Week 15: Catching some Zzzzzs

This is my second-to-last week of NUR 111!!!!! I can't believe how fast this semester has FLOWN by!!!! Yesterday was my last clinical at the hospital for the semester and on Monday we learn our last concept. Then, on December 15, we take our final cumulative exam! We are finally at the end (of the first semester - it'll still be another 16 months before we're at the end of the program)! Then I can finally get some sleep (maybe...possibly...probably not)... :-D

Anyway, this week we studied death and grief, pain and sleep. My favorite one to study? Sleep! So that's what I'm going to write about for this week.

Every person has what's called the Circadian Rhythm which determine when they are awake and sleepy and the body functions associated with that. The Circadian Rhythm can be changed depending on light, noise, activities, and much more. That's why people can adjust to radically different time zones after only a few days. For instance, when I lived in the Philippines for five months, it took me about a week and a half for me to finally feel normal and adjusted. However, towards the end of my time in the Philippines, I worked such a hectic schedule and got an average of 2-4 hours of sleep per day (usually on the 2 hour side) that when I flew back to the States, I didn't experience any jet lag because my body was so thankful I was getting more than 2 hours of sleep at a time!

 So I guess the key to avoiding jet lag is to not sleep for a month before flying to a new time zone. Your Circadian Rhythm will be so messed up it will just be happy you're asleep. :-D

Another weird fact is that experts still claim to not have found the purpose of sleep....Um....Hello?! I think the purpose of sleep is obvious - it refreshes and resets you! When someone sleeps, their body fixes any physical damage that's occurred during the day, the brain solidifies memories and different things that have been learned that day, and it also maintains your emotional health. Basically, it prepares you to continue living the next day. Sleep is IMPORTANT, people!!!!

There is two different types of sleep - REM and NREM. NREM sleep stands for Non-Rapid Eye Movement sleep. There are four stages to it and people stay in this type of sleep for most of the time they're asleep. The first two stages of NREM sleep are considered to be "light sleep." The person can be woken up easily and usually feels as if they've been daydreaming. Their body gradually begins to slow down and rest. Combined, the first two stages of NREM sleep last about 30-40 minutes. However, if someone is EXTREMELY tired (like me when I would get 2 hours of sleep a night in the Philippines), they progress through the first two stages of NREM sleep really fast and move to the third stage.

this is a picture I found on the internet of young twins who fell asleep eating spaghetti. lol.

The third stage of NREM sleep is still fairly short but the person is completely relaxed and difficult to wake up. It's the beginning of deep sleep. After about 30 minutes, they move to the 4th stage of NREM sleep. If someone is extremely tired, they'll spend most of their sleep in this stage. This is the deepest stage of sleep and the person is VERY hard to wake up at this point. Going back to my Philippines illustration, there was one night I worked night shift at the birth center after having been up for about 20 hours already. Not very smart, I know. Anyway, about 5:45am, 15 minutes before the shift ended, we had a quiet moment and I fell asleep. Five minutes later, a lady walked in in active labor and one of the midwives tried to wake me up. She yelled my name in my face several times but I didn't stir. It wasn't until she touched my shoulder that I jumped and woke up. When I'm in a deep sleep, you can scream and yell at me all you want, but I won't hear you. It's not until someone touches my shoulder that I'll startle awake.

If I'm in deep sleep, this wouldn't work for me...

The final stage of sleep is REM sleep. This stands for Rapid Eye Movement sleep since this is when someone's eyes move quickly under their lids and they have very vivid dreams. Their body also becomes briefly paralyzed since otherwise they'd act-out their dreams and hurt themselves. During this stage, their heart rate, respiration rate, and blood pressure all increase as if they were awake. This stage is fairly short. Many people claim they don't dream at night, but that is not true. Everyone dreams at night but they might not be able to remember the dream. This is still a deep stage of sleep. If someone is woken up during REM sleep, they might be briefly unable to move until their body recognizes that they're awake and releases their muscles to move.

During the night, the sleep cycle continues over and over again until someone wakes up. If someone is extremely tired, they quickly progress to the 4th stage of NREM sleep and stay there for a while. However, they then progress to REM and then NREM stage 1 until they eventually wake up.

Some sleep problems people might have are sleep apnea, insomnia, and narcolepsy. Sleep apnea is where someone's airway closes (usually from too much fat on their neck) and they get hypoxic (low on oxygen). Their body then fights to open the airway and wakes up slightly. This can happen hundreds of time a night and the person wakes up feeling worse than when they went to sleep because their body spent the whole night fighting to breathe. People can actually die from sleep apnea. Two of the major characteristics of sleep apnea are loud obnoxious snoring (which doesn't bother you - it only bothers your roommates) and feeling exhausted when awake as if one hasn't slept in days. One solution for sleep apnea is a CPAP machine which pushes air into the person's nose and/or mouth so their airway doesn't close.

