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How to PASS the NCLEX [7 DAY TRAINING] DAY 5 Priority Strategies — Transcript

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0:00on this past the click step by step
0:037-day training day number five you will
0:08learn finally about strategies I want to
0:13know if everybody can listen to me if
0:16you can hear me well if you can see me
0:18well just uh text yes professor comment
0:23on the comment section I can see you
0:24well no problems
0:27and I will tell you is
0:30I have been monitoring YouTube for
0:33several years already. Like I told you
0:36on day one, we have a an academy that we
0:40teach nursing students, nurses from all
0:43over the world, Latino nurses that their
0:46primary language is Spanish. And we have
0:49helped many students, thousands of
0:51students prepare for the ENLEX and pass
0:54the ENLEX. And since then I have been
0:58monitoring YouTube and watching other
1:02reviews, other mentors out there that
1:05help students prepare for the ENCLEX.
1:08And I have noticed something rather
1:11interesting
1:13that very seldom do they talk about
1:19critical thinking and prioritization
1:22strategies. And I've always thought why
1:26why because in my point of view I think
1:30it is one of the most important tools
1:34that a nursing student can have in order
1:37to pass the ENLEX. and I decided to open
1:42this YouTube channel,
1:44ENLEX Crusade International, to help
1:48these students that are preparing for
1:50the ENLEX, students like you, that you
1:53are preparing for the ENLEX. I decided
1:56to open this channel to help you develop
2:00your critical thinking and most
2:03importantly learn prioritization
2:06strategies because I firmly believe that
2:12this is the key to passing the encl
2:18I always say this. I'm not saying that
2:21content is not important. It is. But if
2:26you do not know how to apply nursing
2:30content, if you don't develop your
2:32critical thinking, if you don't apply
2:36prioritization strategies,
2:38the chances of passing the ENLEX are
2:42minimal.
2:44Maybe many of you that are listening to
2:47me, that are listening to this live
2:49presentation or replay video,
2:53maybe you've taken the ENLEX before and
2:56you have failed. Ask yourself, have you
3:00developed your critical thinking? Are
3:02you applying
3:04strategies, prioritization strategies?
3:08If the answer is no, if you are weak in
3:11this area, if you need help on
3:15developing your critical thinking, if
3:17you need help learning to apply
3:20prioritization strategy, this day number
3:24five of our past the enclelex
3:26stepby-step 7-day training is for you.
3:31So,
3:32let's not take any more time and let's
3:36begin.
3:39Uh, Miss Sailor asked me, "If you're not
3:42extremely strong on your content, can
3:45you still pass by applying critical
3:48thinking?" I do believe so. I do believe
3:52so because
3:54once you are at the passing line, the
3:58questions that are going to be involved
4:00in those type of questions are critical
4:02thinking and prioritization
4:04questions. If you develop a strong
4:07critical thinking and you learn how to
4:10apply strategies, you can pass.
4:13Remember, you need to have basic nursing
4:17knowledge. You do not need to be an
4:20expert. But of course, you need to know
4:23if you're answering a question about,
4:26let's say, a client with renal failure,
4:30well, you need to know what is the
4:31function of the kidney. You need you
4:33need to know the pathophysiology of that
4:35condition. You don't need to be an
4:38expert.
4:40You do not need to be an expert in the
4:44kidney function. But you need to know
4:46the basics. That is why I say do not
4:49frustrate yourself trying to memorize
4:53everything. Memorization does not work.
4:56You need to apply nursing knowledge.
5:01So this is our 7-day training agenda. We
5:05are already done with day one, day two,
5:07day three, and day four. For the past
5:09three days, we were focusing on enclelex
5:13categories. So we dedicated three days
5:17of our 7-day training to teach you about
5:20ENLEX categories.
5:23If you did not see day one, day two, day
5:28three or day four, please find that
5:31video, find those videos and study them.
5:36Learn everything that I provided on this
5:38video from beginning to end because then
5:42and only then you will really understand
5:46day five.
5:49If you don't know where to find it, just
5:50go to the playlist on our YouTube
5:52channel and click Crusade International
5:55and find the 7day training playlist. You
5:59will see all the videos there.
6:02All right. So, let's begin with today's
6:06agenda.
6:08Today we will talk about several
6:11strategies or actually two strategies
6:14and we will practice question for each
6:17one of those strategies. The first
6:20strategy that we will cover today is
6:23when to call the doctor strategy and I
6:27will explain what I mean by that. Then I
6:31will explain to you, I will teach you
6:34how to apply the Maslo's hierarchy of
6:38needs strategy
6:40and then we are going to practice
6:43questions.
6:44That way you can learn how to apply the
6:48when to call the doctor strategy and the
6:50mass loss hierarchy of needs strategy.
6:53Are you ready? Are you ready to begin
6:57this awesome day five? Are you ready to
7:00develop your critical thinking? Are you
7:03ready to learn Enclelex prioritization
7:06strategies that will change the way you
7:10analyze enclelex style questions
7:13forever? If you're ready, go ahead and
7:16comment in the comment section that
7:19you're ready to begin.
7:22Let's begin with our first strategy.
7:26When to call the doctor strategy.
7:30Why the name when to call the doctor
7:33strategy. What does that mean?
7:35Basically,
7:37whenever you encounter a question,
7:41you're reviewing a question and you see
7:44that one of the answers
7:47mentions call the healthcare provider.
7:51Call the neurologist. Call the
7:53nephologist. Call the anesthesiologist.
7:57If the answer is saying call another
8:01person, call a health care provider, you
8:05will use this strategy.
8:09And how is this strategy going to help
8:12me, Professor Ray? Very simple. You're
8:16going to follow these three simple steps
8:19and that will take you to the right
8:22answer.
8:24So here is here's how you use this
8:26strategy.
8:28The first thing that you do, you have to
8:31look at each answer and you have to
8:35determine if the answers are within your
8:39scope of practice. You need to find out
8:43if you have answers that are within your
8:47scope of practice as a nurse. That's
8:50step number one. Step number two,
8:54ASK THIS QUESTION,
8:56DO I have an answer that helps me
9:01identify
9:02that helps me solve the patient's
9:06problem? Yes or no?
9:10If the answer is yes that there is an
9:13answer that you can DO TO HELP THE
9:16PATIENT do it and eliminate the answer
9:21that says call the doctor.
9:25So this step number two it is very
9:28important.
9:30Step number three,
9:33if the answers are not within your scope
9:36of practice or
9:39those answers don't help the patient's
9:44condition, then eliminate them and call
9:48the healthcare provider.
9:51Very simple, right? You might need to
9:54review this video again and listen to
9:56this one more time. I want each one of
10:00you to watch this video day five several
10:04times because these strategies you do
10:07not learn learn them overnight. It takes
10:11time to learn how to apply them because
10:14there are multiple scenarios.
10:17There are different ways of using this
10:20strategy.
10:22So what I want to do now I want to put a
10:25question and I want you to try to use
10:29this strategy. [clears throat] Remember
10:32the steps don't forget the steps. So on
10:34the next question read the question and
10:38start identifying
10:40the five key factors of an ENLEX
10:43question. We talked about this day one.
10:47If you do not know what I'm talking
10:48about, go back to day one. You need to
10:51learn first the five key factors of an
10:54enclelex question. Once you have
10:57determined the five key factors, then
11:01read the answer. And as you can see,
11:04answer number one says call the
11:06healthcare provider immediately.
11:10So this is the key that tells you you
11:12can use this strategy. Now when you
11:15develop other strategy you can use these
11:18strategies in conjunction
11:21for example you can use this strategy
11:23with Maslo's hierarchy of needs there
11:26are other questions that you can use
11:28this strategy with assessment versus
11:31implementation strategy
11:33and little bit by little bit you will
11:35learn about all these strategies but for
11:38now let's just focus on when to call the
11:42doctor strategy. So it's very simple. Is
11:46my answer number one to call the doctor
11:50immediately or one of the other answers?
11:55That is the beginning of this analysis.
12:00That is the beginning of your critical
12:03thinking in this question.
12:06If you tell me an answer, if you comment
12:08an answer on the comment section, tell
12:11me why. Why you selected that answer. So
12:15I want you to put the answer,
12:17this is my reason why. This is why I
12:20think this is the answer.
12:23That way I can read and learn what is
12:27your thinking process.
12:31So it says
12:35the nurse working in the PACU post
12:38anesthesia care unit recovering.
12:42So the nurse is working in the PACU
12:45[clears throat]
12:46and is dealing with a male client after
12:50an exploratory
12:52laparottomy.
12:54And he says that this nurse administered
13:00a prescribed medication that is
13:03hydromorphone.
13:05I don't know what happened to the to the
13:07to the writing here. The the PowerPoint
13:10is all messed up. I don't know why, but
13:12let's continue.
