Ward Class

An Online Resource Site For Student Nurses

Welcome

Ward Class is an online resource for student nurses. Created with the aim of helping student nurses cope with the demands of nursing school and clinicals, it offers free downloads, notes, sample NCPs, sample drug studies, study aids, news and updates, and practical tips to its users.

Site Announcement

The December 2012 PRC Nursing Board Exam Result is already available here at Ward Class and at Pinoy R.N.




Musculoskeletal Disorders: Gout


  • also called metabolic arthritis
  • a disorder in purine metabolism; high levels of uric acid in the blood results in the formation of urate crystals that accumulate around joints
  • the presence of urate crystals around joints cause inflammation and intense pain
  • risk factors include:
    • lifestyle factors--> excessive alcohol use
    • medical conditions--> uncontrolled hypertension, hyperlipidemia (increased cholesterol levels), diabetes mellitus, and arteriosclerosis (narrowing of the arteries)
    • medications--> thiazide diuretics, anti-rejection drugs, aspirin
    • family history of gout
    • age and sex--> more common in men, between 40 t0 50 y.o;
Assessment Findings
  • joint pain, redness, heat, swelling--> usually affects joints of the foot (big toe) and ankles
  • intense pain that starts during the night
  • headache
  • malaise
  • anorexia
  • tophi in outer ear, hands, and feet (chronic tophaceous stage)
  • Diagnostic test--> joint fluid test (presence of urate crystals when examined under microscope), blood test (increased serum uric acid levels, more than 7.0mg/100ml)
Medical Management
  1. Non-steroidal anti-inflammatory drugs (NSAIDs)--> includes ibuprofen and naproxen may cause stomach pain, bleeding, and ulcers
  2. Colchicine--> effectively controls gout; may have side effects such as nausea, vomiting, and diarrhea
  3. corticosteroids--> may control gout inflammation and pain; side effects include thinning bones and poor wound healing
  4. Uricosuric agents (probenecid) and allopurinol---> prevents recurrent attacks
Nursing Management
  1. regularly assess joints (pain, motion, appearance)
  2. provide bed rest and joint immobilization as ordered
  3. administer medications as prescribed
  4. increase fluid intake (2 to 3 L/day) to prevent renal calculi formations
  5. apply bed cradle to minimize joint pain
  6. apply heat or cold to affected area as ordered
  7. provide health teachings on:
    • anti-gout and pain medications and their side effects
    • importance of low-purine diet--> avoid organ meats (sweetbreads, lover, brains), sardines, mackerel, herring, anchovies, and shellfish
    • limitation of alcohol consumption
    • increased fluid intake (2 to 3 L/day)
    • weight reduction as necessary
    • importance of exercise
Prognosis

Gout is severely restricting due to intense pain and inflammation. Effective gout treatment usually improves symptoms within hours. Even if left untreated, acute gout attacks resolve on its own. Affected areas return to normal without functional limitations.

Prevention

To reduce the risk of gout, it is important to make certain dietary and lifestyle changes. Intake of red meat, seafood, alcohol, and high-fat dairy products should be limited. Regular exercise is also encouraged to maintain healthy weight.


