Randy @ MDC

2006-05-09T09:30:00.000+08:00

And just like that, I wondered what Levodopa was for. Well I used to know what it was for and I thought that it's a significant drug which will show up in the board exam. I texted my classmate Alona, who was called by her classmates in her former section "Miss Pharma". It's an anti-Parkinson's drug, she texted back. I remember Paul who's in Canada now working as pharmacist. When he was still here, I mentioned levadopa and he said that levodopa is rarely used "as is" these days. Another drug is combined with it for some reason. Carba something. Carbidopa.

Levodopa
L-DOPA is used to replace dopamine lost in Parkinson's disease because dopamine itself cannot cross the blood-brain barrier where its precursor can. However, L-DOPA is converted to dopamine in the periphery as well as in the CNS, so it is administered with a peripheral DDC (dopamine decarboxylase) inhibitor such as carbidopa, without which 90% is metabolised in the gut wall, and with a COMT inhibitor if possible; this prevents about a 5% loss. The form given therapeutically is therefore a prodrug which avoids decarboxylation in the stomach and periphery, can cross the blood-brain barrier, and once in the brain is converted to the neurotransmitter dopamine by the enzyme aromatic-L-amino-acid decarboxylase. (source: Wikipedia)

Nursing Interventions for Levodopa

Assessment
History: Hypersensitivity to levodopa, tartrazine; glaucoma; history of melanoma; suspicious or undiagnosed skin lesions; severe CV or pulmonary disease; occlusive cerebrovascular disease; history of MI with residual arrhythmias; bronchial asthma; renal, hepatic, endocrine disease; history of peptic ulcer; psychiatric disorders; lactation, pregnancy
Physical: Weight; T; skin color, lesions; orientation, affect, reflexes, bilateral grip strength, vision exam; P, BP, orthostatic BP, auscultation; R, depth, adventitious sounds; bowel sounds, normal output, liver evaluation; voiding pattern, normal output, prostate palpation; liver and kidney function tests; CBC with differential

Implementation
Arrange to decrease dosage if therapy is interrupted; observe for the development of suicidal tendencies.

Give with meals if GI upset occurs.

Ensure that patient voids before receiving dose if urinary retention is a problem.

Monitor hepatic, renal, hematopoietic, and CV function.

For patients who take multivitamins provide Larobec, a preparation without pyridoxine.

source: http://www.vandenberg.af.mil/~MDG/drugs/mg/levodopa.htm

Defense Mechanisms

2006-05-08T22:09:00.000+08:00

After reading about Anna Freud's explanation on defense mechanisms, I started to think that almost everything that we do is a form of it.

A good example is me putting off doing the physical exam part of the group nursing process report. I admit I have been procrastinating. Instead of doing the school work, I play Starcraft on the computer instead. Procrastination is a sign of passive-agressiveness according to George Vaillant who wrote Adaptation to Life. He classifies it under Immature Mechanisms which is normal for individuals ages 3 to 15 years old.

These defense mechanisms have to be memorized for it will show up in the local board exam and NCLEX. Dang.

2006-05-08T21:38:00.000+08:00

Dr. Cajucom said today that the midterm exam in Communicable Diseases would be very difficult. Now what is very difficult, I asked myself. Just when I got used to answering board exam type questions, the teacher began to explain the departamental exam. It's going to be full of definitions and identification. Dammit, that is so high school.

I'm supposed to be studying tonight but here I am playing Starcraft and watching Pinoy Big Brother.

A few days ago I stumbled across a really cool nursing blog Pinoy RN. There's this unsettling entry about a couple of House bills (2700 and 2926 holding back nurses from going to the United States right away. I so want to kill these representatives.

2006-04-30T20:38:00.000+08:00

No classes tomorrow due to Labor Day here in the Philippines. That is good news because I'll have time to go to the gym and read my notes. Read my notes. Hah. That doesn't sound like me at all. I've been going through some NCLEX reviewers and I'm just shocked by how much stuff I have not retained mentally. My weakest points are Maternal and Child Nursing and Medical Surgical Nursing while my strong points (which isn't that strong, really) is probably Psychiatric Nursing and Fundamentals of Nursing.

