The job of an LVN is very tough with a lot of challenges. An LVN faces the prospect of infection from bedsores, risk from dangerous diseases such as hepatitis, and dealing with a myriad of reactions of patients. Fortunately, many healthcare schools offer programs for an LVN to be able to progress from this role to the role of an RN or Registered nurse.
Licensed Vocational nurses would need to complete at least two years of service in their current role with a healthcare facility. Upon completion of the desired time, an LVN can opt for a special year-long program that will allow them to get promoted to the next level. The Department of Labor's Statistical Bureau (BLS) has reported that approximately 1200 schools offer this program in the United States.
The schools that have started this type of programs have found a great degree of LVN attrition due to the demand of RNs in healthcare organizations. LVNs enrolling in this special program study human anatomy, microbiology, physiology, psychology, mathematics and other subjects. Those students scoring a GPA higher than 2.5 may qualify to be a RN within the healthcare school.
Many LVNs actually do not complete this program. When polled, LVNs currently working in healthcare organizations cited the one year waiting period of the RN program as the reason. Under these conditions, the LVN would have had to wait for one year after completion of the program to start working as an RN.
The scenario has changed today with a lot of RN advancement programs being made available as summer courses. Enrolling in these summer courses allows an LVN to complete their education while working as an LVN. This mode of curriculum has found increased acceptance among LVN and the enrollments are increasing everyday.
Working the hard grind as an LVN is important for one to move up the ladder in the role of a RN. Putting long hours and yet demonstrating exceptional performance during the role of LVN would make an LVN a good RN. Please note that an LVN deals with a lot of challenges. Getting promoted to an RN does not mean the challenges come to an end.
A lot of healthcare institutions across the States require Registered Nurses. The only way one can move into the role of a Registered Nurse is by spending couple of years as a LVN. Spend a couple of years as a LVN and enroll with the special program promoted by many healthcare schools. Pass the training program with a minimum score of 2.5 and you are on the way to becoming an RN.
Please note that the role titles may be different but the essence of both the roles is the same - to provide quality healthcare assistance to patients.
Gurnick Academy of Medical Arts offers LVN program over the evenings and weekends at their San Mateo Campus, CA. Inquire for further details.
Wednesday, January 16, 2013
Advancement Opportunities for LVN
Monday, June 6, 2011
First man ‘functionally cured’ of HIV
Since HIV was discovered 30 years ago this week, 30 million people have died from the disease, and it continues to spread at the rate of 7,000 people per day globally, the UN says.
There's not much good news when it comes to this devastating virus. But that is perhaps why the story of the man scientists call the "Berlin patient" is so remarkable and has generated so much excitement among the HIV advocacy community.
Timothy Ray Brown suffered from both leukemia and HIV when he received a bone marrow stem cell transplant in Berlin, Germany in 2007. The transplant came from a man who was immune to HIV, which scientists say about 1 percent of Caucasians are. (According to San Francisco's CBS affiliate, the trait may be passed down from ancestors who became immune to the plague centuries ago. This Wired story says it was more likely passed down from people who became immune to a smallpox-like disease.)
What happened next has stunned the dozens of scientists who are closely monitoring Brown: His HIV went away.
"He has no replicating virus and he isn't taking any medication. And he will now probably never have any problems with HIV," his doctor Gero Huetter told Reuters. Brown now lives in the Bay Area, and suffers from some mild neurological difficulties after the operation. "It makes me very happy," he says of the incredible cure.
The development of anti-retroviral drugs in the 1990s was the first sign of hope in the epidemic, transforming the disease from a sudden killer to a more manageable illness that could be lived with for decades. But still, the miraculous cocktail of drugs is expensive, costing $13 billion a year in developing countries alone, according to Reuters. That figure is expected to triple in 20 years--raising the worry that more sick people will not be able to afford treatment.
Although Brown's story is remarkable, scientists were quick to point out that bone marrow transplants can be fatal, and there's no way Brown's treatment could be applied to the 33.3 million people around the world living with HIV. The discovery does encourage "cure research," according to Dr. Jay Levy, who co-discovered HIV thirty years ago, something that many people did not even think was possible years ago.
You can watch Brown talk about his cure in this CBS video report.
(Brown: Eric Risberg/AP)
This article has been updated to include more context about why some people are immune to HIV.
This article was taken from: news.yahoo.com
Tuesday, April 27, 2010
Acute Pericarditis
The patient is a 66-year-old man with hypertension and peripheral vascular disease, presented with one week history of intermittent chest pain, that worsens with inspiration and lying supine and is relieved with sitting up.
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Figure 1. Admission EKG |
See larger view of admission EKG
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Figure 2. EKG after 4 hours. |
See larger view of EKG after 4 hours
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ANSWER
Diagnosis: Acute Pericarditis.
EKG findings: ST segment elevation throughout the ECG, depression of P-R segment.
DISCUSSION
Acute Pericarditis: Inflammation or infiltration of pericardium.
