Latest Comments by Double-Helix

Double-Helix, BSN 26,357 Views

Joined Apr 5, '11 - from 'New Jersey'. Double-Helix is a Nurse, Children's Hospital. Posts: 2,741 (50% Liked) Likes: 4,791

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  • 0

    What is your facility's policy regarding administration of chemotherapy? Many hospitals only allow nurses who have received special education/training in chemotherapy to administer those drugs. That education may help you feel more comfortable.

    Typically, chemotherapy is given through a central line, because all chemo meds are either irritants or vesicants, and safety of delivery is increased through a central line. However, it can be given through a PIV in some circumstances, such as early in diagnosis when central line access hasn't been established, or when long term infusions aren't needed. The IV should either be newly placed, or you should be certain of placement within the vessel evidenced by rapid blood return before, during, and after administration. In my experience (which I'll admit is limited), the only chemo agents I've given through a PIV are those given IV push, when blood return can be checked throughout administration. I haven't given infusions through a peripheral line.

  • 0

    You'll be fine. It depends on what kind of MSN you're looking for, but really, most general MSN programs aren't all that competitive. If you were going for something like CRNA you might be faced with more competition. Many MSN programs don't even require that you take the GRE if your GPA is above a certain level, usually about a 3.4 (B+ average).

  • 1
    offlabel likes this.

    It depends on the program. 1 is a bare minimum. In my opinion, you need at least several years of ICU experience- and general nursing experience- in order to have the skills and knowledge necessary to be a successful CRNA.

  • 1
    vanilla bean likes this.

    Medical management speaks to the plan of care. What equipment is required to care for this patient and ensure survival/recovery? What medications are needed? What tests need to be performed? Etc.

    Nursing management speaks to the specific actions that the nurse will take within his/her scope of practice to care for the patient. What will the nurse assess for each shift? What will the nurse to do make sure the patient remains free from injury or complications from hospitalization? Think about nursing diagnoses for this patient when you're answering. In terms of writing the goals, think about your SMART goal criteria.

  • 1
    chare likes this.

    I agree with providing rationale and showing how to break down an equation. The problem is, the method you used to solve OP's homework question is only applicable to this specific question. The steps of: "Break 90 minutes into 30 minute increments, Divide total volume by 3, Multiply that answer by 2." Only work when applied to a question that asks you to infuse over 90 minutes. What if the OP's next question asks him or her to infuse over 45 minutes? OP will not know how to solve that problem because the method of breaking down the volume into incriments of 30 doesn't work.

    Conversely, using the formula in the link Esme12 provided:
    Volume in mL/Time in hours=mL/hr
    can be applied to any question regardless of the specific volumes or times provided. Does that make sense?

  • 21
    vanessaem, MaxAttack, CCU BSN RN, and 18 others like this.

    Many people do not understand the difference between gastroenteritis (stomach flu) and influenza. Real influenza is a serious respiratory illness and kills many people each year- particularly the old, young, and immunocompromised. The flu shot does not cause the flu. Some people do have an immune response to the vaccination characterized by mild cold-like symptoms. There is no increased risk for reaction if someone has never had the flu shot before. The flu vaccine is developed each year based on what is predicted to be the most prevalent strains, but it doesn't cover everything one. If someone gets influenza after getting the flu shot, it doesn't mean that the flu shot didn't work. It means that they likely contracted a different strain of the virus.

    Encourage your husband to do some research and talk to his doctor. We can't provide medical advice here, and whether your husband should receive the flu shot is something he needs to decide in conjunction with his doctor based on his medical history and present circumstances.

  • 1
    chare likes this.

    Quote from Noctor_Durse
    OK. I'm a student but I will give it me best explanation. So 130ml/90 minutes. So 90 minutes =1.5hr.
    We can break up 90 minutes into 30 30 30.
    If we divide 130/3= 43. So that means the pump is going to run at 43ml/30 minutes. So let's just double that and make it 86ml/60 minutes and let it run for 90 minutes.
    Someone please stop me if I'm wrong.
    In my opinion, this is way over-complicating the problem. You have a total volume. Divide it by the number of hours you want to infuse it over and call it a day.

  • 0

    Part of answering nursing-style questions is learning to read the question and analyze what information is important and what is irrelevant. What is really being asked of you?