13:15Bottom line is the nurse in the PACU is
13:20working with a male patient that is
13:23recovering from an exploratory
13:26laparottomy.
13:28And it says that this nurse administer a
13:32prescribed medication that is
13:34hydromemorphone IVP which means
13:37intravenous push.
13:41Five minutes later the nurse assesses
13:44respiration of eight.
13:48Which intervention should the nurse
13:51implement first?
13:55All right. Let me see. Let me see if I
13:57can fix this because this is driving me
14:00crazy as you guys think. I'll see if I
14:04can change it.
14:13So, tell me what you think and why.
14:22I think that's a little bit better.
14:25There you go.
14:38All right. So,
14:41let me see. Some of you are selecting
14:44selecting answer number two. Some of you
14:46are selecting answer number four.
14:50All right. So I do not see anybody
14:52selecting
14:53call the healthcare provider. So you
14:55decided that calling the health care
14:58provider is not the right answer.
15:02At least most of you
15:06Ryan is saying we assume
15:09we have orders for Alexson.
15:13Correct. We're going to talk about that.
15:16We're going to talk about this statement
15:17that Ryan is writing on the comment
15:21section.
15:25All right.
15:26So, we know that this patient after the
15:32prescribed medication of hydromemorphone
15:35the respiratory rate is eight.
15:40It says [snorts] five minutes later, the
15:43nurse assesses
15:45respiratory rate of eight.
15:49So this tells you that the nurse
15:52conducted an assessment.
15:56What is the nurse first intervention?
16:02So what is the nurse first action?
16:06Call the doctor. administer nlloxxone
16:10intravenous push reassess the client's
16:13respiratory status in 20 minutes and
16:16prepare to ventilate the client.
16:21So let's use the when to call the doctor
16:24strategy.
16:27So is my answer calling the doctor or
16:30not? I have to find out. Do I have
16:33answers that are within my scope of
16:37practice as a nurse? Yes, because as a
16:41nurse, I can administer medication.
16:46I can assess the respiratory status and
16:50I can prepare for ventilate for to
16:52ventilate the patient if necessary. So
16:55as a nurse, I can do that.
16:59So, do I have ANSWERS THAT I CAN do as a
17:03nurse? Yes.
17:07What's the other question?
17:09Do I have any answer that helps the
17:14patient's problem? WHAT IS THE PATIENT'S
17:17PROBLEM? A respiration of eight because
17:21normal is 12 to 20. So, the respiratory
17:26rate is low.
17:28Is there an answer that helps with this
17:32condition?
17:34Yes. Therefore, calling the doctor is
17:39not my priority.
17:42Now, understand this.
17:46This does not mean that I will not call
17:48the doctor. I will call the doctor at
17:51one point in time, but it is not my
17:54priority. It is not my first
17:58answer choice.
18:00So I have two, three, and four.
18:06If you review this scenario,
18:10you will determine that this is an
18:13emergency
18:14because the patient's respiratory rate
18:17is low. The patient has a respiratory
18:21problem. Therefore, I need to do
18:25something quickly.
18:27I need to implement
18:31NOW NOT COMPLETE an assessment.
18:35Therefore, answer number three I can
18:38eliminate. And this is delaying patient
18:42care because WHAT ANSWER THREE TELLS ME
18:45IS THAT WAIT 20 minutes and then
18:47reassess the patient's respiratory rate
18:51or respiratory status.
18:55So answer number three goodbye.
19:00Now I have answer number two and answer
19:02number four.
19:05Is there any clinical indication
19:08to ventilate the client? No. The patient
19:13is breathing on its own right now.
19:17So there is no reason to ventilate this
19:22client. Therefore, answer number four, I
19:27can eliminate. And the correct answer is
19:30answer [clears throat] number two.
19:33administer nlloxxone
19:36which is the antidote
19:39the antidote of hydromemorphon or
19:42delotted.
19:45This is a narcotic and naloxone or
19:49narcam
19:50is the medication that is the antidote
19:55whenever we have an overdose of
19:59narcotics.
20:01So this medication is definitely going
20:04to help my patient.
20:08Now the question that may arise in your
20:13mind is
20:15can I administer nlloxxone
20:19without calling the doctor?
20:22Don't I have to call the doctor first
20:24and tell the doctor my patient
20:27respiration is eight. What medication do
20:30you want to give me? Do you want me to
20:32give deluxon on ARAM?
20:36The answer is no. For the anklex, it is
20:40assumed that you have the doctor's
20:44order. You do not need to call the
20:47doctor TO TELL THE DOCTOR, "PLEASE GIVE
20:49ME THE ORDER." You have the order
20:52already. The only thing that you have to
20:54identify is if that doctor's order, if
20:59that medication order is appropriate for
21:03the client's condition.
21:08So this is a an extremely
21:12important scenario and an important rule
21:16to learn.
21:19This is not a CONTENT QUESTION. THIS IS
21:22A prioritization question.
21:25IT HAPPENS THAT IN THIS CASE the
21:28administration of the medication is the
21:30FIRST PRIORITY. BUT BE VERY CAREFUL. I
21:33CAN TWEAK THIS QUESTION around and maybe
21:37that is not the answer. You have to be
21:40careful with that. Of course you have to
21:43know that hydromemorphone or dal
21:46dilotted is a narcotic and that non
21:50campam is the antidote. But still this
21:54is a priority question. Why? Because
21:57calling the doctor is not wrong. We are
22:00going to call the doctor. It's just that
22:02it's not my first priority.
22:07Thank you, Bronnie, for supporting our
22:10channel. It's been a while since I
22:12haven't seen you here on YouTube. Good
22:14to see you, buddy. Thank you for having
22:17you here, Miss Beverly. Thank you for
22:21supporting our YouTube channel. I
22:23appreciate it. Thanks to everybody that
22:26every day during this training have
22:29supported our channel. So
22:33there's something really important to
22:35learn on this question.
22:38One, how to use the when to call the
22:40doctor strategy. And two, you need to
22:44learn this important rule for the ENLEX.
22:47You have the doctor's order. Remember,
22:50it's the per perfect
22:53world.
22:56Can I administer without a medical
22:57order? That is just exactly what I just
23:00mentioned. So if you are getting here at
23:03different points of the presentation,
23:06make sure you review the whole question,
23:10the whole scenario. It's going to be
23:12very important for you.
23:16If it is mentioned there, it is a
23:18medical order. Great
23:21fib.
23:22Excellent.
23:25All right. So let's review another
23:27question. Here's
23:30the following question.
23:34The telemetry monitor tech notifies the
23:37nurse of the strip shown below.
23:42Which should the nurse implement first?
23:48So, excellent question here. I want you
23:50to think about it, analyze it, look at
23:52the EKG strip and
23:56interpret it. Somebody said, "Professor,
23:59I want to see EKG." Here you go. This is
24:02an EKG question.
24:05All right. So, Senat
24:09Kamies,
24:10if it is assumed that you have a
24:12doctor's order in the ENLEX, how about
24:13in the Rio practice? Do I have to call
24:16the doctor and ask if he wants me to
24:18administer the inalogen? Of course, in
24:21the real practice, you have to call the
24:24doctor and say, "Doctor,
24:26I need this medication order for the
24:29real life scenario." Yes. For the enlex,
24:33no.
24:36Okay.
24:38Thank you, Jismar,
24:40for supporting our YouTube channel.
24:43Thank you very much. Thank you Maria
24:44Maria Suarez for supporting our YouTube
24:49channel.
24:53All right. So I see some of you saying
24:55professor this is VAC.
24:58I will do answer number two.
25:07Okay.
25:10So everybody's agreeing with answer
25:12number two.
25:15All right. So, what am I going to do
25:17first when I see
25:20this EKG strip? We have VTAC ventricular
25:26tachicardia.
25:28So, what is the priority nursing action?
25:32What is my first step?
25:36Once again,
25:39answer number three and four. Call the
25:42code blue. Call the healthc care
25:44provider. Begin CPR.
25:48So I have answers that is telling me to
25:52go get help from somebody else. In
25:56answer number four, the healthc care
25:58provider. Let's use the same strategy.
26:02Is there an answer that I can do as a
26:06nurse
26:07that is within my scope of practice?
26:10Yes.
26:11Do I have an answer that helps the
26:14patient's condition?
26:18That helps me validate the patient's
26:21condition. Yes. So, if that's the case,
26:26do not call the doctor as the priority.
26:32Now,
26:35what do I have to do before I call a
26:39cold blue? The patient needs to be in
26:42cardiac or respiratory arrest. Is my
26:46patient in cardiac or respiratory
26:49arrest? I don't know because the patient
26:53in ventricular tachicardia
26:56can have a pulse or can be pulseless vac
27:02it depends.
