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Search Results Type: Posts; User: PetERNurse

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  1. this did not make sense to me.
    Even though your platelets are 65 or 50, they are still capable of forming a thrombus. This is why the doc ordered the hep drip. Heparin is not a "blood thinner", and does not decrease the...
    Mar 17, '12
    Forum: Cardiac Nursing
  2. med errors
    Good article in the current issue of CCN about med errors.
    Feb 4, '12
    Forum: Cardiac Nursing
  3. Anyone have any good critical care questions to quiz me on?
    CVP, PAP, and wedge will all be elevated.
    Jan 6, '12
    Forum: Critical Care Nursing
  4. Anyone have any good critical care questions to quiz me on?
    The answer to these depends on what the current vent settings are and full assessment of ABG taking disease process into account.
    Jan 6, '12
    Forum: Critical Care Nursing
  5. metabolic acidosis and tachypnea
    It's not as simple as saying the pH is X and the PCO2 is Y, therefore the disorder is N. It's not like a hemoglobin, where if it is low the disorder is anemia. You need a complete ABG to evaluate...
    Jan 5, '12
    Forum: MICU / SICU Nursing
  6. Ketamine during an emergent intubation
    Ketamine causes increased HR and myocardial oxygen demand, while decreasing ventricular filling time. Don't fall into the trap of thinking it doesn't "stress out hemodynamics". Given that the...
    Jan 4, '12
    Forum: MICU / SICU Nursing
  7. Best one sentence handoff report
    "521 is a babysit. When he goes to bite you just toss the pill in the back of his mouth."
    Jan 3, '12
    Forum: Emergency Nursing
  8. Ketamine during an emergent intubation
    I think we can all agree that it increases morbidity and hemodynamic sequalae as it increases the likelihood of vasopressor dependence in the PO period. Yes jury is still out on if it increases...
    Jan 2, '12
    Forum: MICU / SICU Nursing
  9. Ketamine during an emergent intubation
    Controversies surrounding the use o... [Ann Pharmacother. 2010 Jul-Aug] - PubMed - NCBI Etomidate versus ketamine for rapid sequence intubati... [Lancet. 2009] - PubMed - NCBI Acute adrenal...
    Jan 2, '12
    Forum: MICU / SICU Nursing
  10. Ketamine during an emergent intubation
    People used to think the etomidate did not increase m+m, but that is not the consensus now. Even a single dose has been shown to cause prolonged adrenal supression that increases m+m, especially in...
    Jan 2, '12
    Forum: MICU / SICU Nursing
  11. Contractility in tachycardia
    Beta-1 agonists will increase contractility and HR, but as the HR increases there is less time spent in diastole and therefore filling time is reduced. There is an optimal HR when using beta-1...
    Jan 2, '12
    Forum: CCU Nursing / Coronary / Cardiac
  12. Self extubation
    Dipravan causes significant myocardial depression and decreased CO. Definitely can effect BP especially in a CV compromised patient. I agree you may need to up your sedation/look to other meds...
    Jan 1, '12
    Forum: Neuro Intensive Care Nursing
  13. Nitro vs Morphine
    Morphine is also more vasodilatory than fentanyl and will provide more of an increase in myocardial oxygen delivery. Additionally the increase in mortality with morphine demonstrated by the CRUSADE...
    Jan 1, '12
    Forum: CCU Nursing / Coronary / Cardiac
  14. Respiratory acidosis/failure s/s
    Your body wants to blow off the excess carbon dioxide so tachypnea is an early sign. Along with tachycardia as the heart tries to increase it's output to meet an inadequately supplied metabolic...
    Dec 9, '11
    Forum: CCU Nursing / Coronary / Cardiac
  15. How bolus infusions of NaCl may affect low sodium levels...?
    the problem here is that your answer to the op "original simple question" contains fundamentally incorrect material (see post 39 above). i'd be interested to see the clinician's reaction when you...
    Dec 9, '11
    Forum: General Nursing Discussion
  16. How bolus infusions of NaCl may affect low sodium levels...?
    It's not so much that the kidneys separate Na, Cl, and H2O, but that it is an aqueous solution. NaCl does dissociate when in solution. It's just basic chemistry.
    Dec 6, '11
    Forum: General Nursing Discussion
  17. How bolus infusions of NaCl may affect low sodium levels...?
    Right, 140, because that measurement is a measurement of CONCENTRATION, not a count of the absolute number of sodium molecules. Got that? If not, work on it, because you have to "get" it. If you...
    Dec 6, '11
    Forum: General Nursing Discussion
  18. How bolus infusions of NaCl may affect low sodium levels...?
    The OP was referencing this comment when they said that. I guess I just read the OP comment as hyPOvolemic. OP- Just to clarify, was the patient hypervolemic or hypovolemic?
    Dec 4, '11
    Forum: General Nursing Discussion
  19. How bolus infusions of NaCl may affect low sodium levels...?
    Not an appreciable difference. Again, remember that the underlying disease process is still occurring, which means continued fluid retention. Yes if the patient is hypervolemic due to CHF,...
    Dec 4, '11
    Forum: General Nursing Discussion
  20. How bolus infusions of NaCl may affect low sodium levels...?
    It sounds like what she meant was that even though there is sodium in the solution, there is enough water in the solution to dilute serum sodium levels even further. I'm not sure that is...
    Dec 4, '11
    Forum: General Nursing Discussion
  21. How bolus infusions of NaCl may affect low sodium levels...?
    There are a few different types of hyponatremia: 1- Hyponatremia w normal plasma osmolality (aka "pseudohyponatremia"). Usually due to hyperlipidemia/hyperproteinemia, which interferes with sodium...
    Dec 4, '11
    Forum: General Nursing Discussion
  22. Refued to give pain meds due to brady
    Why is the patient bradycardic?
    Dec 3, '11
    Forum: Medical-Surgical Nursing
  23. infection and normal WBC
    If there was bacteremia you would expect changes in the diff (bands at the very least, but frequently if WBC on way back down, P would be neutropenic/low normal neuts and you would see...
    Dec 3, '11
    Forum: General Nursing Discussion
  24. infection and normal WBC
    I would suspect the patient has inflammatory cellulitis secondary to the lymphedema. Abx are Rx because of the decreased barrier integrity and likelihood of infection. Like another poster said, the...
    Dec 3, '11
    Forum: General Nursing Discussion
  25. infection and normal WBC
    Again I would say that there may not be an infection present. Just because you get a positive culture doesn't mean there is an infection. If we swabbed your hand we might grow strep, but that...
    Dec 3, '11
    Forum: General Nursing Discussion


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