Insomnia, another common sleep disorder, is when someone is unable to fall asleep. Some tips for insomnia is read for a few minutes before bed, avoid eating a big meal shortly before bed, and don't exercise before bedtime. Another tip is if someone's been in bed for a while and can't fall asleep, the person should get out of bed and do something else for 15-30 minutes, such as reading, crocheting, taking a shower, etc, and then try again. When someone stays in bed and realizes they're not falling asleep, they become anxious which only makes things worse. When they become anxious, they're unable to fall asleep. However, they're anxious because they're not falling asleep so they only get more and more anxious because they can't fall asleep but their anxiety is preventing them to fall asleep. It's a horrible cycle. One trick to combat it is to get out of bed and do something else for 15-30 minutes (just as recommended earlier).

The last sleep disorder I want to mention is narcolepsy. Narcolepsy is when someone's brain randomly shuts down and causes the person to immediately fall asleep. This can happen multiple times a day, usually when they get excited. The person isn't aware they've fallen asleep. There are multiple drugs to help with this disorder to help people stay awake. If they also have cataplexy, their muscles completely relax so they'll go completely limp wherever they are. The fainting goats have made cataplexy famous - when they get overly excited, they just fall over and can't move. It's hilarious, but imagine how horrible it would be to live like that!

Our instructors also showed us this hilarious video of a dog with narcolepsy:

Next week we have one more subject to learn about - spirituality and how it effects health and actions - and then I'll be done with the semester! I'll probably have a brief post next week and either discuss spirituality or just do a brief overview of the semester.

...Until Next Week! :-D

Week 14: Urinary Elimination

This week, we learned the extremely fascinating concepts of urinary and bowel elimination. (Also known as peeing and pooping... Riveting, I know.) Since there was so much information in this topic, I decided to just share some of the fun highlights or weird tidbits we learned.

Did you know that if someone's having trouble urinating, you can pluck their pubic hair and that can stimulate them to go?

Did you know that old men frequently have problems urinating because their prostate enlarges and pinches their urethra?

Did you know that it is better anatomically for men to stand while urinating and women to sit?

Did you know UTIs (urinary tract infections) are the most common health care acquired infection?

Sometimes I'm shocked this dummy isn't blonde....

Did you know most people only urinate 5x per day (after waking, after each meal, and before bed)?

Did you know that your eyes turn red in a swimming pool from the combination of urine and chlorine in the water? (And did you subsequently know that most people urinate in the swimming pool?!)

Did you know certain medications can change the color of your urine? Depending on what medication you're taking, it could be perfectly acceptable to have blue, green, or orange urine!

Did you know some people believe that urine can heal diseases? If they're sick, they'll mix a drop of urine with water and drink it. Some people claim it really works! (Personally, I think "Eeeewwww!!!")

Next week, I just have a test and a nutrition project presentation and then I'm off for Thanksgiving so there'll be no post next week.

Happy Thanksgiving!

Week 13: Stress!!!!!!!

This week, we learned about stress and coping. The joke at school was that we needed to learn about this topic 13 weeks ago....

There are two different types of stress - eustress (good stress) and distress (bad stress). Eustress causes someone to get the job done and work hard. It brings about positive results. Distress causes someone to freak out and overload and have a melt down. It brings about negative results and eventually causes the person to crash and burn.

...this is what my nursing class looks like half the time.

So the question was asked: Is nursing school a eustress or a distress?

There were multiple opinions expressed about the stress of nursing school. Some people said it was distress since it was just too much and there were too many assignments and they couldn't pass tests and they were starting to get ulcers from the constant stress and they were working part time and trying to raise their family and they don't know how they're going to make it. Other people said that nursing school was eustress since it was stressful enough that we are constantly studying making us better students and eventually better nurses.

When someone is under stress, there's three phases. The first phase is the alarm reaction phase, where their body responds to the stress and the fight or flight response occurs. If it lasts long enough, it moves to the second stage, the resistance stage. In this stage, the body stabilizes and tries to adjust to the stresser. The stress is still there but the body is no longer responding to it. After a while, it moves into the third phase - exhaustion. At this point, the body is so worn down that it gives up. It doesn't have any more energy and becomes ill.

Of course, this week we had a really big skills check off and 31 out of the 39 students failed. It wasn't exactly our fault since there's a ton of miscommunication between students and teachers. Thankfully, the problems are starting to be resolved and everyone passed the re-check off!

...Until next week!

Week 12: Family

This week, we learned about the concept of family. We also learned about tissue integrity and wound care, but it was boring and I decided family would be much more interesting. :)

There wasn't really anything earth shattering I learned so I'll just quickly post some fun facts:

The "typical" family (mom, dad, kids) is no longer the norm. There's now single parent families, blended families, alternative families, and extended family groupings.

26% of households are just one person living alone.

54% of marriages end in divorce... :(

41% of children live with single moms who've never married (I personally found this number shocking)

I couldn't find a good picture for this, so I just found a funny picture that has absolutely nothing to do with single moms.

