May 27, 2017

Nursing Tip of the Day! - Psychiatric Nursing

Category: Psychiatric Nursing 
Amnestic syndrome is a memory disturbance usually associated with thiamine deficiency and chronic alcohol use (Korsakoff syndrome). There is an impairment in the ability to learn new information or recall previously learned information.

May 26, 2017

New Nurse Bootcamp | Mindset

Nursing Tip of the Day! - Psychiatric Nursing

Category: Psychiatric Nursing 
Pseudodementia is a term previously applied to depressed patients who appear to be demented. These patients are often identifiable by their tendency to complain about memory problems vociferously rather than try to cover them up.

#AskNacole | Preceptor Problems

May 25, 2017

Nursing Tip of the Day! - Psychiatric Nursing

Category: Psychiatric Nursing 
Delirium (acute confusional state) is a transient global disorder of attention, with clouding of consciousness, usually a result of systemic problems (medications, hypoxemia). Onset is usually rapid and the mental status fluctuates.

May 24, 2017

Nursing Tip of the Day! - Psychiatric Nursing

Category: Psychiatric Nursing 
Anabolic steroids are abused by people who wish to increase muscle mass. In addition to the medical problems, the practice is associated with significant mood swings, aggressiveness and paranoid delusions.

May 23, 2017

Nursing Tip of the Day! - Psychiatric Nursing

Category: Psychiatric Nursing 
Amyl nitrite is used as an “orgasm expander.” The changes in time perception, “rush” and mild euphoria caused by the drug prompted its nonmedical use. Subjective effects last from 5 seconds to 15 minutes.

May 22, 2017

Nursing Tip of the Day! - Psychiatric Nursing

Category: Psychiatric Nursing 
The signs of alcoholic intoxication are the same as those of overdosage with any other central nervous system depressant: drowsiness, errors of commission, psychomotor dysfunction, disinhibition, dysarthria, ataxia and nystagmus.

May 21, 2017

The Short Game | Short-Term Goals & Nursing


Short-term goals are the name of the game. I learned this in my infertility journey. I would let the concept of conceiving a child overwhelm me and subsequently have a panic attack. There were many nights when I would wake up my sleeping husband just to talk about how we would never have kids and that the process of "trying" was a complete waste of time.

My husband woke up one night and said in the gentlest, kindest voice, "We will take it one day at a time. Don't worry about next week. Focus on the now, the present, and we’ll take it from there. Believe in the future, but don't focus on it so much." After that night, I applied that concept to nursing school, and my stress level decreased significantly. You must understand that having long-term goals is nice, but productivity revolves around making short-term goals and sticking to your game plan. I know life gets in the way (I have a toddler, nothing goes as planned) and some things are out of your control. But many people just make excuses as to why they can't do something and never truly attempt the task. Trying new things is scary. Believing in yourself is scary. But you will never know your true potential unless you see what you're made of. I'm not going to get all Tony Robbins on you, but you have to set your "personal responsibility" bar higher. You have to be accountable for your actions (or lack thereof). 

Hard Limits

For short-term goals to work, you must complete the task within the given time frame. No ifs, ands, or buts about it. Timeframes are crucial to your success. Timeframes keep you accountable and guarantee that tasks will be completed on time. This must be a hard limit. If you come up with excuses as to why you can't, it won't work. There have been many times when I wanted just to close my eyes and rest. But, I had a goal that I would read 10 chapters that night before heading to bed. Yeah, was tired, but I also had professional goals, and they required hard work. I've never guessed on exams and been successful. I have studied my ass off and failed exams though. My knowledge doesn't come naturally - it comes from hours and hours of studying, preparation, and repetition. I must study, so my need to be successful supersedes my laziness. If you allow yourself the ability to accept "partial" goals, that window will open more and more with each attempt. Soon, you will have an excuse locked and loaded before the objective even presents itself. Every morning when I wake up, I walk to my dry erase board and write at least three things I need to achieve that day.

