forms, Instructions, Fingerprint Cards. Application processing and requirements vary from state to state. Please read and follow the instructions carefully to avoid delay in the processing of your application.

4. Submit your completed application(forms, documents, payments, etc.) by mailing it to your chosen state board of nursing. Processing time of your application varies from state to state; some states would approve it as early as 2 months while others would make you eligible in 6-8 months. So it would help if you constantly follow up your status through email (or website, if any) provided by the state.

5. If you are eligible, register with PearsonVue for NCLEX-RN Testing. There are different modes of registering, but doing it online thru pearsonvue.com is the fastest. After registration you will receive 2 emails, the first confirming your registration and payment of $200, and the second, your Authorization to Test(ATT).

6. Schedule your NCLEX exam. If you prefer to take the test in Makati, Philippines, you can schedule your exam by calling Pearsonvue hotline (Asia-Pacific, +60383189964). Have your ATT ready, they’re asking you Candidate ID number and ATT number. You also have to pay $150 for International Testing Fee thru Credit Card(VISA, MasterCard, American Express, JCB). Confirmation email will be automatically sent to you after scheduling.

7. Take the Test. Bring your ATT and Passport, plus other valid IDs.

goodluck!

Registration Instruction for New Nurses (June 2009 Nursing Board Exam Passers)

Those who will register are required to bring the following:

duly accomplished Oath Form or Panunumpa ng Propesyonal,

current Community Tax Certificate (cedula),

2 pieces passport size picture (colored with white background and complete name tag),

1 piece 1” x 1” picture (colored with white background and complete name tag),

2 sets of metered documentary stamps, and 1 short brown envelope with name and profession;

and to pay the Initial Registration Fee of P600 and Annual Registration Fee of P450 for 2009-2012.

Successful examinees should personally register and sign in the Roster of Registered Professionals.The oathtaking ceremony of the successful examinees in the said examination in Manila as well as the previous ones who have not taken their Oath of Professional will be held before the Board on Tuesday and Wednesday, August 18 and 19, 2009, with morning (8:00 A.M.) and afternoon (1:00 P.M.) sessions at the SMX Convention Center, SM Mall of Asia, Pasay City.

All must come in their white gala uniform, nurses cap, white duty shoes, without earrings, hair not touching the collar and without corsage.Oathtaking tickets for the National Capital Region (NCR) and nearby regions will be available at the Philippine Nurses Association (PNA) at 1663 F.T. Benitez Street, Malate, Manila, starting July 29, 2009, Wednesday.

Updated Provincial Schedule:

Baguio__________August 21

Davao __________August 29

Ilocos___________August 22

Legaspi__________August 21

Pangasinan________August 28

Zamboanga/Sulu____August 27

other provincial areas, please keep posted for BON advisory as to the oath taking schedules

Stories of Love and Compassion

Nursing is indeed a profession of compassion.. as Wikipedia would define it, Compassion is a human emotion prompted by enduring pain with others. More vigorous than empathy, the feeling commonly gives rise to an active desire to alleviate another's suffering.. It is what we exactly do right? We somehow always manages to touch other people's lives simply by the therapeutic use of self but haven't you realized lately how others have touched your lives as well?

I am going to share with you two wonderful and heartwarming stories shared by Bo Sanchez from Kerygma.. Hope you too will be touched by the story as I was.

Story 1:

Twins Brielle and Kyrie - born to Paul and Heidi Jackson. Kyrie weighed two pounds and three ounces while Brielle weighed only two pounds. They were placed in a separate incubators.
Kyrie, the bigger baby, responded well to medical procedures, growing well as doctors expected. But Brielle seemed to be in trouble. She had difficulty in breathing and became weaker and weaker.

Doctors did everything to stabilize Brielle's condition but to no avail. Then Brielle's nurse decided to break some rules. She got Brielle and put her in the incubator of her twin sister, Kyrie, and the incredible happened!

The moment the nurse closed the door of the incubator, Brielle snuggled up to Kyrie and automatically her breathing became stable. Her heartbeat stabilized, too. and then Kyrie put her arm around her baby sister.

This happened in 1995. Today, these twin sisters are 14 years old -- both strong and healthy.


Story 2:

One day, a mother came up to her three-year-old son. She said, "Michael, you are going to have a baby sister."
Michael was so happy. And everyday, he sang to his baby sister, morning and evening. "You are my sunshine, my only sunshine. You make me happy, when skies are gray...."

Three months before term, something happened and the baby had to be delivered prematurely. Michael's newly born sister was brought to the ICU. The first week was no good. The doctors told her parents bluntly, "Be prepared for the worst."

The parents cried. For months they were preparing the baby's room -- her crib, clothes, toys -- and now they had to call the cemetery for a burial plot for their baby.
During the entire week, Michael had been insisting, "Mommy, I want to see my baby sister!"

The mother could not tell Michael that his sister was dying and he might not see her because kids were not allowed in the ICU.

When the second week came, the little baby's condition became worse. It then dawned on the mother, "If I dont bring Michael to see his baby sister, he may never see her at all."

So she took him to the hospital.

When the head nurse saw Michael enterig ICU, she warned, "Please do not bring in that child. He is not allowed"

But the mother pleaded and, without the permission of the nurse, brought Michael beside the bed of the little infant. Michael began to sing "You are my sunshine, my only sunshine, you make me happy..."

Almost instantly, the baby's breathing normalized, her heartbeat stabilized. When the nurse saw this, he said to Michael, "Please continue singing. Something's happening"

Little Michael continued to sing, "You are my sunshine, my only sunshine. You make me happy when skies are gray. You never know dear how much I love you. Please don't take my sunshine away."

This is a true story and the baby survived.

All of us are sick -- one way or another. Some of us might be going through tough times now, or disappointments, is depressed or is going through a lot of pain which actually some might not even survive from it.

