Featured

Story Time About the Dog and His Owner.

"You must give everything to make your life as beautiful as the dreams that dance in your imagination"-Roman Payne.
My handsome big dog dedicated to his owner.Runs errand for the owner.
The dog is asked to go into the house and bring kola nut(this could be anything for
entertainment)

It is a bedtime story about a dog and his owner.The owner surprisingly had visitors that they were not expecting .So the owner started a song like this.

My handsome big dog go into the house in the living room and get me some kola nut, so that we can give to these uninvited visitors.I did not invite them and I am sure that you did not invite them.So come on big boy go into the house and get me some kola nut so that we can give to these strangers.Hopefully the kola nut will force them to tell us why they are here.

So the dog went into the house and got the kola nut.The uninvited strangers ate the kola nut.After eating the Kola nut (coca cola) they confessed that they are interested in buying the piece of land in their backyard so that they could be their neighbor.Sometimes a kind gesture can lead to meeting pretty nice people.The dog owner told them that she owns the land but the land is not for sale.So they left back to where they came from.The big dog and his owner live happily there after .The End.

Featured

My Honor As A Nurse.

On my honor as a Registered Nurse.


I will provide compassionate excellent Nursing care.

I will do my best now and tomorrow.
Be a good leader,not a follower.
I must Move Nursing Agenda Forward.
I must do my Best all the time.
I promise to update and obtain required CE every two years.
Advance my knowledge,education,and experiences.
I will be Knowledgeable not Knowledge Deficit.
Team player,work effectively with my colleagues and other ancillary.
Clock or sign in on time.
Clock or Sign out on time. Have all my equipment such as Stethoscope,Pen and Pencils.
I must Reason,and be Reasonable.
Perform my assigned role effectively and efficiently. Follow Hospital policies and Regulations.
Comply with JCAHO Standards of Care and Regulations.
Carry out Doctors Orders on Time.
Troubleshoot and be Supportive of my Colleagues. Know and Understand Patient Bill of Rights.
Respect Patient and Families. “The very First Requirements in a Hospital is that, it should do the sick no harm “Florence Nightingale .
Give medications by mouth and intravenously as ordered. Advocate for my Patients.
And provide TLC.
Must not Abuse Patients Physically, Emotionally or Sexually.
Promote Health and Prevent Diseases.
“I attribute my Success to this -I never gave or took any excuse”- Florence Nightingale .
Nursing Assessment.

CONTINUATION OF MEDICATION 💊ADMINISTRATION QUESTIONS AND ANSWERS.

https://anchor.fm/philomena-okeke/episodes/CONTINUATION-OF-QUESTIONS-AND-ANSWERS-ON-MEDICATION-ADMINISTRATION-e14gsn1/CONTINUATION-OF-MEDICATION-ADMINISTRATION-QUESTIONS-AND-ANSWERS-a654amj

IODOFORM DRESSING. [CADEXOMER IODINE]

This is another type of wound dressing change. Indicated for use in cleaning wet ulcers and wounds such as :

Venous Stasis ulcers.

Pressure sores and infected traumatic and surgical wounds.

Iodosorb gels and iodoflex pads assist in wound area protection and reducing the microbial load in the wound environment.

It retard eschar formation and keep lesion soft and pliable.

TYPE OF DRESSING CHANGES THAT I KNOW. SILVER SULFADIAZINE.

This is a sulfa derivative topical antibacterial creme. It is used to fight bacterial and yeast on the skin.It can impede fibroblast activity. Apply to a thickness of 3 to 5mm to burned 🔥surfaces once or twice daily.

It can be an open treatment or occlusive dressing change. Apply directly to to skin used along with other medications to prevent and treat infection in people with 2nd and 3rd degrees 🔥. Effective against serious bacteria and yeast infections. It is used on Burns, skingraft ,incision, leg ulcer and other clean lesions.

492 CASE SCENARIO. LEFT HAND CELLULITIS.

KINGDOM OF GOD HOSPITAL 🏥 LOS ANGELES CALIFORNIA 900000.

