Richard_Head

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1. NA's, Please tell me this isn't common practice!

   Richard_Head replied to traumaguy8's topic in CRNA

   Just finished browsing through this thread and my 2 cents: When an anesthesia resident is in the process of intubating a patient, who is legally responsible for the outcome of that process? The anesthesia resident. If they tell you to zip it because ...

2. Lasix and CRF

   Richard_Head replied to WonderRN's topic in Emergency

   Lasix is not particularly helpful in this situation. Yeas lasix works in the Loop, if I recall it acts at the Na-K-2Cl cotransporter. It will not trick dead glomeruli into working. It is also probably not harmful. Nitroglycerin is a venodilator but a...

3. Paradoxical Respirations in SCI?

   Richard_Head replied to jelly221,RN's topic in Student Assist

   This is a good question. I am not certain but I think a non-obese patient with a T1 lesion in the supine position will have difficulty generating a diaphragmatic excursion (thus creating a tidal volume) because the abdominal viscera will pull down on...

4. Edema question???????

   Richard_Head replied to kalhonaaho's topic in Student Assist

   Hypervolemia does not cause edema. A change in the balance of net pressures between the tissue and the vascular system causes edema. Hypervolemia can contribute by increasing intravascular hydrostatic pressure (which favors fluid deposition into tiss...

5. Autonomic drug help

   Richard_Head replied to cmonkey's topic in Student Assist

   You are on the right track to a BASIC understanding of the ANS. It's easiest to think in terms of receptor and effect (affinity). Endogenous catecholamines often act different than exogenous ones (they can target receptors more specifically). Epi eff...

6. lawsuit

   Richard_Head replied to Ms.RN's topic in General Nursing

   Lawyers add everyone they can get away with to the suit, that allows them the most felxibility.

7. Toprol and MI?

   Richard_Head replied to fabi_guerra22's topic in General Students

   Toprol is not always indicated post-MI. It is useful in reducing cardiac O2 demand. If the ischemia/infarct is demand (tachycardia) related metop can be useful. The heart is unique in that it's tissue oxygen extraction is about 70-75% compared to 25-...

8. Is there an easy way remembering cardiac medications?

   Richard_Head replied to rn2bn07's topic in Student Assist

   The simplest way to approach this is to re-read the autonomic nervous system chapter in your A&P book, if you don't have a good recall of the underlying systems it's not very effective to try and understand the pharmakokinetics/dynamics of the me...

9. What got you into school?

   Richard_Head replied to RNextraordinare's topic in SRNA

   3 Previous degrees adult and pediatric CCRN GPA 3.8 GRE 1390 3 years RN experience: Flight Nurse, STICU at level trauma center, PICU/peds TCV accepted on the spot at first interview

10. Question regarding drug administration to an infant

    Richard_Head replied to pinkfluffybunny's topic in General Nursing

    Be aware that if it a medicatio ordered as part of their hospital stay you will be the legally responsible party for any irregularities related to the administration of the med.

11. Anyone know what happened to the CNL?

    Richard_Head replied to Joe NightingMale's topic in Post Graduate

    It's always good to get additional education...but....degrees like MSN/CNL that don't specifically translate to revenue generation for a hospital are somewhat risky. I have worked at a place that went with the trend and hired several CNLs but as soon...

12. Should I be concerned/

    Richard_Head replied to milksteak's topic in General Students

    Your school may have accreditation problems with a pass rate that low.

13. First yr nursing student needing help with drug opposites!

    Richard_Head replied to lillian2010's topic in Student Assist

    Imitrex is not a good choice for this assignment. Go easy on yourself and do a alpha agonist (phenylephrine) vs alpha antagonist (hydralazine) or beta agonist vs antagonist etc.

14. Postpartum care plan - r/f imbalanced fluid volume?

    Richard_Head replied to linnaete's topic in Student Assist

    A more exact measure would be to analyze fluid loss during delivery vs fluid replacement and ongoing urine output. Average EBL for vaginal delivery is 500-800ml and for a ceasarean section is 1000-1500ml. Replacent should be 1:1 with colloid or 3:1 w...

15. Nursing care plan- risk for fluid volume deficit

    Richard_Head replied to babycookie's topic in Student Assist

    What were the pre-op vital signs vs post op vital signs? What was the pre-op HGB/HCT, intraop EBL, and intra-op fluid admin totals? As a rule of thumb blood loss should be treated with 3ml of crystallloid for 1ml blood loss or 1ml colloid for 1ml blo...