But come to realize, what we exactly need are these, a little Michael, (our own family), who will always stand by us even through the toughtest trials of our lives, who will continue to inspire us to go through life amidst everything.. and a little twin sister (our friends) who will always be there to hold our hand and give us a comforting hug, a hug of security and assurance that everything will be alright and faith to God Almighty, for only He can make miracles and move mountains..

Have a nice day, Godbless us all!

Practice Test

Hey guys, can you still remember the basics in nursing.. see how well your memory is.. passing score is 7/10! have fun! :)

1. The nurse is caring for a client with burn on his legs. Which nursing intervention will help prevent contractures?

• Applying knee splints
• Elevating the foot of the bed
• Hyperextending the client’s legs
• Performing shoulder range-of-motion (ROM) exercises.

2. A client is diagnosed with metastatic adenocarcinoma of the stomach. The physician prescribed Mitomycin (Mutamycin) with other chemotherapeutic agents for palliative treatment. How hoes Mitomycin exert its cytotoxic effects?

• It inhibits DNA synthesis
• It inhibits RNA sysnthesis
• It’s cell cycle-phase specific
• It inhibits protein synthesis

3. A client is to receive IV Vancomycin. When preparing to administer this drug, the nurse should keep in mind that:

• It may cause irreversible neutropenia
• it should be administered over 60 to 90 minutes in a large volume of fluid
• It should be administered rapidly in a large volume of fluid
• It should be administered over 1 -2 minutes as an IV bolus.

4. The following statement appears on a client’s care plan: “Client will ambulate in the hall without assistance within 4 days.” This statement is an example of:

• Nursing diagnosis
• Client outcome
• Subjective data
• Nursing Intervention

5. When performing an abdominal assessment, the nurse should follow which examination sequence?

• Inspection, auscultation, palpation, and percussion
• Inspection, percussion, auscultation, palpation
• Inspection, auscultation, percussion, palpation
• Inspection, palpation, percussion, and auscultation

6. The nurse is assessing a client with possible osteoarthritis. The most significant risk factor for osteoarthritis is:

• congenital deformity
• age
• trauma
• obesity

7.The nurse administers furosemine (Lasix) to treat a client with heart failure. Which adverse effect must the nurse watch for most carefully?

• Increased in BP
• Increased in Blood volume
• Low serum potassium level
• High serum sodium level

8. When discussing the Food Guide Pyramid with a 75-year old client, the nurse should remember that the guide has been modified for older people. Unlike the standard Food Guide Pyramid, the version for elderly individuals:

• Eliminates the portion of the pyramid for fats, oils, and sweets
• Increases the amounts of recommended milk and dairy products
• Sets upper limits on servings of most food and water
• Includes eight-oz glasses of water at the base of the pyramid.

9. A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client’s care, the nurse should anticipate which measure?

• Administering large doses of oral antibiotics as prescribed
• Instructing the client to ambulate twice daily
• Withholding all oral fluid intake
• Administering large doses of IV antibiotics as prescribed

10. A client gives birth to a stillborn infant at 36 weeks’ gestation. When caring for this client, which strategy by the nurse would be most helpful?

• Be selective in providing the information that the client seeks
• Encourage the client to see, touch, and hold the dead infant
• Provide information about possible causes of the stillbirth only if the client requests it
• Let the child’s father decide what information the client receives

ANSWERS:

1. The nurse is caring for a client with burn on his legs. Which nursing intervention will help prevent contractures?

Correct Answer: A. Applying knee splints

Rationale: Applying knee splints prevents leg contractures by holding the joints in a functional position. Elevating the foot of the bed doesn’t prevent contracture. Hyperextending a body part for any length of time is inappropriate; it can cause contractures. Performing shoulder ROM exercises can prevent contractures in the shoulder but not in the legs.

2. A client is diagnosed with metastatic adenocarcinoma of the stomach. The physician prescribed Mitomycin (Mutamycin) with other chemotherapeutic agents for palliative treatment. How hoes Mitomycin exert its cytotoxic effects?

Correct Answer: A. It inhibits DNA synthesis

Rationale: Mitomycin exerts its cytotoxic effects by inhibiting DNA synthesis rather than RNA synthesis.

3. A client is to receive IV Vancomycin (Vancocin). When preparing to administer this drug, the nurse should keep in mind that:

Correct Answer: B. it should be administered over 60 to 90 minutes in a large volume of fluid

Rationale: To avoid hypotensive reavtion from rapid IV administration, the nurse should infuse vancomycin slowly, over 60 to 90 minutes, in a large volume of fluid. Although neutropenia may occur in approximately 5% to 10% of clients receiving vancomycin, this adverse effects reverses rapidly when drug is discontinued.

4. The following statement appears on a client’s care plan: “Client will ambulate in the hall without assistance within 4 days.” This statement is an example of:

Correct Answer: B. Client outcome

Rationale: A client outcome is short or long-term goal based on projected nursing interventions.

5. When performing an abdominal assessment, the nurse should follow which examination sequence?

Correct Answer: C. Inspection, auscultation, percussion, palpation

Rationale: The correct sequence for abdominal assessment is Inspection, Auscultation, Percussion, and Palpation; because this sequence prevents altering bowel sounds with palpation before auscultation.

6. The nurse is assessing a client with possible osteoarthritis. The most significant risk factor for osteoarthritis is:

Correct Answer: B. age

Rationale: Age is the most significant risk factor for developing osteoarthritis. Development of primary osteoarthritis is influenced by genetic, metabolic, mechanical, and chemical factors. Secondary osteoarthritis usually has identifiable precipitating events such as trauma.

7. The nurse administers furosemine (Lasix) to treat a client with heart failure. Which adverse effect must the nurse watch for most carefully?

