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I haven't laughed this hard in weeks. Dam fine job, beavers!
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Child Health Whoas!
Oh, the study fun continues with child health. I'm surprised how much better I'm performing on child health versus other subjects. I always thought not having kids would make this the most challenging subject.
GI bleeds can cause iron deficiency anemia. In children, however, excessive intake of milk is the most common cause this type of anemia. Milk can interfere with the absorption of iron, as well as keep the child from consuming other forms of iron-rich food. Keep milk intake between 16-24 oz per day.
You cannot microwave milk any time ever. If you see the words microwave and milk in the same sentence then discard.
Leftover milk should be discarded after feeding unless it is unused (ie, not put into a bottle for feeding). In that case, you can store the unused portion for up to 24 hours in the refrigerator.
Use a warm pack on a baby's heal to promote blood flow prior to a heel stick instead of a cool pack. A cool pack helps with pain by causing vasoconstriction. In this case, you want increased blood flow to make the heel stick quick and easy.
A high pitched cry from an infant is cause for concern, so pay attention. They're telling you something is wrong.
Autistic children require lower levels of stimulation because they are incredibly sensitive to light, sound, and touch. Therefore, this is one situation where placing the child in a quiet and private room away from the nurse's station makes sense. You want to reduce the amount of stimulation they experience during their hospitalization.
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Maternal and Newborn Study Whoas!
Been preparing for the NCLEX and I found this worked for me last time, actually writing out things I either did not remember or hadn't learned. Hopefully this is helpful to someone else.
Opioid pain management meds for laboring women should be given during the peak of their contractions. During contractions, the blood vessels are clamped down and less blood flows to the baby. Two benefits: less of the drug make it to the baby, reducing the risk of the infant suffering from respiratory depression; and more of the drug stays in the mother's system for pain management.
Signs of hypertension after 20 weeks gestation is a recipe for bad juju. If you ever see a combination of edema or swelling, headache, and problems with vision then the patient needs to be assessed and the provider notified because there is a risk of developing preeclampsia.
After birth, methylergonovine is a medication given to contract the uterus to a smaller size, but it is contraindicated for patients with hypertension because it works via vasoconstriction. This can lead to stroke or seizure.
Instead, consider using misoprostol because it work on the muscle of the uterus rather than on blood vessels. This will allow further contraction without risking increased blood pressure.
The biggest risk factor after rupture of the membranes (ROM) is infection because there is now an opening to the fetus and the mother. Because of this, make sure to perform a vaginal exam for ROM sterilely.
A post-renal injury is a possible complication of an untreated UTI. UTIs are not uncommon during pregnancy. Therefore, assess possible risk to the kidneys by asking about pain in the back and flank. This signifies a possible kidney infection.
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As one person told me, “Christians get very angry toward other Christians who sin differently than they do.” When people ask me how I can possibly stay friends with a sinner like Mel, I respond by asking how Mel can possibly stay friends with a sinner like me.
- Philip Yancey
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Anxiolytics (WIP)
Antianxiety drugs, or anxiolytics, treat anxiety disorders, insomnia, OCD, depression, PTSD and alcohol withdrawal.
Benzodiazepines
MOA: enhance GABA by facilitating its binding to GABA receptors
Advantages: Most are fast acting and effective
Disadvantages/Side Effects: drowsiness, sedation, CNS depressant, decreased vitals, dependence (especially after long-term use), withdrawal
Alprazolam (Xanax)
Chlorazepate (Tranxene) - more of a steady state
Lorazepam (Ativan)
Oxazepam (Serax)
The following benzodiazepines are usually prescribed for sleep rather than anxiety:
Flurazepam (Dalmane)
Temazepam (Restoril)
Triazolam (Halcion)
The following benzodiazepines are prescribed for alcohol withdrawal, as well as anxiety:
Chlordiazepoxide (Librium)
Clonazepam (Klonopin)
Diazepam (Valium)
Contraindications
Chlorazepate: liver disease because of the time it remains within the body
Nonbenzodiazepines
MOA: enhance GABA by facilitating its binding to GABA receptors
Advantages: none of the side effects of benzodiazepines
Disadvantages/Side Effects: takes 2-6 weeks for drug to take effect
Buspirone (BuSpar) - can also be prescribed as an anticonvulsant and muscle relaxant
Other types of nonbenzodiazepines include:
Selective Serotonin Reuptake Inhibitors (SSRI)
Serotonin and Norepinephrine Reuptake Inhibitors (SNRI)
Tricyclic Antidepressants (TCA)
Beta Blockers (e.g., propranolol)
Antihistamines (e.g., hydroxyzine)
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Psychopharmacology Basics
Another day, another class with pharmacology. This is just a little review on drug principles. Most of these notes came from Videbeck's Psychiatric-Mental Health Nursing textbook and the lecture powerpoint deck. Some information is excluded if it was not covered by the professor, so this is not a complete source of information for nursing psychopharmacology.
