heartrn4duke

heartrn4duke has 8 years experience and specializes in cardiac intensive care.

Latest Activity

1. Milrinone vs Dobutamine

   heartrn4duke replied to mark2climb's topic in CCU

   Which one is used is based on renal function and should be used that way. Milrinone should never be used on someone with a creatinine > 2.5. It has a long half life and if not excreted by the kidneys can cause severe hypotension and right sided he...

2. Milranone and B/P

   heartrn4duke replied to MacNurse's topic in CCU

   Tha fact that she didnt know that hypotension is the number on side effect that any competent cardiac nurse should know and if she had looked it up she wouldn't be asking. So thank you for for your invaluable 2 cents. If you don't know a med look it ...

3. Milranone and B/P

   heartrn4duke replied to MacNurse's topic in CCU

   Milrinone vasodilates so yeah it lowers BP.

4. iabp

   heartrn4duke replied to Feldner's topic in CCU

   I depends on how the pt is. If he has IABP, vent, cvvhd etc he is singled. If the pt is a stable IABP then 2:1. It depends on the stability of the pt for assignments in our unit.

5. Which pressor to use???

   heartrn4duke replied to cardiacRN2006's topic in MICU

   Sounds like an RV infarct in that case fluids and dobutamine for fill and squeeze. Intubate if needed. RV infarcts need fluid. Dopamine for quick response. Dopamine has some alpha effects too and is good for RV infarcts.

6. Is this common knowledge that I missed?

   heartrn4duke replied to USAstudent's topic in CCU

   Levaquin isn't even on our formulary because of this common reaction. Levaquin has alot of interactions with alot of meds. We have system of which a pharmacist reviews every non emergency med ordered and then it is dispensed. There are alot of other ...

7. Easter considered holiday at your facility?

   heartrn4duke replied to Purdue_Nurse's topic in General Nursing

   Its not a holiday at my facility which is ironic because the university started as a divinity school and still has one of the largest divinity schools. Go figure.

8. Criminal Record

   heartrn4duke replied to girtster1979's topic in Criminal

   Why do you move so much? This looks worse than a criminal record. This and your criminal record are what may be holding you back. Someone that moves alot looks "unstable " to an employer and state board of nursing.

9. Iv Fluids

   heartrn4duke replied to Kristy_joyz's topic in General Students

   Where I work unless a pt is currently coding we use an IV Pump for all IV fluids.. That way you can get an accurate and more precise I and O .

10. Question for the cardiac gurus

    heartrn4duke replied to Nurse1966's topic in CCU

    Well these types of patients ballon up then in a few days when the RV begins to pump a little better they begin to auto diurese. Lots of times we monitor CVP to help monitor fluid status.

11. North Carolina Roll Call

    heartrn4duke replied to RNPATL's topic in North Carolina

    Hello I am a RN . I have been an RN for 8 years. I live in Lee County and work at Duke. I work in cardiac intensive care. I love it most days. :yelclap:

12. Iabp...

    heartrn4duke replied to BSN_DEC_2006's topic in CCU

    Our policy is not because of the risks of clots. We have done it in emergent situations but it is frowned upon due to the increased risks of clotting ot air in aorta. :balloons:

13. Question for the cardiac gurus

    heartrn4duke replied to Nurse1966's topic in CCU

    If you think about a right sided Mi can incule the Rv. Which affects preload and forward flow. So the tank needs to be filled to push the blood flow forward. The right side is damaged due to the MI so the ventricle cannot push the blood flow forward....

14. Views on New Grads Entering Critical Care

    heartrn4duke replied to ICUNurse11's topic in CCU

    Some new grads do well some don't. I come from the school of thought that you should work on a floor or step down unit for a year. With the shortage though new grads will be taken into the units. I feel one should be able to look at a patient and kno...

15. "Too unstable for transport"..........WHAT?!?!?

    heartrn4duke replied to TazziRN's topic in General Nursing

    His trop was elevated because he laid on the floor for 3 hours. He is probably in rhabdo and does need to be transported for workup. I work at a large university cardiac intensive care unit and its lifeflights call whether they can fly or truck them....