Correct Answer: C. Low serum potassium level

Rationale: nurse must monitor the serum potassium level and assess for signs of low potassium. As water and sodium are lost in the urine, m BP decreased, and blood volume decreases, and urine output increases.

8. When discussing the Food Guide Pyramid with a 75-year old client, the nurse should remember that the guide has been modified for older people. Unlike the standard Food Guide Pyramid, the version for elderly individuals:

Correct Answer: D. Includes eight-oz glasses of water at the base of the pyramid.

Rationale: The Food Guide Pyramid version for older people adds a base that includes eight-oz glasses of water to prevent constipation and dehydration. The pyramid sets no upper limits on servings of most food and water. It doesn’t increase the milk and dairy recommendation and doesn’t eliminate the fats, oils, and sweets recommendation

9. A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client’s care, the nurse should anticipate which measure?

Correct Answer: D. Administering large doses of IV antibiotics as prescribed

Rationale: Treatment of acute osteomyelitis includes large doses of IV antibiotics (after blood cultures identify the infecting organism). Surgical drainage may be indicated, and the affected bone is immobilized. The client usually requires IV fluids to maintain hydration, but oral intake isn’t necessarily prohibited.

10. A client gives birth to a stillborn infant at 36 weeks’ gestation. When caring for this client, which strategy by the nurse would be most helpful?

Correct Answer: B. Encourage the client to see, touch, and hold the dead infant

Rationale: When caring for a client who has suffered perinatal loss, the nurse should provide an opportunity for her to bond with the dead child and allow the child to become part of the family unit. Parents who aren’t given such a chance may experience fantasies about the child, which may worse than the reality. If the child has gross deformities, the nurse should prepare the client for these. If the client doesn’t ask about her child, the nurse should encourage her to do so and provide any information she seems ready to hear. The client needs a full explanation of all factors related to the experience so she can grieve appropriately. Letting the child’s father decide which information the client receives is inappropriate.

Oathtaking for New Nurses (June 2009 passers)

(The June 2009 Nursing Board Exam Results has yet to be released but BoN Philippines already announced the schedules that are being arranged for the oathtaking of new nurses who will pass the June 2009 (NLE) Nursing Licensure Exam.
(1)The Oathtaking schedules are being worked out for implementation: August 18 and 19, SMX Convention Center will be the Oathtaking Ceremonies in Manila. And the following assignments have so far been made:

• Areas Identified -- BoN Assigned
  Bacolod --------------Hon. Betty F. Merritt)
  Baguio ---------------Hon. Yolanda C. Arugay
  Bohol ----------------Hon. Betty F. Merritt
  CARAGA ------------Hon. Perla G. Po
  CDO -----------------Hon. Amelia B. Rosales
  CEBU ----------------Hon. Betty F. Merritt
  DAVAO --------------Hon. Leonila A. Faire
  GEN. SANTOS -------Hon. Marco Sto Tomas
  ILOILO --------------Hon. Yolanda C. Arugay
  LAOAG --------------Hon. Perla G. Po
  LEGASPI ------------Hon. Carmencita M. Abaquin
  LUCENA -------------Hon. Perla G. Po
  PAGADIAN ----------Hon. Carmencita M. Abaquin
  PANGASINAN -------Hon. Carmencita M. Abaquin
  ROXAS ---------------Hon. Leonila A. Faire
  TACLOBAN ----------Hon. Yolanda C. Arugay
  TUGUEGARAO ------Hon. Marco Sto Tomas
  ZAMBOANGA --------Hon. Amelia B. Rosales

Additional areas may be adopted by the BoN upon request depending on the capability of the combined forces of PNA and ADPCN to organize and lead the Oathtaking Ceremony in the said area. The BoN on deck for such requests are: Hon. Leonila A. Faire, Hon. Amelia B. Rosales, and Hon. Marco Sto Tomas. The Board of Nursing believes this activity brings government particularly PRC and the Board of Nursing closer to our public/constituents.

(2)The BoN strongly recommends that all Regional Oathtaking Ceremonies apply/follow the “Prototype” Oathtaking Program as used in the National Capital Region (NCR) (with minor modifications as applied in the Regions) as provided for in our Oathtaking Souvenir Program.

(3)The names of all successful examinees released in newspapers of national circulation and
printed by the Board of Nursing in the National Oathtaking Souvenir Program and together with other relevant and timely issuances/articles these are considered “historic documents”. It is therefore strongly recommended that regional oathtaking partners include in their budget the cost of this souvenir program so that every successful examinee/new nurse may avail of the same,
In view hereof, all regional organizing partners are hereby advised to place your orders directly at least 2-3 weeks prior to scheduled Regional/Satellite Oathtaking Ceremonies for timely delivery through the EDUCATIONAL PUBLISHING HOUSE or JADE BOOKSTORE, Manila at Tele-Fax Numbers (02) 288-7278 or (02) 525-0468. The souvenir program cost shall be Php 150.00 each and freight cost shall be borne by the oathtaking host organizer.

(4)For purposes of better synchronicity and organization we advise all our oathtaking partners to keep communications open through:
Ms. Edna Luna, BoN Secretary, PRC Central Office at P. Paredes St., Sampaloc, Manila at Telephone Nos. (02) 735 1534 / 735 4476 / 736 3619 / 736 2250; or The BoN website & BoN
e-mail access address: http://www.bonphilippines.org/ or philnursing7@bonphilippines.org
NOTE: The NCR Oathtaking Ceremonies for New Nurses can be viewed nationwide/worldwide/mobile phone by live streaming through BoN Website.

Very truly yours,
HON. AMELIA B. ROSALES, RN, Ph.D.Member, Board of NursingChair, Oathtaking for the June 6-7 NLE New Nurses
Noted:HON. CARMENCITA M.ABAQUIN, RN, PhDChairman, Board of Nursing

(from nursingcrib.com)

Post Operative Complications

Circulatory Problems

1. Shock – It can be often prevented by attention to fluid balance and the administration of blood or blood substitutes during and after surgery. There are several causes of shock, although it usually occurs as the result of a combination of two or more factors.