Integumentary Disorders: Psoriasis


  • Psoriasis is a chronic type of dermatitis that affects the life cycle of skin cells
  • in this common skin disease, the life cycle of epidermal cells is shortened from a month to a few days resulting in thick, scaly, dry, and red patches on the skin
  • the most significant risk factor for psoriasis is family history of the disease; other factors include stress, trauma, infection (eg. HIV), obesity, and smoking.
  • triggers of psoriasis also include heavy alcohol consumption, cold weather, and medications (beta-blockers, lithium, iodides, and antimalarial drugs)
Assessment Findings
  • red patches of skin covered with silvery scales
  • small scaling spots (commonly seen in children)
  • dry, cracked skin that may bleed
  • itching, burning or soreness
  • thickened, pitted or ridged nails
  • swollen and stiff joints
Medical Management
  1. topical corticosteroids-->for mild to moderate psoriasis
  2. coal tar preparations-->oldest treatment for psoriasis; reduces scaling, itchiness, and inflammation
  3. ultraviolet light
  4. antimetabolites (methotrexate) -->suppresses inflammation and halts progression of arthritis; may cause liver damage and decrease in production of blood cells (usually taken with folic acid to reduce side effects)
Nursing Management
  1. apply wraps over prescribed topical corticosteroids
  2. areas treated with coal tar preparations should be protected from direct sunlight for 24 hours
  3. when administering methotrexate, check for side effects
  4. encourage patient to use cover-ups when feeling self-conscious
  5. stress the importance of adhering to prescribed treatments and avoidance of products not prescribed by physician
Prognosis

Although psoriasis is not fatal, it can increase the risk for drug and alcohol abuse, thereby increasing mortality rates in psoriasis patients. Patients, therefore, must be taught coping skills so they will feel more in control despite the emotional and social consequences of having the disease.

Prevention

There is no known prevention of psoriasis. Avoidance of triggers, however, will improve symptoms and reduce the number of flare-ups.

Genitourinary Disorders: Epididymitis


  • a male reproductive disorder; one of the most common intrascrotal infections
  • an inflammation of the coiled tube (epididymis) at the back of the testicles
  • can be acute
  • may also be caused by GU instrumentation and urinary reflux

Assessment Findings
  • Scrotal pain and edema
  • Urinary frequency, urgency, or dysuria
  • Urinary retention from bladder outlet obstruction in older patients
  • Nausea
  • Fever and chills
  • Abdominal or flank pain
  • Bilateral epididymal involvement (10%)
  • Urethral discharge
  • Urine culture-->identifies specific organism
Medical Management
  • antibiotics specific for the organism
  • pain medications
Nursing Management
  • give antibiotics and pain medication as ordered
  • place patient on bed rest with scrotum elevated-->to decrease edema
  • apply ice packs to scrotal area-->to decrease edema
Prognosis

Pain usually resolves within 1 to 3 days but swelling may take longer to resolves. If left untreated, epididymitis may eventually lead to scrotal abscess, chronic epididymitis, testicle atrophy, and impaired fertility (rare).

Prevention

When treating STD-related epididymitis, the patient and all sexual partners should be treated to avoid recurrence. Condom use during sexual intercourse is helpful in preventing the disease.

Neurologic Disorders: Bell's Palsy


  • one of the most common neurologic disorders affecting the cranial nerves
  • it is an abrupt, unilateral loss of ability to move muscles of the face due to a disorder of cranial nerve VII
  • caused by an autoimmune reponse or may be viral (herpes simplex, herpes zoster, cytomegalovirus, and Eipstein-Barr virus)
  • incidence is slightly higher in patients of Japanese decent
Assessment Findings
  • Sudden onset of paralysis or weakness on one side of your face, making it difficult to smile or close your eye on the affected side
  • Facial droop and difficulty with facial expressions
  • Pain behind or in front of your ear on the affected side
  • Sounds that seem louder on the affected side
  • Pain, usually in the ear on the affected side
  • Headache
  • Loss of taste (anterior two-thirds of tongue of affected side)
  • Changes in the amount of tears and saliva your body produces
Medical Management
  • most patients recover fully- with or without treatment
  • medications such as corticosteroids may be given to reduce facial nerve inflammation
  • physical therapy may be prescribed to speed up recovery and to avoid contractures
  • surgery (decompression surgery) is rarely an option
Nursing Management
  1. regular facial nerve function assessment
  2. administer pain medications and corticosteroids as ordered
  3. provide soft diet ; avoid very hot and cold foods
  4. instruct patient to chew on unaffected side
  5. perform mouth care before and after meals
  6. provide special eye care ro protect the cornea: eyeshield or dark glasses, artificial tears, eye patch or ointment to keep eyelids closed at night
Prognosis

Bell's palsy normally disappears within 3 to 5 weeks for most clients. If the damage to facial nerve is unusually severe, the fibers may be irreversibly damaged. Some patients may exhibit partial paralysis, involuntary movement accompanying a voluntary movement, and/or involuntary lacrimation after a voluntary muscle movement.

