Nursing Path

CARING is the essence of NURSING. -Jean Watson

Nursing Path

Knowing is not enough, we must APPLY. Willing is not enough, we must DO. -Bruce Lee

Nursing Path

Treat the patient as a whole, not just the hole in the patient.

Nursing Path

Success is not final. Failure is not fatal. It is the courage to continue that counts. -Winston Churchill

Nursing Path

A problem is a chance for you to do your best. -Duke Ellington

Methods of Teaching

Nursing Beyond Its Scope – Expanded Role of Nurses

I m proud of Nurse, just because  he or she  makes impossible a possible, folding in many jobs into one single job , he or she plays  number of roles, he or she is  flexible among health professionals , a multi-talented, multi skilled and responsible of all. Well i am talking about extended  Nursing care responsibilities and expanded roles.     

Nursing is not just a job instead a profession where one needs to adapt for the burdens imposed by Doctor`s , patient`s , public , political parties, policy makers etc. To answer all these concerns there is only one person called Nurse , do you think it’s easy and gettable on the toe!!

Some of the Nursing roles which are beyond Nursing are
Nurse Practitioner, Clinical nurse specialist, Nurse Anesthetist, Nurse Researcher, Nurse Administrator, Nurse Educator, Care Giver., Nurse Advocate, Nurse Entrepreneur, Nurse Communicator, Nurse Manager. Nurse Counselor and so on.

Nurse Practitioner
A nurse with an advanced education and he or she is a graduate of a nurse practitioner.
Patient prefers to receive care from nurse practitioner than from a doctor. Nurse practitioners provide health care to client usually in an out-patient ambulatory care or community based settings. They provide more holistic approach, attending to symptoms of non-pathological conditions, comfort and comprehensiveness of care. He or She can be an Adult nurse practitioner, Family nurse practitioner, Pediatrics nurse practitioner, Acute care nurse practitioner, Gerontology Nurse practitioner

Clinical Nurse Practitioners
The clinical nurse practitioners may specialize in specific disease/Area of Nursing instead of a vague working pattern . He or She may be specialized in diabetes mellitus, cancer or cardiac problems or in a specific field such as pediatrics or gerontology.

Nurse Anesthetist
A certified registered nurse anesthetist is a registered nurse who has received advanced training in an accredited program in anesthesiology. Nurse anesthetist provides surgical anesthesia under the guidance and supervision of an anesthesiologist.

Nurse Researcher
He or She is specialized in investigate nursing problems to improve nursing care and to refine and expand nursing knowledge. Researcher involves action taken to implement studies to determine the actual effect of nursing care to further the scientific base of nursing, can include all nurses, nurse scientist, graduates and students.

Nurse Administrator
Nurse Manager’s position usually requires at least bachelor degree in nursing, and director and nurse executive positions generally requires a master degree. Chief nursing executive and vice-resident positions in large health care organization often need preparation at the doctorate level.

Nurse Educator
Nurse educator teaches patients and families, the community, other health care team member, students, business and government.  Nurse educators in the health care team; teach other team members about the patient and family and why different intervention may have varying degrees of success .She serves as teacher for next generation of nurse and staff development department of health care agencies and client education department.

Ampicillin Sodium Drug Study

Generic Name:  Ampicillin Sodium
Brand Name: Ampicin,Omnipen-N,Penbritin,Polycillin-N,SK-Ampicillin-N,Totacillin-N
Classifications:  antiinfective; antibiotic; aminopenicillin
Pregnancy Category:  B
250 mg, 500 mg capsules;  125 mg/5 mL, 250 mg/5 mL oral suspension;  125 mg, 250 mg, 500 mg, 1 gm, 2 gm vials

A broad-spectrum semisynthetic aminopenicillin, is highly bactericidal even at low concentrations, but is inactivated by penicillinase (beta-lactamase).

Therapeutic effects
Active against gram-positive microorganisms such as alpha- and beta-Hemolytic streptococci, Diplococcus pneumoniae, non-penicillinase producing Staphylococci, and Listeria. Major advantage over penicillin G is enhanced action against most strains of Enterococci and several gram-negative strains including Escherichia coli, Neisseria gonorrhoeae, N. meningitidis, Haemophilus influenzae, Proteus mirabilis, Salmonella (including typhosa), and Shigella. Inactive against Mycoplasma, rickettsiae, fungi, and viruses.

Infections of GU, respiratory, and GI tracts and skin and soft tissues; also gonococcal infections, bacterial meningitis, otitis media, sinusitis, and septicemia and for prophylaxis of bacterial endocarditis. Used parenterally only for moderately severe to severe infections.