Categories of shock:

1. Hematogenic – cause by blood loss
2. Neurogenic – caused by vasodilatation and reflex inhibition of the heart brought about by an insult to the nervous system.
3. Cardiogenic – results from cardiac failure or an interference with heart functions and in myocardial infarction or coronary thrombosis.
4. Vasogenic – caused by diffuse vasodilation; blood circulates poorly through dilated vessels and is not as available to the vital centers (pools in the small vessels and viscera); may occur in anaphylaxis
5. Toxic or bacteremic – thought to be cause by toxic fact that enters the bloodstream from infection
6. Psychic – results from extreme pain, deep fear, or sudden severe emotional disturbance

Signs and Symptoms of Shock:

o The person in shock appears nervous and apprehensive at first, but later become apathetic.
o The skin is cold and moist, and the lips are somewhat cyanotic.
o The pulse is rapid and thready, respirations are rapid and shallow, and the temperature subnormal.
o The blood pressure begins to fall.
Treatment of Shock:
o Treatment of shock, defends on the type of shock and the cause.
o The primary treatment of hematogenic shock is restoration of blood volume.
o Primary treatments for other types of shock might include the following:
1. Checking of the airway and the administration of oxygen,
2. Checking or changing the patient’s position to relieve pain or assist the airway.
3. Attention to urinary volume and medication.

o Some of the drugs commonly used to treat shock are:
1. Ephedrine
2. Phenylephrine (Neo-synephrine)
3. Isoproterenol (Isuprel)
4. Atropine

Recovery and Convalescence:

When signs and symptoms of shocks are noted immediately and treatment is initiated promptly, recovery is usually rapid. The prognosis becomes more guarded if treatment is delayed. Therefore prompt and intelligent recognition of the early manifestations of shock is important.

2. Hemorrhage – Hemorrhage may be either evident (can be seen) or concealed (cannot be seen). Primary hemorrhage occurs at the time of surgery, intermediate hemorrhage occurs within the first few hours of surgery and secondary hemorrhage occurs some time after surgery.

Symptoms of Hemorrhage:

o The patient is apprehensive, restless and thirsty.
o The skin is cold, moist and pale; his temperature falls.
o The pulse rate increases and respirations become rapid and deep.
o As hemorrhaging continues the blood pressure continues to fall, and the patient’s lips and conjunctivae become pallid.
o He will see spots before his eyes and hear ringing in his ears.
o The patient is weak but conscious.
Treatment of Hemorrhage:
o The surgeon must be notified immediately and emergency measures are instituted until he arrives.
o The patient should be given oxygen, and the rate of intravenous drip should be increased.
o His feet should be elevated, if possible.
o Blood pressure should be checked again.

3. Femoral phlebitis or thrombosis – Phlebitis or thrombosis occurs most frequently after operation on the lower abdomen or in the course of severe septic diseases, such as peritonitis and ruptured ulcer. The condition can be caused by several factors, including:
a. Injury to the vein by tight straps or leg holders at the time of surgery.
b. Blanket roll under the knees.
c. Concentration of blood by loss of fluid or dehydration.
d. Slowing of the blood flow in the extremity due to a lowered metabolism and depression of the circulation after operation.

Signs and Symptoms of phlebitis or thrombosis:

o The primary symptom of phlebitis or thrombosis is pain in the calf of the leg with swelling occurring within 1 to 2 days.
o The patient often ha a slight fever, sometimes with chills and sweat.

Treatment of phlebitis or thrombosis:

o The best treatment of femoral phlebitis or thrombosis is prevention. This is done by administration of adequate fluids after surgery to prevent concentration of blood, leg exercise and bandaging the legs with elastic bandages or antiembolic stockings as necessary.
o Blanket rolls or pillow rolls should not be placed under the knees.
o Early ambulation is also important in preventing phlebitis and thrombosis because it prevents the stagnation of blood in the veins of the lower extremities.
o If ordered, intermittent positive pressure breathing (IPPB) therapy may also be beneficial.
o Active treatment of phlebitis or thrombosis includes ligature or removal of the affected veins and the administration of heparin.

Pulmonary Complications

Pulmonary complications are the most serious and most common post-operative complications. They may be avoided in large measure by careful preoperative observation and teaching and by taking every precaution during and after surgery.
It is well known that those patients who have a respiratory disease at the time of surgery are more likely to develop pulmonary complications post-operatively. Therefore only emergency surgery should be performed on a patient with a respiratory disease.

Predisposing causes of pulmonary complications include:
o Preoperative trauma
o Infections of the mouth, nose and throat.
o Irritating effect of the anesthetic, especially either on the respiratory mucous membranes, with a resultant increase in mucus secretion
o Aspirations of vomitus.
o Shallow respirations after the operation because of the pain.
o History of heavy smoking or chronic respiratory diseases.
o Obesity, debilitation, age (very old or very young)
o Smoke inhalation.

1. Atelectasis – when the mucous plug closes one of the bronchi entirely, there is a collapse of the pulmonary tissue beyond the point.

Signs and Symptoms of Atelectasis:
If the lung tissue is involved, the patient will demonstrate the following:
a. Marked dyspnea
b. Cyanosis
c. Prostration and pleural pain (usually referred to lower chest)
d. Fever (common)
e. Tachycardia
f. Anxiety
g. Labored respirations

Treatment of Atelectasis:

o Treatment involved removal of fluid or air by needle aspiration and sedation.
o The incidence of postoperative pulmonary ateclasis has been reduced significantly as a result of the more conservative and judicious use of preoperative and postoperative sedation and by early ambulation of postoperative patients.
o Other pulmonary complications that may occur later in the postoperative period are bronchitis, pneumonia, hypostatic pulmonary congestion, pleurisy, and pulmonary embolism.

