First of all…congratulations. You have worked so hard to get where you are and you deserve a HUGE pat on the back! I remember the feeling when I learned I’d been accepted into the program. It was a huge relief and, to be honest, a lot of stress instantly disappeared. But then, I started to get nervous. I’d heard rumors about how hard nursing school is, so I did what I do best. Study, get organized and prepare!
And I was really glad I did. Because I went into my first semester with a fresh review of these key topics, I honestly believe it set me up for a successful semester. And it can do the same for you.
Topics to review before nursing school starts
Fluids, fluids and more fluids
A concept many students struggle with is fluid balance and how it contributes to a patient’s overall homeostasis. Yes, fluids can be complicated, but you learned the basics in A&P. So, dust off your notes and refresh on fluid compartments, fluid shifts, pressure gradients, osmolarity, tonicity, osmosis, filtration, diffusion…all the basics!
Understanding fluids will come into play when patients start third spacing, develop cerebral edema, have fluid volume excess, or fluid volume deficits. Then, when you learn about hypertonic saline, you’ll understand why it is used for cerebral edema…or you’ll grasp the concept behind giving albumin followed by a diuretic. It’s also key to understanding the rationale behind which IV fluids are chosen for your patients.
Get a focused review of fluids in Crucial Concepts Bootcamp, the nursing school prep course that has helped thousands of students succeed in their programs.
For cardiac physiology, review the blood flow pathway through the heart and lungs, blood pressure physiology (cardiac output, stroke volume, heart rate, vascular resistance, etc…), and basic cardiac anatomy.
When you understand the blood flow pathway through the heart and lungs you can answer almost any question about valve disorders or heart failure. Seriously. Blood pressure physiology comes up time and time again and is probably the concept I utilize the most at the bedside. And having an understanding of basic cardiac anatomy will help you understand key concepts related to heart failure, ischemia and infarction.
When looking at respiratory physiology and gas exchange, pay attention to how ventilation affects O2 and CO2. You also want to have a firm understanding of oxygenation vs ventilation.
You will use this background knowledge almost daily, as many patients seek medical care for respiratory issues or have an underlying disorder such as asthma or COPD.
The kidneys play an important role in maintaining homeostasis, so make sure you review the physiology of the renal system. You want to understand how the renal system relates to hemodynamics, fluid balance, infection, and tissue perfusion. Also, don’t forget to review the tubules and their role in the balance of electrolyte levels (hint: some diuretics affect this in a BIG way!).
As you are reviewing the renal and pulmonary systems, pay particular attention to how they participate in the important role of keeping the body’s pH in the 7.35-7.45 range. How does the body compensate for metabolic acidosis? How about respiratory alkalosis? What happens if the patient is in renal failure?
If acid/base balance scares you, don’t worry! I’ve got you covered with a review in Crucial Concepts Bootcamp
Electrolytes are a big deal and in the acute setting we try to keep them in perfect harmony. The main ones we follow are Na, K, Mg…then Ca, Phosphorus and Bicarbonate. Review them all and understand their functions in the body. Notice I did not say that you should spend hours memorizing the lab values. Yes, it’s important to have an idea of what the normal reference ranges are, but students will spend 95% of their time memorizing lab values and don’t spend nearly enough time understanding the significance of high or low levels. And then when it comes time for the exam…guess what happens? So, do yourself a favor and seek to understand, not just memorize.
If you’d like a quick reference, you can grab this one. Or if you’d rather have a walk-through of electrolytes, you’ll be happy to hear I also cover this in Crucial Concepts Bootcamp. Are you starting to recognize a pattern?
Endocrine System and Feedback Loops
The endocrine system is vastly complex, and I don’t want you to go back and review every component. What you should do, however, is review how feedback loops work (especially negative feedback loops). As for specific components, review TSH, aldosterone, antidiuretic hormone, parathyroid hormone, cortisol, norepinephrine, and epinephrine. Have a basic idea of what role they play, where they come from, and what triggers (or suppresses) release.
Did you learn dimensional analysis in chemistry class? Well, if you thought you would never use it again, guess what? Dimensional analysis is an excellent framework to use for dosage calculations. Not only does it give you one method to use for every type of question, as long as you utilize the right information from the problem, it’s pretty much impossible to get the answer wrong. Get a quick introduction to how to use dimensional analysis for dosage calculations here.
My nursing school prep course Crucial Concepts Bootcamp takes the guesswork out of what to review and how to prepare before school starts. You can check it out here and see why so many students are thriving in nursing school! You got this!