2006-04-07T13:04:00.000+08:00

Today I finally completed the enrollment process for my summer class in Manila Doctors College. I must say that the whole enrollment thingy was stress-free which was a pleasant surprise. Rhoda had this idea of paying the enrollment fee at Metrobank, the mother company of my school, to spare her from the trouble of lining up at the school cashier. I only have one subject this summer and it's called Enhancement something which is 4 days a week of duty plus lectures. Mrs Cervantes, the fourth year level coordinator, told us during the orientation that the topics to be covered will include psychiatric nursing. I forgot the other topic since I've been a scatterbrain lately.

Mrs Cervantes and Dr Ang were the members of my thesis proposal defense panel. They've managed to change the title which meant changing most part of the thesis. My groupmates and I have been stressed out because of the thesis proposal. I asked Mrs Cervantes before if I could work on my thesis alone but she said no. I prefer to work alone but then I thought that when I'm in the hospital, I'm going to have to learn teamwork so I might as well get a taste of nursing teamwork.

2005-04-24T12:15:00.000+08:00

Last night, we were the last reporters of a slightly boring topics called nursing theories. It's about the different school of thoughts in nursing which nobody really cares about. It was almost 8pm and everyone was hungry and sleepy and I had to find a way for them to listen to me. The reporter before me was excruciating to listen to--she flashed the entire page of the report one at a time and read the whole report word by word. So I said to the class, "I have a question and whoever gets to answer first gets a prize. The prize is burger and fries from McDonald's." The class became wild--everyone wanted that burger. Then I took flashed the picture of Dorothy Johnson (a theorist) on the screen. My question was, "This is the picture of Dorothy Johnson who formulated the theory of the basic needs similar to Henderson's. My question is: who among your classmates looks like her?" Laughter. More laughter. And before anyone could say anything, I took out Johnson's picture and flashed the model of Johnson's theory.

2005-04-23T10:07:00.000+08:00

Ms Tica grouped the class by 4's and assigned nursing behavioral system models for us to report. I so dislike reporting. I so detest working in groups.

2005-03-19T21:42:00.000+08:00

Now that classes are over it feels like Christmas for me. Everyone doesn't seem to be in a hurry anymore.

Today we had our comprehensive exam in Healthcare. It was the most comprehensive exam I've taken in a long time. The exam seemed easy but you know how school exams are--sometimes they can look so easy but you end up getting a failing grade. The exam covered nursing skills from Healthcare 1 to 2. I tried to read chapters and chapters from the Potter and Perry book yesterday at Greenbelt but ended up watching Robots instead.

Submitted the requirements for getting my Parasitology and Microbiology subjects credited.

Looking forward to Nutrition and NCM this summer. :)

2005-03-18T07:28:00.000+08:00

Inside the hospital. :)

2005-03-18T07:27:00.000+08:00

In the school bus bound for Pasay General Hospital.

2005-03-18T06:51:00.000+08:00

So I'm going back to UST today. I wonder what time Ma'am Beth would be there. Hopefully it won't be difficult to borrow the prospectus again.

Health economics exam yesterday. I so didn't have answers to the enumeration part. Copied 3/4 of the answers from my classmates. Oh I don't know why I'm so not motivated to study that friggin subject. Tomorrow will be the comprehensive exam in Healthcare 2. Coverage includes topics from Healthcare 1 to Healthcare 2. C made me promise na I'll let her copy the drug computation part. I'm going to Makati to do some banking stuff and with me I'll be bringing along the thick Potter and Perry book. So if you see someone reading a nursing book at Starbucks or Seattle's Best, ako na yun.

2005-03-16T15:09:00.000+08:00

Went to the University of Santo Tomas to get the course description of my Parasitology and Microbiology subjects to have them credited. Shouldn't my school have asked me this a gazillion years ago and not now when classes are almost over?

