Equal analgesic doses of fentanyl, morphine, meperidine, and pentazocine increase common bile duct pressure 99%, 53%, 61%, and 15% above predrug levels, respectively. Hydromorphone is similar to morphine in that regard. That's distinct from an actual...
What are some examples of times you have frozen up? I think ACLS is every ICU nurses best friend. It's one thing to be certified, it's another thing to be confident with it. Then you have a starting point for action in any situation. Even if you don'...
NewHam CRNA replied to LonghornChic's topic in General Nursing
I've had this happen to me a couple times. It's seriously spooky. And you were clearly right to continue compressions. Patients in comas, if you open their eyes, will sometimes follow your finger with their eyes if you move it side to side right abov...
BIS monitors are neat. Not wildly advanced tech but it's something you might use in the ICU when you paralyze a patient. They're not perfect by any means - and most people who regularly read EEGs think they're nonsense. But i think the future of this...
All the above posters offered insightful comments. I'd just add that if a patient is actively dying, it is nice to have morphine you can give that frequently to keep the patient comfortable and prevent "air hunger" or cheyne-stokes breathing. Idk if ...
NewHam CRNA replied to NEMurse95's topic in Cardiac
So a few thoughts: Some of the infarcted area will recover because of collaterals. The necrotic myocardium is cleared, fibrous tissue/collagen is deposited and scarring is complete within about 7 weeks. So the ECG will evolve over this time. If there...
NewHam CRNA replied to Workinghard123's topic in Critical
I've worked both MICU and SICU at a few different hospitals. I think MICU is a better ICU to start in. No doubt it's challenging, and there's no reliable way to know which patients will be sicker in which unit - all depends on the hospital. That said...
Only a few times have I seen patients have a return of consciousness during CPR without ROSC. First of all, pat yourself on the back for doing damn good CPR. Second, it's almost always in patients who have very low EFs who arrest. Ketamine makes sen...
NewHam CRNA replied to XDeemerDogx12's topic in Critical
This is a very good, and very tricky question. I'm going to give some scattered thoughts: In undifferentiated cariogenic shock, norepi has been found to be an OK choice until the the cardiac process is identified. A few questions first - did the pat...
NewHam CRNA replied to Catticus11's topic in Critical
A number of sedatives/anesthetics cause myoclonus that appear similar to tonic-clonic seizures but are distinct from them on EEG: Propofol, etomidate, barbiturates (not used in US). It tends to happen with small doses of these drugs, but can be seen ...
Keep your chin up! That's exactly how your ought to feel at this point. Honestly you'll be constantly doubling-back because you forgot supplies for 6+ mo after you graduate and get a job and that's TOTALLY OKAY! Advice: 1) Make lists...as intense as ...
Definitely check out hospital policy because that's what'll get ya. That said, If you needed the line is should be perfectly fine to use. Maybe have some caution with things like vasopressors. As long as you resecure it, a picc line thats out even se...
NewHam CRNA replied to NurseSonata's topic in General Nursing
Some scattered thoughts: I agree with everyones comments - your patient's kidneys were properly compensating for the prolonged respiratory acidosis (CO2 retention), and that number alone isn't terribly worrisome given the clinical situation. You're r...