Cardiac Step Down Unit ?, please and thank you

Hello All, I have been following this site since nursing school and recently became a registered user. I have read so much good advice here. So I figured where better to get a realistic view, than from the ladies and gentlemen experiencing this on a daily basis.

I am planning to apply for a position on a step down unit and would like to know what I should brush up on? (skills, diagnosis and theory included) I am a bit intimidated (actually shakin' in my shoes LOL), but have always been intrigued with cardiac. I would like to prepare myself so that I can give my patients my absolute best. What do you see/do in a "NORMAL" day? Any advice would be very much appreciated.

hello football mom :)

I've worked at a cardiac step-down unit for almost the past 2 years,

Here are a couple of points I think that are helpful since I see it so often:

- post-op open heart heart patients; review what they can/ cannot do after surgery. (ex. showering? walking? limitations of ROM? foley out? rehab needed? Normally these are set orders.)

- out unit has patients with chest tubes- get familiar how chest tubes work, how to change the incision dressing, how to change the drainage system if getting full, have supplies always ready in the room (vaseline gauze, secure tape, 4x4s, sterile water).

- the drips i normally see are: Cardizem, Amiodarone & Heparin. Once in awhile I see Dobutamine & Lasix. Review how to titrate them. Normally there are facility protocols.

- big thing- patients coming in with Chest pain!! Remember to keep them NPO before cardiologist sees them- (they may need a stress test or a cath).

- Procedures I normally see; cardiac catheterizations (lots of these), pacemaker insertions, cardioversions and endoscopies.

- Surgeries I normally see: CABG, valve replacements, thoracotomies (and chest tube inertion), and fem-pops. (Sometimes amputations too for those who have really bad circulation.

**with any procedure/ surgeries, you'll get familiar with a list of pre and post-op orders.

- Review your rhythms! These patients are normally on telemetry.

- Other patients normally on the unit (besides those with CP and post-op open heart) are those with heart failure, heart rhythm problems, COPD and once in awhile those with an infection of the heart (ex. endocardiitis).

- ACLS certified is very helpful in addition to BLS.

Hope this helped and best of luck!!

Thank you for the question, FootballmomaRN! And thank you for the information, LanieMe! I start orientation for a cardio/thoracic surgical stepdown unit on Monday (1/31) and I am very excited! I have been doing med/surg (mostly surg to include cardio/thoracic) since June 2008 so I feel like this is a good move for me!

Good luck, FootballmomaRN!