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Joined Aug 17, '00. Posts: 4,688 (32% Liked) Likes: 4,820

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  • Nov 5

    Little old ladies and gents who can't see,claim there fingers and hands are weak but insist on laying all twelve pills out on a tissue,examining them and then attempting to pick them up,one by one.Pick up the water,take a sip,put it down.Count the pills again. Take one.Pick up the water,take a sip,put it down......As the clock winds down .I love that they want to try to maintain independence but not during the med pass from hell.I am glad to review each pill,admin one by one on a spoon.Gladly.

  • Oct 30

    Quote from
    One day her son pooped in his jeans. She got fed up one day, ran some soapy bath water, and made the boy clean the poop from his pants and undergarments. Miraculously, after this incident [I
    he never pooped on himself ever again[/I]. After being forced to clean his poopy jeans, he started defecating at the toilet.
    That worked for my son-he was toilet trained and then our family went through a rough patch and he began to have accidents.The pediatrician recommended that approach. I laid out clean clothes and wipes in the bathroom and waited for the next accident.When it happened he was told to go in the bathroom and not come out until he was clean.I did end up going in an talking him through rinsing his unders in the toilet but he got the job done.I felt horrible because he bawled the whole time but the doc told me to stand firm so I did. He never had another accident.
    I'm thinking "since when is this the school's concern?' There are so many issues that can be causing this and it's up to the family and their pediatrician to solve the problem.I wouldn't want my child to be known throughout his school years as "the kid who crapped his pants in school" I feel he is not ready for kindergarten.Isn't continence of bowel and bladder a basic requirement for school children? I really don't think this issue should be dealt with a school.

  • Oct 30

    Why wouldn't anyone switch a Saturday with her,it is her baby shower....That's a pretty important occasion..

  • Oct 8

    [QUOTE=Poochiewoochie;7129504]Yeah, so do I since my Mom has Alzheimers. These are your patients but it's a lot different if your loved one suffers from the disease. My laughter when she does these strange things is because if I didn't I would be spending my time crying.[/QUOTE)
    I don't know of any other way you could cope--I'm sending a hug your way. A dear friend of mine lost her mom to the disease-she said it was like 15 year wake.

  • Sep 28

    The OP is also an ADN and as we know that is limiting his options. (not trying to start a flame war-I'm an LPN and I know how that limits me)

  • Sep 25

    [QUOTE]Originally posted by angelique777
    what is the difference b/w a PICC line and a Central line would like this helpfull information thanks
    [/QUOTE>>>>>>>>>>>>>>>> Alternative Names
    peripherally inserted central line long-term intravenous catheter

    A PICC line is a long, soft, flexible tube, or catheter, that is inserted through a vein in the arm. The PICC catheter is designed to reach one of the larger veins located near the heart. It is longer and thinner than a regular intravenous catheter. A PICC line is frequently used in the home setting.

    When is a PICC line used?

    A PICC line is used when a person needs intravenous medication, chemotherapy, or fluids for an extended period of time. It is also used when someone requires frequent blood sampling. The most common use for a PICC line is for giving antibiotics and chemotherapy through the veins.

    How is the PICC line placed?

    A doctor or specially trained registered nurse will place a PICC line in a person's arm. The procedure is done either in a hospital or in an outpatient facility. Using a needle or a guide wire, the provider inserts the PICC line into a vein located in the arm. From there it is threaded into a larger vein near the heart. Once the catheter is in the correct position, the needle or guide wire is removed and the catheter is left in place.

    The catheter site is covered with a sterile dressing and the tubing is securely taped to the person's skin. Plastic tubing is connected to the end of the catheter. A chest x-ray will be done after the PICC line is inserted to check that it is correctly placed.

    How long can a PICC line stay in place?

    The PICC catheter can generally remain in place from five days to several months. In some cases, the catheter can remain in place for up to a year.

    What type of care does the PICC line require?

    The dressing is changed once a week by a registered nurse. If the catheter is not being used continuously, the nurse will flush the line with saline solution to prevent it from clogging.

    What precautions should be taken after a PICC line has been inserted?

    The catheter site must be kept dry. The person may bathe or shower as long as the insertion site is protected with a water-resistant covering. The person's blood pressure should not be taken in the arm with the PICC line. The PICC line site should be checked every day for signs of infection, such as redness, swelling, or pain.

    What are the complications associated with a PICC line?

    A PICC line is designed to stay in place for many months. However, the catheter can sometimes cause phlebitis, or vein irritation. If this occurs, a red streak may appear on the arm, and the healthcare provider should be notified. Infection is also possible, but rare. The nurse or doctor should also be notified if the person develops a fever, chills, or a rash.

    central line
    Alternative Names?
    central venous catheter, CVP line

    A central line is a special intravenous line, called an IV. This type of IV is inserted through the chest and threaded into one of the large veins that lie close to the heart. A central line has multiple ports that can be used to:
    draw blood
    give fluids
    monitor central venous blood pressure
    Who is a candidate for the procedure??
    A central line is used for:
    gaining emergency IV access when the usual IV access into an arm vein is not possible
    monitoring central venous pressure during major surgery or after severe blood loss from trauma or illness
    giving fluids, blood products, chemotherapy , and other medicines, as well as for hyperalimentation
    drawing blood samples
    administering long-term IV therapy
    How is the procedure performed??
    A central line is inserted under sterile conditions. The person is usually placed in the Trendelenburg position, which means the head is below the level of the heart. The skin is cleansed, and a local anesthetic is injected to make the area numb. A healthcare professional advances the line until it reaches the large vein of the chest. The catheter is then sutured in place, and a sterile dressing is applied.

