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.