27:04So I need to assess my patient first. So
27:07calling the code blue is not
27:09appropriate. Calling the doctor prior to
27:12doing an assessment in this scenario is
27:15not appropriate. and beginning CPR. Once
27:18again, I have to check the pulse. So,
27:20answer three and four are eliminated.
27:25Now, we have answer one and two.
27:30And we're going to talk a little bit.
27:32This is another strategy that you will
27:36learn in other trainings.
27:39But there are some delegation principles
27:42here involved in this scenario
27:46because answer number one says INSTRUCT
27:49THE UAP TO GO CHECK ON the patient and
27:53there is a guideline for that. If there
27:56is any possibility that your patient is
28:00unstable,
28:02you cannot delegate nursing care to the
28:06UAP or the LPN if the patient is
28:11unstable.
28:13Therefore, answer number one is
28:17eliminated.
28:18The correct answer is answer number two.
28:24So, I will go to the patient's room. I
28:28will check the pulse and I will identify
28:31if the patient has a pulse. Yes or no?
28:35No pulse. CPR. Somebody call the call
28:39blue. I need help. Begin CPR.
28:43But you need to determine if the patient
28:46has a pulse or not because the nursing
28:49intervention in pulseless VTAC is
28:53different than the nursing interventions
28:56in VAC with a pulse. Thank you Miss
29:00Mildred
29:01for that uh super chat. Thank you for
29:05supporting our YouTube channel. I
29:07appreciate it.
29:13Thank you, Antoneta, for that awesome
29:15comment. I appreciate it.
29:19Thank you, Tatiana.
29:25Thank you, Maxino.
29:28Thank you for being here. I'm glad you
29:30like it.
29:37The protocol according to the American
29:40Heart Association is once the patient is
29:43unresponsive and you identify that the
29:45patient does not have a pulse, you
29:47quickly ask for somebody to call the
29:51cold blue, activate the cold blue. If
29:53it's outside the hospital, someone call
29:55911 and then you begin doing CPR. But
29:59this is automatically YOU NO PAUSE.
30:02SOMEBODY CALL 911 OR SOMEBODY ACTIVATE
30:04THE CODE BLUE CPR.
30:07OKAY, it's it doesn't take long, but the
30:10priority accordingly to the American
30:12Heart Association is calling for help.
30:15Okay,
30:18Michila says too, because it is
30:20subjective data from the telemetry
30:22monitor, you need to go and and complete
30:25an assessment. Excellent.
30:28Excellent.
30:30Thank you, Jel Nunes. Every single day
30:34you have donated to our channel. I
30:37appreciate it. Thank you very much. Nice
30:40uh little sticker. Cute sticker.
30:44Thank you, JC Pereira. Thank you for
30:47supporting our YouTube channel.
30:51ALL RIGHT, SO LET'S GO and see another
30:55scenario.
30:58Professor, I am struggling.
31:03I am struggling uh with EKG. All right.
31:07Maybe we can we can do like a Zoom EKG
31:10class very soon.
31:20All right. All right. I'm just looking
31:21at the chat to see if there's any any
31:23questions.
31:32Baba, I like your interpretation. I was
31:35recommended by Liz Beth. Oh, thank you,
31:37Lisbet, for recommending
31:41students to our YouTube channel. I
31:42appreciate it. Thank you, Miss H
31:46or Laiy. Thank you, Laiy, for supporting
31:49our YouTube channel. Thank you
31:55JC. Thank you Fedra Alexandra for
31:59supporting our YouTube channel.
32:02Thank you Susy Pierre for supporting our
32:06YouTube channel.
32:11All right. All right. Let's go to the
32:13next question.
32:15says, "A client receiving chemotherapy
32:18for cancer has an elevated serum
32:21creatinine level. What should the nurse
32:25do next?"
32:28So in this scenario, it's telling us
32:30that there is an elevated serum
32:32creatinine level, but it does not give
32:34us the number,
32:36but it says that is elevated.
32:41What should the nurse do next? Answer
32:44number one says
32:47cancel the next scheduled chemotherapy.
32:50Answer number two, administer the
32:53scheduled dose of chemotherapy.
32:56Answer number three, notify the
32:58healthcare provider.
33:01And answer number four, obtain a urine
33:04specimen.
33:05So once again, we see an answer that
33:10we're calling the doctor. So, let's use
33:13the same strategy again.
33:17Is there an answer that I can do
33:21that helps the patient
33:25with the condition that this scenario is
33:29describing? Let's see.
33:32Does cancelling the next schedule
33:34chemotherapy
33:36helps the patient?
33:39Well, the patient has cancer.
33:42The patient needs chemotherapy.
33:45Is it under my decision making to
33:52cancel a treatment or not?
33:57Nope. I cannot do that because depending
34:01on how elevated the serum creatinine
34:06level is,
34:08the doctor can decide let's continue.
34:10Let's do one more treatment or no, let's
34:12cancel the treatment. The doctor needs
34:15to analyze this before
34:19I cancel a treatment.
34:23So, answer number one is eliminate.
34:27Answer number two, administer the
34:30scheduled dose of chemotherapy.
34:33Answer number two is not appropriate
34:36either because we have a problem. Serum
34:41creatinine level tells us about renal
34:44function.
34:47The chemotherapy is being nephrotoxic.
34:52So I cannot just assume that this is
34:55okay and continue like nothing is
34:58happening. So answer number two harms my
35:03patient. I have to eliminate it.
35:08How about answer number four? Obtaining
35:11a urine specimen. IS OBTAINING A URINE
35:15SPECIMEN going to help me is going to
35:19help a patient with an elevated serum
35:22creatinine level?
35:26No.
35:28This answer does not help my patient's
35:32condition.
35:33Therefore, the answer is call the
35:37doctor.
35:39So, you have something to learn here.
35:42We saw several scenarios.
35:45In two scenarios, we discover something
35:50to do for the patient within the answer
35:53choices that were under our scope of
35:55practice and help the patient's
35:57condition. Therefore, in those
35:59scenarios, we did not call the doctor.
36:03But now we have another scenario that
36:07there is nothing that we can do to help
36:10the patient. Therefore, the correct
36:13answer is calling the doctor. I hope
36:17that you have learned this strategy
36:21because I assure you you will use it a
36:25lot on your exam.
36:29Thank you Alexandra Tronoso once again.
36:33Thank you Alexandra for supporting our
36:36channel our channel every day. Thank you
36:38very much.
36:44Madmood say, "I'm an old age aha and
36:48ACLS trainer." Excellent. And you can
36:52teach us a little bit about that.
36:54[laughter]
36:58Thank you, Mariel Mo, for supporting
37:03our YouTube channel.
37:10All right. Excellent.
37:12So, do you want to keep learning?
37:16Do you want to learn our next strategy,
37:19the Maslo's hierarchy of needs strategy?
37:22You want to learn how to apply that
37:24prioritization strategy on Enklex style
37:27question? Don't go anywhere. It's going
37:29to get very very interesting.
37:33We are day five of our 7 day training.
37:38We got two more training days to go. I
37:41see a lot of you have uh joined our
37:45YouTube training. Today we have 389
37:50uh nurses out there around the world
37:53joining our crusade jouring joining our
37:577-day training today. Please help me by
38:01liking this video right now. I want all
38:06of you guys that are here in this
38:08training right now. If you like this
38:10training, if you think this training is
38:13helping you, like this video, like this
38:17video right now, all you have to do is
38:20click the like button and you will help
38:23me help others out there. And of course,
38:27share this video. Share it everywhere on
38:31Facebook, on Telegram, on WhatsApp, Tik
38:35Tok, or wherever it allows you to share
38:38this video. share it with other people
38:41so they can also learn about this
38:43critical thinking and prioritization
38:46strategy. So let me see let me see you
38:49liking this video.
38:51Thank you Agnesa Corbelloo for
38:55supporting our YouTube channel. Thank
38:57you Miss Rabonda Hooks for supporting
39:00our YouTube channel. Thank you very much
39:04Edina Monttero. Thank you for supporting
39:08our YouTube channel.
39:20H Arei said, "Professor, Mr. Ryan asked
39:25if he said hold the schedule
39:28chemotherapy. Will that be correct?"
39:32Yes, you can hold the therapy and then
39:36call the doctor. That will be a correct
39:39response. So, excellent point, Ryan. I'm
39:43sorry. I did not see your question. If
39:46if you see that I don't see it, there's
39:48a lot of comments. So, I cannot keep up
39:51and concentrate with the uh with the
39:53training, but I I'll try to answer uh as
39:57much as I can. Okay.
40:01Nerl Va, thank you for supporting our
40:05YouTube channel. Batrice Delgado, thank
40:08you for joining and for supporting our
40:12YouTube channel.
