km5v6r EdD, RN

km5v6r has 25 years experience as a EdD, RN and specializes in Acute Dialysis.

Latest Activity

1. Dialysate temperature in hemodialysis

   km5v6r replied to Chisca's topic in Urology

   I agree in an ideal world the room temp would be high enough that the pt is comfortable without additional blankets etc. Unfortunately I have to work in the room with the pt. I have to wear a full paper lab coat with long sleeves, gloves, and mask ...

2. 13 things a nurse won't tell you

   km5v6r replied to ShayRN's topic in General Nursing

   Big Gulps and dialysis equals cramping. You skip your outpt dialysis appointment and then have the ER call me in at 0400 for an emergency treatment and you will have a new dry wt. All the money you just spent to get high and or drunk before dialysi...

3. incontinent NH pts

   km5v6r replied to 3cdn1usa's topic in Urology

   Keep in mind that an Art line has a continuous flow of fluid INTO it from a pressure bag. A dialysis needle has to have the ability to withstand the continuous PULL of blood through the needle at a rate of 400-500 ml/min and maintain the pressure of...

4. Has anyone EVER seen a patient come off CRRT alive?

   km5v6r replied to rph3664's topic in Urology

   CRRT is continous renal replacement therapy. It is a long slow dialysis. Pt's in renal failure, either acute or chronic, who are to unstable to tolerate hemodialysis may be started on CRRT. Instead of being done in 3-4 hours the treatment ideally ...

5. dumping the prime

   km5v6r replied to sueinga's topic in Urology

   Do you ever give Albumen as a prime for unstable pts or pediatric pts?

6. dumping the prime

   km5v6r replied to sueinga's topic in Urology

   You should check the package insert that comes in the box of dialyzers to see manufacturers instructions. I know that the Optiflux dialyzers insert specifies that the prime be dumped prior to HD to prevent 'fibers' from going into pt blood stream. Th...

7. Has anyone EVER seen a patient come off CRRT alive?

   km5v6r replied to rph3664's topic in Urology

   I have seen both adult and pediatric pt's survive CRRT. Granted the ones that don't far out number the ones that do but some do survive; especailly with the adults. We currently have several peds liver/sm bowel transplant pts that have required CRR...

8. Can CNA do an accucheck?

   km5v6r replied to QuigRN's topic in General Nursing

   All of the hospitals in this area have the CNA's do the accu-checks. They report the results to the nurse who then act on the results. The hospital provides the training for the specific machine used.

9. Transplant in Elderly

   km5v6r replied to Pam RN's topic in MICU

   Your MIL probably developed a heptaorenal syndrome pre-op and it is continueing post-op. When the kidney's are "shocked" or stressed they may quit function for a time and take a while to recover. Even though urine is present it may not be "quality"...

10. Help! I need a BLScard ASAP!!!

    km5v6r replied to fostercatmom's topic in General Nursing

    Check with your local American Red Cross about a class. The AHA does do initial classes also; you may have to check with some of the local schools or the local ARC office. The only difference I found between the two is that the ARC expires in 1 yr ...

11. I'm Taking a Poll

    km5v6r replied to NotReady4PrimeTime's topic in PICU

    Almost 90 on Tuesday and snow today. Typical. This type of weather in March though is scary. Probably means the summer will be hiddously hot and long. The CPR class was short and good. I am actually glad to take the class with all the changes b...

12. I'm Taking a Poll

    km5v6r replied to NotReady4PrimeTime's topic in PICU

    Good Grief!!! Makes me even happier to be where I'm at. We are slowly converting over to computer charting and things like the Braden are already on the computer. We just don't have enough computer terminals between the med students, nursing studen...

13. I'm Taking a Poll

    km5v6r replied to NotReady4PrimeTime's topic in PICU

    Interesting. The rational behind nasal intubation makes sense but the sinusitis would be a major deterent. We rarely have an incident of VAP. Many times our kids do have an NGT in one nares and an NJT in the other. These tubes are usually place d...

14. CVVH/CRRT ques.

    km5v6r replied to first_lobster's topic in MICU

    Sorry to be so slow responding. I have been bogged down working. Where would replacement solutions be running? We generally run replacement both into the arterial chamber prefilter and into the venous chamber post fluid. The theory being that th...

15. I'm Taking a Poll

    km5v6r replied to NotReady4PrimeTime's topic in PICU

    Sorry I can't help with the heart surgery aspect as we don't do any heart's. We do the major bowel and liver transplants. Some of our kids will be on the vent for months; one for neary a year before finally trached. Rarely will our docs nasally in...