Flying high on stress

Nursing school has officially started! And I mean officially. Last term was just a teaser, allowing us to get our toes wet without completely falling in the pool. But now... yikes! I'm running around on fast-forward, talking a million miles a minute, and unable to sleep. I will eventually crash and burn (probably over the weekend) but right now I'm a girl on a mission and I'm getting a lot done! The first two weeks of the term are always the worst because clinicals haven't started yet so they "front-load" a lot of theory content and try to get it out of the way. I have my first exam this Friday, and my second one next Friday. Last term we covered a lot of introductory, basic information like "Spirituality" and "Health Care Systems," but this term we are diving right into the good stuff and learning the details and treatments for various diseases. This week we're covering:

• Perioperative care (pre-, intra-, and post-surgery)
• Fluid and electrolyte imbalances
• Thyroid disease (learning some interesting details about my mom's thyroidectomy that I would have been terrified to know at the time)
• Post-surgery pain management (lots of drugs!)
• Anti-infective medications (more drugs!)

I've decided that, by far, fluid and electrolyte imbalances are the most daunting. It's difficult to keep it all straight and remember the minute details about each electrolyte and its effect on the body. And of course they all interact with each other, and further complicating things is that the symptoms are really similar for several different imbalances. I keep reading and rereading the information but can't seem to make it all stick! Thyroid disease is much more fun and only involves two scenarios (too much or too little hormone) so it's easier to keep straight. The instructor told us how one of her past students was thrown into Grave's Disease when she started nursing school, which is an autoimmune thyroid disorder that typically occurs in women age 20-40 after bouts of "acute stress." People with Grave's disease are hyperactive, fidgety, have intestinal disorders and super high metabolisms, and can't sleep. For a minute there, we were ALL thinking we have the condition, until she told us it is accompanied by red palms and bulging eyeballs. Whew! I guess it is just the first-week stress...

I also have to take my second required math test before 1/23. They gave us a practice test to work on and we get several attempts to take the official test, but we must pass with at least 95% in order to progress this term. Last term I passed on the first try but the equations were REALLY simple, and this term they are throwing some fun IV drip-rate calculations into the mix. Here's a couple of the questions from my test. (I want you to feel sorry for me, but if you are a math whiz, this could backfire.)

You have on hand a vial of penicillin in powdered form labeled 10,000,000 units. 200,000 units of the penicillin must be prepared. You reconstitute the drug as directed, adding 15.5 ml of diluents to yield a strength of 500,000 units in 1 ml. In preparing to administer the drug, how many ml should you withdraw from the vial?

1000 ml of Lactate Ringers has been prescribed for IV infusion over 12 hours. You are using an IV administration set that delivers 60 drops per ml. You run the IV at _____ drops per minute?