adria37

adria37 has 21 years experience and specializes in Emergency, Outpatient.

Latest Activity

1. Don't trust my FNP

   adria37 replied to KalipsoRed21's topic in NP

   Why did he get the DVT in the first place? Risk factors? Obesity, smoking, travel, dehydration, surgery, malignancy? Did he have a hypercoaguable workup? Bleeding in the joint? Clot extension? I would ask for a face to face or a phone call from t...

2. Cause of elevated alk phos. in bloodwork?

   adria37 replied to Iggy123's topic in General Nursing

   Cancer in the bone, gallbladder disease, normally elevated with rapid bone growth, hepatitis, mono, gosh there are lots of reasons, parasites etc.

3. Anemia: am I the only one who thinks it's all complicated?

   adria37 replied to BmoreCRNP's topic in NP

   I would do stool for occult blood, erythropoietin level, B12, folate levels, don't forget anemia of chronic disease and MDS in your differential. I suspect her anemia was secondary to infection, CRF, with what you are describing and the rest of her...

4. Difficult family members/visitors

   adria37 replied to anewday's topic in General Nursing

   I can't help but believe this comes from management marketing nurses as servants, waitresses (no offense) and handmaidens instead of the educated professionals that we are.

5. Struggling for a research proposal topic

   adria37 replied to slimmom3's topic in Oncology

   I would check to see if when a narcotic is written is there any documentation of sedation and constipation management and on the next visit see if pain relief is addressed again as well as constipation/sedation.

6. AANP or ANCC?

   adria37 replied to nursetim's topic in NP

   I took both the AANP and the ANCC exams for FNP. AANP you sign FNP-C and ANCC you sign FNP-BC (C=certified and BC=board certified). The AANP seemed more difficult and clinically focused. I believe I could have taken the ANCC exam and passed without...

7. Cipro and ITP. What would you do?

   adria37 replied to tmd76's topic in Emergency

   Surely they were not getting IV contrast too? I wonder what happened at the meeting.

8. Cipro and ITP. What would you do?

   adria37 replied to tmd76's topic in Emergency

   An allergic response can also cause ITP to develop and worsen but based on his low plt count prior to Cipro IV I would still lay it at the sepsis unless his reaction to Tequin was ITP. He is on dialysis was the previous reaction diabetic related? Te...

9. Cipro and ITP. What would you do?

   adria37 replied to tmd76's topic in Emergency

   If their kidney function was bad why in the world would they give Cipro in the first place. ITP can be worsened by infection (IE will be). I would expect a doctor know this about ITP. http://www.emedicine.com/emerg/TOPIC282.HTM

10. Oh No! A port infection!

    adria37 replied to Sonjailana's topic in General Nursing

    Most chemotherapy drugs have nadirs at 10-14 days any open area is fair game. I would be interested in what the cultures grew, I bet a staph epidermis. If you used sterile technique then I would not feel bad about it. TPN is a great medium for bacte...

11. Oh No! A port infection!

    adria37 replied to Sonjailana's topic in General Nursing

    I would question why they had the port. (cancer, chemotherapy, etc) They probably had a suppressed immune system to begin with and an infection a week later would really be reaching IMHO.

12. Nicotine Test

    adria37 replied to NurseDianne's topic in General Nursing

    I can see it coming, I don't smoke but I really think allowing companies not to hire based on LEGAL behavior is wrong. Obesity causes more health problems, burdens the system more, and costs more than smoking. I am waiting for companies to not hire a...

13. So angry right now. Warning: Extremely long

    adria37 replied to HappyPediRN's topic in Relations

    I am so sorry you are going through this. I know it is extremely frustrating. You need and your father needs, to be at a place you guys are comfortable with the level of care he is receiving. I am surprised that your father's physician, the one who ...

14. ACUTE MI -PT/INR results! I need explanation!

    adria37 replied to curious4life's topic in Cardiac

    I don't believe a protime is not measured in seconds either :)

15. ACUTE MI -PT/INR results! I need explanation!

    adria37 replied to curious4life's topic in Cardiac

    That has to be a mistake IMHO to have a PT of .06 and INR of 1.8 INR = PT- test/PT-normal Normal is roughly 1 and blood that takes twice as long to clot than "normal" would be 2. I would question the test.