Prevention

Bell's Palsy is not preventable.

Hematologic Disorders: Pernicious Anemia

megaloblastic cells vs normal cells
  • also called Addison's anemia, primary anemia
  • a type of megaloblastic anemia caused by the lack or deficiency of intrinsic factor (caused by gastric mucosal atrophy or as a consequence of total gastrectomy)
  • results in abnormally large erythrocytes (rbc) and hypochlorhydria
  • specifically refers to anemia resulting from vitamin B12 deficiency caused by an autoimmune metaplastic atrophic gastritis with loss of intrinsic factor
  • risk factors include age of more than 50, family history of the disease, Scandinavian or European decent, and history of autoimmune endocrine disorders such as Type 1 Diabetes Mellitus and Grave's Disease
Assessment Findings
  • anemia, weakness, pallor, shortness of breath, fatigue, rapid heart rate
  • GI symptoms: anorexia, weight loss, diarrhea, constipation, sore mouth, bleeding gum, beefy red tongue
  • neurologic symptoms: tingling fot he hands and feet, unsteady gait, paralysis, positive Babinski's reflex, personality changes such as depression and psychosis
  • diagnostic tests:
    • erythrocyte count-->decreased
    • blood smear-->oval, macrocytic eryhtrocytes
    • bone marrow-->increased megaloblasts or abnormal erythrocytes, few maturing normal erythrocytes, defective leukocyte maturation
    • indirect bilirubin-->elevated unconjugated fraction
    • serum LDH-->elevated
    • Schilling test (definitive)-->positive
    • gastric analysis-->decreased free hydrochloric acid
Medical Management
  1. monthly vitamin B12 injections
  2. iron preparations-->if hemoglobin is inadequate
  3. folic acid-->safe if given in small amounts; reverses anemia and GI symptoms but may increase neurologic symptoms
Nursing Management
  1. provide a diet high in iron (meat, milk, eggs)
  2. if patient has mouth sores, spicy or very hot foods should be avoided.
  3. provide mouth care before and after meals: soft toothbrush, no strong commercial rinses
  4. planned rest periods; bed rest if anemia is severe
  5. ensure saftey during ambulation
  6. discharge planning safety during ambulation, importance of vitamin B12 therapy, dietary teachings
Prognosis

Presently, patients who receive appropriate treatments have a normal lifespan. Perisistent neurologic defects may persist if treatment is delayed. Other complications such as gastric polyps and gastric cancer may also occur if patients do not receive treatment as needed.

Prevention

There is no known prevention for pernicious anemia.

Related Link:
Sample NCP for Pernicious Anemia



Bill of Rights for Registered Nurses

1. Nurses have the right to practice in a manner that fulfills their obligations to society and to those who receive nursing care.

2. Nurses have the right to practice in environments that allow them to act in accordance with professional standards and legally authorized scopes of practice.

3. Nurses have the right to a work environment that supports and facilitates ethical practice, in accordance with the Code of Ethics for Nurses and its interpretive statements.

4. Nurses have the right to freely and openly advocate for themselves and their patients, without fear of retribution.

5. Nurses have the right to fair compensation for their work, consistent with their knowledge, experience and professional responsibilities.

6. Nurses have the right to a work environment that is safe for themselves and their patients.

7. Nurses have the right to negotiate the conditions of their employment, either as individuals or collectively, in all practice settings.

