Case Study (Cynthia)

Read the case, Case Study (Cynthia), then answer the questions below (short bond paper, Font Arial 12, single space). Deadline 9/22/09 (Tues)..

Questions:

Q1: What is the condition of Cynthia

Q2: What time frame would be considered prolonged for second stage? Do you think that Cynthia is having a dysfunctional labor? Justify your answer.

Q3: What is McRobert’s maneuver?

Q4. Give the rationale behind the performance of a suprapubic pressure instead of a fundal push/pressure.

Q5. Do you think this case is an example of a precipitous labor? Justify your answer.

Q6. Is Cynthia considered to have a preterm labor? Support your answer.

Surgical conscience

Surgical conscience is the professional behavior that demonstrates understanding and application of principles of surgical technology and legal, ethical, and moral responsibilities to patients and team members for which each practitioner is accountable. Source: AORN Standards and Recommended Practices for Perioperative Nursing. Denver, CO, Association of Operating Room Nurses, 1988.

Test Yourself: NCLEX practice questions 4

Worried about passing the NCLEX? The more practice questions you do, the more confident you'll feel. Try these, then review the answers and rationales that follow. Experts recommend taking many practice questions before the NCLEX, so take advantage of review courses, books, and other products to help you succeed and pass the NCLEX. ANSWERS BELOW. 1. Which characteristic is expected for a client with paranoid personality disorder who receives bad news? a. The client is overly dramatic after hearing the facts. b. The client focuses on self to not become overanxious. c. The client responds from a rational, objective point of view. d. The client doesn’t spend time thinking about the information. 2. Which term describes an effect of isolation? a. Delusions b. Hallucinations c. Lack of volition d. Waxy flexibility 3. Which health finding is expected in a client who chronically abuses alcohol? a. Enlarged liver b. Nasal irritation c. Muscle wasting d. Limb paresthesia 4. A nurse notes a change in voice and mannerisms of a client with dissociative identity disorder (DID) after he learns that his wife has filed for a divorce. Which nursing intervention is most appropriate? a. Avoid discussing the client’s feelings. b. Force the client to discuss his feelings. c. Offer encouragement to the client that he’ll be able to cope with the divorce. d. Encourage the client to verbalize his feelings about the divorce. 5. A client with an ileostomy tells the nurse he can’t have an erection. Which pertinent information should the nurse know? a. The client will never regain functioning. b. The client needs an abdominal X-ray. c. The client has no problem with self-control. d. Impotence is uncommon following an ileostomy. Answers to NCLEX practice questions 1. c. Clients with paranoid personality disorder are affectively restricted, appear unemotional, and appear rational and objective. Clients with histrionic personality disorder are overly dramatic in response to stress. Clients with narcissistic personality disorder focus on themselves and don’t spend time thinking about bad news. Clients with an obsessive-compulsive personality disorder are preoccupied with the fear of becoming very anxious and losing control. 2. b. Prolonged isolation can produce sensory deprivation, manifested by hallucinations. A delusion is a false, fixed belief that has no basis in reality. Lack of volition is a symptom associated with type I negative symptoms of schizophrenia. Waxy flexibility is a motor disturbance that’s a predominant feature of catatonic schizophrenia. 3. a. A major effect of alcohol on the body is liver impairment, and an enlarged liver is a common physical finding. Nasal irritation is commonly seen in clients who snort cocaine. Muscle wasting and limb paresthesia don’t tend to occur with clients who abuse alcohol. 4. d. Encouraging a client with DID to verbalize his feelings will help him cope with his anxieties. Forcing the client to discuss his feelings can increase his level of anxiety. Avoiding discussion of feelings doesn’t reduce anxiety and avoids the issue. Offering encouragement that the client will be able to cope with the divorce gives false reassurance and can erode the client’s trust in the nurse. 5. d. Sexual dysfunction is uncommon after an ileostomy. Psychological causes of impotence should be explored. An abdominal X-ray isn’t indicated for sexual dysfunction. An ileostomy can change a person’s self-control, making sexual functioning difficult. Source: NCLEX-RN Questions & Answers Made Incredibly Easy!, 4th edition, Lippincott Williams & Wilkins, 2008.

How did swine flu originate? (Just for fun:-)

This picture was emailed to me by anonymous, nevertheless I still want to share it with you guys, just for fun..

