Posts Tagged ‘nursing study guide’

Diabetes Care Specialist Salary

Posted in Diabetes Information on May 28th, 2010 by admin – Be the first to comment

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What Determines Nursing Salaries

Author: ROBYN KNAPP

In today's economy with declining employment in many fields that require degrees, the profession of nursing is as solid as it ever was. People with prior degrees are looking to enter the nursing profession. The salary of a nurse varies greatly. There is really no base salary but a fluctuation across the board. The reasoning for this is a varied as the salaries in nursing.

The base pay of a nurse is determined by many different factors. The first of these factors are the years of experience that the nurse brings to the table. A GN or graduate degreed nurse will start out at the lowest salary of nurse pay. They will remain at this level until they pass their board exam or NCLEX. Upon passing their boards they will receive a small increase in pay anywhere from $2.50 per hour to $5.00 per hour. The most important factor in this scenario is to keep in mind that if the graduate nurse does not successfully pass the board exam the hospital can terminate their employment or extend to them a grace period in which they have the opportunity to pass the boards a second time. In the past years, it was not unusual for a graduate nurse to stay on as a hospital employee for years before finally passing or taking their boards.

This practice is no longer widely accepted. Also the graduate nurse is not allowed to pass any medications until they have their licensure. The question remains, what is the typical base salary for a graduate nurse. It is safe to say that the salary ranges in the low to mid forty thousand dollars per year. This discrepancy of several thousand dollars has much to do with the location of the hospital. For instance, in rural communities where much of the hospital funding comes from the government, the pay rate may be higher or lower than a privately funded institution.

The mitigating factor is how successful the grant writers are at tapping into government funds, and how much private endowment monies are bestowed to the hospital. Even with these two factors in place comes the process of dissemination of the funds. This is dependent on how the board of directors see fit to use the funds. These funds could be put to the construction of a new hospital wing, or to the purchase of new diagnostic equipment.

Whether or not the nurses are unionized is also another factor in entry level nurse pay. Unions can either work for or against nursing wages. Sometimes non-unionized hospitals pay more.

Shift premiums are also a factor. The top shift premium is paid for the midnight shift. Midnight shift premiums range anywhere from $2.50 per hour to $4.50 per hour. Since most shifts in hospitals are now twelve hour shifts, midnights start around 7:30 p.m. and end around 7:30 a.m.. These are attractive hours for many nurses since they get four days off during a week and are still considered full time at thirty six hours per week. Health benefits including dental and optical are included in the total package and begin anywhere from one week after hire up to ninety days.

The area of the hospital that the nurse will work in is also a factor in pay. For instance those nurses that are trained for specialty care areas such as intensive care units (I.C.U.), the operating room, recovery room, or in the cardiac care facility will get paid an extra premium upon completion of their training in the hospital.

Different areas of the United States have been known to differ in nurse pay scales according to the cost of living and population densities.

In the final analysis, the following factors are involved in determining the salary of an entry level nurse; a) their years of experience in patient care, b) the shift they will be working, c) the hospitals location, either rural or metropolitan, d) whether or not the nurses are unionized, e) the population density and per-capita income of the residents in the hospitals region, f) the area of specialty the nurse will work in, such as I.C.U., C.C.U, etc., g) successful completion of licensing boards. h) whether or not to accept a benefit package or keep extra dollars per hour and opt not to take the benefit package, i) whether the hospital is government or privately funded.

Learn more about nursing education at The Nursing Entrance Test Study Guide.

Article Source: http://www.articlesbase.com/careers-articles/what-determines-nursing-salaries-552498.html

About the Author
Pass the Nursing Entrance Test the first time with our guide at Nurses Learning Center. Written by a Professor of Education for nurses, the guide has over 600 pages with details answers to every question.[TEMPLATE]amazon link top[/TEMPLATE]

Ketones In Urine Diabetes

Posted in Diabetes Information on May 20th, 2010 by admin – Be the first to comment