In UST I ran into my old teachers, some of whom have failed me in my major subjects. Ms. Pagulayan looked old and ugly, like a fair-skinned bullfrog. Señor Luis, my Spanish teacher has not aged a bit. My algebra teacher gained a little weight but nothing dramatic. I stopped her on the stairs from the second floor to the third floor of the Main Bldg. "Maam," I said, "I'm an old student of yours!" She looked confused but she smiled then walked away. God, they've all forgotten me there now.

Then I went to the College of Science department which was renovated na. Before it looked like something from the Lawton Post Office but now it's umm renovated nga but that professional or sosyal-looking. Saw Ma'am Beth who looked older na. God, has it really been 8 years since I last went to school there? Seems like yesterday pa lang. They've phased out my curriculum but Maam Beth managed to find a copy of the old curriculum and lent it to me for photocopying.

I lined up in the photocopying, umm, stall, on the ground floor. Students were photocopying notes and books and talking about which subjects they were having problems with. Summer here we come, said one of them. Summer class on the College of Science, unless you're on the accelerated program, meant re-enrolling failed subjects. After 30 minutes of queueing up, I finally got the microbiology parts photocopied and forgot the parasitology. Now I have to go back. Maybe tomorrow. Maybe on Friday.

2005-03-15T10:34:00.000+08:00

Last day of clinical work today. Yipee! I'm bringing a camera. My classmates want to do ghost hunting but I'm not going with them since there are already ghosts where I live.

2005-03-14T19:43:00.000+08:00

Just my luck. My clinical instructor loved the pathophysio and lab results and interpretation parts of the group report and those were the parts I did. She appreciated the fact that "we" did a thorough research and she placed a very good mark on those two parts. We got a 93% grade! Things could be unpredictable when you're a student. Sometimes you study and prepare so hard and you get a low grade and sometimes you're like ready to fail then you get a high grade. I didn't feel well at the hospital today while doing my pre-clinical rotation. Seems like I'm developing upper respiratory tract infection and I was susceptible because I lack sleep and have been working out too much. Tonight and tomorrow morning I rest. Everyone's talking about the upcoming finals. Am I ready? That's a big no. Thanks to Rhoda for photocopying me the health economics notes.

2005-03-14T09:39:00.000+08:00

Nurses for a Healthier Tomorrow: An article about the growing demand of nurses in the United States.

2005-03-14T09:19:00.000+08:00

After putting off ironing my clinical uniform for the longest time, I finally pressed them as soon as I got back from the gym. I hate ironing my clinical uniform. Maybe because it has to be perfectly ironed. As if. As soon as I get in the car and put the seatbelts on, it's going to be wrinkly.

Last night I dreamt of Ms David and in my dream she told me to do this project of some sort of health process something with visuals. I was unsure how to do it but I knew that it was something she taught us to do in the early part of the semester. She drew circles and arrows on a clear plastic sheet which indicated something. I tried to find an excuse not to do it and have my other classmates do it instead but later she came back telling me that nobody else knew how to do it except me and it's going to be presented in some sort of competition. I looked at the finished work of the other sections and they looked like circles and arrows and dots. I planned to do my work that way and pretend that they mean something. Maybe I could get away with it. Then the alarm clock rang.

Maybe that's what's going to happen this afternoon during the defense. I'm just going to wriggle my way out of the difficult questions. Oh I don't know, I'm like so unprepared and unwilling to take part with this semi-silly activity. Hey it's already summer. I should be like out on the beach getting a tan.

2005-03-13T14:14:00.000+08:00

Chatted with Rose at the gym. She's in her 30's and a senior nursing student at Fatima. She told me what NCM 100 (my subject this summer) is all about and it's not very encouraging. It's a good thing they've taught injections and introductory medication in Healthcare 2 and we're having duties at hospitals now so we aren't that clueless like most of the other students elsewhere. We're going to lose like more than 1 section this semester and it's scary. Thank God I don't have problematic grades this sem. I think they'll credit my Microbiology with Parasitology which will free up my summer sched big time. I'm thinking of going to my tailor and have more clinical outfits done--I only have one set and if some fucking patient squirts blood on it, I'm like done. No uniform, no duty, no grade.

