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himilayaneyes, MSN, APRN 8,212 Views

Joined Jul 4, '10 - from 'Florida'. himilayaneyes is a ARNP. She has 'since 2008' year(s) of experience and specializes in 'Critical Care/Coronary Care Unit,'. Posts: 502 (44% Liked) Likes: 667

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  • Aug 31

    Beta blockers as you know decrease the workload of the heart. They also as you say decrease afterload. This is going to be your best friend. CO = HR x SV. Cardiac output = Heart rate x Stroke Volume. Cardiac output = volume of blood pumped by heart per minute (liter/min). Stroke volume = volume of blood pumped from one ventricle per minute (usually left ventricle). Remember that stroke volume consists of preload, afterload, and contractility. If any of these three things are affected, it affects stroke volume....thus affecting heart rate and cardiac output. When one goes up, the other usually goes down. If stroke volume goes down, HR goes up. If beta blockers decrease afterload (resistance heart must work against to pump blood into periphery) and contractility, the blood pressure will decrease b/c you're vasodilating. Heart rate goes down, stroke volume (compensatory mechanism) goes up.

    However, the easiest way to think of it is that you know that beta-blockers affect the sympathetic nervous system which causes you to vasoconstrict and increase heart rate. If it's working against the SNS, it'll have the opposite effect..lower BP and lower HR. However, that formula I gave you is still good to know especially for the cardiac section of your med-surg class. Good luck.

  • Mar 15

    Well that social worker sounds like she has nothing else to do. If she felt what you did was inappropriate, it would have been better for her to approach you. I don't work LTC for a reason...it's always the same stories from these LTCs. I know at the hospital, if I have a medication that isn't essential and a patient that's oriented. I'll give him the cup of meds to take and when I make my rounds to check up on him, the patient says they took their meds. If the patient is confused, well yeah I'll stand there and watch them take the meds. Even if you took a short cut...we all have at some point so I won't sit (type) here and throw stones at you. It would have been better for the social worker to approach you. Perhaps she should shadow a nurse for a bit to see what it is you actually do. However, I've noticed that some social workers will have problems with things nurses do...things they don't even really understand. There's NCLEX world and then there's the real world of nursing. Next time you see her, tell her "welcome to the real world."

  • Feb 5

    It's so true....everyone and their mother is a nurse. You talk to them and find out their a CNA or hospital secretary. RN is definitely a title you bust your butt to earn. The funny part is that if these "perpetrators" portray themselves as nurses and say go into someone's home to care for them as a nurse...they can prosecuted. Be proud of who you are. Maybe hospitals should make a list...CNA not a nurse, Unit secretary not a nurse, Janitor not a nurse, Resp therapy not a nurse, phlebotomist not a nurse, you plan on going to nursing school...still not a nurse. You graduated from nursing school...awesome...still not a nurse yet. Just b/c you work at a hospital or doctor's office..not a nurse. Nurse equals someone who passed the NCLEX-RN or NCLEX-PN and has a nursing license. Patients should start asking to see our nursing licenses since everyone these days is a nurse.

  • Dec 16 '16

    I do believe requiring all nurses to have ACLS is a trend in hospitals now. Yes, there is a code team at your hospital. However, if the patient needs something right away before the code team gets there who's going to give the drug...you can't if ur not ACLS certified. Codes do happen on a med-surg floor, labor and delivery, and so on. And although rare we have had two codes on my floor at the same time...so if med-surg happens to call a code at that time.....who's coming (not me...plus the people not in the code are watching the other patients)...hope there are some ACLS certified nurses over there to run the code. Every health care worker needs to know what to do. This also decreases liability for the hospital. It's a good thing, it'll save more lives. Instead of pts being in unstable SVT on a med-surg floor on the other side of the hospital, but the ICU is on the other side of the hospital (a journey at my facility). Why wait for the patient to get worse when those med-surg nurses can do something about it right then and there? I'm all for it. It's all about patient safety Plus, ACLS isn't that big of a deal. I just renewed mine. Since it'll be required for your job, they should pay for the class and pay you to attend....all good things in my book.

    P.S. A lot of hospital are moving towards cardiac monitors being on every floor as well. Continuous telemetry for all patients. Any area with monitors must have ACLS certified nurses.

  • Dec 16 '16

    I do believe requiring all nurses to have ACLS is a trend in hospitals now. Yes, there is a code team at your hospital. However, if the patient needs something right away before the code team gets there who's going to give the drug...you can't if ur not ACLS certified. Codes do happen on a med-surg floor, labor and delivery, and so on. And although rare we have had two codes on my floor at the same time...so if med-surg happens to call a code at that time.....who's coming (not me...plus the people not in the code are watching the other patients)...hope there are some ACLS certified nurses over there to run the code. Every health care worker needs to know what to do. This also decreases liability for the hospital. It's a good thing, it'll save more lives. Instead of pts being in unstable SVT on a med-surg floor on the other side of the hospital, but the ICU is on the other side of the hospital (a journey at my facility). Why wait for the patient to get worse when those med-surg nurses can do something about it right then and there? I'm all for it. It's all about patient safety Plus, ACLS isn't that big of a deal. I just renewed mine. Since it'll be required for your job, they should pay for the class and pay you to attend....all good things in my book.

    P.S. A lot of hospital are moving towards cardiac monitors being on every floor as well. Continuous telemetry for all patients. Any area with monitors must have ACLS certified nurses.



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