Loving the “learning thread”, kudos, TraumaInTheSlot! It’s great to have access to so many sharp nurses. As an LTC RN some of this stuff is way out of my specialty; however, I like learning about what’s happening on the front lines/cutting edge of medicine.

(I once saw a thread that was a case study of a pt with COPD. It was also very informative and a good refresher.)

Originally Posted by TraumaInTheSlot

succs is contraindicated in head trauma with intercranial pressure. u dont want the vesiculations, you can premedicate with lido to reduce them.

All correct. Fasciculations are not a small matter. Sux is a depolarizing muscle relaxant, causing a brief contraction of all skeletal muscles. Many patients paralyzed and intubated with sux wake up complaining of all over muscle pain. Fasciculations can be eliminated (usually) with a small pretreatment dose of a non-depolarizing medication, such as Zemuron or Vecuronium. 5 mg of Zem, or 0.5 mg of Vec, given about 30 seconds prior to administration of the sux will suppress the fasciculations.

Kevin McHugh, CRNA

OK.... I just recently found this out and thought I'd share.
Question: When performing a bladder scan on a female patient, is there ever an instance in which you would choose the "male" option? Why?

You choose the male option if the woman has had a hysterectomy.

Originally Posted by TraumaInTheSlot

succs is contraindicated in head trauma with intercranial pressure. u dont want the vesiculations, you can premedicate with lido to reduce them. NEXT

Beta blockers do just that, block beta receptors while the cocaine stimulates alpha receptors, which can cause more htn and other problems, and make the patient worse.

good job

You can also give a defassicualting dose of vec prior to Succs

Originally Posted by magicman

You can use D50W instead of Glucagon too.

We use 10 u RHI, amp of D50, amp NaHCO3 (to correct the acidosis that usu goes hand in hand w/hyperkalemia)...also, the Ca is given to protect the heart...it has no effect on the potassium level itself...Also, Kayexcelate should not be given alone, as it does not acutely lower the potassium.

A good rule of thumb also....stop all NSAIDS, BETA BLOCKERS and ACE Inhibitors as they all increase potassium levels...

Originally Posted by zenman

Nope, 3-5pm is the time that ki is the strongest in the Bladder meridian. One of the psychological aspects of this meridian is anxiety/fear.

I would have thought it was because that is when the KIDS get home!!

Originally Posted by kevro1013

Great thread!
Here is one I had last week.
Pt pressents with abd pain and htn (BP 230/120). Non-contrast Ct abd and pelvis shows non-disecting AAA. MD orders nipride to titrate for BP >160/90. What type of medication does this pt need prior to nipride and why?
Kevin

Good one.

Beta blockers-decreases shearing force and incr HR.

I loved this thread-keep it coming!
Here is one we were discussing today- a positive "dolls eyes"-maybe an out of date term? What do the eyes do when you turn the patient's head and what is normal vs abnormal.

Originally Posted by ernurseafterall

I loved this thread-keep it coming!
Here is one we were discussing today- a positive "dolls eyes"-maybe an out of date term? What do the eyes do when you turn the patient's head and what is normal vs abnormal.

It's a neuro test-for lesion or loss of higher cerebral function- checking for deterioration
When you turn your head-your eyes should stay fixated on a certain point-that's normal

If abn-when you turn their head to one side-their gaze turns in the same direction-their eyes do not move , they're centered

Anne