http://joncares.com/

It's really difficult for me to keep my guard up.

Sat, 18 Feb 2012 02:54:00 -0800

I pray and pray everyday. I just want things to be the way they used to be.

If I can’t keep my guard up and I feel hurt like this with me just guessing and guessing, I have to put up a wall again. And only for my own good. I don’t know if you can read me, but I obviously haven’t cut the ropes on my end. There’s gotta be a reason behind it, but I don’t know why. I just have to keep praying about it.

And by the way, I do pray for you too. Every single day. I always pray for your guidance (into whatever path God planned for you), for your safety, and that you do well in school. Everyday. I really mean that. It’s just become routine for the longest time now.

I’ve got my med-surge 2 final drawing near (well one more exam before that). Only 4 more day shifts on the med-surge floor at Kaiser for this semester and then I’m onto OB and Pediatrics. Wednesdays 7am-7pm. (And I’m gonna be at KAISER still!!! I’m so excited!!) This week was a total vacation and I can’t believe it turned out that way. I really gotta get back on the ball and finish up at least most of my care plan this weekend. I’m also really hoping to hang a couple more IV’s during the week. I feel comfortable with programming the pumps, but sometimes I goof up preparing those IVPB’s.

I was a little nostalgic today and I found this picture. My...

Tue, 14 Feb 2012 00:00:05 -0800

I was a little nostalgic today and I found this picture.

My heart still tugs at me no matter how hard I try to cut off the ropes. I don’t understand. Though the other end’s obviously already been cut..

What is the meaning to this? Why must it be so prolonged?

Of all days, why did I have to be off today?

._____.

omgcharmzhere: xlittlebear: I need this in my possession...

Mon, 13 Feb 2012 00:04:00 -0800

omgcharmzhere:

xlittlebear:

I need this in my possession asap.

I would love one

lab values

Sat, 11 Feb 2012 19:53:00 -0800

red app with syringe on it 2.99

http://www.ncbi.nlm.nih.gov/pubmed/7028437

Thu, 09 Feb 2012 00:56:00 -0800

http://www.ncbi.nlm.nih.gov/pubmed/7028437

Note to self:

Wed, 08 Feb 2012 18:43:00 -0800

Lactulose isn’t used just to treat constipation. For patients with LIVER PROBLEMS, it draws out the ammonia for them and into the colon so they can poop it out.. Whereas if they had no liver problems, their liver would be able to get rid of the ammonia. Normal ammonia levels are 11-35 mg/dL at Kaiser. So when giving lactulose, see what they’re actually getting it for. Why did the doctor order it? Does the patient have high ammonia? A big hint is if they’ve got a bad liver.

Today I had a 71 year old female patient who came in for sepsis. Past medical history included non-alcoholic cirrhosis of the liver, diabetes mellitus 2, and osteoarthritis. Her meds included lactulose 10g/15mL and phytonadione/Mephyton (VITAMIN K) 10mg.

I couldn’t figure out why she had lactulose or vitamin K. I haven’t learned anything about liver failure in med-surg yet, so I asked the nurse about it and she had explained to me the pathophysiology of it. It all made sense afterwards. (For future reference, look up the patho of your pt’s disease processes, whether you’ve already learned them or not.)

The reason she was getting lactulose is not only because she’s constipated, but also to keep her ammonia levels down. (Though she refused it at the time I was there to pass her meds because she was having a lot of loose stools).

The liver is also responsible for making the body’s clotting factors, including prothrombin. Her hepatic function is compromised due to cirrhosis, so she’s not making those clotting factors, thus her PT is prolonged. (I looked up her morning labs for INR and she was 1.2, so she was fine) This is why she’s getting VITAMIN K, which is a clotting factor.

Photo

Tue, 07 Feb 2012 21:00:00 -0800

In 2013 I will be wearing that Kaiser Permanente badge with the blue badge that goes under it and says in big white letters, "RN."

Tue, 07 Feb 2012 19:16:00 -0800

I WILL PASS CLINICAL. NOTHING'S STOPPING ME.

Tue, 07 Feb 2012 19:05:00 -0800

regardless of what it is right now.

