Nursing School Week by Week

The difference between working in a hospital and working home health is night and day. I’m going to be talking about my experience as a home health nurse, what a day in the life looks like. I’m going to touch on some myths about home health nurses, kind of the reputation that they have and if I think that that’s warranted or not. And how it compares to working in the hospital. These are just things to kind of tuck in your back pocket if you’re going through nursing school right now, or if you’re about to go through nursing school. And if you’re anything like me, I had no idea what kind of nursing I wanted to do after I graduated. Some of my friends knew exactly what they wanted to do and I always envied that. But that was not me, and I think in some ways, I’m still looking. You know, but I don’t think there’s any shame in that. I think it’s good to be curious, and I hope I’m forever curious and forever learning. And that’s what I’m doing right now. I’m learning about different specialties within nursing, and that is the beauty of nursing.
Get 20% off Picmonic: https://www.picmonic.com/insiderhookup/nursingschoolweekbyweekLDC24
Get 20% off TruLearn: https://truelearn.referralrock.com/l/weekbyweek/
Use code: "weekbyweek"
Get 20% off Lecturio subscription: Use code: "nursingschoolwbw20" for a 20% discount on all nursing premium plans.

This week, the most high-yield topic is hyper and hypothyroidism. You’ll see a lot of your test questions coming from this subject.

I’m gonna talk about hyperthyroidism first, and then I’ll cover hypothyroidism.

So, What is hyperthyroidism? It’s when your body makes too much of the thyroid hormones T3 and T4. I’m not sure how much of the A&P you remember from forever ago, so to review how T3 & T4 are made, your hypothalamus in your brain releases Thyroid Releasing Hormone; this makes the Pituitary gland release TSH, or Thyroid Stimulating Hormone, and that makes the thyroid, the little butterfly-shaped gland on your neck, produce T3 and T4.

In both hyper and hypothyroidism, the main causes are autoimmune disorders. The autoimmune disorder that causes hyperthyroidism is called Graves disease. With Graves disease, the patient will have a goiter, or an enlarged thyroid gland, that’s sometimes so big, you can see it from the door of their room. They’ll also have the characteristic bulging eyes, or exophthalmos. This will also be very noticeable, cause it’ll look like they are staring at you in a creepy way, and their eyes are protruding out of the sockets. Usually, our upper eyelids cover the top half of our iris. But in a patient with exophthalmos, you’ll be able to see the white of their eyeball above their iris, below their upper eyelid. So, if the patient has green eyes, you’d be able to see some white between the green and their upper eyelid. Sometimes the exophthalmos will be so bad that they can’t even close their eyelids all the way.

Hypothyroidism is when the thyroid gland doesn’t make enough T3 and T4. So just the opposite of hyperthyroidism. The most common cause is the autoimmune disorder, Hashimoto’s thyroiditis. I remember that Hashimoto’s causes hypothyroidism like hypO, HashimOto. Hashimotos is when your body makes antibodies that destroy your thyroid gland, which decreases T3 and T4. This causes the gland to grow bigger to compensate, which creates a goiter. So you can have a goiter with both hyper and hypothyroidism.

Another cause of hypothyroidism is simply not getting enough iodine in your diet, but this isn’t an issue here in the US, because we put iodine into our salt.

Also, if someone is getting treated for hyperthyroidism, like they get a thyroidectomy, or radioactive iodine ablation, those can both overcorrect to lead to hypothyroidism. Even if they are just taking antithyroid medication, and they take too much.

Today we are focusing on Strokes, or Brain attacks. This is one of those conditions that is so important for us nurses to know the signs and symptoms of, because your patient could have a stroke at any point. They could come into the ER with a suspected stroke, or they could be recovering on the med-surg unit, about to be discharged, and then have a stroke. So it can happen at any time, and we want to make sure we know what to look for. We also want to make sure we know what their baseline looks like, so we have something to compare any changes to. This is one reason why, when you’re in nursing school clinicals, your instructors will stress that you do a bedside shift report, or at least that you go into the patient’s room and do the physical assessment within the first hour of your shift starting. Because if you don’t go in there for four hours, and then when you finally do, they have slurred speech and limited arm movement, you’re not going to know if that’s what they were like before your shift, or if those are new changes.

Today we’ll be talking about the 10 essential supplies you need for nursing school. Then I’ll run through about 15 more things that are nice to have. This list may be a little different for each school, so if your school gives you a supplies list, definitely go by that first.

Now, I’m going to assume if you’ve made it through your prereqs, that you already have a backpack and pens and paper. If you don’t I highly recommend a rolling backpack. It may look dorky, but it will save your back because these nursing textbooks are huge and heavy, and there are many of them.

So, the top 10 nursing school supplies are:

1. Planner
2. Textbooks
3. Anki App
4. Stethoscope
5. NCLEX Review Guide
6. Scrubs
7. Shoes
8. Laptop
9. Analog watch
10. Badge clip

Nursing school orientation is just one of the many things that is so different in 2020. At orientation, your professors will go over the dress code for skills lab and clinicals, the schedule that you could have for your clinical rotations, what skills lab will look like, the books and supplies you’ll need, and they’ll emphasize how much hard work you are going to need to put into nursing school.