Nurses Notes » Updates

NCSBN Board of Directors voted to raise the passing standard for the NCLEX-RN Examination

Nurses Notes — Sat, 06 Feb 2010 17:34:31 +0000

The NCSBN Board of Directors voted to raise the passing standard for the NCLEX-RN Examination at its meeting on Dec. 10, 2009

Media Contact: Dawn M. Kappel
Director, Marketing and Communications
312.525.3667 direct
312.279.1034 fax
dkappel@ncsbn.org
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FOR IMMEDIATE RELEASE
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CHICAGO – The National Council of State Boards of Nursing, Inc. (NCSBN) voted on Dec. 10, 2009, to raise the passing standard for the NCLEX-RN Examination (the National Council Licensure Examination for Registered Nurses). The new passing standard is -0.16 logits on the NCLEX-RN logistic scale, 0.05 logits higher than the previous standard of -0.21. The new passing standard will take effect on April 1, 2010, in conjunction with the 2010 NCLEX-RN Test Plan.
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After consideration of all available information, the NCSBN Board of Directors determined that safe and effective entry-level RN practice requires a greater level of knowledge, skills, and abilities than was required in 2007, when NCSBN implemented the current standard. The passing standard was increased in response to changes in U.S. health care delivery and nursing practice that have resulted in the greater acuity of clients seen by entry-level RNs.
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The Board of Directors used multiple sources of information to guide its evaluation and discussion regarding the change in passing standard. As part of this process, NCSBN convened an expert panel of nine nurses to perform a criterion-referenced standard setting procedure. The panel’s findings supported the creation of a higher passing standard. NCSBN also considered the results of national surveys of nursing professionals including nursing educators, directors of nursing in acute care settings and administrators of long-term care facilities.
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In accordance with a motion adopted by the 1989 NCSBN Delegate Assembly, the NCSBN Board of Directors evaluates the passing standard for the NCLEX-RN examination every three years to protect the public by ensuring minimal competence for entry-level RNs. NCSBN coordinates the passing standard analysis with the three-year cycle of test plan evaluation. This three-year cycle was developed to keep the test plan and passing standard current. A PDF of the 2010 NCLEX-RN Test Plan is available free of charge from the NCSBN Web site https://www.ncsbn.org/2010_NCLEX_RN_TestPlan.pdf.
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The National Council of State Boards of Nursing (NCSBN) is a not-for-profit organization whose members include the boards of nursing in the 50 states, the District of Columbia and four U.S. territories — American Samoa, Guam, Northern Mariana Islands and the Virgin Islands. There are also four associate members.

Mission: The National Council of State Boards of Nursing (NCSBN), composed of Member Boards, provides leadership to advance regulatory excellence for public protection.
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Media inquiries may be directed to the contact listed above. Technical inquiries about the NCLEX examination may be directed to the NCLEX information line at 1.866.293.9600 or nclexinfo@ncsbn.org.
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The definition of a logit may be found on NCSBN’s Web site at https://www.ncsbn.org/02_18_05_brief.pdf.

Haiti Needs Our Help

Nurses Notes — Thu, 14 Jan 2010 16:48:58 +0000

As of today, it is estimated that more than 500,000 are already noted dead in Haiti because of the massive earthquake that happened last January 13, 2010. They need our help. If we can be of any help, let’s do it. What if it happened to us or to our country? To know that there are concerned citizens overseas is overwhelming and an act no one can ever pay because it’s coming from our own hearts. Even a prayer would mean a lot. Let’s pray for their economy’s faster recovery and their people too.

To residents of the United States of America, please send the word “HAITI” to “90999″. For every SMS sent, you will be donating $10 and it will all be gathered by the American Red Cross for rehabilitation of the people in Haiti.