Urinary Complications

1. Urinary Retention may occur following any operation, but it occurs most frequently after operations on the rectum, anus, vagina or lower abdomen. The cause is thought to be a spasm of the bladder sphincter. Treatment depends on the individual patient but may include diuretics or increasing intravenous fluids.

2. Urinary Incontinence – is a frequent complication in the aged.

Immediate Care of the Newborn

Image via Wikipedia

Newborns are always and should be handled always with care..

The following are facts and tidbits which are helpful in carrying out the care of the newborn and is essentially important to nurses and nursing students alike to understand by heart..

Goals:

- To establish, maintain and support respirations.
- To provide warmth and prevent hypothermia.
- To ensure safety, prevent injury and infection.
- To identify actual or potential problems that may require immediate attention.
- Establish respiration and maintain clear airway

The most important need for the newborn immediately after birth is a clear airway to enable the newborn to breathe effectively since the placenta has ceased to function as an organ of gas exchange. It is in the maintenance of adequate oxygen supply through effective respiration that the survival of the newborn greatly depends.

Newborns are obligatory nose breathers. The reflex response to nasal obstruction, opening the mouth to maintain airway, is not present in most newborns until 3 weeks after birth

.
To establish and maintain respirations:
1. Wipe mouth and nose of secretions after delivery of the head.
2. Suction secretions from mouth and nose.
Compress bulb syringe before inserting
Suction mouth first, then, the nose
Insert bulb syringe in one side of the mouth
3. A crying infant is a breathing infant. Stimulate the baby to cry if baby does not cry spontaneously, or if the cry is weak.
Do not slap the buttocks rather rub the soles of the feet.
Stimulate to cry after secretions are removed.

The normal infant cry is loud and husky. Observe for the following abnormal cry:

High, pitched cry – indicates hypoglycemia, increased intracranial pressure.
Weak cry – prematurity
Hoarse cry – laryngeal stridor

4. Oral mucous may cause the newborn, to choke, cough or gag during the first 12 to 18 hours of life. Place the infant in a position that would promote drainage of secretions.
Trendelenburg position – head lower than the body
Side lying position – If trendelenburg position is contraindicated, place infant in side lying position to permit drainage of mucus from the mouth. Place a small pillow or rolled towel at the back to prevent newborn from rolling back to supine position.
5. Keep the nares patent. Remove mucus and other particles that may be cause obstruction. Newborns are obligatory nose breathers until they are about 3 weeks old.

Care of the Eyes

It is part of the routine care of the newborn to give prophylactic eye treatment against gonorrhea conjunctivitis or opthalmia neonatorum. Neisseria gonorrhea, the causative agent, may be passed on the fetus from the vaginal canal during delivery. This practice was introduced by Crede, a German gynecologist in1884. Silver nitrate, erythromycin and tetracycline ophthalmic ointments are the drugs used for this purpose.
Erythromycin or tetracycline Opthalmic Ointment:
These ointments are the ones commonly used now a days for eye prophylaxis because they do not cause eye irritation and are more effective against Chlamydial conjunctivitis.
Apply over lower lids of both eyes, then, manipulate eyelids to spread medication over the eyes.

Vitamin K or Aquamephyton

The newborn has a sterile intestine at birth, hence, the newborn does not possess the intestinal bacteria that manufactures vitamin K which is necessary for the formation of clotting factors. This makes the newborn prone to bleeding. As a preventive measure, 0.5 (preterm) and 1 mg (full term) Vitamin K or aquamephyton is injected IM in the newborn’s vastus lateralis (lateral anterior thigh) muscle.

Care of the cord

The cord is clamped and cut approximately within 30 seconds after birth. In the delivery room, the cord is clamped twice about 8 inches from the abdomen and cut in between. When the newborn is brought to the nursery, another clamp is applied ½ to 1 inch from the abdomen and the cord is cut at second time. The cord and the area around it are cleansed with antiseptic solution. The manner of cord care depends on hospital protocol. What is important is that the principles are followed. Cord clamp maybe removed after 48 hours when the cord has dried. The cord stump usually dries and fall within 7 to 10 days leaving a granulating area that heals on the next 7 to 10 days.

Instruction to the mother on cord care:

No tub bathing until cord falls off. Do not sponge bath to clean the baby. See to it that cord does not get wet by water or urine.
Do not apply anything on the cord such as baby powder or antibiotic, except the prescribed antiseptic solution which is 70% alcohol.
Avoid wetting the cord. Fold diaper below so that it does not cover the cord and does not get wet when the diaper soaks with urine.
Leave cord exposed to air. Do not apply dressing or abdominal binder over it. The cord dries and separates more rapidly if it is exposed to air.
If you notice the cord to be bleeding, apply firm pressure and check cord clamp if loose and fasten.
Report any unusual signs and symptoms which indicates infection.
- Foul odor in the cord
- Presence of discharge
- Redness around the cord
- The cord remains wet and does not fall off within 7 to 10 days
- Newborn fever

THE APGAR SCORING SYSTEM

The APGAR Scoring System was developed by Dr. Virginia Apgar as a method of assessing the newborn’s adjustment to extrauterine life. It is taken at one minute and five minutes after birth. With depressed infants, repeat the scoring every five minutes as needed. The one minute score indicates the necessity for resuscitation. The five minute score is more reliable in predicting mortality and neurologic deficits. The most important is the heart rate, then the respiratory rate, the muscle tone, reflex irritability and color follows in decreasing order. A heart rate below 100 signifies an asphyxiated baby and a heart rate above 160 signifies distress.