H1N1 Flu Alert! From CDC

Test Yourself: NCLEX practice questions

Worried about passing the NCLEX? The more practice questions you do, the more confident you'll feel. Try these, then review the answers and rationales that follow. Experts recommend taking many practice questions before the NCLEX, so take advantage of review courses, books, and other products to help you succeed and pass the NCLEX. ANSWERS BELOW. 1. A woman is worried she might have lice. Which assessment finding is associated with this infestation? a. Diffuse pruritic wheals b. Oval, white dots stuck to the hair shafts c. Pain, redness, and edema with an embedded stinger d. Pruritic papules, pustules, and linear burrows of the finger and toe webs 2. During group therapy, a client listening to another client's description of an abusive incident that occurred during childhood says, “I didn't think anyone else felt like I did as a child.” The nurse recognizes this statement as a reflection of which curative factor of group therapy, as identified by Yalom? a. Altruism b. Universality c. Catharsis d. Existential factors 3. An 86-year-old client in an extended care facility is anxious most of the time and frequently complains of a number of vague symptoms that interfere with his ability to eat. These symptoms indicate which disorder? a. Conversion disorder b. Hypochondriasis c. Severe anxiety d. Sublimation 4. Which nursing intervention is given priority in a care plan for a client having an acute panic attack? a. Tell the client to take deep breaths b. Have the client talk about the anxiety c. Encourage the client to verbalize feelings d. Ask the client about the cause of the attack 5. A nurse is caring for a client with delirium. Which nursing intervention has the highest priority? a. Providing a safe environment b. Offering recreational activities c. Providing a structured environment d. Instituting measures to promote sleep

ANSWERS:

1. b. Nits, the eggs of lice, are seen as white oval dots. Diffuse pruritic wheals are associated with an allergic reaction. Bites from honeybees are associated with a stinger, pain, and redness. Pruritic papules, vesicles, and linear burrows are diagnostic for scabies. 2. b. One of the 11 curative factors of group therapy identified by Yalom is universality, which assists group participants in recognizing common experiences and responses. This action helps reduce anxiety and allows other group members to provide support and understanding. Altruism, catharsis, and existential factors are other curative factors Yalom described, but they don't describe this particular incident. Altruism refers to finding meaning through helping others; catharsis is an open expression of previously suppressed feelings; and existential factors describe the recognition that one has control over the quality of one's life. 3. b. Complaints of vague physical symptoms that have no apparent medical causes are characteristic of clients with hypochondriasis. In many cases, the GI system is affected. Conversion disorders are characterized by one or more neurologic symptoms. The client's symptoms don't suggest severe anxiety. A client experiencing sublimation channels maladaptive feelings or impulses into socially acceptable behavior. 4. a. During a panic attack, the nurse should remain with the client and direct what's said toward changing the physiologic response, such as taking deep breaths. During an attack, the client is unable to talk about anxious situations and isn't able to address feelings, especially uncomfortable feelings and frustrations. While having a panic attack, the client is also unable to focus on anything other than the symptoms, so the client won't be able to discuss the cause of the attack. 5. a. The nurse's highest priority when caring for a client with dementia is to ensure client safety. Offering recreational activities, providing a structured environment, and promoting sleep are all appropriate interventions after safety measures are in place.

Source: NCLEX-RN Questions & Answers Made Incredibly Easy!, 4th edition, Lippincott Williams & Wilkins, 2008.

H1N1 Flu (Swine Flu): Face mask and Respirator Use

April 27, 2009 011:00AM ET copied from the CDC Website

This document provides interim guidance and will be updated as needed.

Detailed background information and recommendations regarding the use of masks and respirators in non-occupational community settings can be found on PandemicFlu.gov in the document Interim Public Health Guidance for the Use of Facemasks and Respirators in Non-Occupational Community Settings during an Influenza Pandemic.

Information on the effectiveness of facemasks¹ and respirators² for the control of influenza in community settings is extremely limited. Thus, it is difficult to assess their potential effectiveness in controlling swine influenza A (H1N1) virus transmission in these settings. In the absence of clear scientific data, the interim recommendations below have been developed on the basis of public health judgment and the historical use of facemasks and respirators in other settings.

In areas with confirmed human cases of swine influenza A (H1N1) virus infection, the risk for infection can be reduced through a combination of actions. No single action will provide complete protection, but an approach combining the following steps can help decrease the likelihood of transmission. These actions include frequent handwashing, covering coughs, and having ill persons stay home, except to seek medical care, and minimize contact with others in the household.Additional measures that can limit transmission of a new influenza strain include voluntary home quarantine of members of households with confirmed or probable swine influenza cases, reduction of unnecessary social contacts, and avoidance whenever possible of crowded settings.

When it is absolutely necessary to enter a crowded setting or to have close contact³ with persons who might be ill, the time spent in that setting should be as short as possible. If used correctly, facemasks and respirators may help reduce the risk of getting influenza, but they should be used along with other preventive measures, such as avoiding close contact and maintaining good hand hygiene. A respirator that fits snugly on your face can filter out small particles that can be inhaled around the edges of a facemask, but compared with a facemask it is harder to breathe through a respirator for long periods of time. For more information on facemasks and respirators, visit the CDC H1N1 Flu website..