Route & Dosage  

Systemic Infections
adult:   PO  250–500 mg q6 h
IV/IM  250 mg–2 g q6h
child:   PO  25–50 mg/kg/d divided q6h
IV/IM  25–100 mg/kg/d divided q6h
neonate:   IV/IM  <=7 d & <=2000 g, 50 mg/kg/d divided q12h; <=7 d & >2000 g, 75 mg/kg/d divided q8h; >7 d, 50–100 mg/kg/d dividedq6–12 h
adultchild:   IV  150–200 mg/kg/d divided q4–6 h
neonate:   IV/IM  <=7 d & <=2000 g, 100 mg/kg/d divided q12 h; <=7 d & >2000 g, 150 mg/kg/d divided q8h; >7 d, 100–200 mg/kg/d divided q6–12h
adult:   PO  3.5 g with 1 g probenecid times 1
IV/IM  500 mg q8–12h

  • Give with a full glass of water on an empty stomach (at least 1 h before or 2 h after meals) for maximum absorption. Food hampers rate and extent of oral absorption.
  •   Reconstitute each vial by adding the indicated amount of sterile water for injection or bacteriostatic water for injection (1.2 mL to 125 mg; 1 mL to 250 mg; 1.8 mL to 500 mg; 3.5 mL to 1 g; 6.8 ml to 2 g). All reconstituted vials yield 250 mg/mL except the 125 mg vial which yields 125 mg/mL. Administer within 1 h of preparation.
  • Withdraw the ordered dose and inject deep IM into a large muscle.
  • Verify correct IV concentration and rate of infusion with physician for administration to neonates, infants, and children.
PREPARE  direct: /intermittent: Reconstitute each 500 mg or less with at least 5 mL of sterile water for injection. Final concentration must be <=30 mg/mL; thus may be further diluted in 50 mL or more of NS, D5W, D5/NS, D5W /0.45NS, or RL. • Stability of solution varies with diluent and concentration of solution. Solution in NS are stable for up to 8 h at room temperature; other solutions should be infused within 2–4 h of preparation. Give direct IV within 1 h of preparation. • Wear disposable gloves when handling drug repeatedly; contact dermatitis occurs frequently in sensitized individuals.

ADMINISTER  direct: /intermittent: Slowly over at least 15 min. • With solutions of 100 mL or more, set rate according to amount of solution, but no faster than direct IV rate. • Convulsions may be induced by too rapid administration.

Incompatibilities  Solution / Additive:  Any dextrose-containing solution, including parenteral nutrition solutions.   Y-site:  Clindamycin, erythromycin, aminoglycosides, lidocaine, verapamil.
Store capsules and unopened vials at 15°–30° C (59°–86° F) unless otherwise directed. Keep oral preparations tightly covered.

Adverse effects
BodyWhole: Similar to those for penicillin G. Hypersensitivity (pruritus, urticaria, eosinophilia, hemolytic anemia, interstitial nephritis, anaphylactoid reaction); superinfections.
CNS:Convulsive seizures with high doses.
GI:Diarrhea, nausea, vomiting, pseudomembranous colitis.
other:Severe pain (following IM); phlebitis (following IV);

Nursing implications 
Assessment & Drug Effects
  • Determine previous hypersensitivity reactions to penicillins, cephalosporins, and other allergens prior to therapy.
  • Lab tests: Baseline C&S tests prior to initiation of therapy; start drug pending results. Baseline and periodic assessments of renal, hepatic, and hematologic functions, particularly during prolonged or high-dose therapy.
  • Note: Sodium content of drug must be considered in patients on sodium restriction.
  • Inspect skin daily and instruct patient to do the same. The appearance of a rash should be carefully evaluated to differentiate a nonallergenic ampicillin rash from a hypersensitivity reaction. Report rash promptly to physician.
  • Note: Incidence of ampicillin rash is higher in patients with infectious mononucleosis or other viral infections, Salmonella infections, lymphocytic leukemia, or hyperuricemia or in patients taking allopurinol.
  • Take medication around the clock; do not to miss a dose; continue taking medication until it is all gone (usually 10 d) unless otherwise directed by physician or pharmacist.
Patient & Family Education
  • Note: Ampicillin rash is believed to be nonallergenic and therefore its appearance is not an absolute contraindication to future therapy.
  • Report diarrhea to physician; do not self-medicate. Give a detailed report to the physician regarding onset, duration, character of stools, associated symptoms, temperature and weight loss (if any) to help rule out the possibility of drug-induced, potentially fatal pseudomembranous colitis .
  • Report S&S of superinfection (onset of black, hairy tongue; oral lesions or soreness; rectal or vaginal itching; vaginal discharge; loose, foul-smelling stools; or unusual odor to urine).
  • Notify physician if no improvement is noted within a few days after therapy is started.
  • Do not breast feed while taking this drug without consulting physician.