NURS 4921 – PRECEPTORSHIP - Weekly Reflective Log Template
Student Name: Samantha Trupp
Unit: Northside IP Oncology
NCLEX review: EVOLVE Case Studies: Seizure Disorder
Number of NCLEX Review Questions completed: 50 renal
Estimated hours spent on NCLEX review this week: 2
Date/Hours* this week: (list each day separately): 3/25 12 hrs; 3/26 12 hrs; Cumulative hrs to date: 157
*Only list number of hours scheduled (i.e. 12 hours, 10 hours, 8 hours) – overtime is not counted in total
March 21: shadowing my administrator. Clinical director of oncological services This is now the second
week of April
March 28: shadowing the nurse manager on the IP oncology floor.
In-service: Thursday April 4 on chemo precautions
Communication and Collaboration skills include communicating effectively and using technology to
promote quality patient outcomes. We had a patient with a PICC line and who wanted a shower. We
told her to call us before taking one. Apparently there was a miscommunication and she took a shower
without calling us so we did not get a chance to wrap the site which helps prevent infection. We got the
IV team in to change the dressing and be sure that it still worked after the shower. This shows the
importance of communicating with the patient and being absolutely sure they understand what is being
said.
Critical Thinking and Clinical Judgment in Clinical Practice skills include applying clinical judgment and
professional ethics in care delivery. This week our patient load was very busy with five patients and a lot
of chemotherapy, blood products, and procedures to prioritize. For example, one day we sat down for
maybe twenty five minutes the whole shift. This busy schedule allowed me to work on time
management and prioritization with what had to be done immediately and what could wait. These are
critical skills because as a nurse every day is different so I must learn to be flexible.
Scholarship for Evidenced Based Practice: skills are oriented around evidence-based care and reflective
practice. This week I saw chemotherapy pushed for the first time. I did not know chemo could be
pushed over about five minutes, it was neat to me. While pushing it we monitored the patient to be
sure no adverse reaction was occurring as well as to be sure no chemotherapy accidently leaked or
caused extraversion. By doing this we helped ensure quality patient care and patient safety.
Clinical Prevention and Population Health skills include delivering patient-centered care emphasizing
health promotion and disease prevention. One day this week we had a patient who came in with low
counts-an H/H of 3.8 and 10.2 and then his platelets dropped to 13. Those numbers shocked me.
However, to prevent him from getting even worse we pumped him with blood and platelet products. I
think between day and night shift, he got six units of PRBCs and two units of platelets. We also got
orders to draw labs more often so that we could monitor his numbers closely (they did begin to rise
again). We also insisted that if he needed to get up to avoid dizziness that he should call us so that a fall
and excessive bruising/bleeding would be avoided.
Diversity skills include demonstrating cultural awareness, humility, sensitivity, and competency. This
week I cared for an older man who spoke very little English. His primary language is Vietnamese. To
provide the best care with much less confusion I used an interpreter. Using this resource assured me
that the patient understood what was going to be done to him and to be sure he was ok with it. It also
helped me provide the best care because I could better understand what he needed.
Leadership skills include ethical decision making skills, collaboration, delegation, and conflict resolution
techniques at the unit level as well as an understanding of the health care system form a big picture
view. As leaders nurses are advocates for the patient. Nurses can save patient’s money if they do
simple things like keeping track of what the patient already has in the room. For example this week, we
noticed that a patient (who had just come from surgery) had two SCD machines in the room; instead of
leaving them there, we sent one back to avoid charging the patient double for something unnecessary.
DOCUMENTATION FOR NCLEX QUESTION REVIEW:
Student Name: Samantha Trupp
Date: 3/29/13 (Week 9)
Number of questions reviewed: Seizure disorder case study
Resource used for review:
Saunders Comprehensive Review for the NCLEX-RN Examination by Silvestri
Please list the questions you missed and the focus of the question. You do have to list the correct
responses.
Question #
428
Focus of question
Correct response
Hemolytic Uremic syndrome Restrict fluid during peritoneal dialysis
433
Bladder exstrophy
748
Peritoneal Dialysis
753
759
BPH
Urecholine
cover bladder with non-adhering plastic wrap
Abd pain subsides after the first few exchanges
Decongestants, anticholinergics, antidepressants can trigger urinary retention
toxicity=bradycardia, sweating, severe hypotension
763
Tacrolimus (Prograf) Don’t give in immunosuppressed clients and in renal, hepatic or
pancreatic insufficiency