When crowded settings or close contact with others cannot be avoided, the use of facemasks¹ or respirators² in areas where transmission of swine influenza A (H1N1) virus has been confirmed should be considered as follows:

1. Whenever possible, rather than relying on the use of facemasks or respirators, close contact with people who might be ill and being in crowded settings should be avoided.
2. Facemasks¹ should be considered for use by individuals who enter crowded settings, both to protect their nose and mouth from other people's coughs and to reduce the wearers' likelihood of coughing on others; the time spent in crowded settings should be as short as possible.
3. Respirators² should be considered for use by individuals for whom close contact with an infectious person is unavoidable. This can include selected individuals who must care for a sick person (e.g., family member with a respiratory infection) at home.

These interim recommendations will be revised as new information about the use of facemasks and respirators in the current setting becomes available. For more information about human infection with swine influenza virus, visit the CDC H1N1 Flu website.

1 Unless otherwise specified, the term "facemasks" refers to disposable masks cleared by the U.S. Food and Drug Administration (FDA) for use as medical devices. This includes facemasks labeled as surgical, dental, medical procedure, isolation, or laser masks. Such facemasks have several designs. One type is affixed to the head with two ties, conforms to the face with the aid of a flexible adjustment for the nose bridge, and may be flat/pleated or duck-billed in shape. Another type of facemask is pre-molded, adheres to the head with a single elastic band, and has a flexible adjustment for the nose bridge. A third type is flat/pleated and affixes to the head with ear loops. Facemasks cleared by the FDA for use as medical devices have been determined to have specific levels of protection from penetration of blood and body fluids.

2 Unless otherwise specified, "respirator" refers to an N95 or higher filtering facepiece respirator certified by the U.S. National Institute for Occupational Safety and Health (NIOSH).

3 Three feet has often been used by infection control professionals to define close contact and is based on studies of respiratory infections; however, for practical purposes, this distance may range up to 6 feet. The World Health Organization uses "approximately 1 meter"; the U.S. Occupational Safety and Health Administration uses "within 6 feet." For consistency with these estimates, this document defines close contact as a distance of up to 6 feet.

"Energy Drinks" Potentially Harmful to Patients With Cardiovascular Disease

NEW YORK (Reuters Health) Apr 03 - Consumption of energy drinks increases blood pressure and heart rate, and should therefore be avoided by people with hypertension or heart disease, according to results of a small prospective study.

The beverages, marketed to enhance cognitive function and stamina, usually contain caffeine, taurine, sugars, vitamins, and other nutritional supplements, Dr. James S. Kalus, at Henry Ford Hospital in Detroit, and co-authors note in The Annals of Pharmacotherapy for April. The potential hemodynamic or electrocardiographic effects of energy drinks have not been studied.

To look into this, the researchers studied 15 healthy volunteers, 20-39 years of age, who abstained from other dietary sources of caffeine, beginning 48 hours prior to baseline.

The subjects drank 500 mL (2 cans, each containing 100 mg taurine and 100 mg caffeine) of an energy drink over 30 minutes daily for 7 days. On days 1 and 7, blood pressure, heart rate, and electrocardiograms were obtained prior to consuming the drinks and 5 times during the 4 hours afterward.

Mean heart rate increased significantly from baseline by 7.8% on day 1 and by 11.0% on day 7; corresponding increases for systolic blood pressure were 7.9% and 9.6%, and for diastolic blood pressure, 7.0% and 7.8%. EKG parameters did not change significantly.

"Increases in blood pressure and heart rate of the magnitude observed in our study could be significant in persons with known cardiovascular disease," Dr. Kalus and his associates maintain, especially in patients who exhibit impaired baroreflex buffering in response to vasoactive substances. Young individuals with undiagnosed, premature cardiovascular disease could also be at risk.

They advise clinicians that "consumption of these drinks could, theoretically, be a frequently overlooked cause of altered medication effectiveness or even hospital admissions or emergency department visits."

Ann Pharmacother 2009;43.

Copied from http://www.medscape.com/viewarticle/590582?src=mp&spon=24&uac=3980SX

How can you avoid this medication error?

See how your staff or students analyze this error--and how they'd avoid it What happened: Jean Watson, a postoperative patient, has a low serum potassium level on her second postoperative day (2.1 mEq/L), and her health care provider orders an additional 20 mEq of KCl to be added to her I.V. bag. Currently, she has 1,000 ml 5% dextrose in 0.45% NaCl with 20 mEq KCl hanging with 200 ml left in the bag and infusing at 125 ml/hour. The nurse draws up the 20 mEq of KCl and adds it to the current infusion without changing the infusion rate. Situation: This could cause hyperkalemia that might be lethal. Adding KCl to an I.V. bag with 200 ml remaining can create a solution too concentrated to administer I.V. What should have been done: The nurse should have discarded the hanging bag, wasting the 200 ml of I.V. fluid, and hung a new 1,000-ml bag with the additional 20 mEq of KCl added. That I.V. would have 40 mEq of KCl per 1,000 ml, which can be safely given at 125 ml/hour. Administering the I.V. solution through an infusion pump would be safest because it avoids a potential sudden infusion of excess I.V. fluid. Source: Clinical Drug Therapy: Rationales for Nursing Practice, 8th ed., AC Abrams, Lippincott Williams & Wilkins, 2006.

