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Naloxone- given to reverse the effects Opioid overdose
can be given intranasal, IV or intramuscular. intranasal is often chosen in emergency situations as it able to pass into the blood stream easily without the difficulty of gaining IV access.
it is given 100mcg every 2 to 3 minute with a normal saline flush as a standing order when a patient had taken an overdose with a max dose of 400mcg

Escalation of care-
Occurs when a change in the patient condition has occurred and a new level of care needs to be started for the patient
in
an acute change in the patient condition is noted when they are in hospital, either due to a high MEWS score or a gut feeling as a nurse, a MET is called and then a team of doctor and nurse come to provide support.
In a less acute change, the treating doctor will be called to do a review of the patient, to put the necessary changes to their treatment plan

Adolescent assessment tools-
All the tools outlines to necessary to develop a therapeutic relationship with the patient before completing the assessment.
Also start the least invasive question, but moving onto more vulnerable topic for the child
CRAFT only focuses on the substance use of the child whilst the other 2 assessment look at more holistic view of the child's life, they include about the child's health, as well as they their school and home experiences
HEADS is a questioning framework whereas CRAFT and Paediatric assessment tool, are assessment which allows for a sort of answer on the health of the child
Paediatric assessment tool can be complete independently by the family, where as the other assessment are required to be administered by the health professional

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The class this week revolved around the prioritisation of care for patients with gastro.

Prioritisation is a very complicated issue when should take into account many different attributes of the patient. This includes the acute condition they are experiencing, their clinical history as well as any co-morbidities that they may have. Prioritisation becomes more complicated when you take into account the needs of the staff, the games that we played today showed that completing all of the patient care task becomes more difficult when their is limited staff, and so some task just can't be done.

When someone does experience gastro, they will likely become dehydrated. There are many different ways hydration resuscitation can be completed in the clinical setting

Orally- Drinking water if injuries allow
- antiemetics can be given to the patient before they start drinking to prevent vomiting
Via a nasograstic tube- Used in children when they may not be able to orally consume the required amount of liquid
IV- Used when orally is not suitable for the patient
- Allow for faster intake of the fluid but their is a high risk of  fluid overload
Intramuscular- Only used on palliative patient for comfort care

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Strenghts based approach- Health care approach which aims treatment towards the patients strengths. This approach allows for the development of a patients resilience as well as improving their mental health

Trauma informed care- This care takes into count that a large majority of mental health patient will experience some type of trauma in their lives. To effectively offer trauma informed care to my patients I will need to make sure that the patient see the healthcare environment as safe, and trustworthy. I will need to be willing to work collaboratively with the patient when providing healthcare

Deescalate techniques
As a nurse, I will encounter patients who are experiencing difficult emotions, and there are many different skills which I will need to be aware of to allow me to help the person regulate their emotions as well as keep myself safe

Low and Slow- Using a tone and speed of voice which is lower and slower as well as slower body movement to allow someone is frightened or has heightened emotion to not feel threaten and be more able to process the information that you are giving them

LOWLINE
Listen to what the patient concerns are
Offer comments to show that you are listening
Wait for person to release their frustration and express their emotions
Look into the patients eyes
Incline head to show interest and appear non-threatening
Nod to shown that I was listening and understood what was said
Express Empathy

This is a strategy which can be used deescalate when someone is angry

Name it to tame it- Help person to name their emotion, as well as validate their experience of it, allow for better regulation of their emotion

Regulate not educate- Wait to talk to the person about how to better manage their emotion, instead stay calm and give the person time and space to calm before having a discussion with them

Mental Health Terms
ED3- Emergency detention for a 3 day period when the doctor has access a patient of needing urgent treatment
PTO- Psychiatric treatment order, out the treatment the medication and treatment that the patient is required to receive when they are access as being to unwell to make their own choices about their mental health
Seclusion- Sending a patient to a space which they are unable to leave, continuous monitoring occurs whilst the patient is in seclusion
ACAT- ACT civic and administrative tribunal, assessment regarding PTO's and if a patient needs one or not

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Lund and Bowder Chart- Chart which show the percentage of the surface of the body which makes up each different body part. It is used to work out the body surface area effective when a patient has experienced after a burn

Modified Parkland formula-
3ml*TBSA%*Patient Weight

Works out the amount of fluid that the patient need. Half of the fluid is given in the first 8 hours and the rest in the following 16 hours

QUESTT-
Question the child (should be questioned before pain begins to assess the child needs and wants)
Understand developmentally appropriate pain assessment
Evaluate behaviour and physiological changes
Secure parental involvement
Take the cause of pain into account
Take action and evaluate

Pain assessment of a child which is comprehensive and multi-factorial

FLACC- Face, Legs, Activity, Cry, Consolabilty

A way to complete a pain assessment on a child who can not communicate effectively, and so can not use the wonk baker, or numerical pain scale