To people outside US, you can still make a donation to American Red Cross using your debit or credit card accounts. Please go to: http://american.redcross.org/supporthaiti

For any international help, please go to: http://www.cidi.org/incident/haiti-10a/

For any Donation/Volunteer Related inquiries, please call: +1 703-276-1914

For any Media-related inquiries, please call: +1 202-821-1983

For any information, please go to: http://www.whitehouse.gov/blog/2010/01/13/help-haiti

Green Card Through a Job

Nurses Notes — Thu, 07 Jan 2010 17:48:14 +0000

Many people become permanent residents through a job or offer of employment. Some categories require a certification from the U.S. Department of Labor to show that there are not enough U.S. workers who are able, willing, qualified, and available in the geographic area where the immigrant is to be employed and that no American workers are displaced by foreign workers. In other cases, highly skilled workers, those with extraordinary ability in certain professions, and investors/entrepreneurs are given priority to immigrate through several immigrant categories. In all cases, the process involves several steps.

The main ways to immigrate based on a job offer or employment are listed below. For more information on the categories below, see the links to the left under “Green Card Through a Job.”

Green Card Through a Job Offer
You may be eligible to become a permanent resident based on an offer of permanent employment in the United States. Most categories require an employer to get a labor certification and then file a Form I-140, Immigrant Petition for Alien Worker, for you.

Green Card Through Investment
Green cards may be available to investors/entrepreneurs who are making an investment in an enterprise that creates new U.S. jobs.

Green Card Through Self Petition
Some immigrant categories allow you to file for yourself (“self-petition”). This option is available for either “Aliens of Extraordinary Ability” or certain individuals granted a National Interest Waiver.

Green Card Through Special Categories of Jobs
There are a number of specialized jobs that may allow you to get a green card based on a past or current job. All of these require a Form I-360, Petition for Amerasian, Widow(er), or Special Immigrant, and are described in Section 101(a)(27) of the Immigration and Nationality Act (INA) :

Afghan/Iraqi Translator
Broadcaster
International Organization Employee
Iraqi Who Assisted the U.S. Government
NATO-6 Nonimmigrant
Panama Canal Employee
Physician National Interest Waiver
Religious Worker

In some cases, you may be able to file the immigrant petition (either a Form I-140 or I-360, depending on your category) at the same time that you file Form I-485, known as “concurrent filing.” For more information, see the “Concurrent Filing” link to left under “Green Card Processes & Procedures.”

If you are not eligible to adjust your status inside the United States to a permanent resident, the immigrant petition will be sent to the U.S. consulate abroad to complete the visa process. In order to apply for a green card, there must be a visa immediately available to you.

Source:

http://www.uscis.gov/portal/site/uscis

Asthma in all forms

Nurses Notes — Sun, 03 Jan 2010 09:50:56 +0000

■ A stimulus → inflammation, which ↑mucus, mucosal edema, and bronchospasm. This traps air in lungs → chronic tissue irritation, scarring, and hyperinflation

■ Peak expiratory flow rate, the maximum flow of air forcefully exhaled in 1min, decreases

■ Occurs secondary to allergens (mold, pollen, dust mites, cockroach allergen) or nonimmunological stimuli (infections, exercise, cold air, odors, smoke, stress, dairy products)

■ Characterized by remissions and exacerbations. May be mild and intermittent to severe, persistent and intractable (status asthmaticus)

SIGNS AND SYMPTOMS

■ Dyspnea, dry cough, prolonged expirations with wheezing, sternal retractions, flaring nares, barrel chest

■ Prodromal S&S of exacerbation: Rhinorrhea, low-grade Temp, itching on neck/chest/upper back, anorexia, headache, irritability, restlessness,

fatigue, chest tightness, anxiety

■ Progression of exacerbation: Frothy, clear, gelatinous sputum, productive cough, ↑R, SOB, pale or malar flush with red ears, lips dark red

progressing to cyanosis, tripod/orthopneic position, chest hyperresonance on percussion, breath sounds coarse with sonorous crackles

■ Imminent ventilatory failure: SOB with absence of breath sounds

TREATMENT

Removal of stimulus and medications:

■ Long-term control meds (preventor meds): Corticosteroids (↓inflammation), cromolyn and nedocromil Na (block mediators of type I allergic reactions)

■ Quick-relief meds (rescue meds): ↓Exacerbations; -adrenergics, anticholinergics (↓bronchospasm)