Pistachio Recall Expanded

April 7 (HealthDay News) -- A nationwide recall of pistachio products from a California plant was significantly expanded Monday after federal and state health officials found salmonella bacteria in "critical areas" of the Setton Pistachio facility. Investigators didn't provide any more details. The company announced it's now recalling all lots of roasted in-shell pistachios, roasted shelled pistachios and raw shelled pistachios produced from nuts harvested in 2008, the Washington Post reported. Last week, Setton recalled about 2 million pounds, which represents just a small portion of the 2008 harvest. At the time, it was believed the pistachios may have been contaminated by a sanitation problem that affected only one or two production lines. Setton is the second-largest pistachio processor in the United States and supplies about 35 wholesalers and food manufacturers that repackage the nuts for retail sale or use them as ingredients in other products, the Post reported. The U.S. Food and Drug Administration said it could take weeks before there's a complete list of affected products. To help consumers, the pistachio industry created a Web site that lists products not affected by the recall. The Web site address is www.pistachiorecall.org.

Test Yourself: NCLEX practice questions 3

Worried about passing the National Council Licensure Examination (NCLEX), the test from the National Council of State Boards of Nursing (NCSBN) that your state board of nursing will use to determine whether you’re ready to practice nursing? The more practice questions you do, the more confident you'll feel. Try these, then review the answers and rationales that follow. Experts recommend taking many practice questions before the NCLEX, so take advantage of review courses, books, and other products to help you succeed and pass the NCLEX. A nurse is preparing a teaching plan for a client who was prescribed enalapril maleate (Vasotec) to treat his hypertension. Which of the following instructions should she include in the teaching plan? Select all that apply. Instruct the client to avoid salt substitutes. Tell the client that light-headedness is a common adverse effect that he doesn't need to report. Inform the client that he may have a sore throat for the first few days of therapy. Advise the client to report facial swelling or difficulty breathing immediately. Tell the client that blood tests will be necessary every 3 weeks for 2 months and periodically after that. Advise the client not to change position suddenly to minimize orthostatic hypotension. A physician prescribes I.V. normal saline solution to be infused at a rate of 150 mL/hour for a client admitted with dehydration and pneumonia. How many liters of solution will the client receive during an 8-hour shift? _____________________ A nurse is caring for a terminally ill client. In which order is she likely to observe the following five stages of death and dying, as described by Elisabeth Kubler-Ross? bargaining denial and isolation acceptance anger depression A nurse is caring for a client in the fourth stage of labor. Based on the nurse's note below, which postpartum complication has the client developed? 6/7/06 1745 Pt.'s 24-hour blood loss is 600 mL. Uterus is soft and relaxed on palpation and pt. has a full bladder. Assisted pt. in emptying bladder and notified Dr. G. McMann of findings. Vital signs stable at present. See graphic sheet for ongoing assessments and perineal pad weights.-----S. Jones, RN postpartum hemorrhage puerperal infection deep vein thrombosis mastitis Which nonpharmacologic interventions should a nurse include in the care plan for a client who has moderate rheumatoid arthritis? Select all that apply. massaging inflamed joints avoiding range-of-motion exercises applying splints to inflamed joints using assistive devices at all times selecting clothing that has hook-and-loop (Velcro) fasteners applying moist heat to joints