    What happens right after the procedure??
    A chest X-ray will be done right away after a central line is inserted to confirm that it is in the right position. The line should not be used until the X-ray is done . A central line can usually stay in place for up to 4 weeks.

    What happens later at home??
    If the person is going home with the central line, the family will need to learn how to care for the catheter. A visiting nurse can come to the home to help the family with the care at first. The bandage at the insertion site will need to be changed every 3 days. The insertion site should also be inspected closely for signs of infection. These signs include redness, warmth, drainage, and swelling.

    What are the potential complications after the procedure??
    While inserting the line, it is possible to puncture the lung. The catheter may irritate the heart and cause irregular heartbeats, called arrhythmias. Other complications may include:
    air embolism
    blood clot in the tubing
    Any of these complications may lead to the removal of the central line.

  • Sep 16

    Quote from KathyDay
    In defense of "visitors" who I prefer to call care partners, they often do not understand acronyms. NPO except Ice needs to be interpreted for them saying DO NOT GIVE HIM/HER anything except ICE! Also, post written instructions on the PCA medication. Never assume that they know these things just because you do and don't question their intelligence because they don't know "nursely" things.
    Every patient needs a trusted advocate by their side while they are in the hospital, but they do not need droves of visitors including tiny babies and toddlers, who will exhaust them and disrupt everything. The designated advocate can be the note taker or the recorder of doctor visits, keeping a list of medications, special instructions, etc. Then they can relay pertinent information to the rest of the family/guests as appropriate.
    There is a way to work out all of these things, and communication is the first step in all of it.
    And we can never assume they have common sense,either.Simple common sense would keep a visitors butt in a chair ands their off equipment until they could speak to staff to find out what they can and can't do for their loved one.Sadly it seems common sense is being bred out of human beings.We feed our kids took animals .....

  • Sep 9

    So we are NEVER supposed to "make a mistake?" Physicians make mistakes...pilots and air traffic controllers make mistakes.....What an absurdly high standard...

  • Sep 9

    You can be as obvious as possible but the sad fact is when someone in LTC wants something they usually don't give a crap about anyone else's needs.

  • Aug 6

    Quote from TDub
    . I held it in my bare hand puzzled, when she said in a gravelly, tequila-and-4-packs-a-day voice, "Hit fell outta mah cooter."
    Like the smooth professional I am, when I realized it had been in her vagina, I screamed and tossed it on the floor. I ate lunch with my hand held behind my back, because I was convinced I could still smell her crotchal area on my fingers*. Ick.
    I never told my husband...
    I forgot to add---after you wash,wash ,wash ya hands do a final scrub with shaving cream.....Takes care of that lingering odor..sometimes after dealing with a particulary smelly impaction -even double gloved- I think I can smell that odor on my fingers....argh....

  • Jul 3

    This makes me think of the case in NYC in the news,a foster father molested an untold number of children in his care for years.You should not go into fostering with any motive other than caring

  • Jun 11

    Quote from SmilingBluEyes
    Therefore, I SO disagree that "the other end of the spectrum" is reserved for nurses who were "called" as if divinely or something. There are SUPERB nurses who were not "called" but looking for job security or opportunities for advancement, when they entered. I hate when people believe only nurses "called" to the *profession* (which by definition is NOT synoymous with "calling") are any good.
    We have spoken to this topic many times on this board-and I don't like what the phrase" called to nursing" implies....even though I feel that I was meant to do exactly what I am doing....Too many excellent nurses have settled for low pay and crappy working conditions because they felt that is what they deserve-as if they have to suffer for their "calling" Nursing is a profession and we will never have truly equal pay and benefits until it is recognized as such.....PS=the term "calling" (according to Encarta) has no religious connotation.....but I think many use it in that way..

  • Apr 16

    Quote from cjwensley
    I smell it too, but this last time, the smell has been lingering strongly for 3 days. Could it be me?
    Oh,Lovey-it's not you.It's stuck on you and you need a fresh breeze to blow it off.And a prayer .Smell coffee beans or fresh ground coffee,lavender,peppermint,orange...Or vanilla extract.
    We humans are so dependent upon technology now that we tend to ignore our basic senses,our sense of smell,our intuition.Except for those of us in this field...

  • Apr 16

    Before middle and upper white class kids started dying no-one really much cared.

  • Apr 7

    Quote from anh06005
    And I've never had good experiences with women and inserting catheters. I have only ever actually seen the urethra once (something to get excited about!). Otherwise it's a shot in the dark on a hope and a prayer. And many of these old ladies having hip/back/knee issues doesn't help.

    Did I mention I don't often cath women anyway? Lol
    Try turning them on their side and going in from the back (atrophy has made everything droop, it's often really easy to visualize in that position) or place them on their back on top of a fracture pan turned upside down (juts the pelvis up).Also ask them to cough as you wipe with the betadine-the urethra will "wink" at you. Have plenty of catheters available-if you miss just leave that one in place,it will block something (an instructor gave me that tip ) Now back to topic....