Endocrine Disorders: Diabetes Insipidus

  • a disorder characterized by intense thirst and the excretion of large amounts of urine
  • hypofunction of the posterior pituitary gland resulting in deficiency of ADH (antidiuretic hormone)
  • types: central, nephrogenic, gestational
  • common causes: tumor, trauma, inflammation, pituitary surgery
Assessment Findings
  • polydipsia (excessive thirst) and severe polyuria (2.5 to 15L per day) with low specific gravity
  • fatigue, irritability, weight loss, muscle weakness, and signs of dehydration
  • tachycardia, and shock if fluids are not replaced
  • for infants and young children:
    • unexplained fussiness or inconsolable crying
    • unusually wet diapers
    • fever, vomiting, or diarrhea
    • dry skin or cool extremities
  • diagnostic tests:
    • water deprivation test reveals inability to concentrate urine
    • urinalysis-->urine specific gravity less than 1.004
    • magnetic resonance imaging (MRI) of the head-->for abnormalities near or in the pituitary gland
Medical Management
  1. hormone replacement like Vasopressin (Pitressin)-->will eliminate increased urination
  2. maintenance of fluid & electrolyte balance
Nursing Management
  1. maintain fluid and electrolyte balance: I&O, weigh daily, administer oral/IV fluids as ordered
  2. monitor VS and observe for signs of dehydration and hypovolemia
  3. administer hormone replacement as ordered:
    • vasopressin (Pitressin) and vasopressin tannate (Pitressin tannate in oil): give via IM injection, warm to body temperature before giving, shake tannate suspension to ensure uniform dispersion
    • lypressin (Diapid)-->nasal spray
    • note: some books state desmopressin (DDAVP) as the drug of choice
  4. provide client teaching on:
    • lifelong hormone replacement to control polyuria and polydipsia
    • need to wear Medic-Alert bracelet (if applicable)
Prognosis

Mortality is rare in adults as long as fluid lost is readily replaced. Severe dehydration, cardiovascular collapse, and death can ensue in children, elderly, and those with complicating illnesses.

Prevention

There are no known ways to prevent diabetes insipidus. Complications, however, can be prevented by immediately seeking medical attention once symptoms appear.

Cardiovascular Disorders: Buerger's Disease


  • also called thromboangiitis obliterans, an acute inflammatory disorder affecting medium/smaller arteries and veins of the arms and legs
  • results in occlusion of a blood vessel with subsequent collateral circulation
  • the classic patient with Buerger's disease is a male patient between ages 20 and 40 who smokes heavily
  • also found in women and people over the age of 50
  • common in Southeast Asia, India, and the Middle East
  • caused by cigarette smoking and tobacco use
Assessment Findings
  • intermittent claudication (leg pain during activity such as walking)
  • sensitivity to cold (skin becomes white->blue->red)
  • decreased or absent peripheral pulses (posterior tibial and dorsalis pedis)
  • swelling of feet and hands
  • open sores and gangrene (advanced)
  • elevated serum sodium
  • diagnostic tests:
    • oscillometry may reveal decrease in pulse volume
    • Doppler ultrasound reveals blood flow through affected vessels
    • angiography reveals location and extent of obstructive process
Medical Management
  1. cessation of smoking
  2. calcium-channel blockers and thrombolytics to improve circulation
  3. oral antibiotics-->for ulcers
  4. pain medications
Surgical Management
  • surgical sympathectomy (nerves in affected area are severed to control pain)
  • amputation of affected extremity if infection or gangrene occurs
Nursing Management
  • for clients who will undergo surgery
    1. prepare client for surgery
    2. provide client teaching and discharge planning concerning:
      • drug regimen (vasodilators, anticoagulants, analgesics) including dosage, frequency, and side effects
      • need to avoid trauma to affected extremity
      • need to maintain warmth, especially in cold weather
      • importance of cessation of smoking
Prognosis

Death from Buerger's disease is rare but for patients who continue smoking, 1 or more amputations are required in a span of 7 years.

Prevention

The best way to prevent Buerger's disease is to cease smoking or tobacco use.