Mon, 06 Feb 2012 00:29:00 -0800

i just want to be able to talk to you the way we used to before we were together. before we even liked eachother. or before you even knew my name.

gonna earn my way to gold card by the end of the year

Sat, 04 Feb 2012 13:14:00 -0800

gonna earn my way to gold card by the end of the year

29 y/o male with sickle cell crisis

Tue, 31 Jan 2012 16:15:00 -0800

came in the other day and has not had a single physician or nurse give him O2.

proud to say i caught that and took initiative to give it to him myself. it was even in the orders and NOBODY bothered to do it. my instructor wasn’t even there.

nigga has sickle cell CRISIS and is satting 90% on ROOM FUCKING AIR. AND THERE WASN’T A NASAL CANNULA HOOKED UP. we just learned this in med-surg. for sickle cell pts it’s all about hydration, pain management, and adequate oxygen delivery. the pathophysio says it all. they’re in a hypoxic state, so how do you fix that? O2! (and hydration of course)

and not a single PHYSICIAN or rn bothered to give him that. and yeah maybe he was satting fine before i saw him or when he saw his healthcare team, but O2 should always always always be ready bedside for sickle cell pts. and if not hooked up, at least packaged up @ bedside and ready to be hooked up.

for future reference, when you first walk into the room to do your environmental-safety check, make sure O2 is already hooked up when caring for sickle cell pts. even if they’re O2 sat is fine.

note to self: quick jot of today's agenda

Thu, 19 Jan 2012 02:24:00 -0800

wake up 8ish

head straight to panera in cerritos to finish up paperwork and study for pharm quiz

grub

medsurg from 12:30-3:30

study

pharm from 4-6

happy hour drinks with the nursing crew again maybe? been craving jeremiah red.

hang out with my boys maybe late night happy hour.

study?

tiffaaahny: deng.. HAHA I’m fortunate enough to think...

Thu, 19 Jan 2012 02:05:13 -0800

tiffaaahny:

deng..

HAHA I’m fortunate enough to think so! The little guy would be bragging about me to all his friends at school saying, “Dude, I met myself at 21 years old! He’s so cool and awesome!”

Yeps.

So I hung my very first IV today. :D

Wed, 18 Jan 2012 21:00:00 -0800

3.375 mg of Zosyn. It felt pretty awesome. Every step of the way through actually doing it was awesome, from mixing the contents into 50 mL D5½NS to programming the IV pump to do its thang. Even back-priming the piggy back tubing was awesome. Today was a good day. I suppose you can say having a patient get an early discharge (from yesterday) was a blessing in disguise.

It’s kinda neat to think only RN’s (not LVN’s) and MD’s can hang IV meds. I made sure I bragged about it to papa when he got home. xD

little snippet of my life. making sure I get my picture taken...

Tue, 17 Jan 2012 21:21:00 -0800

little snippet of my life. making sure I get my picture taken every semester, so here’s the 2nd one :)

my patient got dc’ed this afternoon, so i gotta prep for another. he was POST OP DAY 1, so I really didn’t see that coming at all. it sucks big time. gotta wake up at 5 am. goodnight.

Tomorrow I'm going to be working on the medical surgical floor of Kaiser Permanente.

Mon, 16 Jan 2012 07:00:05 -0800

There’s such sentimental value attached to this hospital, not just because it’s my dream hospital to work at (when I become an RN), but also because Kaiser is the very hospital that my parents made a living off of. A little over 20 years ago, my parents started working on the med-surg floor together at Harbor City Kaiser. They’d commute all the way from Riverside to Harbor City and work their butts off all day to make sure that they’d have a good future and so they can take care of me and Christina. I know I’m only there for a short time for clinicals, but it really means a lot to me to have the opportunity to grow into an RN at that hospital. (Then again, I already feel like an RN because of my last clinical rotation. I had a remarkable experience, especially because of the opportunity to work at the telemetry floor)

And in a sense, you can say Kaiser gave us our livelihood. The money that paid for my tuition to go to school you could probably even say came from Kaiser. And my dad’s still working there, but now at the injection room.

This blog entry is about Kaiser and it sounds like I’m obsessed with Kaiser, but this is my thanks to the hospital I’m going to work at in 2013. I’m going to become the best RN I can be there— at the very hospital that took care of my family, both in health and financially, the very hospital that is at this moment allowing me to grow into the career I’ve been pursuing for the last 4 years, and the very hospital my life began at on October 23rd, 1990.

I’m going to look at this very blog entry once I get that job I’ve been destined for.

jonsense: 20 Rules for Formulating Knowledge

Mon, 02 Jan 2012 01:31:55 -0800

jonsense: 20 Rules for Formulating Knowledge:

keepsdiary:

image via time.com

I’m sure I’m not alone in taking the start of the new year as a jumping off point in learning (or relearning) things. As seen in my last post, I’m pushing myself to really get better with the guitar.

I recently came across a great article on…

I love it! It’s very practical. :-)

Taken just about an hour ago on the strip. Happy New Year! :)

Sun, 01 Jan 2012 01:12:00 -0800

Taken just about an hour ago on the strip. Happy New Year! :)

Hahah, find me! VEGAS IS CRACKIN’!!! click to enlarge

Sun, 01 Jan 2012 01:09:00 -0800

Hahah, find me! VEGAS IS CRACKIN’!!! click to enlarge