At the hospital which I just started working, they hold fluids for 1 minute prior to drawing blood from PICC? I was wondering if this was long enough?
Also, when you guys listen to lung sounds do you only check anteriorly. I was taught to check posteriorly but my preceptor only checks anteriorly. How can you tell what the lung sounds are at the bases?
I am not knocking my preceptor just wondering what the majority do. Thanks!!
is it necessary to waste 10 ml? when i worked medsurg, we wasted 5 ml. it was the protocol, but now i wonder if that would mess with anything?
*jess*
you're supposed to waste whatever you use as the flush. if you're flushing with 10cc, you should be wasting 10cc. put it in, draw it out, then get "fresh" blood for the labwork.
Specializes in Medsurg/ICU, Mental Health, Home Health.
you're supposed to waste whatever you use as the flush. if you're flushing with 10cc, you should be wasting 10cc. put it in, draw it out, then get "fresh" blood for the labwork.
thanks so much for letting me know that, although i've never heard it. i was also taught to flush tpn lines with 20 ml, so i guess that means (eek) 20 ml of waste?
What lab told me -- and it can depend on the test they are running, too -- is they want a 10 cc waste, especially if it's a heparinized line. If it's a saline locked PICC, 5 is okay. I always do 10, then look in the MAR to see if they are a saline or hep flush.
Specializes in Medsurg/ICU, Mental Health, Home Health.
what lab told me -- and it can depend on the test they are running, too -- is they want a 10 cc waste, especially if it's a heparinized line. if it's a saline locked picc, 5 is okay. i always do 10, then look in the mar to see if they are a saline or hep flush.
*whew* that makes me feel a lot better! my facility only used saline locked piccs.
I always listen to lungs pretty thoroughly. If it is someone that is difficult to turn for whatever reason (size, debility, pain) I will only listen anteriorly initially, and then when it is the next time to turn or change the pt, or if the pt is going to get up to the BSC soon, I just wait until then to listen posteriorly. If it is going to be a while, I get someone to help me at the time of the inital assessment.
I agree, I seem to hear "diminshed at bases" an awful lot. I try to chart that subjectively. I do not expect an 80 year old to sound like a 20 year old. But if the 80 year old sounds MORE diminished than a typical 80 year old should sound, I'll chart diminished.
Likewise, I've come across 30 year olds whose lungs are clear, but more diminished than a 30 year old should be. Clearer and fuller than your typical 80 year old with no pulmonary problems, but I'll still chart diminshed. KWIM?
RNsRWe, ASN, RN
3 Articles; 10,428 Posts
you're supposed to waste whatever you use as the flush. if you're flushing with 10cc, you should be wasting 10cc. put it in, draw it out, then get "fresh" blood for the labwork.