Gastrointestinal Disorders: Stomach Cancer


  • also called gastric cancer is cancer that forms in tissues lining the stomach; most often develops in the distal third and may spread through the walls of the stomach into adjacent tissues, lymphatics, regional lymph nodes, other abdominal organs, or to the lungs and bones
  • affects men twice as often as women; more frequent in African Americans and Orientals; commonly occurs between ages 50 and 70
  • causes
    • excessive intake of highly salted or smoked foods
    • diet low in quantity of vegetables and fruits
    • atrophic gastritis (chronic inflammation of the stomach mucosa)
    • achlorhydria (lack of hydrochloric acid in the digestive juices in the stomach)
    • H. pylori infection
Assessment Findings
  • fatigue, dizziness, weakness, shortness of breath, pallor, lethargy
  • nausea and vomiting, hematemesis, weight loss, indigestion, epigastric fullness, feeling of early satiety when eating, epigastric pain (late symptom)
  • palpable epigastric mass
Medical Management
  1. chemotherapy -->may use combinations of mitomycin, cisplatin, 5FU, doxorubicin, methotrexate, and eprubicin ; capecitabine or uracil (oral tablet forms of 5FU)
  2. radiation therapy
  3. treatment for anemia, gastric decompression, fluid and electrolyte maintenance
Surgical Management
  • surgery depends on the location and extent of the lesion:
    • subtotal gastrectomy (Billroth I or II) --> part of the stomach is removed; for early stages
    • total gastrectomy--> total removal of the stomach and nearby lymph nodes; may also include the duodenum, spleen, and part of the pancreas
Nursing Management
  1. give consistent nutritional assessment and support
  2. provide care for client receiving chemotherapy
    • monitor IV site for extravasation and stop if it occurs (if using IV chemotherapeutic drugs)
    • administer antiemetic as ordered prior to chemotherapy and up to 48 hours afterwards
    • monitor CBC
    • monitor I&O (diarrhea is expected)
    • monitor liver and renal function tests
    • inspect oral cavity daily for sores and signs of infection
    • discharge teaching:
      • intake of frequent, small portions of high-calorie, high-protein, low-residue foods
      • increase liquid intake and frequent rest periods
      • expect hair loss and purchase scarves and wigs
      • prevent infection: good handwashing technique, avoid crowds, individuals with infection
      • minimize stomatitis by using soft-bristled toothbrush and baking soda rinse
      • use relaxation techniques to cope with nausea
  3. provide care for the client with gastric surgery
    • provide routine post-operative care
    • ensure adequate function of nasogastric tube: measure drainage accurately (notify physician if there is no drainage, anticipate frank, red bleeding for 12-24 hours
    • provide adequate ventilation:
      • place client in mid- or high-Fowler's position to promote chest expansion
      • teach client to splint abdominal incision before turning, coughing, deep breathing
    • promote adequate nutrition : clear liquids to small amounts of bland food after NG tube removal, monitor weight daily, assess for regurgitation (if present, instruct patient to eat small amounts of food at a slower pace)
    • provide discharge planning concerning:
      • gradual increase of food until 3 meals/day is tolerated
      • daily monitoring of weight
      • stress-reduction measures
      • report signs of complications to physician: hematemesis, vomiting, diarrhea, pain, melena, weakness, weakness, feeling of abdominal fullness/distension)
      • controlling symptoms associated with dumping syndrome (rapid gastric emptying) such as weakness, diarrhea, faintness, feeling of fullness, and diaphoresis
        1. avoidance of concentrated sweets
        2. taking six, small, dry meals per day
        3. refraining from taking fluids during meals
        4. lying flat on bed for 20-30 mins. after meals
Prognosis

Stomach (Gastric) Cancer is readily treated when diagnosed in its early stages. Unfortunately, symptoms often manifest when this type of cancer is in its advanced stage and has spread beyond the stomach.