Answers to NCLEX practice questions

1,4,6 Rationale: When teaching a client about enalapril maleate, the nurse should tell him to avoid salt substitutes because they may contain potassium, which can cause light-headedness and syncope. He should report facial swelling or difficulty breathing immediately because they may be signs of angioedema, which would trigger his prescriber to discontinue the drug. The client should also be advised to change position slowly to minimize orthostatic hypotension. The nurse should tell the client to report light-headedness, especially in the first few days of therapy, so his dosage can be adjusted. The client should also report signs of infection, such as sore throat and fever, because the drug may decrease his white blood cell (WBC) count. Because this effect is generally seen within 3 months, the WBC count and differential should be monitored periodically. 1.2 L Rationale: The ordered infusion rate is 150 mL/hour. The nurse should multiply 150 mL by 8 hours to determine the total volume in milliliters the client will receive during an 8-hour shift (1,200 mL). Then she should convert milliliters to liters by dividing by 1,000. The total volume in liters that the client will receive in 8 hours is 1.2 L. 2,4,1,5,3 Rationale: According to Kubler-Ross, the five stages of death and dying are denial and isolation, anger, bargaining, depression, and acceptance. 1 Rationale: Blood loss from the uterus that exceeds 500 mL in a 24-hour period is considered postpartum hemorrhage. If uterine atony is the cause, the uterus feels soft and relaxed. A full bladder can prevent the uterus from contracting completely, increasing the risk of hemorrhage. Puerperal infection is an infection of the uterus and structures above; its characteristic sign is fever. Two major types of deep vein thrombosis occur in the postpartum period: pelvic and femoral. Each has different signs and symptoms, but both occur later in the postpartum period (femoral, after 10 days postpartum; pelvic, after 14 days). Mastitis is an inflammation of the mammary glands that disrupts normal lactation and usually develops 1 to 4 weeks postpartum. 3,5,6 Rationale: Supportive, nonpharmacologic measures for the client with rheumatoid arthritis include applying splints to treat inflamed joints, using Velcro fasteners on clothes to aid in dressing, and applying moist heat to joints to relax muscles and relieve pain. Never massage inflamed joints because massage can aggravate inflammation. A physical therapy program including range-of-motion exercises and carefully individualized therapeutic exercises prevent loss of joint function. Use assistive devices only when marked loss of range of motion occurs. Source: NCLEX-RN 250 New-Format Questions, 2nd ed., Lippincott Williams & Wilkins, 2007.

Bridging the Gap: Basic Spanish keywords

When you're caring for a Spanish-speaking patient, sometimes it isn't necessary to translate an entire sentence. Instead, you may be able to use one keyword or phrase to convey information to your patient.

- please - thank you - yes - no - maybe - sometimes - never - always - date - signature - good-bye

por favor gracias sí no quizás or tal vez a vecas nunca siempre fecha firma hasta luego or adiós

Source: Medical Spanish Made Incredibly Easy!, 3rd edition, Lippincott Williams & Wilkins, 2008.

Test Yourself: NCLEX practice questions 2

Worried about passing the NCLEX? The more practice questions you do, the more confident you'll feel. Try these, then review the answers and rationales that follow. Experts recommend taking many practice questions before the NCLEX, so take advantage of review courses, books, and other products to help you succeed and pass the NCLEX. ANSWERS BELOW.

1.	To maintain airway patency during a stroke in evolution, which nursing intervention is appropriate?
	1.	Thicken all dietary liquids.
	2.	Restrict dietary and parenteral fluids.
	3.	Place the client in the supine position.
	4.	Have tracheal suction available at all times.
2.	Primary prevention of osteoporosis includes which measure?
	1.	Place items within reach of the client.
	2.	Install bars in the bathroom to prevent falls.
	3.	Maintain the optimal calcium intake.
	4.	Use a professional alert system in the home in case a fall occurs when the client is alone.
3.	A client is admitted with right lower quadrant pain, anorexia, nausea, low-grade fever, and an elevated white blood cell count. Which complication is most likely the cause?
	1.	A fecalith
	2.	Bowel kinking
	3.	Internal bowel occlusion
	4.	Abdominal wall swelling
4.	Which nursing intervention should be taken for a client who complains of nausea and vomitus 1 hour after taking his morning glyburide (DiaBeta)?
	1.	Give glyburide again.
	2.	Give subcutaneous insulin and monitor blood glucose.
	3.	Monitor blood glucose closely and look for signs of hypoglycemia.
	4.	Monitor blood glucose closely and assess for symptoms of hyperglycemia.
5.	Which comfort measure can be recommended to a client with genital herpes?
	1.	Wear loose cotton underwear.
	2.	Apply a water-based lubricant to the lesions.
	3.	Rub rather than scratch in response to an itch.
		4. Pour hydrogen peroxide and water over the lesions. Answers to NCLEX practice questions 1. 4 Because of a potential loss of the gag reflex and potential altered level of consciousness, the client should be kept in Fowler's or a semiprone position with tracheal suction available at all times. Thickening dietary liquids isn't done until the gag reflex returns or the stroke has evolved and the deficit can be assessed. Unless heart failure is present, restricting fluids isn't indicated. 2. 3 Primary prevention of osteoporosis includes maintaining optimal calcium intake. Placing items within reach of the client, using a professional alert system in the home, and installing bars in bathrooms are all secondary and tertiary prevention methods to prevent falls. 3. 1 The client is experiencing appendicitis. A fecalith is a fecal calculus, or stone, that occludes the lumen of the appendix and is the most common cause of appendicitis. Bowel wall swelling, kinking of the appendix, and external occlusion, not internal occlusion, of the bowel by adhesions can also be causes of appendicitis. 4. 3 When a client who has taken an oral antidiabetic agent vomits, the nurse should monitor glucose and assess him frequently for signs of hypoglycemia. Most of the medication has probably been absorbed. Therefore, repeating the dose would further lower glucose levels later in the day. Giving insulin will also lower glucose levels, causing hypoglycemia. The client wouldn't have hyperglycemia if the glybluride was absorbed. 5. 1 Wearing loose cotton underwear promotes drying and helps avoid irritation of the lesions. The use of lubricants is contraindicated because they can prolong healing time and increase the risk of secondary infection. Lesions shouldn't be rubbed or scratched because of the risk of tissue damage and additional infection. Cool, wet compresses can be used to soothe the itch. The use of hydrogen peroxide and water on lesions isn't recommended. Source: NCLEX-RN Questions & Answers Made Incredibly Easy!, 4th edition, Lippincott Williams & Wilkins, 2007.