Wong Baker Faces- pain assessment used for children with faces which represent how much pain that they are in. One of the issues with this assessment is that that child could confuse pain faces with emotions, and so the score they report may not be accurate

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Research type- The research article is literature review as the author have collated all of the current information about ketoaicdosis in children rather than doing original research for themselves

Research Aim - Explore the pathology treatment methods for Ketoacidosis in children with type 1 Diabetes. The aim was not explicit within the research, but through reading the article, the aim became clear

Limitation- It does not contain original research, and so it doesn't add to our understanding of Ketoacidosis, however the review does allow for new pathways for research to be identified

Research Strength- The research is of good quality for my circumstances, as it peer reviewed and was published within the last 5 years. For my education about ketloadictios, the article is a good resource as it allows for comprehensive overview  ketoacidosis in children which would not be present in an article which contains original research.

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The three most important members of an MDT for a patient after a workplace injury are a OT, Physio and social worker.

OT- assess and provide support for a patient's ADL's
Physio- Diagnose and treat issues relating to the patients muscle, and bones and allow for the patient to return to their normal functioning
Social worker- provide patients with what they need to feel comfortable and safe in hospital as well as support in treatment and discharge planning

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The focus of the class this week surround a trauma workplace injury. When caring for a trauma patient, the most important thing that I should be doing as a nurse is to be constantly doing assessments as the deterioration can be really quick, and so with continuous monitoring it will be faster and easier to identify changes in the patient condition. This is specially true for head trauma, which the issues of can have a delayed appearance.
As a novice nurses, one of the skills which is necessary for me to have to the ability to ask for help, both when calling for a MET as well as support the patient's condition before the MET has arrived.

After someone has experienced a traumatic injury, a MDT is necessary to allow for the patient to receive the care that they need so that they are able to return to their normal function (or as close as possible). As a nurse, one of the most important things that I can do as a part of the MDT is observe the patient, and then pass details information to the other health professionals as this aids in discharge planning as well as allow for better relationship between the health professionals

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One of the most important things which I took away from the first reading this week was the fact that all nurse experience fear and anxiety when they first graduate. This is a comfort to me, as knowing that the people around me will most likely feel the same way that I do, but though gaining more experience after starting to work as a nurse, hopefully this will fear that I am feeling as stated in the article.
Leadership is a position that I need to be to feel comfortable in, one way that I will able to develop the comfort that I feel is through practising being a leader during my first few years as a nurse as well as asking for support when I need it

When looking at the prioritation nurses do in the clinical setting, stress and time play a major role the necessary that nurse experience when it comes to the need to priortation of patient care. This stress and lack of time leads missed patient care as well as the highlighting of uncurious biases which nurse experiences (for example ageism).
Nurse that I have worked with also experiences pressure from a lack of time due to patient discharge. Care (direct and indirect) for patients who are due to be discharged was priorities due to them leaving the ward soon, as well as the ability to document would be time limited when had left as their file would no longer be available easily on DHR.

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The focus of the learning this week was assessment of a detecting patient, as well as overcoming biases that I might hold as a nurse.

As a nurse, it will be really important that I am able to regonise and respond to deterioration to my patients quickly as it will allow for the best outcomes for the patient. Some skills that will allow me to effectively do this include being able to complete a A to G assessment quickly so that I am able to identify the health concerns which the patient is facing. I also need to know how to complete a ISBAR handover so that I am able to communicate with other health professional and the patient the care that they need.

When things about the basis which I hold, one of the most important take home messages from this week was that it is normal as a human being to have predisposed ideas about people, these ideas can revolve about work that they participate in, their socioeconomic level as well as they demeanour when engaging with people. These ideas that I hold may not be accurate, and actually be opposed to the real life that the person leads.
As a nurse, I have to find a way to push them to side, so that they do not impact the level of care which I deliver to my patients. As well as being willing to work with the patient to figurer out how to best provide care to the patient.

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This video (as well as the second part) was effective for refreshing my knowledge, as the way that the information was sent out (with spoken words, images and simple analogies) made it easy for me to take in the information.

The integumentary system comprises the skin, as well as all of the nerves, respecters, and sweat glands which are present within it. It also include the hair, and nails
The skin works to keep infections out, manage body temperature, express emotions and sense the outside world. The most important thing that I need to know about as a nurse, is the relation that the skin has disease and illness. The skin protects the internal organs form infections though acting as a barrier as well as containing immune cells in the dermis which from infections. As well as this, the skin can be cause of the development of skin cancer as UV light alters the make of the skin cells, and so I should make sure that I am effectively educating my patients about sun-safety

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The Integumentary System, Part 1 - Skin Deep: Crash Course Anatomy & Physiology #6