Etiology:
- MI: occurs in first 24hrs or may occur from 1wk to several months after MI due to autoimmune reaction to the damaged heart muscles called Dressler’s syndrome.
- Infectious: viral, bacterial, tuberculous, fungal, amebic, toxoplasmosis.
- Collagen vascular disease: SLE, rheumatoid arthritis, and scleroderma.
- Drugs: procainamide, hydralazine, isoniazid.
- Uremia: common in chronic renal failure.
- Postpericardiostomy syndrome.
- Malignancy: primary or metastatic (pulmonary and breast cancer are common).
- Radiation: after mediastinal radiation.
- Trauma or post traumatic.
Clinical features:
- Symptoms: inspiratory chest pain, left side relieved by sitting up and leaning forward.
- Signs: classic sign is pericardial friction rub, which is scratchy, leathery sound heard both in systole and diastole.
Note: one of the comment for this video was helpful so i am posting it.
if you auscult a friction rub, it can be one of two things:
1. Pleural rub
2. Pericardial rub
If it's pericardial tell pt to hold breath and if sound continues it's pericardial bc those pleura will rub despite held breath. If it stops it's pleural.
If it's pleural it can be due to pneumonia. HOWEVER, a likely cause is pulmonary infarct 2ndary to PE! The dead lung inflames and rubs against the parietal pleura just like with pneumonia.
Diagnosis:
- Physical exam: pericardial friction rub.
- EKG: diffuse ST segment elevation without reciprocal ST segment depression, as seen in myocardial infarction. Depression of P-R segment is unique to pericarditis.
- Echocardiography: any form of pericardial inflammation can induce pericardial effusion and bleeding; therefore, an echocardiogram is recommended.
- Other Labs: CBC with diff, ESR, Viral titers, ANA, Rfactor, Renal function, cardiac enzymes.
Treatment:
- Treat the underlying cause.
- NSAIDs: aspirin, indomethacin and ibuprofen.
- Steroid therapy: patients should be given steroids if they are unresponsive to NSAIDs.
EKG Manifestations and Differential Diagnosis of Acute Pericarditis:
The EKG is a useful, simple tool that may aid in the diagnosis of acute pericarditis. Typical EKG findings include diffuse concave-upward ST segment elevation and, occasionally, PR-segment depression.
The EKG is useful in the diagnosis of acute pericarditis, with abnormalities found in approximately 90 percent of cases. Changes on EKG classically occur in four stages. In fact, all four stages are present in only 50 percent of patient or less.
- Stage I: Typically occurs during the first few days of pericardial inflammation and is mainly characterized by Diffuse concave-upward ST segment elevation with concordance of T waves; ST-segment depression in aVR or V1; PR segment depression; low voltage; absence of reciprocal ST-segment changes.
- Stage II: ST segment return to baseline; T wave flattening. This stage last from days to several weeks.
- Stage III: T wave inversion. This stage begins at the end of the second or third week and last several weeks.
- Stage IV: Gradual resolution of T-wave inversion and may last up to three months.
The most sensitive EKG changes in acute pericarditis is diffuse ST-segment elevation; a very specific change is depression of the PR segment in all leads except aVR and V1.
Differential Diagnosis of Acute Pericarditis by EKG:
- Myocardial infarction
- Early repolarization
- Myocarditis
- Pulmonary embolus
- Cerebrovascular accident
- Pneumothorax
- Hyperkalemia
- Subepicardial hemorrhage
- Ventricular aneurysm
Table 1. Comparison of EKG Changes Associated with Acute Pericarditis, Myocardial Infarction and Early Repolarization.
| ECG Finding | Acute Pericarditis | Myocardial Infarction | Early Repolarization |
| ST-segment shape | Concave upward | Convex upward | Concave upward |
| Q waves | Absent | Present | Absent |
| Reciprocal ST-segment changes | Absent | Present | Absent |
| Location of ST-segment elevation | Limb and precordial leads | Area of involved artery | Precordial leads |
| ST/T ratio in lead V6 | >0.25 | N/A | 0.25 |
| Loss of R-wave voltage | Absent | Present | Absent |
| PR-segment depression | Present | Absent | Absent |
Wednesday, April 29, 2009
Neurological Examination
NOTE CONTENTS IN THIS VIDEO ARE VERY GRAPHIC
SO PLEASE DON'T WATCH IT IF YOU ARE NOT IN MEDICINE
THIS VIDEO IS NOT PORNOGRAPHIC..ITS TO TEACH HOW TO DO A SPECULUM EXAM CORRECTLY
CATERED FOR MEDICAL STUDENTS OR 1ST YEAR RESIDENTS
OR
ANYONE WHO DOES NOT KNOW HOW TO DO A EXAM PROPERLY
NOTE: THIS VIDEO IS TAKEN FROM YOUTUBE AND ITS FOR EDUCATION PURPOSE ONLY
EXAMINATION: