I hope everyone’s week is going great. My week has overall been good….who can complain when I had a true snow day today. Everything this week has played out perfectly really. Monday….I done assignments (started writing on my Population Based Community Assessment Paper), studied for a test that I might not even have next Wednesday, and of course done HESI questions. It gets exhausting, but studying regularly is one of the best nursing school tips I can give.
Nursing Clinicals Update
Tuesday I had clinicals from 7am-7pm and it was overall a good day. I was nervous that I might not get to go to clinicals because we were suppose to get this huge amount of snow and I figured that A.) School would be called out (I can’t attend clinicals if school is called out because of insurance issues) B.) I would get there and my preceptor would not be able to get there because of snow (I have to leave if my preceptor does not work). C.) I would have to leave in the middle of my shift because school would be called out later in the day. But guess what….thank goodness none of those issues came up! The snow that was actually suppose to hit us yesterday missed us or came in late and we ended getting snow later that night around 7pm right when I got off.
So when I got off last night it was like a blizzard, snow was blowing every where, and the roads were covered in minutes…..thankfully I had Ben drive me that morning to clinicals and he picked me up…so I didn’t have to drive in it. Today, which is Wednesday, school was cancelled because of the snow we got last night…so no class today. I’m so over the class part of school….I enjoy my clinical so much more. I guess I can tell I’m ready to work as a Registered Nurse and quit the whole school thing!
Nytroglycerin for Chest Pains in Clinicals
Clinicals were good yesterday! I got to document…yah!! The most interesting thing that happened yesterday was my pt who had some severe chest pain. To give you some back ground info….the pt had been admitted due to a “potential” MI…pt had a history of a past MI, had a pace maker (which are the coolest things ever), diabetic, pt’s last heart cath showed pt had some blockages in some arteries and current lab results showed a very high Troponin level (which indicates that the heart has experienced some ischemia (decreased oxygen supply to the heart) ).
Anywho…during the afternoon the pt started having some bad chest pain so we gave him some Nitroglycerin Sublingual for it. This was my first time working with Nitroglycerin so that is what made the pt’s case so interesting. You can only give Nitroglycerin 3 times Sublingual (under the tongue) every 5 minutes for chest pain and if it doesn’t relieve it after 3 times you have to call the doctor. While we gave it to the pt. we stayed at the bedside monitoring vital signs very closely…especially blood pressure because Nitro dilates the blood vessels causing a reduction in blood pressure. So we gave the pt Nitro 3 x and the pt’s blood pressure was dropping with each dose with unrelieved chest pain. The pt’s pressure went to around 88/56 which was bad for the pt because it was far from his baseline. To make a long story short…the patient ended up having to get morphine and a nitroglycerin drip. I learned how to handle a patient with chest pain (be calm) , how to properly administered Nitro, and what to do if it doesn’t work.
Today..I plan on doing the same thing I did on Monday….continue writing on my paper, study for my test, and study for HESI. I am just going to enjoy this day off. Until next time,