This section will cover pharmacology basics, treatment principles and neurotransmitters.
Pharmacology Basics
Efficacy: the maximum therapeutic effect that a drug can achieve. Aka, the drug's ability to work within the human body.
Potency: the amount needed to achieve efficacy. Aka, the drug's concentration that allows it to work.
Half-life: the time it takes for a drug to be reduced by half within the body. The shorter the half-life, the more of the drug is required to maintain a therapeutic level within the body. The longer the half-life, the less is required to maintain the same level because it stays in the body longer.
Off-label use: uses for a drug other than what it was approved to treat
Black box warning: if a drug has a life-threatening side effect then there must be a warning in a literal black box on the label so it stands out
Pharmacologic Treatment Principles
Selecting the Drug. The chosen medication is selected based on how well it treats or reduces the patient's symptoms
Starting the Drug. Most psychotropic drugs take several weeks to be effective, so adequate doses must be given over a sufficient amount of time before the effects are realized
Amount of the Drug. The lowest effective dosage is used and titrated up or down as needed
Taking the Drug. The medication regimen should be as simple as possible to promote compliance
Differences for Older Adults. Older adults require lower dosages because it takes longer for their bodies to metabolize drugs
Stopping the Drug. Gradually taper off a drug rather than abruptly stopping it or the patient may suffer from temporary rebound, recurrence or withdrawal effects
Adjusting the Drug. Continuous follow up is necessary to ensure the patient is receiving the adequate dosage required
Neurotransmitters
There are four neurotransmitters that are of particular interest to mental health.
Dopamine
MOA: Excitatory
Effects: controls complex movements, motivation, cognition and regulates emotional responses
Increases schizophrenia, mania
Decreases Parkinson's Disease
Antipsychotics block dopamine receptors and reduce dopamine activity
Derived from the amino acid tyrosine
Norepinephrine (NE)
MOA: Excitatory
Effects: changes in attention, learning, memory, sleep, wakefulness and mood regulation
Increases mania, anxiety, schizophrenia
Decreases depression
Antidepressants block NE reuptake or inhibit MAO from metabolizing it
Serotonin
MOA: Inhibitory
Effects: controls food intake, sleep, wakefulness, temp regulation, pain control, sexual behavior and emotions regulation
Decreases depression
Antidepressants block serotonin reuptake so there is additional volume available in the synapse
Derived from the amino acid tryptophan
γ-aminobutyric acid (GABA)
MOA: Inhibitory
Effects: moderates the other neurotransmitters through inhibitory action rather than promoting direct stimulation
Increases apathy (lack of anxiety)
Decreases anxiety disorders, schizophrenia, mania
Benzodiazepines increase GABA to help treat anxiety and induce sleep
#nursing school#pharmacology#mental health pharmacology#pharmacology basics#neurotransmitters#nclexrn prep
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Sunday morning is the best time to tour the south (usually). The streets are empty, the tourists are gone and you can simply enjoy the day in quiet. Mostly quiet. Cicadas. Need I say more? The only downside for some would be the closed stores. Small Town America doesn’t really open on Sunday and certainly not before 11 am. Luckily I’m only seeking free experiences this year. This is the Euharlee covered bridge. It was constructed in 1886 after the original bridge was washed away. It’s been on my bucket list of places to visit in Georgia ever since I bought Backroads and Byways of Georgia by David Jenkins. #coveredbridge #northga #northgeorgia #euharleecoveredbridge #euharleega #historicgeorgia #originalphoto (at Euharlee Covered Bridge) https://www.instagram.com/p/ChiQG21JrZ9/?igshid=NGJjMDIxMWI=
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One of these days I’m actually going to get a slice! (at Pie Bar) https://www.instagram.com/p/ChYTxFKpMnL/?igshid=NGJjMDIxMWI=
