Latest Likes For Lev <3

Lev <3, BSN, RN 52,894 Views

Joined: Jun 3, '11; Posts: 2,895 (53% Liked) ; Likes: 5,348

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  • Apr 20

    "Patient states that pain is "better" after dilaudid administration but continues to rate pain at 10/10. Comfort measures offered, which patient declined. "

  • Apr 20

    "Patient given PO, ok per MD." - verbally given go ahead to give patient food without electronic order (in ER) so if a floor doc gets mad at me - I got permission.

  • Apr 20

    "Offers no complaints" - patient doesn't want to bother me and I am too busy to ask them what they want.

  • Apr 18

    When Your Patient Is Mentally Galaxies Away.

  • Apr 18

    When Your Psych Patient Thinks He's A Superhero.

  • Apr 16

    That sounds like a very tough disciplinary action for pulling a med under the wrong patient's name. It was a simple easy mistake that didn't lead to any harm. I personally would not have filed an incident report and I see no reason for notifying the MD. I would have taken the med out under the right patient's name and then "returned" the med for the "wrong" patient.

  • Apr 15

    Family members who want to be served.

  • Apr 13
  • Apr 11
  • Apr 10

    Quote from Hope888
    Hi Everyone! I'm currently a nursing student and we recently just learned about blood transfusions. I kept reading about how after the patient has a blood transfusion reaction, you should "Keep the vein open" with normal saline to maintain IV access in case we need to administer an emergency medication. I don't get how running normal saline at a slow rate will maintain the IV access, can't you just insert the new IV but not have the saline run, or at least just do a saline flush? Does the continuous saline infusion just wash out all the clots?

    Thank you for your help in advance!
    When your patient has signs of a transfusion reaction, you first stop the infusion, run the normal saline (does not have to be at KVO, can be faster), get vital signs, and then notify the physician. You don't spend time getting a new line. Even if the fluids are infusing at a KVO rate, that is still adequate to keep the current IV open.

  • Apr 4

    Quote from gjl5148


    Critical Thinking Questions


    1. S.G. is a 70 year old male who has just had abdominal surgery. He is NPO and has an IV of D5RL infusing at 100 cc/hr. You enter the room and notice the IV has stopped running. The patient has poor skin turgor and is hypotensive. The patient tells you the IV is hurting him. Answer the following questions.


    1. What could be the problem?
    2. What should you assess?
    3. What should you do?
    4. What would be a nursing diagnosis for this patient?
    Yes, skin turgor is an indication of dehydration. This patient is also hypotensive. What could be a bigger issue here? The IV is not running (presumably it is still hooked up) and the site hurts. What can be going on? Also, what type of fluid is D5LR and what is its affect on fluid status? Think about abdominal surgery..what is the colon full of?


    Quote from gjl5148
    1. J.D. is a 48 year old female 2 days post-op abdominal surgery. She has a foley to gravity drainage. While assessing J.D.'s vital signs at 12 noon, you note that there is no urine in the tubing and there is only a little in the bag.

    The patient tells you "I am in pain and I feel like I need to urinate." Answer the following questions.

    1. What could be the problem?
    2. What should you assess?
    3. What should you do?
    4. What could be a nursing diagnosis for this patient?
    There are multiple issues that may be in play. There is a foley present. What is a foley catheter a risk factor for? Why do we want to get foleys out stat, especially after surgery? What could the pain be from? Also, there is just a little drainage in the catheter. How is the patient's fluid status? Is there an obstruction somewhere? What does the bladder scan show?

    Quote from gjl5148
    1. A patient is admitted with complaint of shortness of breath, chronic cough with small amounts of sputum, loss of appetite and fatigue. He states that these symptoms have become worse within the last 2 months. He is 40 years old and smokes cigarettes. Answer the following questions?


    1. What could be the problem?
    2. What should you assess?
    3. What should you do?
    4. What could be a nursing diagnosis for this patient?
    Smokers are at increased risk for many conditions including chronic respiratory conditions and cardiac conditions. Remember to stick to nursing diagnoses and not be tempted to use a medical diagnosis.

  • Apr 3

    Quote from gjl5148


    Critical Thinking Questions


    1. S.G. is a 70 year old male who has just had abdominal surgery. He is NPO and has an IV of D5RL infusing at 100 cc/hr. You enter the room and notice the IV has stopped running. The patient has poor skin turgor and is hypotensive. The patient tells you the IV is hurting him. Answer the following questions.


    1. What could be the problem?
    2. What should you assess?
    3. What should you do?
    4. What would be a nursing diagnosis for this patient?
    Yes, skin turgor is an indication of dehydration. This patient is also hypotensive. What could be a bigger issue here? The IV is not running (presumably it is still hooked up) and the site hurts. What can be going on? Also, what type of fluid is D5LR and what is its affect on fluid status? Think about abdominal surgery..what is the colon full of?


    Quote from gjl5148
    1. J.D. is a 48 year old female 2 days post-op abdominal surgery. She has a foley to gravity drainage. While assessing J.D.'s vital signs at 12 noon, you note that there is no urine in the tubing and there is only a little in the bag.

    The patient tells you "I am in pain and I feel like I need to urinate." Answer the following questions.

    1. What could be the problem?
    2. What should you assess?
    3. What should you do?
    4. What could be a nursing diagnosis for this patient?
    There are multiple issues that may be in play. There is a foley present. What is a foley catheter a risk factor for? Why do we want to get foleys out stat, especially after surgery? What could the pain be from? Also, there is just a little drainage in the catheter. How is the patient's fluid status? Is there an obstruction somewhere? What does the bladder scan show?

    Quote from gjl5148
    1. A patient is admitted with complaint of shortness of breath, chronic cough with small amounts of sputum, loss of appetite and fatigue. He states that these symptoms have become worse within the last 2 months. He is 40 years old and smokes cigarettes. Answer the following questions?


    1. What could be the problem?
    2. What should you assess?
    3. What should you do?
    4. What could be a nursing diagnosis for this patient?
    Smokers are at increased risk for many conditions including chronic respiratory conditions and cardiac conditions. Remember to stick to nursing diagnoses and not be tempted to use a medical diagnosis.

  • Mar 23

    I would say...start off in ICU/Stepdown, preferably surgical (because you will get medical cases too and if the surgical ICU takes cardiac surgery cases too, even better) and then work in the ER.

  • Mar 15

    "Offers no complaints" - patient doesn't want to bother me and I am too busy to ask them what they want.

  • Feb 11

    These people shouldnt be in the ER to begin with. I have little pity for people who don't use their primary physicians or go to the drugstore.


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