    In this case, you need to find the drug volume, which you calculated correctly. Then you're asked to dilute that amount with 125mL of D5W. So what is the total volume that you are administering?

    And if you're administering that amount over 90 minutes, how many mL/hr is that?

  • 2
    Esme12 and brains090 like this.

    Quote from brains090
    I have been working on these problems for 3 hours now. The professors did not go over drops per minute calculations. Please help!

    The label states to add 10ml sterile water for 1g of cefamandole for IV solutions

    Order: cefamandole 500mg, IV, q6h
    Set and solution: Calibrated cylinder with drop factor, 60 gtt/mL. 500ml of D5W.
    Instruction: Dilute cefamdole 500mg reconstituted solution in 50 mL of D5W and infuse in 30 minutes. Determine gtt/min.
    There's a lot of information in the question that you don't need. So let's start by eliminating the unnecessary words.

    What is the total volume of the drug you're going to administer? The question did that math for you: 500mg of drug in 50mL of fluid. So 50mL is the volume you're going to give.

    How quickly will you administer the drug? Again, this is provided for you: over 30 minutes.

    Your tubing has a drop factors of 60gtt/mL. That means for every 60 drops, 1mL of medication will be given.

    So now you can use the formula: (Volume in mL/time in minutes) x drop factor = drops per minute.

  • 1
    chare likes this.

    Universal precautions does not specify the use of any PPE. Universal precautions refers to treating all blood and body fluids as though they are potentially infectious. Therefore, in universal precautions, you wear whatever PPE is appropriate related to your potential exposure to blood or body fluid. This includes things like wearing gloves during IV starts or wearing a mask with a face shield when performing suctioning. So if the patient is on droplet precautions, a mask is the only PPE item required, but if the patient was actively coughing, or you were suctioning, an eye shield or gown may be appropriate.

    Without seeing the exact wording of the rationales, I would say uworld is correct.

  • 0

    Are you in the US now? You don't typically have to "prove" employment with another facility by providing paper records. Do you have colleagues or a supervisor at this facility that you are friendly with or have stayed in contact? If so, I would list that person as a reference from that institution. You would otherwise just list your work experience with accurate dates and, if the employment gap comes up in an interview, you say you took time off to care for family.

  • 0

    What do you have so far? For a new grad, the typical resume will include: School, Degree, Date of graduation, GPA (if it's good) and any distinguishing awards, groups, or activities. It also should include past work experience (even if not nursing related). Any additional licenses or certifications that you hold (BLS, CNA, etc) would be included. If you're applying to a facility where you have done clinical rotations and made a good impression, put that experience on your resume for those positions.

  • 2
    NurseKatie08 and Kuriin like this.

    It's pretty standard in many hospitals that inpatients be on an H2 blocker to reduce amount/acidity of stomach acid to protect the lining of the stomach and esophagus. Many factors associated with being the hospital- such as stress, lack of regular diet, medications, and vomiting, all create risk of stomach ulcers or bleeding. The pepcid helps mitigate that risk.

  • 13

    Stories like this tend tend to run rampant in hospitals and schools. Usually they exist to "scare" students or staff into paying close attention to certain issues having the potential to cause harm. Yes, wrong site surgeries do happen, but they are never due to the error of a single person.

    Sometimes these wives' tales begin as humor and get perpetuated because it just sounds so crazy it must be true. You know, even though I work in one of the largest children's hospital systems in the country, and even though everyone and their mother knows someone who knows the infamous twins, Lemonjello and Oranjello, I have yet to see their name on a census board.

  • 3
    loveofrn, RainMom, and RenKenn72 like this.

    One of the functions of the liver is to help bilirubin bind (conjugate) into something water-soluable so it can be excreted in the urine and stool. Bilirubin is a byproduct of the "heme" part of hemoglobin created when red blood cells are broken down. In infants, immature livers often mean this byproduct can't be conjugated and excreted quickly enough, causing a build up in the blood stream called jaundice. The point of phototherapy is to use light waves to transform the unconjugated (also called indirect) bilirubin in the blood into a water-soluable form so that it can be excreted while bypassing the liver.

    So, based on that explanation, you'll see that a blood test to measure hemoglobin or RBC level wouldn't tell you whether phototherapy is indicated, because that level reflects healthy red blood cells, not those that have been broken down. That leaves you with your second choice, plasma bilirubin levels, specifically indirect/unconjugated bilirubin.