INTERDISCIPLINARY KARDEX.

Age/Sex 45years male.

Acount number: Q002101364.

MR# : Q000558215476.

Admitted: 02/13/21 @ 0450am.

Location: MedTelemetry.

Room 42120.

Attending doctor: Tomtom Worry,MD. Resuscitation Status Full code.

Isolation Status: Standard Precautions.

Suicidal risk:No.

Risk for fall:No.

Do you have advance Directive: No.Copy of advance Directive on the chart.

Diet Carb Controlled cardiac diet.

Alert and oriented ×4.

Patient belongings at his bedside.

Primary diagnosis :Left hand Cellulitis.+ Blisters.( Etiology of wound Bug bite developed Cellulitis.Sharp debridement done 02/13/21 @1pm.)Cellulitis will appear as red,swollen and painful.It is caused by different types of bacterial. It is warm and tender to touch.Cellulites can appear in any part of the body but this Cellulitis is in the left hand.Some people can develop fever and chill due to Cellulitis. Antibiotics is usually given intravenously to eradicate that bacteria. Some Cellulitis will lead to open wound which must be addressed. Dressing change done as ordered by the doctor or the wound care team.

Secondary diagnosis: Hypertension, DM, infection. Gram+ infection left hand wound. Doctor orders:

Amolodipine 10mg po daily.

Hctz 12.5mg po daily.

Dressing change. Irrigate with saline .

Apply Bactroban adaptive, guaze and band net.Goal is a complete wound healing. Infection control doctor on Board -doctor Vancuva,Micha, MD.

Vancomycin 1gm IV Q12hours.

Zosyn 3.375gm IV Q8hours.

Lovenox 30mg SubQ 09am.

Norco 10/325mg po prn Q4hours pain. Morphine sulfate 4mg IV Q4hours.

Qac/Qhs.

0.9NS @ 50ml/hour right forearm 18guage clean/dry/patent.

Laboratory tests:

WBC 10.5.

H/H 12.9,38.3.

Na 138.

K: 4.0mEqkcl.

501 CASE SCENARIO.LEFT LEG CELLULITIS/ DYSPHAGIA.

KINGDOM OF GOD HOSPITAL LOS ANGELES CALIFORNIA 900000.

INTERDISCIPLINARY KARDEX.

Age/Sex 53years old man.

Account number Q005634372.

MR #Q00058867544.

Admission date 📅2021.

Status: Inpatient admit.

Location General Surgery.

Room 62112.

Attending doctor: Keehope Benjamin.

Patient name:Thompson Mystone.

Resuscitation Status: Full code.

Primary Cellulitis/ Dysphagia.

Secondary diagnosis: Hypertension. Recurrent ICP AVM.S/P Craniotomy No bone flap on the left.(intracranial pressure with A brain arteriovenus Malformation. )Hx of Stroke. Isolation Status: Standard Precautions.

Suicidal risk:No.

Is patient at risk for falls: yes.placed in a sitter room and fall Precautions protocols maintained.

Do you have advance Directive: No.Copy of advance Directive on the chart.

Diet Cardiac heart health diet- Pureed.Feeder patient.

Liquid thickness:Nectar thick liquids.

Allergy: NKDA.

Weight :135lbs.

Height: 5feet 3inches.

Alert and oriented × 1.

Transportation: Bed.

Lung sounds diminished. 02 @2liter NC.

Impaired skin intergrity: Yes.

Language: Spanish speaking.

Debridement of left leg 🦵Cellulitis by the Podiatry : Doctor Buttermilk,Kent.

Infection disease doctor :Hussain, Babylon MD following patient.

Neurosurgeon on board,doctor Nguyen Godforbid.

Saline right Ac intact.

Incontinent of bowel ,condom catheter in place. Drained 400ml of clear yellow urine.

SCD to right lower Extremity.

Stage 1 pressure ulcer to the occyx areas,myperlex dressing change QOD. Restraint left hand ,right hand flaccid.

Mumble all the time and does not follow simple commands.