40:15Madmood, I sent it to many of our
40:18Palestinian nurses. Excellent. Thank
40:20you. Thank you very much,
40:23Miss Rosapan. Thank you, teacher. Your
40:25class is very good. All right. Well,
40:29let's continue. This is getting better.
40:33Let's talk about our Maslo's hierarchy
40:35of needs strategy. I love this strategy.
40:38I teach it to all my students.
40:41In our course, we have a course for our
40:43Latino nurses that is called uh how to
40:47pass the ENL step by step, the Spanish
40:50version. So, if there's any Latino
40:52nurses out here that you're listening to
40:56this uh YouTube live training and you
40:59want to join the Latino the Spanish
41:02Academy, we can help you with that as
41:05well. Make sure you communicate with our
41:07advisor. She's probably going to put her
41:09number sometime. Just follow that and
41:14give her a call. But remember only
41:16Spanish nurses because h that is our
41:19Spanish side of the academy. But us
41:22English speaking nurses out here. Let's
41:24continue.
41:26Maslo's hierarchy of needs strategy.
41:29This strategy has four essential steps.
41:35The first step, you're going to look at
41:37the answers
41:40and you're going to determine if within
41:43the answers you have a mixture
41:46of physiological
41:49responses and psychosocial responses.
41:54But you may say, "Professor, what is a
41:57physiological response? What is a
41:59psychosocial response?" Physiological
42:02needs are those related to body
42:05functions, homeostasis,
42:08nutrition,
42:11airway, breathing, circulation,
42:14AGS. Basically, if those physiological
42:20needs are affected, the patient dies,
42:24the patient decompensates and die. Now
42:30what is a psychosocial need?
42:33Psychosocial need usually has to do with
42:36emotions,
42:37feelings,
42:39um learning process,
42:42mind stuff, not neurological functioning
42:45because that is also physiological. And
42:48also remember that for the ENLEX
42:51pain is a psychosocial need. for the
42:56anklex. Okay, if you don't know what I'm
43:00talking about, go back to day one and
43:02listen to day one review.
43:06All right,
43:10let me see what your professor. We need
43:14an English academy.
43:17I'll try I'll try to do something very
43:19soon.
43:35All right. And a prescription. You're
43:37you're a miracle, professor. Thank you,
43:40Joanna. This is my my favorite strategy.
43:47H Fariba, my friend pass. You said 5%
43:51from you world have to relay on your
43:54knowledge. Yes, knowledge is very
43:56important. Knowledge it is very
43:58important. Remember it's 50/50. 50%
44:01knowledge, 50% critical thinking. You
44:05can have all the knowledge you want. If
44:07you don't use your critical thinking,
44:09apply nursing knowledge and use
44:11prioritization strategies, you will not
44:13pass the ENLEX. Guarantee. Guarantee.
44:16I've been doing this guys for four years
44:19already. Thousands of students that I've
44:21been interacting with. I talk with
44:23students every single day.
44:27Trust me on what I'm telling you. I'm
44:30not selling you here nothing. This is a
44:32free course. I'm not interested in
44:35selling anything here. I'm trying to
44:37help you. Listen to what I'm saying. I
44:40know that it's a little bit different
44:42than what you're hearing out there, but
44:44trust me,
44:46don't believe that 99%
44:50effectiveness and all they teach is
44:52content. That is not true. You need to
44:55learn prioritization.
44:57You need to learn how to apply nursing
45:00knowledge or you will fail. Listen to
45:03what I'm telling you. I have over and
45:07over day by day nurses contact me and
45:12tell me the same thing. Professor I took
45:15the enlex I thought I was ready. I've
45:19studied for many months. I know every
45:22content I studied the sounders from left
45:24to right and I failed with 75 questions
45:29the minimum amount of questions.
45:32And as soon as they tell them, I tell
45:34them learn strategies, learn critical
45:37thinking, apply this, they go take the
45:41ENLEX and pass with 75 questions. So why
45:45the difference?
45:47Because that is the key. And I'm not
45:49saying that all my students pass. I will
45:52not lie to you. I'm not going to lie.
45:54I've had students fail. YES. WHY? GOD
45:58KNOWS WHY. Maybe they didn't dedicate
46:01enough time. Maybe they didn't study
46:03enough. I don't know. But it is simple.
46:07A lot of our students have passed the
46:09ENLEX using these guidelines and
46:11techniques. The question is why others
46:15have not been able to pass? What
46:17happened?
46:19They didn't develop that critical
46:21thinking. So I repeat once again, it is
46:25not I'm never telling you and I will
46:28never tell you put nursing knowledge
46:31aside. No, it is important. It is
46:34important to learn nursing knowledge but
46:38do not stop there and develop your
46:41critical thinking enough said. Okay. So
46:44you need to identify
46:48physiological, psychosocial,
46:51what which of my answers are
46:54physiological and which of my answers
46:56are psychosocial. And just keep that in
46:59mind. Then you're going to do step
47:03number two.
47:05Step number two is eliminate all the
47:08psychosocial
47:10answers.
47:12Why? Why am I going to eliminate the
47:16psychosocial answers? Because if I have
47:20a physiological problem that needs
47:23attention and I have a psychosocial
47:26problem that needs attention,
47:28physiological is the priority.
47:31Therefore, I eliminate psychosocial.
47:35Always know there's some exceptions that
47:39we will see.
47:41Step number three, very important.
47:45Does the remaining physiological answers
47:50make sense?
47:53Does it make sense? Yes or no?
47:57And I see a lot of students making this
48:01mistake.
48:03They go from two to four
48:08and they eliminate step number three.
48:13They eliminate the does it make sense.
48:17So as soon as they see a oxygen
48:22FLUID OPTION, THEY AUTOMATICALLY PICK
48:25THAT WITHOUT REALLY thinking if it makes
48:28sense to the patient's condition.
48:32So you have to ask does this
48:34physiological response that I have in
48:37front of me does it make sense to the
48:40patient's condition? Does it help my
48:43patient's condition? If the answer is
48:45yes, then apply ABC.
48:51That is very important. Do not
48:53automatically go to ABC because you're
48:56going to make a lot of mistakes.
49:00Lur this teacher I have a doubt with
49:02pain because there are some cases where
49:04I can see the pain as a physiological
49:06symptoms can you talk about that
49:10the problem with pain I'm going to give
49:12you an example let's say a patient has a
49:14heart attack a myioardial inffection the
49:17patient has chest pain WELL THAT IS THE
49:20priority professor because the patient
49:23is having an MI yes the priority with
49:27the MI is not the pain the priority with
49:32the MI is the occlusion of the coronary
49:36artery you need to relieve that
49:40that's why one of the first medication
49:42that you give is nitroglycerin
49:44you have to help with the circulatory
49:47problem yes the pain is the
49:50manifestation of the physiological
49:52problem but let's say you have a patient
49:54with a chronic back pain and you have
49:58another patient that has hypotension.
50:01Hypotension has the priority. Why?
50:04Physiological chronic pain, psychosocial
50:07or let's say you have a patient with
50:09sick cell anemia.
50:12Those patient present to the ER with a
50:15lot of pain.
50:17THE PRIORITY IS NOT GIVING pain
50:20medication is giving intravenous fluids.
50:24Why? Once again physiological need. So
50:27you have to be very very careful with
50:30that.
50:32Thank you Lette for supporting our
50:34YouTube channel.
50:37Professor, we need help with uh selector
50:41applies.
50:42We will we will get to that as well.
50:47All right, perfect. So let's practice
50:50our next scenario.
51:02They said my ass nlex exam won't be a
51:04problem if you go work with someone like
51:07Miss Josephine. She's godsend. She saved
51:10me from taking the exam. Miss Maya
51:13Natalia, what are you doing here? You
51:16know, go be with Miss Josephine.
51:20You are in ENLEX Crusade International.
51:23Please be respectful. I know you're
51:26probably a scammer trying to comment and
51:29getting nursing student to buy
51:32not good stuff. So, please be respectful
51:36unless it's like a robot or something
51:37like that. [laughter]
51:40It's funny. It really is. Uh Kille,
51:44thank you, Miss Kille H, for joining our
51:48our live and supporting our YouTube
51:51channel.
51:52[laughter]
51:53Bronza say Maya leave us leave us alone.
51:58[laughter]
52:02Oh my god, there's some people trying to
52:04promote another [laughter] professor.
52:06It's okay, Jessica. I don't I don't I I
52:08don't really care. Listen, whoever is
52:10here is here. If you like what you see,
52:14you think that this training can help
52:16you, stay. If you don't like, hey, it's
52:18okay. It is what it is. I do it with uh
52:22with with love. I do it because I enjoy
52:24it. So let's continue. Let's practice
52:27this Maslo's hierarchy of needs
52:30strategy. This is the question. So
52:32remember,
52:34look at the question, identify the five
52:37key factors of an enclelex question.