Key Step to Reduce Lawsuits

The Ins and Outs of Patient Abandonment As a nursing student, you know that you should never "abandon" a patient. But what exactly is patient abandonment? And how do you protect yourself from being accused of this type of unprofessional conduct? Source: http://www.accelacommunications.com/microsite/liability_center/

Prostate Test Found to Save Few Lives

The PSA blood test, which measures a protein released by prostate cells, does what it is supposed to do -- indicates a cancer might be present, leading to biopsies to determine if there is a tumor. But it has been difficult to know whether finding prostate cancer early actually saves lives. The studies conducted confirm concerns about the wisdom of widespread prostate cancer screening. More From NursingCenter.com

To: Dr. Nante Payod

The links below are outputs for my PhD course Educ 305 ICT in Education. For those who are interested to view my accomplished requirements, besides my professor Dr. Payod, let me first give you a description of the course. Educ 305 (Information and Communication Technology [ICT] in Education) is a 3 unit subject designed to provide doctoral students with the technical requirements and learning opportunities to develop and update essential skills, knowledge and dispositions for optimal and effective use of of ICT in Education. It is delivered through a combination of lecture and discussion, laboratory and e-learning activities whereby students use and organize technology and web-based resources to create environments that foster stimulating and meaningful learning to meet desired educational outcomes (Source: Syllabus 2nd Sem 08 - 09). Requirements: 1. Reaction Paper on the Generation Y Model 2. Powerpoint presentation of my report (Scope of ICT and Rationale for the Introduction of ICT in Education) 3. Reaction Papers a. Impact of ICT on the Curriculum b. ICT and Cognitive Process 4. Exercise 1: Task 1: Word Processing Task 2: Computating with the use of Excel Task 3: Powerpoint Designing 5. Exercise 2: Task 1: Asynchronous and Synchronous Communication Task 2: The Internet in Education Task 3: Copyright and Intellectual Property You can click on COMMENTS, located below this post (right side) for feedbacks which I would really appreciate..

The Case of the Missing Shaving Blade!

1. The Case of the Missing Shaving Blade!

A 41-year-old cognitively impaired man who possibly ingested a shaving blade is presented to the ED. The patient is not in any distress. A chest radiograph is taken. What is seen on the radiograph?

2. A 30-Year-Old Woman With Fever and a Rash A 30-year-old woman presents to the ED with malaise, myalgia, and a spreading purpuric rash, as well as fever and intermittent confusion. What syndrome is suggested by this presentation?

3. A 25-Year-Old Woman With Hypotension and a Rash

A 25-year-old woman presents to the ED with a 2-day history of left lower quadrant pain, nausea, fever, and a rash. She was recently diagnosed with streptococcal pharyngitis. What is the diagnosis?

4. Recurrent Syncope in a 10-Year-Old Boy

A 10-year-old boy visits the pediatrician for a history of multiple fainting spells that are sometimes caused by external events. His father had similar symptoms as a child. What is the diagnosis?

5. A 9-Year-Old Boy With a Recurrent Urinary Tract Infection and Failure to Thrive

A 9-year-old with a 3-year history of intermittent fever and abdominal pain has tenderness in the left lumbar region and a urine culture that is positive for Escherichia coli. What is the diagnosis?

Source: Medscape CME

MedscapeCME for Nurses: What's the latest?

FEATURED CE Are Two Insulin Pumps Better Than One? Article, March 2009 Health Effects of Global Climate Change: How Health Professionals Can Be Part of the Solution Article, March 2009 Environmental Justice and Air Pollution: The Right to a Safe and Healthy Environment Article, March 2009 CASE PRESENTATIONS A 55-Year-Old Man With Recurrent Renal Stones Clinical Case, March 2009 Be Wary of Radiographs and Monitoring Paraphernalia! Clinical Case, March 2009 A 60-Year-Old Man With Chest Pain Clinical Case, March 2009 Shortness of Breath in a 62-Year-Old Man 26 Months After Cardiac Transplantation Clinical Case, March 2009 HIV/AIDS HIV Screening and Initial Treatment: Clinical Practice Assessment Clinical Review ASTHMA Antibiotic Use in First Year of Life Linked to Small Risk of Developing Asthma News, March 2009 BRAIN INJURY Mild Traumatic Brain Injuries May Cause Transient, Persistent Symptoms After Injury News, March 2009 CARDIOLOGY Depression and Antidepressant Use Linked to Sudden Cardiac Death in Women News, March 2009 Correcting CV Risk Factors, Comorbidities in Blacks Seen as Key to Ending Racial MI-Outcomes Disparities News, March 2009 WOMEN'S HEALTH DMPA Causes Significant Weight Gain, Changes in Body Mass News, March 2009 Hormone Therapy in Menopause: Applying Research Findings to Optimal Patient Care and Education Clinical Review, March 2009 POISON CONTROL Management of Common Childhood Poisonings Reviewed News, March 2009