HEART RATE
0 - Absent
1 - below 100
2 - Above 100

RESPIRATION
0 - Absent
1 - Slow
2 - Good crying

MUCLE TONE
0 - Flaccid
1 - Some flexion
2 - Active motion

REFLEX IRRITABILITY
0 - No response
1 - Grimace
2 - Vigorous cry

COLOR
0 - Blue all over
1 - Body pink, extremities blue
2 -Pink all over

Score:
*7 – 10 Good adjustment, vigorous
*Moderately depressed infant, needs airway clearance
*Severely depressed infant, in need of resuscitation.

ASSESSING THE AVERAGE NEWBORN
Head Circumference 34 – 35 cm
Temperature 97.6 – 98.6 F axillary (anal temp is preferred to check for imperforated anus)
Chest Circumference 32 – 33 cm
Heart Rate 120 – 140 bpm
Respirations 30 – 60 bpm
Weight 2.5 to 3.4 kg
Length 46 to 54 cm

Checklist of Requirements for PRC Filing (NLE NOV 2009)

Please prepare the following documents for your PRC filing. Make sure all entries are correct to prevent delays.

PERSONAL (PREPARE THE ORIGINAL AND PHOTOCOPY)

• NSO BIRTH CERTIFICATE
• LOCAL CIVIL REGISTRAR (LCR) form of your BIRTH CERTIFICATE
• CURRENT COMMUNITY TAX CERTIFICATE (CEDULA) -2009
• 4 PCS PASSPORT SIZE PICTURES - they are either taken at the PRC / at the school if the PRC staff would go to your respective school and it would cost you Php 90.00.. just make sure that the PRC logo appears on your picture to avoid delay and additional cost..
• NSO MARRIAGE CERTIFICATE (for Married Female Applicants Only)
• LCR MARRIAGE CERTIFICATE (for Married Female Applicants Only)
• EXAMINATION FEE OF PHP 900.00
• ONE OF THE FOLLOWINNG FOR FOREIGN SOUNDING NAMES:

VOTER'S ID, CERTIFICATE OF REGISTRATION , OR PASSPORT

SCHOOL

• TRANSCRIPT OF RECORDS with Degree/Course, Exact Date of Graduation, Special Order (S.O), Number/Exemption/Deregulation Status, Scanned Picture and Remarks "BOARD EXAMINATION PURPOSES ONLY"
• SUMMARY OF RELATED LEARNING EXPERIENCE with total number of hours and metered documentary stamps

FACULTY

• RECORD OF OR/DR CASES WITH METERED DOCUMENTARY STAMPS
• CLINICAL ROTATION WITH METERED DOCUMENTARY STAMPS (FOR SECOND COURSERS)
• CERTIFICATION/JUSTIFICATION WITH PROGRAM OF STUDIES FOR SIGNATORIES WITHOUT OR ON-GOING MASTERAL UNITS IN NURSING
• CERTIFICATION/JUSTIFICATION FROM THE DEAN FOR SIGNATORIES (SCRUB NURSE, CLINICAL INSTRUCTORS, CHIEF NURSE, ETC) THAT ARE NO LONGER CONNECTED WITH THE HOSPITAL OR SCHOOL

GOODLUCK GUYS! GODBLESS US ALL!

Deadline for November 2009 NLE Filing

Hey guys for your information...

The PROFESSIONAL REGULATION COMMISSION (PRC) announces that the filing of applications for the November 29-30, 2009 (Sunday-Monday) Nursing Board Exam is now on-going in the Central Office and in the Regional Offices of PRC.

The following are the deadlines of filing of applications:

NEW/1ST TIMERS - SEPTEMBER 16, 2009
REPEATERS - OCTOBER 16, 2009

Applications shall no longer be accepted after these deadlines

Start processing your papers now and avoid the rush... Believe me, falling in line at PRC is a hell, (with all the long lines, scorching heat and stampede)

Goodluck to all of us. Godbless!

1000 Nurses Needed in KSA

Image via Wikipedia

Hey guys! wanna work in Saudi? this maybe the opportunity that you have been waiting for..The Philippine Overseas Employment Administrator (POEA) announced yesterday that the Ministry of Health of the Kingdom of Saudi Arabia is in urgent need of 1,000 Female Nurses to be deployed in government hospitals in Saudi.

Qualifications:
Applicants must be a licensed female nurse with at least one year hospital experience
Not be more than 45 years old.

Requirements:
- detailed resume with job description
- school credentials
- employment certificates
- copy of passport
- two pieces of 2×2 recent photo at the Manpower Registry Division, Window M at the ground floor lobby of the POEA building.

Benefits:
-annual paid vacation
-free economy round trip ticket
-housing and transportation allowance
- yearly renewal of contract.

Qualified nurses may personally submit their documents to:
Philippine Overseas Employment Administrator (POEA) EDSA cor Ortigas Ave. Mandaluyong City Philippines

Goodluck! Happy job hunting!

Nursing Field that Reallly Pays Off

after grad, maybe i should consider further studies and specialization after all, having expertise on a certain field reallly pays off a lot.. but of the many specializations that a nursing graduate has to choose from, which among them could be the best choice? not to mention the series of exams you have to pass and on the job training that will eat up most of your time.. but wait, before you consider what field you would want to specialize, check this list first.

