Latest Comments by hypocaffeinemia

hypocaffeinemia 12,937 Views

Joined Feb 25, '06. Posts: 2,127 (59% Liked) Likes: 3,651

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  • 1
    leslie :-D likes this.

    Dunno if you guys remember me because I barely post here since graduating, but I've been an S/MICU RN since May 2009, recently became the full-time charge nurse for the next door combined stepdown/MICU unit, and their manager just stepped down due to personal issues. Long and short, I'm now in that position. ADN, but enrolled in an online bridge to BSN. It also helps that I have worked at this facility for 7+ years and the critical care director has long wanted me in such a role. Being CCRN also carries equal if not more weight than the BSN.

    The only real concern is that some of the staff under my watch were here three+ years ago when I was their monitor tech, so I have to prove my worthiness daily.

  • 1
    greenerpastures likes this.

    What I do for ativan:

    1. Take a 10 cc pre-filled flush syringe.
    2. Place blunt needle on it.
    3. Expel 1 cc of fluid.
    4. Draw up ativan so that total volume = 10 mL.
    5. If I need to only give 1 mg I waste half in the sink.

  • 0

    1000 mg dopamine in 250 mL.

    You're giving 13.5 mL/hour.

    Cross multiply this and you find that you're giving 54.16 mg an hour.

    54.16 mg divided by 60 minutes in an hour divided by the patient's weight in kg yields 12 mcg/kg/min.

  • 0

    Quote from leslie :-D
    it just wouldn't make sense that the millions who have experienced nde, were all hypercapniac??

    to me, it makes better sense that since we only use approx 10% of our brain, the remaining 90% is capable of functions we have no idea that even existed.

    leslie
    The "We only use 10% of our brain" thing is a complete myth.

    Were it true, traumatic brain injuries would be a walk in a park for most people, heh.

  • 2
    vanburbian and canoehead like this.

    Quote from rotteluvr31
    This just made me curious, how does this work legally if I'm licensed in one state and taking orders from an MD who is who knows where and I'm somewhere above a different state or country? How does the emergency situation supercede my license to a particular state BON?

    (After reading all the posts I now know the MD is in AZ)
    Dunno. If I were placed in such a situation, I'd rather ask forgiveness than permission, though.

    I do know that AZ is a compact state as is TX where my license is, but I dunno if taking an order from a doc in AZ means I'm practicing in AZ as well. Doubtful, actually.

  • 2

    LINK: http://news.nationalgeographic.com/n...arbon-dioxide/


    I'm very happy this was studied. For years on this site and others, I've long defended my empirical worldview by stating there was likely to be some physiological explanation for what some people experience in near-death situations and that it is wrong to automatically assume and assign supernatural properties to them.

    I think this warrants further studying, but such strong correlation between pCO2 and NDE is very interesting.

  • 10

    Having a favorite politician is akin to having a most enjoyable place on your body to receive a papercut.

  • 2
    Armygirl7 and XB9S like this.

    Cover it with something sterile, get baseline labs, and start fluid resuscitation per the Parkland formula.

    I know ER tends to prioritize the active wound, but the burn will be nothing compared to the problems from possible rhabdomyolysis, hyperkalemia, acute kidney failure, lactic acidosis, etc.

    Acting ASAP helps to reduce the severity of those secondary problems that aren't often present until after transfer out of the ER.

  • 6

    Quote from KeeperMom
    the correct answer is......drum roll please.......

    B. "Are you married?"
    Rationale: While obtaining the health history the nurse should ask because it addresses the patient's psychosocial status.
    I keep having to remind myself..."when in doubt, think Maslow." I've heard that so many times and how you should always think about those needs when answering these types of questions.

    I think I got the question right at least!

    meredith
    That's just brilliant.

    "Excuse me, sir. May I interrupt your dying to find out your relationship status so that I can properly assess your psychosocial needs? "


    On top of that, it doesn't even address the question asked. Key words in bold:

    "...Which of the following [may] best help with determining why the client is currently having health problems?"

    I don't see why or how the patient's marriage status (which is quite a bit different than psychosocial wellbeing in its own right!) is relevant to current health problems.


    You're absolutely right to think Maslow. In this patient's case, stabilizing his physiological status takes the top priority. It's the bottom of the pyramid for a reason.

    Heck, if you look at the ABC's his C is in very poor condition and his B is quickly deteriorating.

  • 3

    Less passive-aggressive behavior, for one. If people upset/disappoint/anger me they know about it from me.

  • 1
    RNperdiem likes this.

    CDU is the politically correct term for "serial troponins until negative = discharge or positive = cath then IMU/ICU or stress" unit.

    Also known as "Fancy Observationland" or "Med/Surg Overflowland".

  • 7

    I'd go with D for excess sodium / fluid intake. And I'm only partially joking.

    The problem is the answer choices all avoid asking directly relevant questions merely to throw students off.

    If I ask if someone's been out of the country lately here in Texas, they could have been just as likely to hopped on a cruise or to have driven over the border into Mexico. It would be wrong to assume "international flight = DVT" in this case, especially when the symptoms are not those of pulmonary emboli, per say.

    Hx CHF plus the current symptoms scream exacerbation of CHF, so then narrow down to what would possibly exacerbate it. Being married, babysitting, and traveling don't particularly or directly exacerbate CHF. Although I suppose one could make a case for forgetting to timely take medications while traveling.

    Another quality question designed to trick students instead of teach them. In reality, people ask "Have you flown more than two hours recently?", "have you taken all of your prescribed medications on schedule?", and "Has your diet changed or been modified in some way recently?"

  • 1
    MassED likes this.

    ICU Here. We had an incident last year that led to us only being able to silence the alarm at bedside, not at the nursing station. Makes responding very fun...

    As for number of monitors per monitor tech ratio, as a former monitor tech and the guy leading that committee for the design of our new building (opens next month!) we did a ton of research and we can't find any standards anywhere. We (not I) agreed to a 50-patient cap per monitor tech based on practice at other facilities. I agree it is too many, but there is literally no literature out there that looks at what should be considered safe practice for monitor techs.

  • 1
    vanburbian likes this.

    While I've never witnessed any need for medical intervention on a flight, I used to work with a nurse who was also a flight stewardess. She once mentioned that while obviously you're concerned with "scope of practice" issues as an RN responding, pretty much all companies have a medical liason (e.g. MD) in radio contact with whom you can speak to and receive orders from to cover yourself legally if you need to intervene.

  • 2
    Not_A_Hat_Person and Moogie like this.

    You guys realize a good many of our medicines come from extracted, purified, and concentrated natural sources, right?

    And you understand the benefits of having that process regulated, right?

    The two obvious examples are belladonna and foxglove. How DARE the companies try to make money off of mere plants! Why, I do believe we'd all be better off with unregulated and untested atropine and digoxin (respectively)!


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