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My grandma used to take me on walks through cemeteries when I was a kid. They were exciting adventures. The older the cemetery, the better the walk. We would hunt for the strangest headstones. We would guess at the name time and weather had stripped from the granite. She would have loved walking through Marietta cemeteries. The south venerates their dead far more than the west coast. It makes for beautiful architecture and the quietest, most scenic walks. #mariettacemetery #marietta #mariettaga #cemetery #cemeteriesofinstagram #southerncemetery (at Old Marietta Historic Confederate Cemetery) https://www.instagram.com/p/ChP1jtjpOwa/?igshid=NGJjMDIxMWI=
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I never get tired of this view. This is the old path for the Western & Atlantic railroad. The cliffs are covered in moss, ferns and other native plants. There is a constant stream of water trickling down the rocks. Used the #hefefilter for the first, but the second is the original without edits. #allatoonapass #northgeorgia #cartersvillega #allatoonapassbattlefield #originalphoto (at Allatoona Pass Battlefield and Trail) https://www.instagram.com/p/ChNj9z7p-eF/?igshid=NGJjMDIxMWI=
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A bit random, but I found this on the floor of #starfort at #allatoonapass and couldn’t resist. It’s beautiful! Looks like Clavaria zollingeri, but that’s based off a cursory internet search. #allatoonapassbattlefield #allatoonapass #fungus #purplenature #originalphoto (at Allatoona Pass Battlefield and Trail) https://www.instagram.com/p/ChK4cGRJFsH/?igshid=NGJjMDIxMWI=
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If you’re looking for a good cry, go to the National POW Museum at Andersonville. It’s a stark reminder of just one of the many terrible costs of war. Andersonville serves as a memorial for all American POWs from all conflicts. #nationalpowmuseum #andersonvilleprison #andersonvillenationalhistoricsite #centralga #civilwarsite (at National Prisoner of War Museum) https://www.instagram.com/p/Cg9M4dOOSpm/?igshid=NGJjMDIxMWI=
#nationalpowmuseum#andersonvilleprison#andersonvillenationalhistoricsite#centralga#civilwarsite#original photo#originalphoto
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Looking out over Andersonville from Star Fort. 26 1/2 acres for 33,000 men. #andersonvilleprison #andersonvillenationalhistoricsite #centralga #civilwarsite (at Andersonville National Historic Site) https://www.instagram.com/p/Cg9K-wSuV-v/?igshid=NGJjMDIxMWI=
#andersonvilleprison#andersonvillenationalhistoricsite#centralga#civilwarsite#original photo#originalphoto
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Doesn’t matter how many times I go, Andersonville is forever a moving and emotional place to visit. I first saw it in 2020, but the museum was closed. Now I got to visit the museum and see the grounds with the most vibrant sky on the move. Beautiful. #andersonvilleprison #andersonvillehistoricsite #civilwarsite #centralga (at Andersonville National Historic Site) https://www.instagram.com/p/Cg9I5FkuZrt/?igshid=NGJjMDIxMWI=
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Alabama is full of surprises! This was taken at a boat ramp on #lakeguntersville and wow, so beautiful. #northernalabama #scottsboroalabama #alabama #visitalabama (at Scottsboro, Alabama) https://www.instagram.com/p/Cg5Ww8SpPTy/?igshid=NGJjMDIxMWI=
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I’m told it’s pronounced Monti-sell-oh. Only in Jawjeh. That being said, pretty sure I’m going to move here after school. Fingers crossed Jasper Memorial is hiring in a year. #monticelloga #centralgeorgia (at Monticello, Georgia) https://www.instagram.com/p/CgxS4NhuEXRkskT4Gg_-f9m4eEZMc4wV35X1ag0/?igshid=NGJjMDIxMWI=
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I’ll tell you what’s problematic about being over 40 and being friends with someone under 25: if you say “but I am le tired” they do not understand that they are supposed to say “well have a nap AND ZEN FIRE ZE MISSILES”
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