“How I Passed the Nursing Board Examination – Part 1/2” plus 4 more nursing article(s): NursingCrib.com Updates

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• How I Passed the Nursing Board Examination – Part 1/2
• Glasgow Coma Scale (GCS)
• Nursing Ethics
• Torticollis (Wry Neck)
• Psychiatric Mental Health Assessment

How I Passed the Nursing Board Examination – Part 1/2 Posted: 15 Nov 2010 09:25 PM PST Waiting for the board examination is quite frustrating and agonizing. It is anxiety-producing in a sense that everyday you are haunted by the thought of what are the possible concepts or questions that may be asked in the exam. Frustration rises as the date of the examination is fast approaching and you have not finished reading all the concepts. You really want to know EVERYTHING! But hey, I want to remind you that successful exam takers did not memorized and knew every topic on the concepts. They are those people who used their critical thinking skills through a relaxed mind and a heart that has faith in God or Allah. Based on my experience, I would say that the nursing licensure examination questions are not that hard, they are just tricky and confusing. Thus, passing the board examination is not an easy task. Personally, I embraced certain principles for me to make it to pass the NLE. Since one of my favorite concepts is Pediatrics, I made the mnemonic P-E-D-I-A to summarize the things I did and principles I employed before and during the board examination. P – Prayer I've been there, and those feelings made me down and burdened. But I cannot make use of my brain to answer the set of questions well if I won't relax. And that's where prayer plays a vital part. Not only that it makes a person calm but it gives divine intervention. Prayer can be done silently before studying or examination which can also be done in a form of song. I usually listen to the song "Lead me Lord" and silently utter a short prayer for wisdom and guidance before studying. I encourage you to pray before you study. Always remember, to make your day or studying session a less frustrating one, start it with a prayer. E – Effort If a person prays without ceasing yet did not exert any effort to gain knowledge through studying, nothing will happen. The famous Filipino proverb says, "Nasa Diyos ang awa, nasa tao ang gawa." Read your books! Extend your studying time just to finish a concept. Understand the concepts, do not merely memorize and make your own mnemonics. And of course, practice answering board exam questions with time limit (1 hour for 100 items) to enhance your critical thinking skills. D – Diet You cannot exert much effort if you are not well nourished. Feed your brain to make it work more efficiently. And feed on foods that won't make you drowsy throughout the day. Fatty foods tend to make someone sleepy, making someone distracted in listening to lectures and studying. (See section on "Foods that Help Improve Grades") I – Intercourse During my lectures, when I ask the reviewees about what they think about intercourse I usually get mischievous smiles and stares. I'm telling you guys, intercourse helps people pass board examination. According to Encarta dictionary, intercourse is the exchange between people or groups especially conversation or social activities. Meaning to say group study is a form of intercourse. Brainstorming is one best way to remember a concept and it is done when reviewees gather together. However, before having a group study carefully choose your company, because if you chose a friend who loves sleeping more than studying no sharing of ideas will take place. A – Aiming high What is your aim or goal in taking that big test? Do you aim for just the passing score (75%)? Or you aim to top it? So, why am I talking about aim here? Because a person's effort in studying and pattern of joining the review sessions or lectures are affected by the individual's goal. Who do you think would exert the greater effort? Who would manage to continuously join the review sessions even though he/she is already tired?  Who would survive the boring leadership, management, research and CHN lectures? – The person who wants to top the exam. A PERSON'S AIM DETERMINES THE FLAME OF HIS/HER EFFORT TO PASS TO THE EXAMINATION. No related posts.