■ Emergency protocol: 3 treatments with short-acting -adrenergic spaced at 20–30min, systemic prednisone, and an anticholinergic; hydration with caution to prevent pulmonary edema, O2 with caution to prevent CO2 narcosis

NURSING

■ Support child and parent in coping with chronic illness and fear related to SOB

■ Prevent exacerbations: Avoid triggers (dairy, animals); allergy-proof home (eliminate carpets, drapes, down bedding; wet-mop floors). Assess status via peak expiratory flow meter

■ Care during an exacerbation: Provide a calm presence; monitor cardiopulmonary status; place in ↑Fowler’s position; encourage pursed-lip

breathing; give ordered meds

How to use a peak expiratory flow meter (PEFM):

■ Measures respiratory volume with 1 breath

■ Begin with indicator at bottom of scale, stand straight, place mouthpiece in mouth, blow out as hard and fast as possible

■ Note result on scale

■ Repeat 3xs, record highest value

◆ Green: Under control

◆ Yellow: Exacerbation and may ↑maintenance dose of meds

◆ Red: Severe airway narrowing and give rescue med

How to use a metered dose inhaler (MDI):

■ Delivers premeasured dose of aerosolized med

■ Shake inhaler, place canister/spacer mouthpiece in mouth with lips sealed (closed method) or 2–4cm from mouth (open method)

■ At end of exhalation, depress canister while inhaling slowly through mouth (3–5sec)

■ At height of inhalation, hold breath 5–10sec and then exhale through nose

■ Wait 1min between puffs, document results, rinse mouth and equipment after

■ Use a spacer particularly with steroids to ↓oral yeast infections

■ Take the bronchodilator first to open airway before a corticosteroid

How to use a nebulizer:

■ Delivers aerosolized med over several min

■ With mask, place over nose and mouth, take slow deep breaths through mouth

■ With handheld nebulizer, place between teeth with lips sealed around mouthpiece. Take slow deep breaths; hold inhalation for several

seconds, continue until med in chamber is gone

Celebrating National Palindrome Day

Nurses Notes — Sat, 02 Jan 2010 20:29:33 +0000

How’s new year everyone? By the way, today is National Palindrome Day! The date today is 01022010! Try reading it backwards and it’s still the same! The last numerical palindrome was August 31, 1380 (08-31-1380)! We are again part of national history! This 2010 is definitely full of surprises! Let’s all hope for a positive 2010! This is a year for us! Cheers to life fellow nurses!

What is Multiple Sclerosis

Nurses Notes — Tue, 24 Nov 2009 05:58:07 +0000

Here is the concept you need to know about Multiple Sclerosis. Spread the awareness of this Neurologic Disorder.

Etiology and Pathophysiology
■ Autoimmune response → demyelination of CNS neurons and formation of sclerotic plaques → ↓impulse conduction
■ Remissions and exacerbations with downward plateaus
■ S&S vary depending on nerves involved

Risk Factors
■ Caucasian race 20-40yr old
■ Female gender

Signs and Symptoms
■ Charcot’s triad (intention tremor, nystagmus, scanning speech)
■ Visual disturbances (diplopia, visual field deficits)
■ Fatigue, paresthesias of face and/or extremities, incoordination, slurred speech, spasticity
■ Bladder dysfunction

Treatment
■ Disease modifying therapy (interferon beta-1a and -1b, glatiramer acetate)
■ Meds: Corticosteroids, antispasmodics (baclofen)
■ Palliative care

Nursing Care
■ Monitor S&S, balance activity/rest, provide cool environment, ↓fat diet
■ Safe mobility: Wide base of support, assistive devices
■ ↓Pressure ulcers: Change position q1-2hr, skin care, pull sheet to ↓shearing, pressure relieving devices
■ Improve elimination pattern: Respond to urge, follow bowel and bladder toileting schedule, ↑fiber and fluids, ascorbic acid to acidify urine if ordered
■ Emotional support: ↑Ventilation of feelings, refer to National Multiple Sclerosis Society