Physical Reminders

I had an assignment due within a few days. I wanted to complete the assignment before 6:00 p.m., before getting my son from daycare. I put the goal on my dry erase board around 8:00 a.m. I would start writing and stop to do laundry or clean my son's room. Each time I stopped, I saw the big, bold, black writing on my crisp, stark white dry erase board. The words were taunting me. It was a reminder of my goal for the day. You should have a physical reminder that's in your eye view as a motivating factor. I've tried using my phone, and it didn't work. I would simply ignore the alarm or silence my phone. It was a barrier that I found an easy way around. What I can't avoid is big, bold writing on the dry erase board in my office (a.k.a. our dining room). It's unavoidable, and I put it there for that very reason. I would be vacuuming and look up, and there it was. I'd be watching television, get up to go to the bathroom, and see that damn dry erase board. It was beyond annoying, but I wouldn't remove the message until the task was completed. Again, you must set rules for this game to work in your favor. Because again, any compromise or settling on your end will allow you to not do what is needed.

Short-term goals will keep you on track and keep you vested in your future. Your long-term goals will remain on track if you have daily or weekly short-term goals in place. When I was a nursing student, I wasn't concerned about passing the NCLEX-RN exam during the first semester of my nursing program. I was worried about passing the upcoming quiz or clinical. You set the short-term goals, so you are in the running for the long-term aspirations. You can't be a registered nurse without passing the NCLEX-RN exam. But you aren't eligible for the NCLEX-RN exam if you don't pass the course. And you can’t pass the course without successfully passing the assignments and tests. It's a trickle-down game, and you must start with the tiny things. You become successful at the tiny things, and soon, you're at the large things - the life changing moments.

Nursing Tip of the Day! - Psychiatric Nursing

Category: Psychiatric Nursing 
The National Institute on Alcohol Abuse & Alcoholism formally defines at-risk drinking as more than 4 drinks per day or 14 drinks per week for men or more than 3 drinks per day or 7 drinks per week for women. 

May 20, 2017

Nursing Tip of the Day! - Psychiatric Nursing

Category: Psychiatric Nursing 
Alcohol use disorder is a syndrome consisting of two phases: at-risk drinking and moderate to severe alcohol misuse. At-risk drinking is the repetitive use of alcohol, often to alleviate anxiety or solve other emotional problems.

May 19, 2017

Nursing Tip of the Day! - Psychiatric Nursing

Category: Psychiatric Nursing 
Kleine-Levin syndrome occurs mostly in young men, is characterized by hypersomnic attacks three or four times a year lasting up to 2 days, with hyperphagia, hypersexuality, irritability and confusion on awakening.

May 18, 2017

Nursing Tip of the Day! - Psychiatric Nursing

Cateogry: Psychiatric Nursing 
There are two classes of treatment for insomnia: psychological (cognitive-behavioral) and pharmacologic. In situations of acute distress, such as a grief reaction, pharmacologic measures may be most appropriate.

May 17, 2017

Nursing Tip of the Day! - Psychiatric Nursing

Category: Psychiatric Nursing 
Abuse of alcohol may cause or be secondary to the sleep disturbance. There is a tendency to use alcohol as a means of getting to sleep without realizing that it disrupts the normal sleep cycle. 

May 16, 2017

Nursing Tip of the Day! - Psychiatric Nursing

Category: Psychiatric Nursing 
Lamotrigine is thought to inhibit neuronal sodium channels and the release of the excitatory amino acids, glutamate and aspartate. It is FDA approved for the maintenance treatment of bipolar disorder. 

May 15, 2017

Nursing Tip of the Day! - Psychiatric Nursing

Category: Psychiatric Nursing 
Patients receiving lithium should use diuretics with caution and only under close medical supervision. The thiazide diuretics cause increased lithium reabsorption from the proximal renal tubules, resulting in increased serum lithium levels.

#NacoleMedMath | Nursing Math - Dosage Calculations

** ANSWERS BELOW **
MIDAZOLAM: 1 MG/ML x 7 MG = 7 ML
SUCCINYLCHOLINE: 350 MG / 20 MG/ML = 17.5 ML
ETOMIDATE: 45 MG / 2 MG/ML = 22.5 ML
FENTANYL = 150 MCG / 50 MCG/ML = 3 ML

May 14, 2017

Three Reasons Why I Love Nursing


When I was a nursing student, I had people tell me all about the negative aspects of nursing. If it wasn't my father telling me that working for free (e.g., doing clinicals) was a "scam," it was my friends telling me, "Wiping asses is for suckers." Everyone around me had an opinion about nursing. I remember shadowing a local nurse, and she even had problems with nursing. So with that in mind, please know that I will not be complaining or talking about how much nursing sucks. You came to the wrong blog for that. What I will do is share all the amazing things nursing has brought into my life.