Prevention

The following practices may reduce the risk of stomach (gastric) cancer:
  • Incorporating fruits and vegetables into the diet (high in vitamin C and beta-carotene)
  • Avoidance of foods high in nitrites and nitrates (e.g. cured meats)
  • Limited intake of smoked, heavily salted, or pickled foods
  • Avoidance of tobacco smoke
  • Limited consumption of alcohol
  • Limited intake of red meat
  • Early treatment of gastritis and ulcers
Related Link:
Sample NCP for Stomach Cancer


Respiratory Disorders: Emphysema



  • a type of Chronic Obstructive Pulmonary Disease involving the damage of alveoli (air sacs) in the lungs
  • three types: centriacinar, panlobar, and paraseptal
  • alveolar, bronchial, and bronchiolar tissue are damaged resulting in loss of recoil, air trapping, thoracic overdistension, accumulation of sputum, and loss of diaphragmatic muscle tone
  • results in carbon dioxide retention, hypoxia, and respiratory acidosis
  • caused mainly by cigarette smoking; other causes include infection, inhaled irritants, heredity, allergic factors, and aging
Assessment Findings
  • anorexia, fatigue, weight loss
  • difficulty of breathing, cough, sputum production
  • resonance to hyperresonance
  • decreased breath sounds with prolonged expiration
  • normal or decreased fremitus
  • diagnostic tests: pCO2 may be elevated or normal; pO2 normal or slightly decreased
Medical Management
  1. bronchodilators such as aminophylline, isoproterenol, terbutaline, and theophylline -->treat brochospasm
  2. corticosteroids like prednisone -->reduces inflammation
  3. Cautious low-flow oxygen delivery is prescribed for patients with emphysema (usually 1 to 3L/min by nasal cannula) due to long-standing hypercapnia; high levels of oxygen can obliterate to patient's respiratory drive
  4. postural drainage and chest physiotherapy -->remove bronchial secretions
  5. aerobic and breathing exercises-->enhance cardiovascular fitness and strengthen respiratory muscles
Surgical Management
  • surgery is relatively uncommon but there are times when patients need to undergo procedures such as bullectomy (removal of a large bullae that compresses the lung) or Lung Volume Reduction Surgery (LVRS)
Nursing Management
  1. administer medications as ordered: bronchodilators, antimicrobials (ampicillin, tetracycline) for bacterial infections, corticosteroids
  2. facilitate removal of secretion
    • ensure fluid intake of 3L per day
    • provide chest physiotherapy, teach coughing and breathing exercises
    • suction and provide oral hygiene as needed
  3. improve ventilation
    • maintain in semi- or high-Fowler's position
    • instruct on diaphragmatic breathing
    • encourage productive coughing after treatments (splint abdomen to produce expulsive cough)
    • instruct on pursed-lip breathing (prolonged, slow relaxed expiration) techniques
  4. provide client teachings prior to discharge
    • prevention of infection: avoid crowds, immunization for influenza and pneumonia
    • worsening of symptoms: fatigue, increased dyspnea, increased tightness of chest
    • importance of diet: high-carbohydrate, high-protein, increased vitamin C
    • control of environment: use of home humidifier at 30-50% humidity, wear scarf over nose and mouth in cold weather to prevent bronchospasm, avoid smoking and irritants
    • avoid abrupt changes in temperature
    • increasing activity tolerance: mild exercises, breathing techniques, have low-flow oxygen available as needed, frequent rest periods
Prognosis

Emphysema is an irreversible, chronic, and serious disease. If detected early and if the patient stops smoking immediately, treatment can slow the progress of the disease. Overall, prognosis for patients diagnosed with emphysema is poor. With supplemental oxygen and other treatments, patients may significantly improve their prognosis.

Prevention

The best way to prevent emphysema is to avoid smoking.