TOP 10 HIGH PAYING NURSE SPECIALTIES
(courtesy of nursinglink.com)

1) Certified Registered Nurse Anesthetist – $135,000
2) Nurse Researcher – $95,000
3) Psychiatric Nurse Practitioner – $95,000
4) Certified Nurse Midwife – $84,000
5) Pediatric Endocrinology Nurse – $81,000
6) Orthopaedic Nurse – $81,000
7) Nurse Practitioner – $78,000
8) Clinical Nurse Specialist – $76,000
9) Gerontological Nurse Practitioner – $75,000
10) Neonatal Nurse – $74,000

though money matters most of the time, (im not being a hypocrite here, am just saying the truth).. you still have to consider that you should be enjoying what you do so that work will no longer have to feel work and be so stressed out.. after all, when we love what we do we, can provide the utmost care for our patients at the same time achieve job fulfillment and satisfaction.. and most of all pray to God for guidance and blessing for the success of your chosen career and in your life in general because without Him, we are nothing!

after grad, what now?

barely three months had past after our graduation and honestly im still figuring out for myself what am i supposed to do next. Its like i am soul-searching or should i say career searching.. not to mention that i am eagerly awaiting for the result of the local board exam i have taken few weeks back.. (still keeping my fingers crossed and constantly saying my prayers)
actually, if you'd try to figure out things, what really are the opportunities instore for a new nursing graduate like me?
many of us new grads are hoping to get out of the country to work because of the better compensation packages other countries offer nurses not to mention that nurses abroad have a far better living and working conditions than those nurses here and their families too.. but come to think of it, how many of us actually would make it to go out and work as a nurse?
to start with, most of the job vacancies ive seen thru the internet looks for clinical experience.. now tell me, how in the world could we get that clinical experience when most of the graduates now are all nurses? its like there's a nurse in every family.. and some would even have more than one.. say for instance, in our family of 4 children, 3 of us are nurses.. its like nursing is the IN thing now. and because of this, most of the hospital no longer have to fill in vacancies because there are more volunteer nurses than actual staff nurse and mind you, before you can even have your turn as volunteer nurse, you would have to wait for few months and you would have to pay the hospital.. isnt it ironic? you are looking for work and here you are paying the hospital to hire you as volunteer nurse.. by the way, volunteer nurse doesnt get paid during her hospital stint..
and before you could even start packing your bags to leave.. you have to take the several exams needed to complete your qualifications like nclex, cgfns, ielts, toefl and others which will really cost you a lot.. not to mention that application or processing fee entails another major expenses.. so what will i do now?

Top Paying Nursing Degrees

As nurses, we should never stop acquiring knowledge thru continuing education. After all this world is ever changing and we need to keep ourselves updated in the same manner that we put more value to our selves being RN's not to mention that it also adds up value to our pocket. Try to consider the 5 top paying nursing degrees enlisted below...

1. Master of Science in Nursing
All four advanced practice nursing specialties require at least a master’s degree. Most programs include about 2 years of full-time study and require a BSN degree for entry; some programs require at least 1 to 2 years of clinical experience as an RN for admission. In 2006, there were 342 master’s and post-master’s programs offered for nurse practitioners, 230 master’s and post-master’s programs for clinical nurse specialists, 106 programs for nurse anesthetists, and 39 programs for nurse-midwives.

Potential Careers:
Certified Registered Nurse Anesthetist
Nurse Administrator
Certified Nurse Midwife
Salary Range:$60,00 – $134,000

2. Bachelor of Science in Health Sciences
Many Health Sciences programs offer two different tracks: The pre-professional track and the clinical manager track. The pre-professional track is designed for students who wish to further their studies with a master’s level health professions program such as health administration, physical therapy, or health informatics. The clinical manage track is for students who are already healthcare professionals or hold an associate or technical degree.

Potential Careers:
Health Informatics
Emergency Medical Services
Health Educator
Salary Range:$35,000 – $76,000

3. BS in Health Administration
A Bachelor of Science in Health Administration provides a balance of health sciences knowledge with business administration skills. The degree is awarded by a college or university after completion of a minimum number of academic units, with a specific number of units in the Health Administration major. A BS in Health Administration is often the minimum requirement for most medical and health services manager positions. A BS is also a stepping stone toward a Master of Science in Health Administration or a Master of Business Administration with an emphasis on healthcare administration.

Potential Careers:
Healthcare Administrator
Medical and Health Services Manager
Administrative Assistant
Salary Range:$42,000 – $74,000

4. Bachelor of Science in Nursing
A Bachelor of Science in Nursing prepares students for a rewarding and challenging career as a nurse. While studying for your BSN, you will take classes in anatomy, physiology, and advanced patient care. The clinical experience will equip you for working in a variety of nursing settings, from hospitals to schools. Many employers prefer nurses who hold BSN degrees because their advanced knowledge and extensive training.

Potential Careers:
Registered Nurse
Case Manager
Genetics Nurse
Salary Range:$40,000 – $70,000

5. Associate Degree in Nursing
Offered through community and technical colleges, an ADN can be completed in as little as two years if you took all the science prerequisites (typically microbiology, chemistry, anatomy, physiology, algebra and psychology) in high school. It will take you three or even three-and-a-half years if you need the science prerequisites, which are part of every nursing program, to complete your ADN. Once you’ve finished your ADN, you’ll be eligible to become an RN upon completing the NCLEX.

Potential Careers:
Registered Nurse
Medical Assistant
Holistic Nurse
Salary Range:$35,000 – $65,000

I bet your eyes popped out seeing the figures with each nursing degree.. Its not too late to think about this stuff right?.. Make your move now..
by the way, thanks to www.nursinglink.com for this very helpful info!

5 Best States for Nursing Jobs

Looking for a nursing job elsewhere in the United States? Well, let me help you find a job by enumerating the best 5 states for nursing jobs as posted in www.nursinglink.com, read on...

It’s no surprise that nurses are one of the most in demand professions. But some states have a much worse nursing shortage than others. If you are having trouble finding a job in your area, or you are just looking for a fresh start, these five states are estimated to offer the most job growth over the next decade. From sunny California to bustling New York, there is a nursing position for you waiting in one of these five great states.

