Learning Thread: Med/Surg

carbon monoxide posioning.

I hope this ? is appropriate for this thread. I am a 2-year LPN, 6-month Med-surg nurse with nothing but ?'s.

When patients are on MRSA/VRE restrictions, do you (personally) always gown up, glove up, mask up??? Are there exceptions? WHY?

I hope this ? is appropriate for this thread. I am a 2-year LPN, 6-month Med-surg nurse with nothing but ?'s.

When patients are on MRSA/VRE restrictions, do you (personally) always gown up, glove up, mask up??? Are there exceptions? WHY?

In my facility, we don't mask up unless they are coughing. Typically it's either an old MRSA/VRE that they are still testing postive for, or it's in a wound. I personally take it much more seriously if it's in a would than if it's in the nares.

I hope this ? is appropriate for this thread. I am a 2-year LPN, 6-month Med-surg nurse with nothing but ?'s.

When patients are on MRSA/VRE restrictions, do you (personally) always gown up, glove up, mask up??? Are there exceptions? WHY?

We are expected to do so no matter what and no matter where the infection is. If it's in a wound that is covered, and I'm going in just to pass meds, I am expected to wear full PPE. I actually had a CNA tell on me the other day for not doing so!

Of course I wear full PPE when coming in close contact with any "contact" isolation patient, but I still fail to see the point when passing meds and NOT coming in close proximity with the patient. I love this idea that the door-way is some sort of magical barrier...

With regard to Homan's sign, we were taught never to perform once a positve diagnosis of thrombosis is made but it could be done prior to positive diagnosis. I am current student in med surg section of my program and our text states homan's sign should not be done post positive diagnosis for thrombosis but mentions nothing else. Thanks for the info

ok here is one.

If you suspect your pt has DVT in his/her calf muscle do you do the Homan's sign or not???

No - b/c Homan's sign isn't a reliable way to diagnose DVT. Plus if it was a DVT could you actually turn it into an embolus by dorsiflexing the foot?

wow, this is a great thread...hopefully, other knowledgeable med-surg RNs can post more, to help the new ones like me.

any more inputs?

I really enjoy this thread and hope that it continues. I am a new grad med/surg float rn with 10mths experience. It has been a bumpy road but I am starting to feel a SMALL level of confidence. So far, I have been able to correctly answer the questions posted but would like to continue to be challenged. Bring them on people!!!

Thanks for the explanation of the insulin therapy. I thought that it had to do with the recovery period in the hospital and the hormone response, but was unsure how to word it to the patient. I often joke that a hospital visit usually renders people with kooky blood glucose and constipated!

I just graduated, and I did my senior clinicals on a renal/dialysis floor. I have a question I've been pondering for a while now. This concerns dialysis pt.'s. Fact: Dialysis pt's have little to no urinary output so most are on some type of fluid restrictions. Question: How do you maintain pt's hydration if pt. is febrile or experiencing nausea- is hospital admit & IV therapy the only solution?

:yeah:you are correct! When carbon monoxide attaches to the Hgb molecule the pulse ox still pics it up as if the oxygen molecules are the ones attached to the Hgh molecule. Do you have a question to post?

I thought in CO poisoning that the skin usually never presents as cyanotic, but cherry-red or pink and flushed?

great thread