The '5 Rights' of Drug Administration

When administering medications, student nurses are expected to be responsible for their own actions. To avoid medication errors and ensure patient safety before administering any drug, regardless of the route of administration, the prudent student nurse remembers the following:

  1. The Right Patient. Ensure that you are giving the drug to the right patient. How do you do this? You can ask the patient to state his or her name and check the ID bracelet. In cases wherein no ID bracelet is attached or the patient is not able to state his name, withhold the medication until positive identification is established. Once the patient has been positively identified, check if the patient's name matched the name on the medication order.
  2. The Right Drug. When giving medications, make sure you are giving the right drug. Be very careful when reading medication orders because the most common factors contributing to medication errors are poorly-written medication orders and look-and-sound alike drugs. To ensure that the drug you are about to administer is the right drug, always check the generic and brand name of the drug. Also check if the drug matches the patient condition. For example, an anticonvulsant has been prescribed to a patient admitted due to fungal infection, then by all means withhold the medication and clarify the order with the prescriber. Furthermore, if the drug to be administered requires preparation, make sure it has been prepared correctly.
  3. The Right Dose. Make sure that the dose has been interpreted and calculated correctly. Take into account the age, weight, and kindney and liver function of the patient. Also check if you correctly interpreted the abbreviations used by the prescriber.
  4. The Right Route. You might have heard of cases wherein Potassium Chloride has been inadvertently administered to a patient via IV bolus resulting to cardiac arrest and death. Scary, right? To avoid route-related medication errors, make sure that the route ordered is the route being used. Of equal importance is to check if the route is appropriate for the patient and that the correct administration technique is being used.
  5. The Right Time. Before administering any drug, it is important to check if the drug is being administered at the right time. Take note if the frequency ordered by the prescriber has been interpreted correctly. It is also very prudent to check any possible food and drug interactions before drug administration.

Taking into account the '5 Rights' of Drug Administration will help the student nurse avoid medication errors and ensure patient safety. It is thus the responsibility of the student nurse to be very familiar with these guidelines on drug administration to steer clear of untoward consequences.


A Patient's Bill of Rights

Nurses are patient advocates. The nurse shall conduct his or her professional duties and responsibilities in consideration of the rights a patient, a recipient of medical and nursing care, is entitled to.

Since student nurses provide supervised nursing care to patients during clinical rotation, they are expected to be very familiar with the patient's basic rights in order to render care in a manner consistent with the standards of nursing practice.

The patient's rights are as follows:
  1. The patient has the right to considerate and respectful care.
  2. The patient has the right to and is encouraged to obtain from physicians and other direct caregivers relevant, current, and understandable information concerning his or her care, except in emergencies when the patient lacks decision-making capacity and the need for treatment is urgent. He also has the right to know the identity of persons involved in his or her care and the immediate and long-term financial implications of all treatment choices.
  3. The patient has the right to make decisions about the plan of care prior to and during the course of treatment and to refuse a recommended treatment or plan of care to the extent permitted by law and hospital policy and to be informed of the medical consequences of this action.
  4. The patient has the right to have an advance directive (such as a living will, health care proxy, or durable power of attorney for health care) concerning treatment or designating a surrogate decision maker with the expectation that the hospital will honor the intent of that directive to the extent permitted by law and hospital policy.
  5. The patient has the right to every consideration of privacy. Case discussion, consultation, examination, and treatment should be conducted so as to protect each patient's privacy.
  6. The patient has the right to expect that all communications and records pertaining to his/her care will be treated as confidential by the hospital, except in cases such as suspected abuse and public health hazards when reporting is permitted or required by law.
  7. The patient has the right to review the records pertaining to his/her medical care and to have the information explained or interpreted as necessary, except when restricted by law.
  8. The patient has the right to expect that, within its capacity and policies, a hospital will make reasonable response to the request of a patient for appropriate and medically indicated care and services. The hospital must provide evaluation, service, and/or referral as indicated by the urgency of the case.
  9. The patient has the right to ask and be informed of the existence of business relationships among the hospital, educational institutions, other health care providers, or payers that may influence the patient's treatment and care.
  10. The patient has the right to consent to or decline to participate in proposed research studies or human experimentation affecting care and treatment or requiring direct patient involvement, and to have those studies fully explained prior to consent.
  11. The patient has the right to expect reasonable continuity of care when appropriate and to be informed by physicians and other caregivers of available and realistic patient care options when hospital care is no longer appropriate.
  12. The patient has the right to be informed of hospital policies and practices that relate to patient care, treatment, and responsibilities.