1. California
The Golden State may be sunny in disposition, but its number of employed nurses is bleak. There is an estimated need for 291,200 RNs, 64,800 LPN / LVNs and 83,600 CNAs ending in the year 2016. That is a total of 439,600 available nursing-related jobs in California.
This is especially true in the field of geriatric nursing. As the Baby Boomers age and need more medical care, the demand for nursing dramatically increases.
To help alleviate California’s dire nursing shortage, California Governor, Arnold Schwarzenegger announced the California Nurse Education Initiative which provides $90 Million over 5 Years through a public-private partnership to reduce California’s nursing shortage.
“Nurses are people of compassion and courage. Their profession is a labor of love and without them we simply could not deliver quality care for patients. California is facing a severe nursing shortage and it is absolutely critical that we open up the nursing profession to everyone who has the passion and potential,” said Governor Schwarzenegger. “With this new Initiative we are going to improve the quality of health care everywhere in our state. We are going to provide more classes, more teachers and more resources to expand the ranks of nurses in California.”

2. Florida
Florida is one of the states most affected by the aging Baby Boom generation. With 3 million residents over 65, Florida is in dire need of nurses to care for their aging population. This is good news if you are looking for a nursing job. Salaries are increasing in an effort to recruit new talent, and many hospitals are offering fantastic benefits like on-site childcare, gym memberships, and relocation reimbursement. There is an estimated need for 183,480 RNs, 61,440 LPNs and 14,130 CNAs by the end of 2016. That is a total of 259,050 nursing-related jobs that will need filling in the next eight years.

3. New York
While the nursing shortage rages on in New York, groups are advocating for state funding of nursing degree programs and continued education. Although with increased advocacy, the shortage has also brought about higher salaries in an attempt to bring in more workers. The state of New York has also put together a task force on the future of nursing. There is an estimated need for 196,470 RNs, 55,660 LPNs and 112,450 CNAs by the end of 2016. That is a total of 364,580 nursing-related jobs that will need filling in the next eight years.

4. Ohio
According to the Ohio Hospital Association, data from Ohio’s hospitals show significant vacancy rates in certain health care professions, with registered nurses (RNs) topping the list in most of the state. The demand for RNs and other health care workers will continue to rise with the growing health care needs of the 78 million “baby boomers” who will begin to retire in 2010. There is an estimated need for 130,920 RNs, 41,510 LPNs and 25,020 CNAs by the end of 2016. That is a total of 197,450 nursing-related jobs that will need filling in the next eight years.
Local hospitals have also joined forces with universities and community colleges to create programs that entice students to enter the nursing field. Many employers have increased tuition reimbursement and increased salaries as well as implement perks to increase job satisfaction.

5. Pennsylvania
In order to find solutions to the nursing worker shortage, Pennsylvania created the Pennsylvania Center for Health Careers. The center tackles ways to fill the current 17,000+ job openings in the healthcare field. The Center has worked to increase educational opportunities, create career ladders and retain nurses. There is an estimated need for 128,100 RNs, 43,350 LPNs and 37,500 CNAs by the end of 2016. That is a total of 208,950 nursing-related jobs that will need filling in the next eight years.

Happy job hunting!

getting started

Few weeks after i had finished my bachelor of science in degree in nursing, and awaiting the result of my local board exam, i stopped and figured out what's the next best thing for me to do... instead of making up with the vacations i never had during the undergrad years and during the review for the local board, i opted to create this blog...

I created this blog not only for the sole reason that i wanted to express myself as everyone did on the web, but i wanted to also help out those people who would in the end benefit from a few bits and notes that i would be posting and discussing over here.

Those bits of information might be very useful not only to the nursing students, nurses and patients alike, but to all who would want to have some information regarding health promotion and disease management written in the simplest way i could explain patterned after the NCLEX (with questions, some with multiple choices and rationalization).But come to think of it, this information are surely significant to those who are preparing for the NCLEX exams and nursing students. Reading stuffs in the books and the internet could be tedious and most of the time too technical for a student or a non-medical person to understand.. i hope i could help in this little way i know of..

first things first, if you are in a dilemma, always prioritize client's SAFETY..

and the ABC's of care: AIRWAY, BREATHING AND CIRCULATION..

So let's start the ball rollin...

1. when performing an assessment on a client with emphysema, the nurse finds that the client has a barrel chest. this alteration in the client's chest is due to:

hyperinflation of the lungs

remember that client's with emphysema normally develops a barrel chest due to the trapping of air in the lungs causing them to hyperinflate.

2. the nurse notes that a client with COPD's (chronic obstructive pulmonary diseases) respiratory symptoms are altered by his position. which position helps alleviate the client's dyspnea?

standing, siting upright (high fowlers) or orthopneic position (seated position, slightly bent forward with arms rested over the foot of the bed or in chair/bed)

patients with COPD, has increased difficulty breathing when lying down. His respiratory effort is improved by standing, sitting or in orthopneic position which facilitates lung expansion. But if faced with the different positions, always remember that in general, patients with difficulty breathing uses orthopneic positions, the best position of comfort.

3. the physician orders oxygen at 3 liters per minute via nasal cannula. oxygen amount greater than this are contraindicated to patient with COPD because..

Hypoxic drive is needed for breathing

Respiratory effort is stimulated by hypoxemia or low levels of oxygen in the blood and in the same manner that the level of carbon dioxide in the body increases leading to hypercapnea/hypercarbia. The safest oxygen level to be given to a patient in COPD is 1-3 Liters/min to maintain his hypoxic drive to breathe ideally at 2Liters/min.

4. the client taking aminophylline tells the nurse that he is going to begin a smoking cessation program when he is discharged. the nurse should tell the client to notify the doctor if his smoking pattern changes because he will:

Need his aminophylline dosage adjusted

changes in smoking patterns should be discussed with the physician because they have an impact on the amount of aminophylline needed. You have to remember that aminophylline is a bronchodilator that helps your bronchioles or the tiny pathways in your lungs dilated so that oxygen can get through while on the other hand, smoking causes vasoconstrictor, it makes your bronchioles constrict or narrow down causing you the difficulty of breathing. When a patient is on bronchodilator therapy, smoking should be stopped because it counteracts the effect of the drug.