Latest Comments by cocolococna

cocolococna 613 Views

Joined: Oct 25, '08; Posts: 9 (11% Liked) ; Likes: 1

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    I can't get onto any of these websites. They are either no longer in existence or the link is broken. The few that do open, I do not know what to click on to get what you say is there. I still don't see any "sticky".

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    Forgive me, but I am clueless about a "sticky". Help!

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    how do i get into the dosage calculations on this website (thepoint)? - 90 iv rate calculation problems! and here are the answers to all 90 fully worked out and shown to you by both dimensional analysis and ratio methods!

    the first website doesn't come up anymore either. i will keep trying the others. i know the testandcalc one works because i have used that already.

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    Quote from Daytonite
    Absolutely! Agreed! To think and make decisions requires possession of as much knowledge as is available.

    OP. . .I would note the post by patwil73. The simulator may ask what you would do for this patient and this poster pretty much nailed it on the head. Symptoms (manifestations) appear as pathology of a condition proceeds untreated. Follow the steps of the nursing process. Be cautious to the simulator giving you questions that place you somewhere within the steps of the nursing process already in action so you don't get confused as to what you should be doing at that point in time. The simulator is testing your critical thinking ability.
    your info. was extremely helpful. I sent the websites to my teacher to pass on to the class. I will let everyone know how it goes. Thanks!

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    Quote from Michigan RN
    It doesn't matter if your scenario is ARF, what the patient is presenting to you, suggests otherwise. You can't just determine that the patient needs dialysis because the urine output is 250/12hours. To me thats big woop. The patient has a positive wound culture, low grade fever, is vomiting, no bowel sounds, no bowel movement. Are you trying to convince me that the patient is truly in acute renal failure? It's not working. Plus you do not have a current set of labs to back it up. You are not looking at the big picture. There is something else going on with the patient which is causing the acute renal failure. That is what you should focus on.

    Can you tell me how the other group killed Stan? I bet they suggested dialysis.
    O.K. I get it. I don't know how the other group killed him, but they were the first to use the simulator. A good assessment head to toe is first. Knowing what to look for is helpful. Thank you. I will let you know how it goes with "Stan".

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    I guess that is what our teacher is expecting. It sounds right on target.

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    Sorry, typo. We have to do this scenario exercise on the simulator and this is the only info. we have. No vitals, lytes, no values. I don't know if he has edema or is anemic, either. The scenario is for acute renal failure which is what we are studying now. Thanks

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    RN1982 likes this.

    I guess you are right. What kind of IV fluid should be hung. What do you suggest is the nursing priority?

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    I have a scenario from my teacher that we have to do acute renal failure on a state of the art very expensive simulator. He breathes, coughs, vomits, pees, poops, bleeds, has vitals, talks, etc. The info. follows:

    Location: Medical-Surgical Unit

    History/ Information:
    The patient is a 61 year old male with a history of hypertension and hyperlipidemia. His home medications include enalapril, atorvastatin and baby aspirin daily. He weighs 100 kg and smokes one pack of cigarettes per day. He is allergic to penicillin. The patient presented to the Emergency Department three days ago with complaints of abdominal pain and yellow skin and had an emergency open cholecystectomy for obstrictive jaundice. He was admitted to the Medical-Surgical Unit postoperatively. On the second postoperative day, his IV was converted to a saline lock and clear liquid diet ordered. On the third morning, he has nausea, vomiting, absent bowel sounds, urine output 250ml/12 hour shift, and low grade fever. He has not had a bowel movement. His surgical wound is positive for methicillin resistant staphylococcus aureus (MRSA), which is now being treated with vancomycin. He is in contact isolation.

    Healthcare Provider's Orders:
    Vancomycin 1g every 12 hours
    Enalapril 20 mg PO once daily
    Atirvastatub 10 mg PO once daily
    Hydromorphone 1-2 mg every 2-4 hours IVP prn pain
    Promethazine 12.5mg IV every 6 hours prn nausea
    Oxycodone 5mg/acetominophen 325mg 1-2 tabs PO every 4-6 hours prn mild pain
    Enoxaparin 40 mg SQ once daily
    Saline lock flush 0.9% NS every shift
    CBC, Electrolytes, BUN, Creatinine, Glucose in AM
    Incentive spirometer

    My husband is a nurse and says he should get immediate dialysis. What about fluids? He has Vanco q 12 hours piggyback, but piggyback to what? What do you think, anyone? The last group in our class killed "Stan". I don't want to do the same.