24% of children have their fathers as their main caretaker (I find this number hard to believe...)

Being 65-years-old is no longer considered "old," but "middle aged."

party time!

...Well, that's the interesting facts from this week! Until next week!

Week 11: A Wonderful Week and Medication Administration

Last week, I was really discouraged at the end of the week because it had been a long, stressful, fairly unpleasant week. The teachers had yelled at us due to miscommunications (every class...), I failed a nursing skill, and we had a test I needed to be studying for. And, we got dispatched to a surprise cardiac arrest (as in, we were told it was an allergic reaction instead of a dead person) five minutes before we could call out of service Saturday night. Ok, so that was actually pretty exciting (it was my first code!) but the adrenaline crash afterward was pretty horrible... lol.

I just learned about how to put .gifs into Blogger so this post will be full of them... :-D

However, this week was wonderful - I aced my test on Monday (yay!), passed my skill test (yay!), the teachers were nice to us this week (yay!), my group got a lot accomplished for our nutrition project presentation due the week of Thanksgiving (yay!), and I got hired to photograph a guy proposing to his girlfriend on Saturday (yay!). This week was a wonderful respite from last week. :-D

Anyway, this week we learned about medication administration. I thought it would be fun to share some of the weird facts I learned this week:

Don't ever give ear drops to someone if they're cold. You need to roll them between your hands for a few minutes to bring the drops to room temperature. The middle ear is super sensitive to temperature and cold ear drops will cause the patient to have nausea, vertigo, and debilitation for a few minutes!

Fainting goats :)

When giving an injection, it should take 10 seconds to inject 1 mL. Yesterday, we had to pretend to give an injection of 2.5 mL so yes, it took us 25 seconds to give this shot!

1...2...3...4...5...6...7...etc...

If a patient uses a Metered Dose Inhaler (MDI), they need to rinse their mouth out two minutes later so fungus doesn't grow in their mouths.

There are between 600,000-1,000,000 accidental needle sticks of health care providers reported each year...

Insulin has to be given by injection instead of orally because the GI tract digests insulin before it can do any good.

I couldn't find a good gif for this so I decided to post a funny gif of the Kardashians because they're dumb.

Well, folks, that's it! :-D

...Until next week!

Week 10: Infection. Inflammation, and Bacteria - Oh My!!!

In week 10, we studied infection and inflammation.

Of the two, inflammation is the more general and can occur with or without infection. Slam your toe against a wall? Inflammation! Get a splinter? Inflammation! Get Tuberculosis? Infection and inflammation! It's a party! Ok, maybe not...

Anyway, inflammation is what causes the pain, redness, and swelling from an injury or illness. Let's say you were building a wooden fort and accidentally hammered a nail into your finger. Ouch! From the outside, your finger really hurts, a giant nail is sticking out of it, and it is probably bleeding.

This is actually a prank kit you can buy - the nail is not actually puncturing her finger!

On the inside, your white blood cells (WBCs) are flooding to the scene of the trauma, trying to ascertain whether any bacteria entered. Most likely, there are several foreign bacteria who entered with the nail. Your white blood cells start attacking the bacteria and call for help. One type of WBC releases histamine (which constricts veins, decreasing venous return), heparin (which decreases clotting abilities), and kinins (which dilate arteries).

The arteries bring blood to the area while the veins take blood away from the area so having dilated arteries brings more blood to the scene of the crime. However, the veins are smaller so it is harder for the blood to leave. This causes the redness you see in inflammation.

The 5 Pillars of Inflammation

Since all the blood is staying in the area, the area begins to grow and swell causing edema. Since the area is growing, this puts pressure on the nerves in the area which causes the pain involved in inflammation. Also, the edema and pain causes the person to not move the area as much so the last sign of inflammation is loss of function.

So there you have inflammation in a nutshell! :-D

Another very important topic we talked about was antibiotic resistance. Antibiotic resistance has become a huge problem lately because bacteria are smart and can easily figure out how to change so that the antibiotic is no longer effective on them. This can be caused by people taking antibiotics when they don't need to or by taking antibiotics for a little bit and stopping before the bacteria is fully killed. Either way causes bacteria to build up resistance to the antibiotics which makes it really hard to kill the bacteria. One famous example of an antibiotic resistant bacteria is MRSA - Methicillin-resistant Staphylococcus aureus. MRSA starts looking like a harmless spider bite but then it progresses and becomes really bad, eventually killing the person if it's not treated and stopped in time.

Harmless spider bite? Maybe not!

Anyway, almost all antibiotics have bacteria that are resistant to them. So the moral of the story, folks, is be careful with your antibiotics! If your doctor prescribes antibiotics for you, take them until they're completely gone! Don't just stop taking them because you "feel better!" You aren't just harming yourself, you're also harming everyone else around you who might get your newly antibiotic-resistant bacteria!

...Until next week!