Nursing Defined

Nursing
  • Nursing is the act of utilizing the environment of the patient to assist him in his recovery (Nightingale 1860).
  • Nursing is the act of providing assistance to the individual, sick or well, in the performance of activities contributing to health or its recovery that the person performs unaided if he had the necessary strength, will, or knowledge (Henderson 1960).
  • Nursing is the diagnosis and treatment of human responses to actual or potential health problems (ANA 1980).
  • Nursing is the identification of and treatment of human responses to actual or potential health problems and includes the practice of and supervision of functions and services that, directly or indirectly, in collaboration with a client and health care providers other than nurses, have as their objectives the promotion of health, prevention of illness, alleviation of suffering, restoration of health and optimum development of health potential and includes all aspects of the nursing process (CNA 1984)
  • The more modern theoretical definitions of nursing are centered around the following concepts of nursing:
    • Nursing is caring.
    • Nursing is an art.
    • Nursing is a science.
    • Nursing is client-centered.
    • Nursing is holistic.
    • Nursing is adaptive.
    • Nursing is concerned with health promotion, health maintenance, and health restoration.
    • Nursing is a helping profession.


And Finally, My Own Mini-hospital...



Okay, Okay. I shouldn't be cross-posting but this article I posted in my other blog is so dear to me that I have to share it to you, cool studes. Here goes:


I decided to take cybernursing a notch higher (whatever that means) by designing my own mini-hospital. Mini-hospital.Com was kind enough to provide us nurses with a virtual dress-up game where we can make our own mini-hospital. Cool, isn't it? This make-your-own-mini-hospital flash game is just perfect for those who are ambitious in their virtual lives but for some reason slack it off the moment they're back on Earth.

Having my own mini-hospital is like playing God (sorry to all the surgeons out there...). I have a pink-themed hospital with the cutest hospital beds and i.v. stands. I even have an O.R. table complete with my own surgical team performing surgery for everybody to see! And to top it all, my pediatric patients are being chased by nurses carrying gigantic syringes! How cute is that?


This may look like a no-sweat, drag-and-drop activity but it is not! You have to decide which furniture to use and make sure that the nurses you pick give justice to nursing by looking really
kawaii on the job. Truly nursing management at its greatest! Tee-hee!

If you want to experience what it is like to design and manage your very own mini-hospital, please visit Mini-hospital.Com. Just make sure not to take the task too seriously and end up sweating and nauseous like me.

P.S. For those who think that my mini-hospital sucks, get real! I'm a nurse not an interior designer or something...Chill!


I hope you get the hang of it, guys. Good luck!

What To Expect From This Blog

Hi, all! My BFF suggested that I set up this resource site for nursing students as he noticed that I have a lot of time to spare. I agreed with him as I am kind of experiencing a lull in my blogging. I think that the idea is not bad since I know first-hand the difficulties a nursing student goes through like what subjects (and requirements) are the easiest, most boring, or the most difficult to understand .

I believe that this will be a great opportunity for me to put this skilled brain to use (pun intended) and make the most out of all these nursing-related materials I have in storage boxes and in my very limited hard disk. I have also studied like crazy for the NLE and NCLEX exams and now that I am done with all that, I might as well utilize all these nursing-related information I crammed in my head.

On a more serious note, here is a short list of nursing-related stuff you will find here from this day onward:
  • review notes on different concepts and subject areas
  • sample drug studies
  • sample nursing care plans (NCPs)
  • free downloads
  • relevant nursing news and updates
  • nursing trivia
  • nursing humour
I think this is all for now. Do come back for more updates. For requests and suggestions, leave me a comment or two or better yet, email me at hodgepodgemail(at)yahoo(dot)com. I promise I'll get back to you.