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Module 5 revolved around communication with patients who are experiencing acute mental health episodes. The strategies which were discussed during class this week focused on the safety of myself and others, as well as allowing for the effective management of the patients concerns.
Some of the most important take home messages which were discussed this week were
- When looking after someone with a mental health issue, I should make sure that I remember that they are a human being, and I should treat them in a way that preserves their dignity
- How the language that I use as a nurse impacts the patient. For explain using 'schizophrenic patient' can reduce the identify of the patent use to their illness and thus impede my ability to offer them holistic care
-  When communicating with someone who is experiencing a acute mental health issues I should make sure that I am also assessing the risk to myself and other
- When risk is lower, I should take time to sit down and           talk to the patient so that I can form a therapeutic relationship with them, and help them to manage any concerns that they may have, through using active listening.
- When there is a higher risk, I should make sure that I keep a safe distance from the patient, and well as know how to exit if needed. As well as these things, I should make sure that I act in a way that does not aggravate the patient more. I should also make sure that I escalate care and ask for staff support when needed

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The topic of class this week was Paediatric burns. There are many different things that I will need to remember when looking after paediatrics in my future practise as a nurse.

When the child first comes into the hospital the two first things that I will do are provide them with anaglesia to help to reduce their distress as well as assess the burn so that I can get fluids started.

Fluids is important when dealing with burns, and heat damages the capillaries, allowing fluid to escape into the interstitial space. This loss of fluids can lead to hypovolemic shock, and the replacement helps to avoid that.

When nursing this patient, I will need to aware that their family impacts there health. So as the nurse I will need to make sure that I find ways to help the parent manage their emotions, as well as finding way to effectively communicate with both the child and parents

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For this placement, I completed pre-learning which revolved around hand hygiene and minimising the risk of hospital arrequired infections.
Even though I have learnt about this before, it is important, as it such a simple thing, but if I become complacent it can have serious consequences for the patients I look after. These consequences can include sepsis and death.

Some of the things that I can do to avoid these things occurring are completing the 5 moments of hand hygiene as well as appropriately using PPE

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Date: 16/08/2023
Length: 30mins
Presenter: Janet Chifuntwe

The function of ICC drains is to get rid of the fluids around the lungs or heart after someone has had surgery.

The drain should be assessed every few hours, this assessment include, seeing if there is any swing or bubbling when the patient inhales or exhales, as well as how much fluid has been draining.

The swing and bubbling are sign that there is still fluid in the interstitial space. When the bubbling and swing in no longer present within the drain, it is a sign that the drain can be removed.

If the drain ever falls out of the chest, as gel dressing should be put on the drain sight in the short term before the patient can be reviewed by the doctor. The gel dressing allows for air to continue to flow out of the body, but stops air from entering the body.

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Date: 22/08/2023
Length: 30 mins
Presenter: Janet Chifuntwe

I attended an inservice which discussed different medications which are used for patients after they have cardiac surgery. This inservice discussed, calcium channel blockers, diuretic and ACE inhibitors.

Some of the important things that I will need to considered when my patients are taking these medications:

When someone taking medications like calcium channel blockers, which reduce blood pressure, I need to observe the patient when they go from sitting or lying to standing. This is as there is a risk of them experience postural hypotension, which may result in them experiencing a fall.

When patients are taking diuretics, I need to make sure their electrolytes are being monitored as they will be excreting more urine, which can lead to decrease levels of sodium and potassium. This alteration in electrolytes, can impact the functioning of the heart and the cells.

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DKA- occurs due to the breakdown of fat as a source of energy due to cells  not being able to uptake glucose. This breakdown of fat leads to ketones to build up within the blood stream to become more acidic.
Symptoms include- thirst, increased urination, nausea, fruity breath, and abdominal pain

Another important thing that was discussed in class this week was empathy. I learnt that taking step to allow for the patient's comfort can be very useful in helping allowing for effective communication with patients. One example of this was through allowing for discussion with Avery, it allowed them to share their diverse gender identity

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Date: 24/08/2023
Length: 30mins
Presenter: Janet Chifuntwe

I attended an inservice during placement which was based on how to complete documentation on DHR during a MET.
To get to the part which allows you to complete the appropriate documentation, you have to clip 'restutation documentation' on the drop down menu, which will take you to a page which allows you to document any observation complete during the MET call such as neurological observations. You are also about to document medications given and bloods taken during the MET.
The section also allow for 'updates' to be made if the person filling it out is too busy to use each individual category available.

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Started the semester off with a orientation to the way that the class will run this semester

I think the way that classes are structured, with it being discussion based and working in small group is very good. I think that it will allow for my learning in these classes to be very effective, as I will easily to able to clarify any issues that I may be experiencing or ask questions if I need to

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One question that I had around the content this week, was how you would manage a patient with an opioid overdose if they were allergic to naloxone.
Through outside research, I found that Naloxone will still be administer even with the presence of a allergy, as it is easier to manage the allergic reactions of the patient rather than use another strategy to manage opioid overdose