52:39Analyze the answer, determine which one
52:42is physiological, which one is
52:44psychosocial, does it make sense? Apply
52:47ABC. So, think of that. And I know you
52:51probably won't get it right away, but
52:54you'll get it little bit by little.
53:00Thank you, Mr.
53:04Lester. Lester Pina, thank you very
53:07much.
53:13Shia, please block her. It's so
53:16misleading. I don't know how to block. I
53:18don't know how to do it.
53:20I I'll block it later on.
53:24Don't follow that one. Don't Don't go to
53:26the scam. All right. So,
53:33if you don't know nobody, please
53:38I need to uh I I need to hire somebody
53:40there to to help me block the client
53:43diagnosed with cell anemia. Huh? We're
53:45talking about cle cell anemia. We talked
53:47about that in a few minutes a few
53:48minutes ago. Plan diagnosed with cle
53:51cell anemia comes to the emergency
53:53department complaining of joint pain
53:56throughout the body. The oral
53:57temperature is 102.4 and the pulse
54:00oximter reading is 91%. Which action
54:04should the emergency department nurse
54:07implement first? Request arterial blood
54:11gases. Stat administer oxygen via
54:14nasocanula. Start NIV with an 18 gauge
54:19angioath and prepare to administer
54:23anesics as order. Let me fix this uh
54:27this one too.
54:35All right. So, what do you think is the
54:37answer? And most important, why? Why do
54:41you think that's the answer?
54:47Thank you, Miss Dena Dia Sanchez for
54:50supporting our YouTube channel.
54:55I see some responding.
54:59Number two,
55:02three,
55:03four. Uhhuh. You see this a little bit
55:06more difficult.
55:08It's a more difficult scenario. So we're
55:11getting to the core
55:14of uh critical thinking.
55:19All right. So what is my problem? Let's
55:22identify those key words. The diagnosis
55:25is cleosal.
55:29We don't know who the client is. There's
55:31not a lot of description about the
55:32client.
55:34comes to the emergency department.
55:39Okay.
55:41Comes to the emergency department.
55:44It goes all right. Complaining of joint
55:48pain throughout the body. So the patient
55:50has pain.
55:53The overall temperature is 102.4. So we
55:56have fever, high fever. And the O2
56:00saturation is 91%.
56:06Which action should the emergency
56:07department nurse implement?
56:10First priority keyword
56:15request arterial blood gases stat
56:19administer oxygen
56:23via an asocanula.
56:25Start IV for an 18 gauge angath and
56:29prepare to administer analesic. So let's
56:32use this strategy.
56:34Request arterial BLOOD GASES. SO
56:36ARTERIAL blood gases we're going to
56:39categorize as physiological.
56:44Administer oxygen.
56:46This is
56:48physiological
56:51and start an IV with an 18 gauge
56:54angioap. What is the reason for the IV?
56:57Administration of fluids. So we're going
57:00to categorize this as a physiological
57:04response as well. And answer number
57:06four, prepare to administer analesics
57:10medication.
57:11This is psychosocial
57:14because it's going to take care of the
57:17patient's pain. Remember what I told you
57:20and I talked about this in day one. pain
57:24we're going to categorize for the
57:27enclelex as psychosocial. So the first
57:31step is identify which answer is
57:35physiological and which answer is
57:38psychosocial. We have determined that
57:41answer number four is psychosocial and
57:44we are going to eliminate answer number
57:48four. So we have answer number one,
57:51answer number two, and answer number
57:53three left. Which one of the three
57:58physiological answers is going to be the
58:01correct one? And I saw a few of you
58:04selected one, a few you selected two, a
58:07few selected three, AND SOME OF YOU
58:09SELECTED FOUR. NOW YOU KNOW that if you
58:13use the assess the if you use the
58:15master's hierarchy of need strategy you
58:18would have eliminated answer number four
58:21you would not have made that mistake.
58:26Okay so answer number four eliminated
58:30gone.
58:33Okay. So,
58:36answer number one, two, and three.
58:39Look at answer number one. Request
58:41arterial blood gas. This means call
58:45somebody,
58:47request the another department to come
58:51collect the arterial blood gas, send it
58:54TO THE LAB, WAIT FOR THE LAB TO COME
58:56BACK WITH RESULTS and then I will know.
58:59This is delaying patient care. The
59:02patient has an emergency.
59:05I need to deal with that emergency.
59:09Okay.
59:12Uh, thank you, Miss Risa Espinosa, for
59:15supporting our channel. Thank you very
59:17much. So, we took one out of the game.
59:24We took four out of the game. Now, we
59:28have to decide in between two and three.
59:32So we ask step number three of the
59:35strategy.
59:38Does it make sense?
59:41Does it make sense to apply oxygen? Yes.
59:45The patient's O2 saturation is 91. The
59:49patient has hypoxia.
59:52Therefore,
59:53answer
59:55oxygen is appropriate.
59:59Makes sense. So, we're going to leave
1:00:01it. Does inserting a an IV 18 gauge make
1:00:06sense? Yes. The patient needs fluids.
1:00:10Therefore, I need an IV gauge. I need an
1:00:1418 gauge, 20 gauge maximum to administer
1:00:19fluids. So, answer number three makes
1:00:22sense. So, now I go to step number four.
1:00:27Which one is A B C?
1:00:33Oh, oxygen is ABC and is the priority
1:00:40answer. So the correct answer is answer
1:00:48number
1:00:50two, oxygen.
1:00:54Okay.
1:00:56All right.
1:01:03Let me review some of your answers that
1:01:06way I can I can help you.
1:01:11Let me see
1:01:14for psychosocial. Excellent.
1:01:17Mmud
1:01:19Ambrose said why eliminate four anal
1:01:22analesics?
1:01:25So I don't know if if that was a
1:01:27question. I think it was a question. Why
1:01:29eliminate four? The reason why we
1:01:32eliminated number four is because it's
1:01:34psychosocial in nature and the patient
1:01:37has also hypoxia by the 91% O2
1:01:41saturation. So we have pain psychosocial
1:01:46and then we have O2 saturation 91 that's
1:01:49physiological. Physiological takes the
1:01:52priority over pain. But remember the
1:01:55patient has two conditions
1:01:58minimal well it has SEVERAL CONDITIONS
1:02:00SAY PSYCHO CELL JOINT pain fever and
1:02:04hypoxia but OUT OF ALL THOSE problems
1:02:07the priority is the oxygen problem. That
1:02:11is why our answer is number two. Okay
1:02:17she number one is out because that is
1:02:20delaying patient care. I don't have time
1:02:22for that. Excellent.
1:02:24Excellent. Very good.
1:02:28Nicholas, I have selected four because
1:02:30the patient came to the ER for pain.
1:02:33Nicholas, remember this
1:02:36when we're thinking about
1:02:37prioritization.
1:02:39We are not saying that we will not
1:02:42administer pain medication. Yes, the
1:02:45patient will get pain medication. It
1:02:48means that it's not the first answer. It
1:02:52means that it will not be my first
1:02:54choice. This is extremely important
1:02:58because if you have in your mind that if
1:03:00you eliminate it is because you're not
1:03:02going to do it, then you're going to
1:03:04make a lot of mistakes. I will do it,
1:03:07but it will not be my priority or first
1:03:11action.
1:03:14The patient has fever and needs
1:03:18antipietics.
1:03:19True. But that is not one of the answer
1:03:22choices.
1:03:24Okay, that is not one of the answer
1:03:26choices. So I cannot think about that
1:03:29one. Be careful. That is called
1:03:32something we call the whatif syndrome.
1:03:35Okay, that's for another day.
1:03:48Lester, I plan to take the ENLEX exam
1:03:51early next year. I'm a regular nurse,
1:03:52but I have been away from the profession
1:03:54for more than 20 years. Can I still pass
1:03:57my the exam? Absolutely, Lester.
1:03:59Absolutely. It may take you a little bit
1:04:02longer to catch up, but yes, you can do
1:04:04it. If that is your dream, you can do
1:04:06it.
1:04:16I see you guys still talking about I
1:04:18don't see Maya anymore. I don't
1:04:19[laughter] I don't know where Maya went.
1:04:22I don't see it anymore.
1:04:33All right, sounds good.
1:04:36Okay, you want to go to the next
1:04:37question? You want to see how we apply
1:04:41this strategy in another scenario?
1:04:45Because I want I want to give you
1:04:47several scenarios so you see how this
1:04:50strategy changes. Okay.
1:04:5490% not too bad for cle cell anemia.
1:04:58Yes. But remember, we have to think of
1:05:01parameters, normal parameters. Most of
1:05:04the nursing books says usually 92 to 100
1:05:0993 to 100 normal. So anything below that
1:05:12is abnormal and requires an
1:05:15intervention. Okay.