2005-03-12T19:03:00.000+08:00

Finally finished doing or should I say copying and editing the pathophysiology of our patient. Sent copies to Bianca and Shyla. I don't really know who's collating the report. I'm half tempted to do the developmental history part. Discovered another useful website--

eMedicine Clinical Knowledge Base - Contains news, alerts, medical dictionary, drug information, ID Pill by imprint code, diagnosis search, and cases (image, ECG, radiograph, and clinical pearls).

2005-03-11T11:30:00.000+08:00

StudyStack - Nursing Study Resources - Study Stack works very much like flash cards which helps in memorizing. This particular category is a comprehensive list of study stacks nurses and student nurses might find useful. Topics include cranial nerves and functions, medical abbreviations, human needs, integumentary disorders, the psychosocial stages (Freud, Piaget, etc), acid-base-electrolyte imbalances, oncology skills for nurses, patho exams, etc.

nursing care process

2005-03-11T08:37:00.000+08:00

Ms. Diamse required our group to submit a nursing care process for a chosen patient due for defense on Monday. For the past few days I've been putting off doing my assigned parts--developmental history, laboratory result or findings, and pathophysiology. I called Jennifer up this morning and learned that she did the developmental history already and said that I could like make it more comprehensive if I wanted to. The whole morning I've been doing the lab result part and came across a very useful website--

Lab Tests Online - a public resource on clinical lab testing from the laboratory professionals who do the testing.

Now on to the pathophysiology section. I don't even know what the heck pathophysiology is. Okay, according to Answers.com,

path·o·phys·i·ol·o·gy (păth'ō-fĭz'ē-ŏl'o-jē) n. In both senses also called physiopathology.
1. The functional changes associated with or resulting from disease or injury.
2. The scientific study of such changes.

Gosh, so nakakatamad gawin.

2005-03-10T21:16:00.000+08:00

This is how the school looks like from the microbiology lab where our organic chem class used to squat last summer. Our class used to end at 7pm which was just too much for me. This afternoon I ran into Ms. Dimaiwat, my organic chem teacher, and reminded her how fast time flew and it's already almost summer now. I miss the summer of 2004.

2005-03-10T21:03:00.000+08:00

It's clearance time once again! Mrs. Cervantes has been bugging me every now and then to remit the payment for the shoes. I kept on excusing myself from Mr. Villamor's class today so that I could give her the money as well as the list of students who haven't paid yet. The first few times I went there she was in a meeting and the when I got back for the last time she already left. Well I don't have a class tomorrow.

Jennifer and I saw Ms. Nartates outside the College of Nursing office. She was more alive than usual. We chitchatted a bit and learned that she's teaching the level 3 now. Level 3 is tough, she tells us. It's the most crucial part of our stay at Manila Doctors--micro defense, grand defense and clinical work. Oh dear, I might not survive this school. Sometimes I think about quitting since I've already finished two four-year BS courses already. Am I a quitter. Yes. ;) Well, I just know when to quit. This noon as I was going through my stuff looking for the receipt for my payment for the school transportation, I came across some of my grades back in AMA. Wow I miss being competitive and seeing my name on the Dean's List.

I wonder what Shyla has made out of the diagnosis of our patient in Pasay City General Hospital. I must finish typing my report today and send it to Bianca. Thank God I've got no class tomorrow. Final exams are next week!

First Post

2005-03-10T12:46:00.000+08:00

Three hours from now and I'll find myself in Prof. Villamor's class. But I have not started getting ready for class yet since I'm a bit excited about this college blog and having pictures hosted online. I plan to go to school earlier than usual maybe around 2PM so I can study for the compre exam on the 19th. O di ba. Mrs. Cervantes said that she's going to make the exam difficult kasi.