ClauICURN

ClauICURN has 2 years experience and specializes in Critical Care Nursing.

Latest Activity

1. Considering going back to telly

   ClauICURN replied to nugspugsanddrugs's topic in MICU

   I would start applying to ICU positions somewhere else. This unit is very toxic and you won't be able to change it, so get out with your sanity intact. Good luck!

2. IABP Alternative

   ClauICURN replied to HeliKel's topic in Critical

   If you are just looking to buy the patient some time until you can get an IABP, an inodilator like dobutamine might help. The thing is to figure out what is going to be done longterm, like is the patient getting valve surgery or a LVAD.

3. Tool needed for restraints in critical care

   ClauICURN replied to Andee137's topic in Critical

   We use mittens for ventilator patients (which in our hospital are not considered restraints), and they work pretty well. If the patient is appropriately sedated usually there is no need for restraints, and the majority of our patients can be coached/...

4. Would you suggest a different drug brand to a patient?

   ClauICURN replied to MunoRN's topic in Medications

   I would answer questions in a general sense if it came up, or recommend they discuss it with their provider but would never suggest any specific brand to patients be it generic or proprietary.

5. NEW RN: Need recommendations

   ClauICURN replied to Emilyyredd's topic in Critical

   I recommend The ICU Book by Marino and The Ventilator Book by Owens

6. ARDS patient, dialysis

   ClauICURN replied to zzyzx's topic in Critical

   Yes, true, but a pH of 7.20 requires an intervention unless it's trending up? As for bicarb administration, I still see it used in cases of NAG metabolic acidosis and don't think it's going away.

7. Moderate (Concious) Sedation by RT?

   ClauICURN replied to OkieICU_RN's topic in MICU

   I don't have an issue with it if it's for a respiratory procedure and the physician is at bedside. In practice, however, if it's my patient you better believe I'm the one pushing it!

8. Big Trouble

   ClauICURN replied to Bentlysnurse's topic in MICU

   The only logical explanations I can come up with is that you are either consistently bypassing the scanning step to clear the task before you actually pull the med, that you are scanning some sort of label instead of the actual medication, or that yo...

9. Pressure Support Mode VS CPAP/BiPAP

   ClauICURN replied to SterlingArcher's topic in MICU

   Colleagues have provided very good information on this. To follow up on PressG33's comments, CPAP is generally used for people with OSA. Not only does it provide a continuous positive pressure (like PEEP but we don't call it that if we are talking ab...

10. Which unit is more manageable for a newbie: MICU or SICU?

    ClauICURN replied to Workinghard123's topic in Critical

    "Less stressful" This part made me laugh, haha MICU patients tend to be older with multiple comorbidities, while SICU varies but can have more of a mix or even a higher number of comparatively younger patients. In MICU you will see very sick patient...

11. New icu nurse and feeling discouraged

    ClauICURN replied to Audi3181's topic in Critical

    Hi there, Sorry to hear that you are going through a difficult time. I've been in the ICU less than two years, so kinda new myself. I can share what helped me when I was starting out, and maybe some of it can make this transition easier for you. Wha...

12. ARDS patient, dialysis

    ClauICURN replied to zzyzx's topic in Critical

    I mean it all depends on the severity of the condition. Pulmonary edema, pneumothorax, pneumonia, ARDS can all cause serious problems with lung compliance. I'd say the worst case of noncompliant lung I've seen was a severe ARDS case. ARDS is like the...

13. ARDS patient, dialysis

    ClauICURN replied to zzyzx's topic in Critical

    OK I think there's a few different things we should consider. OP states that the renal function appeared normal with BUN/creat in range. The patient is in severe respiratory acidosis, which cannot be expected to be compensated by the kidneys to any m...

14. ARDS patient, dialysis

    ClauICURN replied to zzyzx's topic in Critical

    Why was the patient hypotensive? Was this a MODS patient, volume down? Was the patient paralyzed? How much sedation was the patient on and what was the patient RR or vent rate? And no, the patient being anuric for 24 hours is not an indication for im...

15. Can lungs be clear AND diminished?

    ClauICURN replied to Cvepo's topic in Critical

    I get what you mean, but diminished breath sounds are abnormal breath sounds. Let's say a patient has clear lung sounds to the upper fields/lobes but diminished to the bases bilaterally, then that's what you would say clear to upper fields but dimini...