1:05:24uh other than fluids,
1:05:29fluids, oxygen, pain, medication, that's
1:05:33usually the priority in uh cleosh
1:05:43not confidence in this answer. Well, it
1:05:47is it is the answer. No doubts in my
1:05:49mind. That is the answer. So the most
1:05:52important for you Mr.
1:05:56Mahmud Amro you have to try to get what
1:06:00I'm trying to teach you. Okay remember
1:06:04we have several answers that are
1:06:06important in this scenario but we have
1:06:09to think of prioritization.
1:06:13We have to think what is the most
1:06:15important answer that if I don't do it
1:06:20the patient can ser seriously be harmed
1:06:24what do we have getting the arterial
1:06:27blood gas we can do that later starting
1:06:30the IV line we can do that later and
1:06:34administering pain medication okay
1:06:36analesics is usually administered IV so
1:06:40I would NEED TO START THE IV FIRST give
1:06:43the analesic medication via IV. So, I'm
1:06:48going to do all that and delay the
1:06:50administration of oxygen. No, incorrect
1:06:54thinking and you have to be careful with
1:06:56that. Okay.
1:07:08Let me see.
1:07:10below 93 is is is bad.
1:07:14Yes, for most nursing books they say 93
1:07:17to 100 but I have seen some nursing
1:07:20books saying 92 to 100. So below 92 uh
1:07:24hypox.
1:07:30Okay. All right. Very good.
1:07:34Let's go to the next question.
1:07:37Here it is.
1:07:40So, we have a a nurse caring for a
1:07:43client who arrived to the ER from a
1:07:46local skilled nursing facility. The
1:07:49client is confused. The temperature is
1:07:52102.5.
1:07:53The blood pressure is 82 over 36 and the
1:07:57heart rate is
1:07:59124. Which prescription should the nurse
1:08:03implement first?
1:08:06So we have
1:08:08another priority question here. What do
1:08:11you think is the answer and why? Try to
1:08:14use the strategy.
1:08:26So
1:08:27don't worry about the chat, guys. Okay?
1:08:30I see you getting too worried about
1:08:32these people joining the live and
1:08:35texting. Who cares about them? Listen to
1:08:38what I'm telling you. Do not let the
1:08:40chat
1:08:41uh take you out of focus. Only look at
1:08:44the chat to text your answer and then
1:08:47take away your eyes from the chat. Look
1:08:50at the question, analyze the question,
1:08:52listen to me because there's nothing we
1:08:54can do about that. Okay? So, don't worry
1:08:56about it. Just listen to me.
1:09:03So I see a lot of you are selecting
1:09:06answer number four.
1:09:08Mhm.
1:09:12So remember still think of the steps.
1:09:16Step number one, number two, three and
1:09:19four.
1:09:22So the problem in this scenario we have
1:09:26neurological problems confused we have
1:09:30fever we have hypotension and we have
1:09:35compensatory tachicardia.
1:09:38What are we going to do first? Another
1:09:40priority question.
1:09:43Oh look what we have here.
1:09:46Notify the healthcare provider. you know
1:09:49a strategy for that. So now you see that
1:09:53answer number one it says call THE
1:09:55DOCTOR. YOU'RE ALREADY saying uhhuh I
1:09:58know I know what strategy I can use.
1:10:02I can say okay do I have an answer that
1:10:06is under my scope of practice that I can
1:10:10do and assist and help my patient with
1:10:13the problem? Yes, there is.
1:10:17Yes, there is. So, I'm not going to call
1:10:20the doctor as my priority answer. We're
1:10:23going to eliminate that one
1:10:25automatically.
1:10:28So, administering antibiotics, that's
1:10:31going to help a physiological problem.
1:10:34Assessing for oxygen saturation, that's
1:10:38going to help with a physiological
1:10:40problem. and administering fluids that's
1:10:44going to help with a physiological
1:10:46problem.
1:10:48Excellent.
1:10:50So, step number one, we did it. We have
1:10:54physiological answers. There are non
1:10:58psychosocial answers to eliminate. So,
1:11:00we don't have to do that step. STEP
1:11:02NUMBER THREE, the important step.
1:11:07Does it make sense?
1:11:09So, does it make sense to administer
1:11:13antibiotics
1:11:16in this patient's condition? Well,
1:11:20I DON'T HAVE A LOT OF INFORMATION, but
1:11:23this could probably represent sepsis
1:11:27because of the fever, hypotension, and
1:11:30tachicardia. So, my patient could need
1:11:34antibiotics.
1:11:37I need to do a blood culture first. But
1:11:42that is a possible answer and it makes
1:11:44sense.
1:11:46Administering or assessing the O2
1:11:50saturation or the oxygen saturation.
1:11:54Does it make sense in this condition?
1:11:57I can always assess for O2 saturation.
1:12:02But if you read the clinical scenario,
1:12:06THE PATIENT'S PROBLEM, the description
1:12:09of the patient's problem is not an
1:12:12oxygen problem like we saw in the
1:12:15previous scenario.
1:12:18So answer number three does not make a
1:12:23whole lot of sense accordingly to the
1:12:26problem that I have described. You
1:12:28cannot start playing the game of well if
1:12:32the patient uh is septic then the uh
1:12:37cardiac output is going to be low and
1:12:40then the perfusion is going to be low.
1:12:42So ultimately THAT IS GOING TO CAUSE
1:12:45OXYGEN PROBLEMS because you're thinking
1:12:48way too head too ahead of yourself. You
1:12:52have to learn how to analyze the
1:12:54scenario you have in front of you.
1:12:56Remember this is not a medicine
1:13:00test. It's not USMLE step one or step
1:13:03two test. This is basic nursing
1:13:07knowledge. So I have fever. I HAVE LOW
1:13:11BLOOD PRESSURE AND TAGIC CARDIA. WHAT DO
1:13:14I NEED TO DO? FLUIDS. THIS PATIENT NEEDS
1:13:17FLUIDS. Plus these are symptoms of
1:13:22shock. This patient probably is in
1:13:26septic shock. Fluids need to be
1:13:29administered yesterday.
1:13:33So my answer number two and four make
1:13:37sense. Three I have to eliminate because
1:13:41there's no indication of a respiratory
1:13:44problem in the stem of the question. And
1:13:46if I analyze two and four, four has the
1:13:51priority. Four is the correct answer.
1:13:56Why? It is physiological.
1:13:59It is ABC.
1:14:02CIRCULATION THREE IS ALSO ABC.
1:14:07But does not make sense to this
1:14:11condition.
1:14:14So
1:14:15I hope that makes sense. Now there is
1:14:19another strategy that you will learn
1:14:23tomorrow. I'm not going to go over that
1:14:25today. You will learn tomorrow. That is
1:14:28the assessment versus implementation
1:14:32strategy.
1:14:33And if you use that strategy, this same
1:14:37scenario,
1:14:38assessment is not going to be the answer
1:14:42because we're dealing with an emergency.
1:14:46So that will be another reason
1:14:49another reason not to select answer
1:14:53number three.
1:14:56All right.
1:15:02Okie dokie. Let me see. Let me read the
1:15:04chat.
1:15:09Professor
1:15:11I see talking about the needing a
1:15:13doctor's order. Professor, don't I need
1:15:16to call the doctor first in order to
1:15:19tell me that it's okay to administer the
1:15:21fluids? No, we already talked about
1:15:24that. Go back to the beginning of day
1:15:28five. I talked about that. I talked
1:15:31about the enlex rule. If you if you came
1:15:34late to the training and you didn't hear
1:15:37that part, go back go back to the
1:15:40beginning of the training so you can
1:15:41learn about that rule. It's very
1:15:43important.
1:15:49Why the administration of antibiotic
1:15:52will be a physiological need? What is an
1:15:56antibiotic administered for? To treat a
1:15:59bacterial infection and bacteria affects
1:16:04the client in a physiological way. So
1:16:08that is why we categorize the
1:16:10administration of antibiotics as
1:16:13physiological.
1:16:17Okay.
1:16:24Uh FIA going back to the question before
1:16:27why is pain considered psychosocial?
1:16:29It's just a rule for the ENLEX. It takes
1:16:33the priority physiological needs over
1:16:36pain. Unless like I said about the
1:16:39problem from the MI that patient has a
1:16:43circulatory problem and that is the
1:16:45priority in that scenario. Okay
1:16:57Jar there are no other explanation like
1:17:00your profession. Thank you. Thank you.
1:17:01Thank you Jar. Thank you very much.
1:17:14Okay. Well, very good. So, let's go to
1:17:18the next scenario. Okay. So, we know we
1:17:23have eliminated number one, number two,
1:17:25number three. The answer is number four.
1:17:28Let's go to the next scenario that is
1:17:31going to be very interesting. I'm going
1:17:34to teach you something that
1:17:38I don't see it being taught very often
1:17:41and I have seen some Q banks making a
1:17:46lot of mistakes when it comes to this
1:17:48following scenario and I want you to
1:17:50learn it because it will definitely
1:17:53increase your chances of selecting the
1:17:56correct answer in scenarios like that.