Medical Knowledge 

I have a son with autism, a husband who had a heart attack (and who currently has diabetes as well), and I had gastric bypass surgery and am now suffering from hypotension. Everyone in my immediate and distant family has some chronic or acute condition that needs managing daily. Diabetes, hypertension, stroke, renal disease - you name it - I'm helping a family member manage it. My family members are some sick folks. Nursing gives me the ability to be educated on various disease processes and conditions. I'm not going to pretend I know it all, but I know enough to educate my family members. I know enough to make sure they are caring for themselves appropriately, and I know when I'm being told a boldface lie. My dad had hip surgery, and he tried to tell me that he was cleared to walk without his cane after postoperative day two. Yeah, NO! The point is, when a disease process pops up, I know enough to make sure my family members are doing the proper things and following the given instructions. Knowledge is power and nursing has given me the power to help my loved ones in their times of need.

Work Schedule 

I work three 12-hour shifts per week. If you do the math, that leaves me with four days all to myself. I wouldn't have been able to go back to graduate school if I worked Monday through Friday. With clinical rotations and exams, I can only work three days a week. Three 12-hour shifts equal thirty-six hours a week, which equals seventy-two hours per pay period. I'm a full-time employee working ONLY three shifts a week. Who wouldn't love that? I've worked at many places Monday through Friday, and I was unable to enjoy my life like I am currently. Nursing has given me the opportunity to be financially stable (with full-time pay) and also spend a significant amount of time with my friends and family. I love my schedule.

Yes, I work nights, and yes, I love my schedule. I'm able to work when everyone else in the world is sleeping. Plus, when I get off, everything is just opening up, so I'm able to run errands in the morning. I love the flexibility of my schedule too. I can work my first week's shifts up front (e.g., working Sunday, Monday, and Tuesday), then I can work my second week's shifts on the back end (e.g., working Thursday, Friday, and Saturday). That leaves me with eight blissful days off to do whatever I want. I LOVE my schedule. I love the flexibility nursing has given my family and me. I'm a full-time employee, I get full benefits, and yet I only work three days per week. The only downside is you will have to work some holidays (if you work in the inpatient setting), but hey, I have no problem with that considering what I just told you.

Career Advancement

As a woman, there have been many instances where I was overlooked or ignored for an upcoming position. Even if I were the hardest working person there, it just wouldn't happen for me. I've worked in varying office settings, with most settings being predominately male. I'm not some delicate flower. I can work with men - don't start with that. The problem was that every time I would request a raise or want to advance my position, I would be brushed off and told to be grateful for the position I had currently. It was as if me asking for advancements was an insult. But when men asked for the same thing, they would get the new position plus get praise for stepping up.

Nursing isn't like that. I work in an environment with constant openings for advancement and specialty practice. I never feel stuck. There are always opportunities for nursing professionals. Now, obviously that's based on your job experience and professional goals, but I get offered a job every couple of months (thank you LinkedIn). I never had this type of flexibility and advancement in the traditional job setting (office setting). Someone had to damn near die for a position to open up, and even then, I'd get overlooked. With advancements in technology, the current nursing shortage, and people living longer, the nursing profession isn't going anywhere anytime soon. People will always be sick, seek medical care, and that means my job will always be necessary (until the robots get online, haha).

That's it folks, the main reasons why I love nursing. Every job has its set of issues. No job is perfect, but even so, I chose this career. I'm not stuck or trapped. I'm grateful I work in this profession, and I appreciate what it's given me.

Nursing Tip of the Day! - Psychiatric Nursing

Category: Psychiatric Nursing 
Frank lithium toxicity usually occurs at blood lithium levels > 2 mEq/L. Because sodium and lithium are reabsorbed at the same loci in the proximal renal tubules, any sodium loss (diarrhea, use of diuretics) results in increased lithium levels.