Allergies, Asthma & Children Quiz

Your score on this self–test is not as important as the fact that it could help solidify your knowledge of allergies and asthma and maybe even teach you something you didn't know. These quizzes are completely confidential, so no one will see your score except you. To complete the quiz, click on the answer that seems the most correct from the choices given, then click 'Submit.' The correct answer will be provided along with some additional information on the same topic. At the end of the quiz, your final score will be provided along with links to additional information on allergies and asthma. It might be helpful to retake the quiz after reading over the additional material. Good luck! Let's get started.. Source: http://yourtotalhealth.ivillage.com/

EDUCATION EXTRA

Don't miss these peer-reviewed, continuing education articles from the March/April 2009 issue of Nursing made Incredibly Easy! For staff development instructors and nursing faculty, we've included PowerPoint slides (links below) that you can use as the basis for your lectures on these topics.

• Bowel obstruction: Backup along the 750 By Shelba Durston, RN, CCRN, MSN BONUS: PowerPoint slides, click here.
• CA-MRSA: The emerging pathogen By Suzanne M. Bonner, RN, CMSRN, BSN BONUS: PowerPoint slides, click here.

Source: April 2009 issue of Nursing made Incredibly Easy! eNews,

RNCentral Care Plans

Free sample care plans provided by RNCentral.com is very useful for student nurses. Their library has been visited for over 100,000 times. Patient problems are arranged according to impairment or alteration.

Posttest. Male Reproductive Disorders

Take the test on Male Reproductive Disorders and find out which disorder and its management you do not know. Answer Key will be posted later. Posttest. Male Reproductive Disorder - for IIIF and IIIG

Posttest: Renal Disorders

The following set of questions are related to the discussion on Renal Disorders. The Answer Key will be posted on a later date. Click on the link below to view and to take the test. Posttest. Renal Disorders Set A - for IIIF Posttest. Renal Disorders Set B - for IIIG

Key Facts: Mitral stenosis

• Thickening and calcification of valvular tissue
• Increased pressure in the left atrium
• Pulmonary hypertension and left atrial hypertrophy
• Right ventricular failure
• Narrowing of the mitral valve opening results

Source: Straight A's in Medical-Surgical Nursing, 2nd edition, Lippincott Williams & Wilkins, 2007.

Charting Tips: Guarding against liability

Good documentation should offer legal protection to you, your patient's other caregivers, and the healthcare facility.

Admissible in court as a legal document, the medical record provides proof of the care received by the patient and the standards by which the care was provided. Medical records typically serve as evidence in disability, personal injury, and mental competence cases. They're also used in malpractice cases, and how and what you document--or don't document--can mean the difference between winning and losing a case, not only for you but also for your employer.

For the best legal protection, make sure your documentation shows that you not only adhere to professional standards of nursing care but also follow your employer's policies and procedures--especially in high-risk situations.

Source: Complete Guide to Documentation, 2nd edition, Lippincott Williams & Wilkins, 2007.

Test Yourself: NCLEX practice questions

Worried about passing the NCLEX? The more practice questions you do, the more confident you'll feel. Try these, then review the answers and rationales that follow. Experts recommend taking many practice questions before the NCLEX, so take advantage of review courses, books, and other products to help you succeed and pass the NCLEX. Answers are found below.