1:17:58So here's the question. Read it.
1:18:02identify the key factors and use the
1:18:06strategy.
1:18:11And as you're thinking, I'm looking here
1:18:13at the your your comments.
1:18:32Missina, is there a scenario where in
1:18:35the enllex none of the answers are
1:18:38correct? No. No. There's always going to
1:18:41be a correct response and you have to
1:18:44identify. [snorts]
1:18:49Shia, this is really helpful. Thank you.
1:18:56Excellent. I'm glad I'm glad he's
1:18:58helping you out.
1:19:01Mr. Ramon, thank you. Wonderful class.
1:19:08So, I see some of you,
1:19:15some of you selecting four, some of you
1:19:17selecting three.
1:19:32Okay. So in between three and four ah
1:19:35you're going to learn something very
1:19:38very important today.
1:19:44All right. So the nurse providing care
1:19:46to a client following a prostatectomy.
1:19:50Which of the following nursing diagnosis
1:19:53is the priority? And I want you to
1:19:56listen to this. Whenever you see the
1:19:59question that states, which of the
1:20:02following nursing diagnosis is the
1:20:05priority, the strategy to use is Maslo's
1:20:09strategy? The one that I just taught
1:20:12you. Whenever you see that, think
1:20:15Maslo's strategy. That's the strategy
1:20:18that applies here all the time,
1:20:22but we're going to add something extra.
1:20:27Remember, I'm trying little bit by
1:20:29little bit increase your your critical
1:20:33thinking. I cannot
1:20:35tell you everything because you're going
1:20:37to get so confused. Little bit by little
1:20:39bit.
1:20:40We're going to use Maslo, but we're
1:20:42going to use another guideline and that
1:20:46is
1:20:48risk
1:20:51versus
1:20:53real problem.
1:20:55So in this scenario, not only we have
1:21:01the masslos hierarchy of need strategy
1:21:04to use, but we are going to use the
1:21:07risk.
1:21:10Okay? Or risk and potential
1:21:15means the same thing
1:21:18versus real.
1:21:22So I ask you a question.
1:21:26What is more important?
1:21:30A real problem that is happening right
1:21:33now
1:21:35or something that is not happening yet
1:21:38and has the potential to occur.
1:21:42What do you think is the priority
1:21:45real
1:21:47now or potential? Maybe maybe happens
1:21:52later on. What has the priority? Tell
1:21:56me. Comment on the chat.
1:22:03Gina says real.
1:22:14Rio has the priority. A real problem is
1:22:19the priority over a potential problem.
1:22:25So in this scenario, yes, imbalance
1:22:28fluid volume, yes, hemorrhage, it is
1:22:33ABC, but it is a risk OR POTENTIAL
1:22:38PROBLEM. Real problems has the priority.
1:22:43A real problem has the priority over a
1:22:47potential problem or a risk. Therefore,
1:22:50two and three gone.
1:22:53Eliminated.
1:22:56Now we have two real problems.
1:23:00Deficient knowledge
1:23:02psychosocial.
1:23:05Acute pain. We talked about pain.
1:23:08Psychosocial.
1:23:10But acute pain
1:23:14has priority over
1:23:17knowledge.
1:23:19So I eliminate answer number one and the
1:23:22answer is
1:23:24four.
1:23:28Now
1:23:29listen to me very careful
1:23:33and I'm going to take all these
1:23:35drawings.
1:23:37If answer number two, let's say answer
1:23:41number two, instead of saying risk four,
1:23:45it says
1:23:47IMBALANCED FLUID volume
1:23:52without the risk part.
1:23:56Listen to me.
1:23:58If the same question instead of saying
1:24:00in answer number two RISK FOR IMBALANCED
1:24:03FLUID VOLUME, it said imbalance fluid
1:24:07volume
1:24:08and I have all the same answers. The
1:24:11answer will not be the acute pain will
1:24:15be the imbalanced fluid volume.
1:24:19Does that make sense? Do you understand
1:24:22what I'm saying?
1:24:24If you do not understand
1:24:27this small detail, you're going to
1:24:30answer a bunch of questions wrong.
1:24:35You have to understand this.
1:24:38Remember, a real problem is the priority
1:24:42over a potential problem every day.
1:24:47Why? BECAUSE A POTENTIAL PROBLEM IS NOT
1:24:50OCCURRING YET.
1:24:55very important.
1:24:59All right.
1:25:02What do you think about today's
1:25:04training? I know it's different. You've
1:25:08probably never heard any of this. You're
1:25:12probably in shock. It is what it is. You
1:25:15have two options. Okay? And I tell you
1:25:19this with uh being humble and because I
1:25:23care. You have two options. You can
1:25:27either say this professor is making
1:25:30sense.
1:25:32This makes sense. I'm going to give it a
1:25:34shot. I'm going to try to apply this. Or
1:25:38you can say, "Eh,
1:25:40he doesn't know what he's talking
1:25:42about." And move on. The choice is
1:25:46yours.
1:25:48If you're taking the ENLEX, if you've
1:25:50taken the ENLEX before and failed
1:25:54and whatever you've been using so far is
1:25:56not working, maybe, just maybe, you can
1:26:00give it a shot,
1:26:03try to apply it, use it in Enclelex
1:26:06style questions, and your scores will
1:26:10begin to change. Or don't do it. Up to
1:26:15you.
1:26:17Thank you for being here. Thank you for
1:26:20joining Enclelex Crusade International.
1:26:23Thank you for trusting our channel.
1:26:27Thank you for being here even though we
1:26:30had some
1:26:32scammers on the chat today. Hey, they
1:26:34they'll continue to come. Especially the
1:26:38the more I I I am known by other nurses,
1:26:41the more they're going to join the
1:26:43channel. It is what it is. But it's
1:26:45okay. Don't worry about them. Focus,
1:26:47concentrate in what I'm teaching you and
1:26:50you will learn. If you haven't
1:26:53subscribed to our channel yet, go ahead
1:26:55and do it right now. Don't do it later.
1:26:58You'll forget. Find the subscribe button
1:27:00somewhere in our YouTube channel. Join
1:27:03it so you are not missing any of our
1:27:07videos. And also I put the link to our
1:27:11to our telegram group in the comment
1:27:14section in the description section. Make
1:27:17sure you have joined our YouTube
1:27:19channel. Subscribe to our YouTube
1:27:21channel and also join our telegram group
1:27:24so you don't miss any of the valuable
1:27:28information. Thank you Carlos for uh
1:27:32supporting our YouTube channel. THANK
1:27:33YOU, MISS VICTORIA, for uh talking about
1:27:38Miss Josephine and the passing the ENLEX
1:27:41with Miss Josephine. I don't know who
1:27:43Miss Josephine is, but okay, whatever.
1:27:47Thank you, Carlos. Thank you for being
1:27:49here. Thank you, Vivian
1:27:53S. Rio versus risk. Real is the
1:27:56priority. Correct.
1:27:59Erh, may I ask Mr.
1:28:03Mammud, I don't know if I'm pronouncing
1:28:05it correct. May I ask why you call this
1:28:09Crusader?
1:28:11Well, the name of the of my company when
1:28:14I first uh developed it back in 2007,
1:28:18the the Latino version,
1:28:21I called it Enkllex Crusade
1:28:24because I think preparing for the ENLEX
1:28:27is like a crusade. It's like a it's like
1:28:30a a battle that we all have to face
1:28:34where we're going to encounter
1:28:36obstacles. We're going to face problems.
1:28:39It's going to be difficult.
1:28:41And in between you have to develop a
1:28:46warrior mentality.
1:28:48And back in the days the the warriors,
1:28:52the knights that were involved in the
1:28:54crusades, they were called crusaders.
1:28:58So that's why I call my students enklex
1:29:02crusaders.
1:29:04So that's the story [laughter] behind
1:29:06it. I don't know if it makes sense to
1:29:08you, but it makes a whole lot of sense
1:29:10to me. So that is why. So I call all my
1:29:14students enclelex crusaders. And I'm
1:29:17very h happy to call that. And they get
1:29:22very happy when they're called that
1:29:24because it's part of our family. We are
1:29:26a big family.
1:29:28All right.
1:29:30Thank you, Siler. Thank you, Dianetis.
1:29:35That is an Enklex crusader who is a
1:29:38registered nerd now in days. She passed
1:29:40the ENLEX.
1:29:44There goes Victoria. [laughter]
1:29:50Adrien Clark, I need you to be my
1:29:52mentor. Taking the ENLEX in May. Okay,
1:29:56Adrien. Good.
1:30:00Thank you, Alva.
