The Dog Ate My Care Plan…

Just a mom/wife/nursing student extraordinaire trying to make it in the big bad city…

Posts Tagged ‘insulin’

No Crystal Stair

Posted by isntshelovlei on April 28, 2010

We had an exam last night in Maternity/OB (final next Tuesday!). Usually there are not a lot of meds to remember for maternity since technically the patients aren’t “sick.” Other than epidurals and such during labor most of what you’ll see is postpartum—percocet and motrin for pain, maybe a stool softener if mom had a episiotomy. But when something goes amiss—antepartum, intrapartum, or postpartum—that’s when you get hit over the head with all kinds of stuff—pitocin to start or augment labor, tocolytics to stop labor, hydralazine  for hypertension, magnesium sulfate to prevent seizures (in eclampsia), methergine for hemorrhage, and injection-only insulin for diabetics since oral agents are teratogens. It’s enough to make your head spin and this is only scratching the surface of all the meds I need to know!

So needless to say I can already tell that pharm is going to be a beast. Everyone makes it sound like such a “bird course,” and that “it’s just straight memorization”…OK, if you say so. You not only have to learn the names (trade and generic) of about a gillion drugs, but also the actions, interactions, indications, contraindications, side effects, rationale for why you are or aren’t giving it…the list goes on. You have to know all of these things to be able to challenge that brand new resident’s order for your pregnant patient to receive coumadin (which crosses the placenta), or to be able to question why he wrote an order for methergine when your patient’s blood pressure is already 160/100. You have to know all of these things because in the end YOU are giving the patient their medications—YOU are their last line of defense before a potential medication error occurs. Yes, Mr. Resident that wrote the order should have some accountability as well, but everyone will be looking at YOU because YOU should have caught it. 

So although the wonderful world of maternity is coming to a close, I now have to prepare myself for a whole new kind of headache. One of my favorite poems, “Mother to Son” by Langston Hughes, sounds just like the plight of a student nurse. Nursing school for me ain’t been no crystal stair…

Posted in Nursing school | Tagged: , , , , , , , , , , , , , , , | 5 Comments »


Posted by isntshelovlei on March 16, 2010

Let me tell you a little secret–nursing students LOVE mnemonics. There would be absolutely no way to store all of the information we need to know without them. You’ve got the basics like “ADPIE” (which is the nursing process: assessment, diagnosis, planning, intervention, and evaluation) and “OLDCARTS”  (the attributes of a symptom: onset, location, duration, characteristics, aggravating factors, relieving factors, timing, and severity). Some others I’ve picked up so far are “Nancy Reagan, RN” (how to draw up a mixed insulin dose–air into NPH, air into Regular, draw up Regular, then draw up NPH); “LAB RAT” (left atrium: biscuspid; right atrium: tricuspid–which I always used to mix up!); and there are about gillion different ones for cranial nerves. I like “Olympic Opium Occupies Troubled Triathletes After Finishing Vegas Gambling Vacations Still High”–olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear/acoustic, glossopharyngeal, vagus, spinal accessory, and hypoglossal. Tonight, I learned a new one to add to the list–VEAL CHOP–which relates to fetal heart rate.

Variable decels => Cord compression (usually a change in mother’s position helps)

Early decels => Head compression (decels mirror the contractions; this is not a sign of fetal problems)

Accelerations => O2 (baby is well oxygenated–this is good)

Late decels => Placental utero insufficiency (this is bad and means there is decreased perfusion of blood/oxygen/nutrients to the baby). You’ll also hear/see this called “uteroplacental insufficiency,” but VEAL CHOU just doesn’t have the same ring to it does it?

And that’s our lesson for today folks. It’s only the first lecture but so far I think I’m really going to like this class. My professor is really on the ball and I actually didn’t mind that she kept us until the last minute of class because the material was interesting and I felt like I was actually learning something–like the stages of labor (not to be confused with the phases which all occur during the 1st stage) and the 5 P’s (powers, passage, passenger, psyche, and position). I think I’m almost ready to catch a baby–clinical starts on Saturday! 🙂

Posted in Nursing school | Tagged: , , , , , , , , , , , , , , , , , , , , | 7 Comments »