Glasgow Coma Scale (GCS) Posted: 15 Nov 2010 09:03 PM PST Glasgow Coma Scale (GCS) Definition A Glasgow Coma Scale (GCS) is the most widely used scoring system that determines the level of consciousness of an individual with a suspected or confirmed brain injury. Use of the GCS scale does not take place an in-depth neurologic assessment Purpose This scale is used to: Address the three areas of neurologic functioning Gives an overview of the patient's level of consciousness (LOC) Evaluates the neurologic status of patients who have had a head or brain injury This scale is not only used after a traumatic head or brain injury but is also utilized in first aid, Emergency medical services (EMS), acute cases and for the monitoring of chronic patients in intensive care units. What is assessed or measured in GCS? Use of the Glasgow Coma Scale does not take place an in-depth neurologic assessment rather it provides an evaluation of the patient's responses in the following areas: Eye-opening responses Motor responses Verbal responses The three areas are further divided into different levels where a number is assigned to each of the possible responses within the categories. A high number means that the response is normal while a low one denotes impairment of neurologic function. The calculated total figure indicates the severity of the coma a patient is experiencing. The lowest score is 3 (least responsive) suggests or reflects that a patient is in a deep coma, while the highest score of 15 (most responsive) means that the patient is fully intact. The Glasgow Coma Scale Characteristic Response Score Eye Opening(E) Spontaneous 4 To verbal command or speech 3 To pain 2 Does not open eyes to painful stimuli or no response 1 Best Motor Response (M) Obeys commands 6 Localizes pain; pushes stimuli away 5 Flexes and withdraws 4 Abnormal flexion (decorticate response) 3 Abnormal extension response (decerebrate response) 2 No motor response 1 Best Verbal Response (V) (arouse patient with painful stimuli if necessary) Oriented and converses 5 Disoriented and converses (confused conversation) 4 Uses inappropriate words 3 Makes incomprehensible sounds 2 No verbal response 1 Total: E + M + V 3 to 15 Interpretation of Scores Individual categories or elements as wells as the sum of the score are important. The score is expressed in this form for a client who is most responsive: "GCS 15 = E4 V5 M6 at 14:00" This means that the client's GCS total score is 15 where the Eye Opening is scored 4, Motor response of 6 and verbal response of 5 as of 2:00 in the afternoon or 14:00 in a 24-hour time format. Coma is suspected if the GCS score is equal to or less than 7. A score equal to 8 or less could also suggest a severe brain injury. GCS 9-12 indicates moderate brain injury and more than 13 denotes minor brain injury. Coma with the use of GCS is defined as not opening the eyes, not obeying commands and no verbal response. Related posts: Myxedema coma Traumatic Brain Injury Arteriovenous Malformation (AVM)

Nursing Ethics Posted: 15 Nov 2010 08:58 PM PST Definition Ethics is defined as the standards or principles of moral judgment or actions. It provides a methodical system in differentiating right from wrong basing on a certain belief. Significance in profession Ethics reflects the standards that govern a proper conduct in a particular profession. For instance, the nurse on duty knows that she is obligated to act for the good of the client and to prevent any incident to harm the patient. This principle of doing no harm to the client is the intervention of knowing the ethics in nursing. Values, Morals and Ethics To formulate an ethical decision, the nurse should gain knowledge on the situation taking a look at all angles to promote maximal benefit to the client. Aside from scrutinizing every possible aspect of the problem the nurse should be able to understand the relationship between values, morals and ethics. The values of the client, nurse and society and so as the morals interact to set the environment for ethical behavior. If in a given situation the value systems of the nurse, client and society is opposing, an ethical dilemma will most likely occur. A dilemma is a situation with unsatisfactory alternatives or options. Ethical dilemma requires the medical team to make challenging and difficult decisions regarding the possible best way to care for the patients. Values are operational beliefs an individual chooses as the basis for behavior which can change over time. These beliefs serve as the building blocks of moral and ethical development. Values influence not only the behavior but also the decision making of a person. It could be based on the following: Experience Religion Education Culture Professional peer group Morals are personal opinion or principle that a particular action or behavior is absolutely right or wrong in all situations. Usually a person is reluctant or unwilling to change his personal opinions on specific issues of a moral nature. For instance, some people view abortion a totally wrong and there is no justifiable excuse for it. However, some hold the belief that aborting a fetus is better rather than improperly rearing a child. Ethics in Nursing Nursing ethics provides the standards of professional behavior for nurses and the principles of knowing right from a wrong conduct during implementation of nursing duties and responsibilities. Through this set of standards, nursing duties and responsibilities of nurses towards their clients, co-workers, profession and community is made known. It promotes the philosophical and theological study of morality, moral judgments and moral problems. The three types of ethics are the following: Descriptive ethics – this type of ethics provides an accurate and realistic narration of moral behaviors without producing a moral judgment. Metaethics – the center of this type is on reasonable and justifiable judgments. It is basically concerned with theoretical issues of meaning and its justification. Normative ethics – with this classification, a question is raised about what is right or wrong. Something should be done in a situation that calls for an ethical decision. For instance, a teenager who is maintaining a scholarship is pregnant. She is to decide whether she will abort the baby to avoid issues and being kicked out of the school or sustain the pregnancy and deliver the baby. Related posts: NURSING AS A PROFESSION Medical Malpractice and the Nurse ETHICO-MORAL ASPECTS IN NURSING