1:30:03Uh, Phyllis, what is your link to
1:30:05Telegram? Um, Elizabeth, can you put the
1:30:08the link to the Telegram now so they can
1:30:10see it, please?
1:30:13Maximo, excellent job, professor. I'm on
1:30:15my way to success. Yes, sir. Let's do
1:30:18this.
1:30:23Kimberly, I have been seeing the
1:30:25training videos and I absolutely love it
1:30:28and is it is motivating me a lot. Very
1:30:30good, Kimberly. I'm glad you like it and
1:30:33I'm glad he's helping you.
1:30:50[laughter]
1:30:51Max says Miss Josephine is a liar.
1:30:55[laughter]
1:31:02Miss Tomasa, thank you for a great
1:31:04class. Thank you, Tomasa. Welcome.
1:31:06Welcome.
1:31:10Alexandra, I am an enlex crusader and I
1:31:13am very proud of that. Thank you,
1:31:15Alexandra, I know you are and you have
1:31:18changed so much. Your critical thinking
1:31:21have changed so much since we started
1:31:23working together and I am very proud of
1:31:25that and I know for a fact that you will
1:31:28pass your ankle soon and you will tell
1:31:31your testimony to everybody. I know that
1:31:33for a fact.
1:31:37Uh, God love don't know why my financial
1:31:40support have not been reflected yet.
1:31:43It probably appear later on. Thank you
1:31:45very much. Thank you for being here. And
1:31:48that is the least important. The most
1:31:51important is that you hear you're
1:31:52learning and that you're preparing. Any
1:31:54questions that you may have that you
1:31:56might want me to answer? Maybe a few
1:31:59more minutes and then we'll end up end
1:32:01this live. Okay.
1:32:11Shade I can be what is the next
1:32:13teaching? Our next live will be
1:32:17tomorrow. Actually I forgot to put that.
1:32:20H our next live will be tomorrow at 5:00
1:32:23p.m. And we are going to continue with
1:32:25priorities. So what I want to share
1:32:28tomorrow is other prioritization
1:32:32uh and critical thinking strategies to
1:32:34continue helping you develop that
1:32:36critical thinking. Okay.
1:32:44Professor can you explain cat computer
1:32:47adaptive testing? Okay. So, Angelina,
1:32:52Angelina, the CAT computer adaptive
1:32:55test,
1:32:57the name of the test tells you what it
1:32:59does. It adapts to you. What that means
1:33:03is, let's say you answer a question
1:33:07incorrectly.
1:33:08The Enclelex has an algorithm that is
1:33:11going to determine, okay, and let's say
1:33:15Angelina answered this question
1:33:17incorrect in this category.
1:33:19The next question could be a different
1:33:22category, but it's going to be an easier
1:33:26style question,
1:33:28less difficult. But if you answer the
1:33:32question correctly, the algorithm says,
1:33:35"Okay, she's okay at that level of
1:33:38thinking. I'm going to put a higher
1:33:41difficult question, a more difficult
1:33:44question." And then you're going to
1:33:46answer that question. If you get it
1:33:48correct, the algorithm says, "Okay,
1:33:50let's give her another question a little
1:33:53bit harder." And that is why it's so
1:33:56important to stay above the passing
1:33:59level. There is a video in our YouTube
1:34:03channel that talks about the computer
1:34:05adaptive test. Find it in one of the
1:34:08playlist. It I explain it very very
1:34:11simple there and hopefully it it helps
1:34:14you.
1:34:18The next class is tomorrow at 5:00 pm.
1:34:24Lrice Robert, please help me pass the
1:34:27ENLEX. I love the way you break it down.
1:34:30Sure, come with me. I'll be here to help
1:34:32you guys.
1:34:35Sat after the day seven, what what are
1:34:40you doing again?
1:34:42I [laughter] don't want the class to
1:34:43end. So my goal is after day seven in
1:34:48the uh telegram group I'm going to ask
1:34:52the students there which topic they want
1:34:56to review next and I'm going to select
1:35:01seven topics that are uh frequently
1:35:05mentioned by uh students let's say EKG
1:35:09or whatever it is EKG pharmarmacology
1:35:13AGS these and I'm going to pick seven
1:35:16topics and I'm going to create a
1:35:18training. Of course, it takes me some
1:35:20time to create it. I cannot create it
1:35:22overnight, but I'll start thinking of
1:35:24that and I'll create our next 7-day
1:35:27training to do uh another week. I know
1:35:31after immediately after this training,
1:35:33I'm going on vacation for for a week and
1:35:37basically I'm going to take some time to
1:35:39rest. But then what I plan to do after I
1:35:43come back from the uh vacation, I am
1:35:48planning to give a few uh live classes
1:35:52on Zoom. Okay, that I'm going to I'm
1:35:54going to tell when it is and the topic
1:35:56that I will be sharing and that was
1:35:58going to be for a cost a very minimum
1:36:00cost uh to help those students that are
1:36:03taking the ENLEX like right away. Like I
1:36:06said, I don't have a a full ENLEX
1:36:09preparation training uh fully in
1:36:12English. The one that I have is
1:36:14basically Spanish and English and it
1:36:17will it will not be beneficial for you
1:36:18guys.
1:36:20But at least with those classes, I call
1:36:24them practice classes, maybe I can help
1:36:27some of you right before the taking your
1:36:30ENLEX until we start our next our next
1:36:347-day training. So, that is my goal.
1:36:36That is my plan. That's what I I plan to
1:36:38do. Remember, meanwhile,
1:36:41cuz I know I've seen some scammers on
1:36:43the Telegram group as well selling a
1:36:46course or something saying that it's me.
1:36:48Be careful with that. I am not selling
1:36:50anything yet. Okay? I'm not You should
1:36:53not be sending money to anybody
1:36:55anywhere. So, be careful with that. Are
1:36:58you going to teach your SA? Yes.
1:37:01Tomorrow, I will talk a little bit about
1:37:03select.apply apply and we will practice
1:37:05some questions.
1:37:09Is are these trainings recorded? Yes,
1:37:12these training stay recorded uh on on
1:37:16YouTube. If you're talking about the
1:37:19live trainings that I will be doing, the
1:37:22live Zoom classes, yes, I will be
1:37:24recording them. I have to always kind of
1:37:27like edit it a little bit, take the
1:37:28interaction with the students out of the
1:37:30recording and I will make it available.
1:37:32I usually make it available within a
1:37:34week and yes, I give some time for you
1:37:37to to review that class again and study
1:37:39it again. But that's for for a later
1:37:42time. Okay, let's not worry about that
1:37:44now.
1:37:46Would it be before May? Yes, absolutely.
1:37:48It will be before May.
1:37:57Yes. For those um nurses that are
1:38:02Spanish speakaking or that's your
1:38:03primary language, there is a
1:38:07huge YouTube channel uh that we have for
1:38:11our Spanish nurses, but everything there
1:38:14is in Spanish. Zero English. There's no
1:38:17English there. Or actually, I should say
1:38:19half and half, but a lot of Spanish
1:38:21there. So, English speaking nurses, do
1:38:24not go there. you'll get so confused
1:38:26because you're not going to understand
1:38:28half of the things I speak there. So
1:38:29that's why I created this channel just
1:38:32for you guys and also to help my Spanish
1:38:35nurses learn and get better with
1:38:38English.
1:38:42Okay.
1:38:46Uh the ones that want to know how to
1:38:48join the telegram group on the top of
1:38:52the chat there is a blue line that says
1:38:56Anklex Crusade International join RT
1:39:01or Telegram. Click on that blue line on
1:39:04the top that has the title for the
1:39:07YouTube channel and it will take you to
1:39:09the to the Telegram group. So try to do
1:39:12it now. those who are not in the
1:39:15telegram yet in the telegram group yet.
1:39:18See if I see you guys joining.
1:39:30Okay. So I see you a few of you joining
1:39:32now.
1:39:36Uh Dis
1:39:40channel is Enlex Crusade without the
1:39:44international. Take the international
1:39:46part out and all that is half in
1:39:49Spanish.
1:39:51So hope it helps.
1:40:09[laughter]
1:40:10Maya Victoria, what other professor
1:40:13takes the time to stay extra after
1:40:16they're given a class? [laughter]
1:40:18Thank you, Brice. I appreciate it.
1:40:26Um, I'm going to say this foris,
1:40:30okay?
1:40:46Okay, back to English. I apologize. I
1:40:49just wanted to help Adalisses
1:40:53with her question.
1:40:56All right. Well, I'm done. Thank you for
1:40:59being here. Thank you for joining our
1:41:02day five training. Tomorrow it will get
1:41:05even better. Don't miss the opportunity
1:41:08to join our day six where you will be
1:41:10learning more strategies, more critical
1:41:14thinking. Thank you very much. God bless
1:41:17you. Bye-bye.

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