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

Introduction..

Dear readers, First and foremost, welcome to my blog..we will learn new things together as we continuously strive to search for new knowledge in the field of nursing. This blog has been made possible because I was challenged by our professor (Dr. Nante Payod) to "effectively use ICT in education by organizing technology and web-based resources to create environments to foster stimulating and meaningful learning to meet desired educational outcomes." Happy blogging!