Torticollis (Wry Neck) Posted: 15 Nov 2010 08:37 PM PST Torticollis Definition Torticollis literally means "wry neck". It comes from the term tortus meaning twisted and collum denoting to neck. Infants born with this deformity has a twisted neck (congenital torticollis) has a head tipped to one side while the chin is rotated to one side. Types Torticollis is classified into: Congenital Muscular Torticollis– present at birth and the most common form. Acquired Torticollis – acquired later in life Incidence 1 in every 250 neonates is born with congenital torticollis. Ten to twenty percent of infants with torticollis have also a congenital hip dysplasia (improper formation and function of the hip socket.) Risk Factors Fetuses with wide shoulders are at high risk of injuring the sternocleidomastoid muscle during delivery due to the pressure exerted on the head to deliver the shoulder. Causes Congenital Torticollis causes Injury of sternocleidomastoid muscle during birth Injured blood supply of the fetus' neck at birth Wrong position of fetus while inside the womb resulting to tightness of the sternocleidomastod muscle (muscle that connects the breastbone and the collarbone to the skull) Klippel-Fiel Syndrome  (less common cause) This is characterized by abnormalities in the bones of the neck (cervical vertebrae) where the bone is abnormally formed and/or fused. Inherited (rare cases only) Result of underlying condition that damages the nervous system or muscles (e.g. spinal or brain tumor) Acquired Torticollis causes Damage of the nervous system Damage of the muscles around the neck Tumors of the skull base (posterior fossa tumor) Pharyngitis (can irritate the nerves supplying the neck muscles and cause a wry neck) Use of antipsychotics (acute dystonia) Assessment Positional plagiocephaly (asymmetrical head shape) X-ray Electromyogram (EMG) Clinical Manifestations Congenital Torticollis Painless Head posture abnormality: If the right sternocleidomastoid is injured: the infant's head is rotated to the right and chin rotated to the left. If the left sternoceidomastoid muscle is affected: the infant's head is rotated to the left and chin turned to the right. Lump in the affected muscle (can be palpated or noticeable at about 1-2 months of age) Limited range of motion of the head Swelling of the neck muscles (possibly present at birth) Shoulder is higher on one side of the body Stiff neck muscles Acquired Torticollis Painful neck Shoulder is higher on one side of the bosy Stiff neck muscles Head posture abnormality Head tremor Headache Shoulder is higher on one side of the body Management Congenital Torticollis Passive stretching exercises and encouraging the infant to look at the affected muscle (by feeding at the direction of the affected area and positioning mobiles on the injured part). If simple exercises are not effective, a surgical correction is done. This is followed by usage of neck immobilizer to further correct the deformity. Acquired Torticollis Identification of underlying cause of the disorder. Heat application for head and neck pain Cervical spine traction Neck massage Anticholihergic drugs Use of Botulism (Botox) Image from mountnittany.org, nlm.nih.gov Related posts: Head-To-Toe Assessment (O. Neck) PROCEDURE FOR ARTIFICIAL RESPIRATION CHECKLIST FOR MOVING AND LIFTING

Psychiatric Mental Health Assessment Posted: 15 Nov 2010 04:57 PM PST Accuracy in assessment determines whether the following steps of the nursing process will produce accurate nursing diagnoses, palnning, and intervention. Psychiatric-mental health assessment is the gathering, organizing, and documenting of data about the psychiatric and mental health needs of the client and family. Assessment The first step of the nursing process. Interview The degree to which the interview is therapeutic, or helpful, to the client may determine the extent and honesty of the information shared by the client. Clients expect the interviewer to be an expert who is confident in the professional role, maintains confidentiality, demonstrates warmth and genuineness, is nonjudgmental toward them and their past or current behavior, and recognizes that clients are experts on themselves and their behavior. Assessment Data Subjective Client's current problem and reason for seeking help. Past mental illness and treatment Family history and mental illness Medical history Allergies to medications, foods, and other substances Past and present medications and their effects Past and present abuse Substance abuse history Educational and/or vocational history Health habits Safety issues Cultural beliefs and practices Objective Behavior Communication Physical assessment Laboratory or testing data Mental status Appearance Hygiene, grooming, appropriateness of clothing, posture, and gestures. Behavior Eye contact, motor behavior, body language, behavioral responses to others and environment, volume and speed of speech, tone of voice, flow of words. Affect and Mood Happy, sad, anxious, sullen, hostile, inappropriate for situation, silly, and range of emotions. Orientation To person, place, time, situation, relationship with others. Memory Immediate recall, recent and remote memory. Sensorium or Attention Ability to concentrate on a task or conversation, perception of stimuli. Intellectual functioning General fund of knowledge about the world, cognitive abilities such as a simple arithmetic. Ability to think abstractly or symbolically. Judgement Decision making ability, especially regarding delay of gratification. Insight Awareness of one's responsibility for and analysis of current problem, understanding of how client arrived in current situation. Thought Content Recurrent topics of conversation, themes. Thought process Processing of events in the situation, awareness of one's thoughts, logic of thought. Perception Awareness of reality vs. fantasy, hallucinations, delusions, illusions, suicidal or homicidal ideation or plans. Related posts: Assessment – First Step in the Nursing Process NCLEX-Psychiatric Mental Health Nursing Family Nursing Care Plan (FNCP)

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