Cardiac nurses....allow me to pick your brain : )

surferbettycrocker · Jul 12, 2011

never "push" potassium! ;0) but you knew that already. 'always recheck vitals' before giving medications.

these cards patients can and do turn on a dime so 'always' be greatful for a "good" shift :up: :heartbeat

nursej22, MSN, RN · Jul 12, 2011

Treat the patient, not the monitor.

Some patients may tolerate an abnormal heart rhythm, and others may feel every PVC. If the is a change on the monitor, assess your patient including vitals, and what they are feeling before you treat.

The first question our cardiologists always ask when we report an abnormal rhythm is "are they symptomatic?"

Do-over, ASN, RN · Jul 12, 2011

Treat the patient, not the monitor.
Some patients may tolerate an abnormal heart rhythm, and others may feel every PVC. If the is a change on the monitor, assess your patient including vitals, and what they are feeling before you treat.
The first question our cardiologists always ask when we report an abnormal rhythm is "are they symptomatic?"

That, and check that each patient is on the correct monitor each shift.

tma0312 · Jul 12, 2011

Know your drips, what is considered safe dosing, etc. I once had a resident accidentally order Dopamine at a dosage that was similar to that of Dobutamine. I looked at the order and questioned it and caught it before it was given.

Like another poster said, these patients can go downhill fast so check in on them often. Always ask specifically if they are having or have had any recent chest pain and get an EKG asap, because sometimes they may be having minimal pain but are in fact having a STEMI. They don't tell you about the pain because they don't want to be "a bother."

Refresh yourself on rhythms, too!

bumblebee2010 · Jul 17, 2011

good advice! I'm a new nurse...

but what do you mean by know your "drips" please give a resource or something thanks

bumblebee2010 · Jul 17, 2011

This question is for "do-over"

What different monitors are the patients on? :) Thanks

Do-over, ASN, RN · Jul 17, 2011

This question is for "do-over"
What different monitors are the patients on? :) Thanks

They are all on the same type of monitor, you just need to be sure that the correct telemetry box is on the correct patient. For example, if patient John Doe is assigned tele box #1 on the monitor - verify that John Doe is actually wearing tele box #1. I do this with each assessment.

bumblebee2010 · Jul 17, 2011

oh i get it..thanks a lot :)

Jules Anne · Jul 25, 2011

You have received some great advice from the above posters. In answer to your question about cardiac drips, the drips that I deal with regularly on cardiac stepdown: Heparin, Integrilin, Nitroglycerin, Dopamine, Dobutamine, Milrinone, Diltiazem, Amiodarone, Vasopressin, Furosemide, Bumetanide. I suggest that you ask your preceptor what drips and oral are common on your floor and get to know them.

Also,even though cardiac units can be very busy, don't skimp on your assessment. For example, I know a nurse who "looks at" her IV access but doesn't take the time to flush her sites to check if they are patent. I always flush my sites at the beginning of my shift. I wouldn't want to find out that I need to start a new IV when I'm starting a critical drip or pushing a code drug.

I started in cardiac stepdown as a new grad and getting my ACLS certification early helped me to feel more comfortable. Your unit may not require ACLS but I felt so much better to know that, as a brand new nurse, even though there was a lot that I didn't know, I could handle myself in a code situation.

Best of luck to you!

OpenHeartRN24 · Aug 13, 2011

One more thing. Use common sense. If your pt is odered 25mg PO lopressor and the order says do not give if systolic bp is less than 100. You take there bp and there systolic is 103. Guess what there systolic wont be that for long if you give the PO lopressor. Just use common sense. Ask questions. Ask advice from experienced nurses on your unit.

Cococure · Aug 15, 2011

Ask questions, Ask questions and Ask more questions no matter how silly it might seem. If you have multiple drips going on a patient monitor that patient more closely esp cardizem, tridil and amiodarone. Get to know who your strong nurses are on the floor that you can ask for help...try to work the same schedule as your preceptor after your orientation has ended. Follow your gut feeling about something, if your pt. doesn't seem right and you feel they are a bit off...dont ignore it you will know your patient! Do a good assessment dont assume what the previous nurse told you is correct!

Good luck...I started on a cardiac floor with 5-6pts and I survived...you will also!!