queenjulie RN

queenjulie has 13 years experience as a RN and specializes in Step-down, cardiac.

Latest Activity

1. DMV reporting of unsafe driving

   queenjulie posted a topic in HIPAA

   Got a dilemma: I am a nursing risk manager at a family practice. PA at our office has a patient who is refusing all treatment for what are probably multiple (now old) strokes. Has fairly serious motor deficits, but can walk and talk. Pt is a pro...

2. Reno/Sparks RN salary?

   queenjulie posted a topic in Nevada

   My husband and I are considering relocating to Sparks to be near family who moved there, and because my husband is retired Navy and interested in working for Tesla. I'm an RN with five years' experience primarily in telemetry and Step Down with some ...

3. Orders from hell...

   queenjulie replied to Leonardo Del Toro's topic in General Nursing

   I got a new admission one time of a CHF patient, and the family was furious when they asked what diet he had ordered, and I told them it was our low-sodium cardiac diet. They insisted, "He doesn't eat ANY salt! He has heart disease! He is on a NO SAL...

4. Is this real? Vein light

   queenjulie replied to ladysushi's topic in General Nursing

   Yep, it's real, and I've used it a bunch of times. Whether it's helpful is a mixed bag. It can give you a good view of the location of veins in someone with very dark skin, which is the best benefit as far as I'm concerned. However, it doesn't help y...

5. Magnesium for oxygen absorption?

   queenjulie posted a topic in Cardiac

   I got an ER admit today who has COPD exacerbation. The ER nurse reported that she was given 2 g of magnesium IV to help with her oxygenation. I'd never heard of such a thing, and neither had the most senior nurse on my unit. I Googled and found one s...

6. Bleedind at PIV insertion site

   queenjulie replied to tg982's topic in Cardiac

   SummitRN is quite right--it's incredibly common to have a little blood leaking around a heparin or Integrilin drip, because they are anticoagulants. Now, if it's bleeding a lot, or the IV won't flush or the arm is swollen or something like that, that...

7. Coumadin therapy

   queenjulie replied to IM4patients's topic in Medications

   I'm on a primarily cardiac, high acuity step-down unit. Our Coumadin patients generally get a PT/INR every day or every other day, and if they're new to Coumadin, we refer them to our local Coumadin clinic, where there is a specific protocol. I think...

8. Lexiscan vs. stress echo

   queenjulie posted a topic in Cardiac

   I'm on a Step-Down tele unit, primarily cardiac, and I just realized that I don't know the difference between a Lexiscan and a stress echocardiogram. Can anyone explain? It seems to be the difference checking for blood flow versus structural abnormal...

9. Pushing a Cardizem bolus

   queenjulie replied to queenjulie's topic in Cardiac

   Thank you! I thought I was going crazy when she said that!! I'm wondering if maybe she was thinking of Primacore. That makes me feel so much better!

10. Pushing a Cardizem bolus

    queenjulie posted a topic in Cardiac

    How slowly do you push a 20 mg Cardizem bolus on a person with afib with RVR? My patient was an elderly woman with stable BP but HR up to 150 BPM. I pushed her Cardizem bolus over four minutes and her BP stayed stable, but within ten minutes, her fra...

11. PCCN--is it worth it?

    queenjulie posted a topic in Cardiac

    Is getting a Progressive Care certification worth it? If you have one, did it help your career at all? I'm a relatively new nurse on a Step Down unit; I've been an RN for a year, so I'm just now qualified to get certified. My hospital just had a roun...

12. petechia/purpura during dying

    queenjulie posted a topic in Hospice

    I had a patient recently who was actively dying, and during her last few days, she developed petechiae and purpura essentially all over her entire body. It was more than usual, but I know that petechia is very common in the elderly. Her family asked ...

13. Any ADN-BSN programs without ridiculous papers?

    queenjulie replied to adnrnstudent's topic in Online Learning

    Why would a college *not* require you to write papers? Learning to do research and write critical papers is a vital part of a college education--one of the most fundamental parts, in my opinion.

14. Med/Surg Experience

    queenjulie replied to hoverton's topic in General Nursing

    Honestly, our local psych facility is so understaffed that they definitely don't require anything but an RN after your name to work there. I'm sure they prefer med/surg experience or other psych experience, but it's not mandatory. But it's not a grea...

15. Accuracy of Automatic BP machines?

    queenjulie replied to blackvans1234's topic in General Nursing

    We used to have that kind of BP cuff, but our hospital got rid of them because of concerns about infection, so now we have disposable cuffs that come sealed, and we give each patient one on admission and throw it away when they go home. Apparently th...