Roles of a Staff Nurse

Nurses Notes — Mon, 16 Nov 2009 08:04:24 +0000

■ Function as role model regarding professional conduct
■ Receive report from nurse previously responsible for patient
■ Make rounds on all pts immediately after receiving report
■ Set priorities regarding pt needs: Immediate threat to survival (problems with breathing, VS, ↓LOC), requests for help (pain, toileting), urgent but not immediate needs (teaching)
■ Coordinate and/or perform care for assigned pts; use time-management skills; complete all care assigned
■ Delegate care to subordinates that is within their job description
■ Monitor care delegated; establish clear expectations; encourage communication; evaluate patient outcomes related to delegated tasks (nurse retains accountability for delegated tasks)
■ Give report to next nurse responsible for patient
■ Engage in quality improvement (QI) activities
■ Participate in intradepartmental and interdepartmental meetings

The Early Signs of Cancer

Nurses Notes — Wed, 04 Nov 2009 07:41:33 +0000

Let us still remember that one of the most important concept in minimizing the mortality rate for cancer is to detect it in the earliest time possible. But how would you know if it can be cancer? Check this out!

CAUTION: EARLY SIGNS OF CANCER

C – hange in bowel or bladder habits

A – sore throat that doesn’t heal

U – nusual bleeding or discharge

T – hickening or lump

I – ndigestion; dysphagia

O – bvious change in a wart or mole

N – agging cough ot hoarseness

We hope that this information would be disseminated so we can all decrease the mortality rate for Cancer. Let’s all fight against Cancer.

What’s your internet connection?

Nurses Notes — Wed, 28 Oct 2009 20:58:35 +0000

The use of internet is proven to make the life of most students and most professionals easier nowadays. Can you just imagine if all you have to research would all come from thick encyclopedias, newspapers, and magazines? Were you able to see yourself going to national libraries to get statistics and get information? It’s definitely a hard task to do. Or have you imagined yourself writing a telegram or calling your boss and spending too much because he’s out of the country? Of course not anymore! Most of us now have computers and have decided to sign for an internet connection. But try to see yourself as a student or as an employee. After that, try to answer my question. Do you always stay at home? Don’t you do overtime from work or spend extra hours from school because of a group project? Commitment is a word always attached whenever we want something to have a positive result, isn’t it? That is why I am very proud to share with you Globe Tattoo Broadband, a wireless broadband that will surely help you gain a positive output, WHENEVER, and WHEREVER you are! You don’t really have to worry if it will be recognized by your system because it is compatible in any operating system that you may have. Aside from that, Globe Tattoo has innovated a lot and they are now sharing to us different Globe Tattoo Broadband New Skins which anyone can choose from depending on the preference they want. If you are interested to have one, check out first the Globe Tattoo Broadband Gallery of products which can help you decide.

“The Tattoo is available as a pre-paid and as a post-paid service. I use the former, and I am charged on the basis of duration. I remember when Internet service providers used to charge on a per-kilobyte basis, which was OK back then because connections were still very slow. But now that we have broadband access, it’s very advantageous for users of Globe Tattoo to be charged on a time-connected basis. We can download (and upload) much more in a short span of time and get charged only for the duration of connectivity,” said Blogie

And speaking of which, the Tattoo will be able to detect signal strength as well as the availability of WCDMA or HSDPA in your area. For best download/upload speeds, make sure you’re in an area where either WCDMA or HSDPA is present. (Where neither is available, chances are, you’ll be glad you had Internet connectivity at all.)

So what are you waiting for? Go ahead and get yours now.

How YOU can help

Nurses Notes — Wed, 30 Sep 2009 17:25:52 +0000

The Philippines is still in need of your help. Those that were affected by the tropical storm Ketsana (local name: Ondoy) has to start from scratch. Rich and poor society are all called victims of this calamity. And in an effort to spread the word on how anyone can help, please click the link below:

How You can help – A compilation of MLQ3

We will highly appreciate your gift of time, effort, and kindness. Let us help one another especially at this time when almost everyone is in dire need of your help.

Sincerely,

Nurses Notes team