Medications:

Seroquel 50mg Qam and Before bedtime.

Keppra 100mg IV Q8hours.

Lisinoprol 10mg po daily.

Hctz 12.5mg po daily.

Laboratory tests:

WBC 8.5.

H/H 12.0,37.2 %.

Na: 142.

K: 4.4mEqkcl.

Plans:

Discharge to boarding Care in two days.

500 CASE SCENARIO. SEVERE HYPERGLYCEMIA NON KETOTIC STATE.

KINGDOM OF GOD HOSPITAL LOS ANGELES CALIFORNIA 900000.

INTERDISCIPLINARY. KARDEX.

Age/Sex: 50years old man.

Account number Q006115328.

MR # Q00069593426.

Admitted 07/04/21@03am.

Status: Inpatient admit.

Location: MedTelemetry.

Room :42123.

Attending: Hamilton, Odogua.

Patient name: Jose Carrygo.

Resuscitation status: Full Code.

Weight 162.

Height:5feet 7inches.

Primary diagnosis:Non ketoacidosis hyperosmolar.Secondary diagnosis:.DM,HYPERTENSION,no blood sugar medications for 25days.

Isolation Status Standard Precautions.

Is patient at risk for fall: No.

Suicidal risk:No.

Do you have advance Directive: No.Copy of advance Directive on the chart.Belonging list done.■

Diet Carb Controlled cardiac diet.

Alert and oriented ×4.

Allergy : NKDA.

Doctor orders: Vital sign+ neurocheck Q4hours.

QAC/QHS and 02am.

1/2+20meqkcl @150ml/ hour.

Hctz 12.5mg po daily.

Hydralazine 10mg IV Q8hours prn blood pressure over 160SBP.

Norco 5mg po prn Q4hours.

Humalog 12unit blood sugar >350ml.

Levemir 15unit Qac and at bedtime.

Follow doctor orders and your hospital policy and procedures.

499 CASE SCENARIO. FALL ACUTE T12 AND L2 FX.

KINGDOM OF GOD HOSPITAL 🏥LOS ANGELES, CALIFORNIA 900000.

INTERDISCIPLINARY KARDEX.

Age/Sex 80years old female.

Account number: Q006543246.

MR # :Q000524356798.

Admitted : 03/18/21 @0456am.

Location : MedTelemetry.

Room 42121.

Attending doctor: Tomtom,Worry. Patient name:Jesenter Ohodum.

Resuscitation Status: Full code.

Primary diagnosis: Fall acute T12,L2 fractures. Secondary diagnosis:Hypertension, Dyslipidermia, Seizure disorder.

Weight: 170lbs.

Height:5ft 8inches.

Allergy: NKDA.

Isolation Status: Standard Precautions.

Is patient at risk for falls: yes.Daughter at her bedside 24/7.Reposition for comfort and pressure redistribution Q2hours,log rolling, spinal Precautions.

Suicidal risk: No.

Do you have advance Directive: No.Copy of advance Directive on the chart.

Diet : Cardiac heart health diet.

Transportation:Bed.

Doctor orders:

TLSO at all time,aspen collar in place.

MRI Lumbar ■ T12: 96% Stenosis.

L2 20% Compression fracture.

Ultrasound of left arm ■ negative .

Picc line place for long term antibiotics at home with home health.( Home Sweet home health Agency,Wilshire Blvd Los Angeles, California 900000)

Discharge home to wife in two days with home health nurse, physical therapist/Occupational therapist. (Wife refused discharge to SNF or Rehabilitation center)

Gram + cocci in the blood/ stool.

Alert and oriented ×3.

Lung sounds diminished.

Discontinue IV at 10am today.Saline lock right forearm 18guage,patent, intact and clean.

Laboratory tests:

WBC 9.5.

H/H 9.6, 28.8 %.

Na:144.

K: 4.0.

Repeat blood culture ,CBC, and Chemistry today.

Hx of seizure disease. 🛌Bedrails well padded.And the floor around the bed is also well padded.