1.	A nurse is preparing to bathe a client who has been hospitalized for emphysema. Which nursing intervention is correct?
	1.	Remove the oxygen and proceed with the bath.
	2.	Increase the flow of oxygen to 6 L/minute by nasal cannula.
	3.	Keep the head of the bed slightly elevated during the procedure.
	4.	Lower the head of the bed and roll the client to his left side to increase oxygenation.
2.	A 56-year-old client with heart failure is allergic to sulfa-based medications. Which type of diuretic should be used cautiously?
	1.	Osmotic diuretics
	2.	Thiazide and thiazide-like diuretics
	3.	Potassium-sparing diuretics
	4.	Carbonic anhydrase inhibitors
3.	Which condition most commonly results in coronary artery disease (CAD)?
	1.	Atherosclerosis
	2.	Diabetes mellitus
	3.	Myocardial infarction (MI)
	4.	Renal failure
4.	Which blood test is used first to identify a response to human immunodeficiency virus (HIV) infection?
	1.	Western blot
	2.	CD4+ T-cell count
	3.	Erythrocyte sedimentation rate
	4.	Enzyme-linked immunosorbent assay (ELISA)
5.	An elderly client with pneumonia may appear with which symptoms first?
	1.	Altered mental status and dehydration
	2.	Fever and chills
	3.	Hemoptysis and dyspnea
	4.	Pleuritic chest pain and cough Answers to NCLEX practice questions 1. 3 The elasticity of the lungs is lost for clients with emphysema, who can't tolerate lying flat because the abdominal organs compress the lungs. The best position is one with the head slightly elevated. The rate of oxygen delivery shouldn't be increased or decreased without an order from the physician. Increasing oxygen flow in a client with emphysema may also suppress the hypoxic drive to breathe. Positioning the client on his left side with the head of the bed flat would decrease oxygenation. 2. 2 Thiazide and thiazide-like diuretics are sulfonamide derivatives, so their use should be used cautiously in clients allergic to sulfa-based medications. Osmotic, potassium-sparing, and carbonic anhydrase inhibitor diuretics can be safely administered to these clients. 3. 1 Atherosclerosis, or plaque formation, is the leading cause of CAD. Diabetes mellitus is a risk factor for CAD but it isn't the most common cause. Renal failure doesn't cause CAD, but the two conditions are related. MI is commonly a result of CAD. 4. 4 The ELISA is the first screening test for HIV. A Western blot confirms a positive ELISA test. Other blood tests that support the diagnosis of HIV include CD4+ and CD8+ counts, complete blood counts, immunoglobulin levels, p24 antigen assay, and quantitative ribonucleic acid assays. 5. 1 Fever, chills, hemoptysis, dyspnea, cough, and pleuritic chest pain are the common symptoms of pneumonia, but elderly clients may first appear with only an altered mental status and dehydration due to a blunted immune response. Source: NCLEX-RN Questions & Answers Made Incredibly Easy!, 4th edition, Lippincott Williams & Wilkins, 2007.

Online Presentations

• International Stroke Conference 2008 In this series of online presentations taken from the International Stroke Conference 2008, you can choose from a variety of topics pertinent to nurses in the care of patients with stroke. Topics include post-stroke depression, neurologic assessment, and self- management. Learn evidence-based current, applicable information pertaining to stroke care from your colleagues in the field as presented at the conference dedicated to the care of patient with stroke.
• Emerging Technologies in Nursing and Nursing Education Learn the latest technologies in nursing from this interactive Power Point slide presentation from a renowned educator. Technology is always changing, especially in healthcare. Whether in the clinical setting or education, you're sure to find this presentation full of takeaway information you can use in your practice.

In the Know: New reports, resources, guidelines

• American Academy of Orthopedic Surgeons clinical practice guidelines on the treatment of carpal tunnel syndrome
• American College of Physicians pharmacologic treatment of low bone density or osteoporosis to prevent fractures: A clinical practice guideline
• FDA advisory February 4, 2009: Xigris (Dotrecogin alfa [activated]): The FDA is working with the manufacturer to further evaluate the incidence of serious bleeding events and mortality. FDA will communicate its conclusions and any resulting recommendations to the public when the review is complete.

Good Reads: Don't miss these articles from other LWW journals

Title: New Drugs 2009: Part I Authors: Daniel Hussar, PhD Abstract: In this article, you'll learn about ten new drugs. Join the author for this look at some exciting new drugsÂ…such as a new beta-blocker for hypertension, a new subcutaneous injection for opioid induced constipation, and a new drug to combat postoperative ileus. Source: Nursing2009, February 2009, Vol. 39, No. 2 Title: Boost Your Asthma IQ Authors: Margaret McCormick, RN, MS Abstract: Get the tools you need to gain a better understanding of asthma in adult patients so you can help them deal with this chronic disease. This article will cover the anatomy and physiology behind asthma, and give the nurse the latest in care and management techniques. In this continuing education article you can boost your asthma IQ while earning CE credits as well. Source: Nursing Made Incredibly Easy!, January/February 2009, Volume 7, Number 1

Title: Caring for a Patient with a Temporary Pacemaker Authors: Damon B. Cottrell, CCNS, CCRN, ACNS-BC, CEN, and Eugenia (Gena) Welch, RN, CCRN, MSN Abstract: Temporary pacemakers are typically used in an emergency to achieve adequate cardiac output. Here's everything you need to know about these lifesaving devices and how to care for patients who have one. In this continuing education offering you can learn the latest on pacemakers and earn CE credits in the process. Source: LPN2009, January/February 2009, Volume 5, Number 1