Heart and vascular help!!

Specialties Cardiac

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I might start to work on a heart and vascular step down floor.. I've only web an office nurse .. They said ill have to do cardiac drips.. I have no idea! Can someone give me a little lesson please??

Specializes in Cardiology and ER Nursing.

Nitro, Heparin, Integrilin.

Specializes in community small-town med/icu unit.

Some step-downs also have dopamine or other pressors.

Specializes in ER, progressive care.

and Cardizem. You might even see Lasix and Octreotide.

Not all stepdowns have pressors, it just depends on the floor and not all floors are created equal. On my floor we can have dopamine drips up to 5mcg/kg/min. We may also have dobutamine, but that's if a patient is being weaned off it.

Specializes in Acute Care Cardiac, Education, Prof Practice.

If the step down you are going to is worth its salt they will give you classes and a strong orientation.

Things to Review:

EKG rhythms and strips, basic, anomalies, fatal rhythms, and ACLS protocols.

Make sure your BLS is up to date, which I assume it has to be and find out if they will provide ACLS or if you need to get it before.

Review cardiac medications. Here is a great table from the AHA that highlights many of them in oral form.

http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_304568.pdf

Here is a list of common cardiac drips and infusion rates, however your facilities protocols will lead this. However at least you see a list of common infusions, though these are for critical care, so you might not deal with all of them, however you never know!

IV Critical Care Infusion Drip Chart

Review your other common medications such as diabetic meds, and be aware of interactions with anti-depressants, sedatives (e.g. xanax and ativan).

Take time to prime and run a few pumps if it has been awhile since doing those tasks.

Brush up on chest tubes, catheter care, pacer wires, and wound care.

I don't bring up the nursing school stuff to be offensive to your expertise, however I am not sure what "office nurse" has entailed for you :)

I would also ask if you will expect to be dealing with LVADs and if there is a class you need to take.

Also brushing up on CHF, clotting disorders, common vascular surgeries, and new heart surgery techniques (robotic etc) might make you feel more confident.

Medscape has had a lot of articles lately on CHF, clotting medication management, and even some heparin/Lovenox information. Might be worth a browse since that is free to use.

Just for the record I am not a step-down nurse, however my experience is in complex cardiac.

Best of luck!!

Tait

I'm pretty certain you will have a lengthy and thorough orientation. I'm surprised as an LPN though that you would be handling cardiac drips, what state are you employed in?

Specializes in ER/ICU/STICU.

Check out this website and go under "med tips" and you will find some useful information.

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