MelissaS (644 Views)
Joined Nov 2, '09.
Posts: 7 (14% Liked)
That does seem confusing. We actually aren't supposed to dilute fentanyl the way described above. We have to draw up our dose in a 1ml syringe, then we can dilute it a little- but there is no rule as to how much it has to be. Our med tubing holds 0.7ml, so I'll usually dilute to about 0.5. What we can't do is add NS to the ampule to change the concentration of the Fentanyl, and then draw it up.
We have quite a few male nurses in my unit. I think we have 8. I don't think it's true about NICU nurses coming from L & D. Most of our nurses have either been in NICU forever, were originally new grads, or came from peds.
I have both. I prefer the book by Merenstein and Gardner. I feel like it goes into way more explanation then the other. Plus one is ALL in outline format (Core Curriculum for Neonatal Intensive Care Nursing) and the other isn't. So it depends on what you are wanting the book for. When we took our test as new grads I would have loved the outline format because we were looking up a lot of questions, it was a take home test and it was very hard. But if you want to sit down and read something, and you want it broken down better, then I prefer Merenstein and Garder.
I remember learning in nursing school that if the tube was actually in their lungs you would still hear the sound. But when I listen, and I'm pretty sure when everyone else listens, I can tell that the sound is coming from right below where my stethoscope is placed. I'm assuming that if I was listening and the tube was in their lungs, it would sound a little different. This has actually never happened to me, but it did happen to a nurse a few weeks ago, and she could tell that it didn't sound right.
We verify placement the same way you would in an adult. We either check for stomach content, or auscultate. I don't know what more you need to verify placement. I learned this in nursing school. We were also taught that you could check the pH, but we don't do that.
As for depth, we use the different methods mentioned above. I don't think all nurses measure the same. Occasionally after a baby has had an Xray the docs may write to advance or pull back the OG/NG by so many cm.
We don't use a line of stopcocks at all. We only use stopcocks on our PALS and UACS. Everything else has double and triple lumen Y connectors.
Sometimes we get kids back after PA banding. Only our preemies. They'll have a totally different set up. There's a big disk of stopcocks. Once the kid is settled, we change everything back to the way we do it.
Our NICU also uses rubberbands. I don't like them so much on the little babies because it seems like the pull on the skin. What I've been doing lately is pulling off the cloth/elastic from the side of the yellow masks you use when a baby is in isolation. It's softer, so I like using it better. It's also usually closer then going to get a rubberband.
I also don't think there would be much of a market for a baby tourniquet.
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