November 23, 2017

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The decision to intubate should be based on patient assessment and three criteria: (1) failure to maintain or protect the airway, (2) failure of ventilation or oxygenation and (3) the patient’s anticipated clinical course and likelihood of deterioration.

November 22, 2017

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Exenatide (Bydureon) is a degradation-resistant GLP-1 peptide analog (incretin mimetic) that reduces HbA1c as well as producing moderate weight loss. There is a boxed warning on the possible risk of medullary thyroid carcinoma.

November 21, 2017

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
In general, control of blood pressure and of blood lipids improves macrovascular disease and clinical outcome, whereas the control of glycemia limits microvascular disease (retina, kidneys, nerves).

November 20, 2017

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Cholesterol absorption inhibitors selectively interrupt intestinal absorption of cholesterol. The first of this drug class to reach the market, ezetimibe (Zetia), acts at the brush border of the small intestine and inhibits the absorption of cholesterol.

November 19, 2017

#NacoleMedMath | Nursing Math - Dosage Calculations

** ANSWER: 4.95 ML ** 
65.91 KG x 0.15 MG = 9.89 MG/KG
9.89 MG/KG / 2 MG/ML = 4.95 ML

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
As a rule, none of the fibrates reduces blood cholesterol as much as do the statins or nicotinic acid. Their prime action is to decrease triglyceride, thereby increasing HDL-C, and to increase the particle size of small, dense LDL.

November 18, 2017

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Bile acid sequestrants - cholestyramine (Questran), colesevelam (Welchol), and colestipol (Colestid) - bind to bile acids to promote their secretion into the intestine. There is loss of hepatic cholesterol into bile acids and cellular cholesterol depletion.

November 17, 2017

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Women desiring to become pregnant should stop statins for approximately 6 months before conception. If a patient becomes pregnant when taking such drugs, therapy should be discontinued.

November 16, 2017

#NacoleMedMath | Nursing Math - Dosage Calculations

** ANSWER: 4.70 ML **
62.7 KG x 1.5 MG = 94.05 MG/KG 
94.05 MG/KG / 20 MG/ML = 4.70 ML 

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Statins are contraindicated in patients with active liver disease or unexplained elevations of serum transaminases. Statins must not be prescribed to women who are pregnant because cholesterol is essential to fetal development.

November 15, 2017

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
New diabetes is a newly discovered side effect, first reported with rosuvastatin and now with high-dose statins. As a result, the FDA has added information concerning increases in hemoglobin A1c and fasting plasma glucose to all statin labels.

November 14, 2017

From Bedside Nurse ➡️ NP Student: Full-Time Student, Full-Time Nurse

Not every individual will have to work during nurse practitioner school. I, on the other hand, had to. I had a newborn and responsibilities in my life that did not afford me the ability to stop working full-time as a bedside nurse. I received my acceptance letter around the same time I found out I was pregnant. Both were a blessing, but I originally wanted to focus on one life-changing event at a time. Life is unpredictable, and when blessings come, you shut up, say thank you, and make it work. And that is what my husband and I did. We sat down and came to the conclusion that night shift would work best for our family. I am going to be honest with you - at first, I wanted to ignore the acceptance letter to nurse practitioner school. I was a new mother! I had no idea what the hell I was doing. I did not see myself being successful at both being a mother and starting graduate school. But mid-freakout, my husband held my hand and said, “You're just afraid, and that's okay, dear. But we will make this work. I don't want you regretting the decision later. At least give it a try.” I wiped my eyes and smiled. I was going to do this.

In the end, I worked nights, and I worked every weekend (I still do). It is the only way I can attend my clinicals during the week and meet my course requirements. Is it tough? Of course it is, but being organized keeps my academics and family life on track. I'm a full-time student, full-time nurse, and full-time mother and full-time wife. There are no gaps or holes. Every aspect of my life is in the green (I hope, haha) and I have a son with special needs. I make sure I stay engaged and present. I'm not some superstar. I am just professionally hungry and motivated. I have never half-assed anything I've set my mind to. If you are like me, you can do this too. The key is to be organized and prepared. My schedule usually extends a month out, and I review my monthly needs with my husband to make sure I have time for studying and exams, as well as pedestrian appointments and date nights. There is no point in failing classes, missing work days, and fumbling family events. You must balance everything, and that takes organization and maybe a little coffee. There will be days when you are tired. I have two friends do this very same schedule, and they manage it well. Some even have more children than I do, and they are rocking it! It all comes down to how bad you want it and what you are willing to do to make it work.

The point of this story is to let you know it is doable. There will be moments of anxiety, and you might feel overwhelmed from time to time. Just take a deep breath, remember why you started this journey, sit down, and get reorganized. Whether you are doing part-time or full-time, being organized is the key. Write your exam dates on a calendar, and write your work schedule down as well. Make sure you honor your commitments, and make sure you have a few days to decompress. The goal is to balance the vital things in your life, and it is possible with the right support system and mindset. I'm not saying this will work 100% for everyone regardless of setting. What I'm saying is that there are examples of people successful attempting the full-time "everything" gameplan. Whether you work or not, the point is that you're investing in yourself and your future. Every individual will have a custom journey. You determine what works for you.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
The package inserts for statins were revised by the FDA in 2012. Pretreatment liver function tests are recommended, but routine periodic monitoring of liver enzymes is not, as it was in the past, because serious liver injury rarely occurs.

November 13, 2017

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
All of the statins decrease hepatic cholesterol synthesis by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase. They are highly effective in reducing total cholesterol and LDL-C.

#NacoleMedMath | Nursing Math - Dosage Calculations

** ANSWER: 12.48 ML ** 
83.2 KG x 0.3 MG = 24.96 MG/KG 
 24.96 MG/KG / 2 MG/ML = 12.48 ML

November 12, 2017

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
The currently available lipid-lowering drugs can be divided into the statins, the bile acid sequestrants, nicotinic acid, the fibrates and cholesterol absorption inhibitors. These all reduce LDL-C. Of these drugs, statins are usually the first drugs of choice.

November 11, 2017

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Atherosclerotic inflammation is triggered when circulating LDL enters the arterial wall and is retained through interaction with proteoglycans. LDL modification within the arterial wall occurs through a series of oxidative steps.

November 10, 2017

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
When urgent activation of the clotting mechanism is essential (for example, traumatic hemorrhage with life-threatening bleeding), then powerful activation of thrombosis can be attempted by giving recombinant factor (rF) VIIa.

November 9, 2017

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Antiarrhythmic drug classifications are grouped into four classes: class I, sodium channel blockers; class II, β-adrenergic blockers; class III, repolarization blockers; and class IV, those agents that block the calcium current in the AV node.