Fresh tidbits on surviving a cardiacstepdown

Specialties CCU

Published

I have accepted a position on a cardiac stepdown unit since graduating in 12/07 dependent upon me passing my boards on 02/13:bugeyes: and I wanted some advice on surviving this new position and personal experience or advice thanks

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Specializes in Telemetry/CCU/Home Health.

If it's anything like the one that I work on, buy some roller skates! Very fast paced, lots of admissions and discharges, learn your cardiac meds (beta blockers, ACEs,CCB's, Anti-dysrrythmics (amiodarone, ticosin), learn how to interpret rythyms. Good luck!

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Specializes in Cardiac, Post Anesthesia, ICU, ER.

Having spent nearly 9 yrs on Cardiac step-down units, I'd say you're entering a very fun place to work from my experiences. Know about EKG's, Rhythm's, know the different classes of anti-hypertensives, and varied medications commonly used in cardiac patients, but keep in mind, patients from ALL various pathophysiologies can develop cardiac problems.

Common rules of thumb with MOST cardiologists include, keep the K 4.0 or better, and Mg 2.0 or better, the heart will like you better.

If a groin bleeds, MOST of the time manual (using your hands, with gloves on of course) is the best option to achieve hemostasis.

Statin drugs are recommended to be taken at night, because they are more effective.

Smoking cessation keeps 50 yr olds from coming back to see you in 6 months.

Plavix may be expensive, but dying is too. Remind your patients to take their Plavix for as long as directed, and if they are low income, the drug company actually has its own "financial assistance program" where they will help individuals get the drug at a discounted price.

Aspirin is your friend, and MOST of the time, in MOST people, and 81mg Aspirin is as effective with less dangerous side effects as a 325!!!

If and EKG say INFERIOR INFARCT, and the pt's BP is around 100, BE VERY CAREFUL WITH NITRO!!!!

Open heart patients need to WALK, Cough and Deep Breath, and use their Incentive Spirometers until they hate them, then reinforce using them MORE!!!

And remember that ACE-Inhibitors are BAD for renal insufficiency patients!!!!

Good Luck!!!!

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