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Diabetic Ketoacidosis

Author: ROBYN KNAPP

Diabetic ketoacidosis or (DKA) is a complication of diabetes. When the individual's blood sugar gets very high and they are profoundly deficient in insulin, the body becomes unable to utilize blood sugar efficiently. The body then begins to burn fat stores for food. As these fat stores are burned, a by product is released called Ketones. It is ketones that are responsible for lowering the body's pH level below 7.35. Metabolic acidosis occurs when the pH of the body drops below 7.35. The body attempts to excrete the ketones via the kidneys, causing ketones to be released in the urine, a term called ketonuria. However along with the negative ketones, the body's positively charged electrolytes are also excreted. This leads to an electrolyte imbalance. The body continues to burn other glucose stores in the body such as proteins, causing nitrogen losses.

Now the body has depletion in electrolytes. This can cause nausea and vomiting, depleting more electrolytes. The individual is now in a severe hyperglycemic state and is hypovolemic as well. If these conditions are left untreated, the person can go into hypovolemic shock, become comatose and die.

Outward signs and symptoms of DKA include the following; eyeballs are soft and appear sunken, skin turgor is poor, (Dehydration of tissues can be tested by pinching the skin fold on the sternum. If the skin stays in one place or does not loose its shape rapidly, then dehydration can be assumed.), the person is very pale, cold, clammy, and exhibits deep rapid respirations, an effort the body makes to eliminate excess carbon dioxide. The individual may also exhibit severe abdominal pain and tachycardia, (heart rate greater than 100 beats per minute.) Diagnostic laboratory findings from arterial blood gases would indicate a pH less than 7.35, blood glucose level greater than 250 mg/dL, serum bicarbonate level less than 15 mEq/L, as well as ketones in the urine.

Interventions must be immediate to prevent irreversible destruction to the body's organs and prevent coma or death. Ensure a patent airway, and begin to administer oxygen via nasal cannula or mask. Establish an intravenous access with a large bore needle (18 to 20 gauge). Begin fluid stabilization with 0.9 Normal Saline. This is an isotonic fluid, compatible with the body's pH. The purpose of using an isotonic infusion initially is to re-establish blood pressure which was low and to increase urinary out put to 30-60ml/hr. When urinary output is less than 30 ml/hr, kidney failure can rapidly occur. Fluids should continue for one hour or until stabilization occurs. Next begin insulin infusion with a drip rate or 0.1U/kg/hr. During this time it is important to monitor the person's vital signs every fifteen minutes until stable or for at least one hours after treatment begins. If necessary, potassium should be administered to correct for hypokalemia, and sodium bicarbonate to correct for metabolic acidosis, if the pH is less than 7.0. The person should also have electrocardiogram leads placed on chest to monitor heart rhythms.

When the diabetic is at home and feels these bodily signs and symptoms beginning to occur, they should take the following steps; call 911, check their blood sugar, administer insulin per sliding scale, drink an electrolytic fluid, (i.e., sports fluids), breath into a paper bag, use oxygen if available, lie down, raise feet level with the heart and wait for the ambulance.

Preventative measures to avoid DKA include consistent control of blood sugar with administration of insulin per protocol. The diabetic should avoid too much food intake, and avoid taking too much or too little insulin. Stressful life situations can also cause elevations in glucose levels. Therefore the diabetic should prepare to check their blood sugar more often during times of stress and administer insulin as prescribed.

Understanding the complications of diabetes can help the diabetic take the necessary actions to prevent DKA from occurring and help them live a healthy life.

References:

1. Lewis, Heiitkemper, Dirkesen, Medical Surgical Nursing 6th ed., Copyright 2006, Mosby, St. Louis., pages 1273 -1278.
2. http://www.defeatdiabetes.org/support_groups
3. http://www.accu-chek.com
4. http://www.Type2Diabetes-Info.com
5. http://www.ChildrensDiabetesFdn.org
6. http://www.diabetesinmichigan.org
7. http://www.diabetesmonitor.com

Article Source: http://www.articlesbase.com/health-articles/diabetic-ketoacidosis-560697.html

About the Author
Pass the Nursing Entrance Test the first time with our guide at Nurses Learning Center. Written by a Professor of Education for nurses, the guide has over 600 pages with details answers to every question.

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