potassium

[ebethluther]

how do you administer potassium? on an empty stomach or full?

[RazorbackRN, BSN, RN]

The patient already has a GI Bleed, giving Toradol (a drug that causes mega GI problems for many people) to a person with an existing GI problem is not wise. Yes, Toradol is used for pain but that is what we are treating, a GI bleed with pain. MS04 isn't good for GI problems, what if the guy is obstructed? MS04 is really the last narcotic you'd want to use (fluid and motility) although many docs still use it anyway, and in an ED setting with a person who has GI problems, gut pain, etc., they wouldn't likely be getting anything PO.

BTW.. Toradol IS used on a short term basis, GREAT job!

You done goodly. :)

Personally, I would think that any NSAID would be withheld during a GI bleed, since NSAIDS can cause more bleeding. Also, since this guy was already bleeding, would MS04 be appropriate? I wouldn't think so, but I have different rationale. I would think that since he has an internal bleed, he is at a risk for shock (depending on the severity of the bleed), and MS04 is going to further decrease his respirations.

As far as the original poster, I have to say that I agree with NursiePooh. I think she could've maybe sugar-coated her reply a bit more, but in the real world, things aren't sugar coated. Honestly, it makes me FURIOUS to think that I work so hard to research things and do my own work so that I can have an understanding, which takes time away from my kids and my family, and then other students just expect the answers to be handed out. Why shouldn't you have to work just as hard for the answers as I do? It's not fair to us who put forth the diligent effort.

[Bipley]

Personally, I would think that any NSAID would be withheld during a GI bleed, since NSAIDS can cause more bleeding. Also, since this guy was already bleeding, would MS04 be appropriate? I wouldn't think so, but I have different rationale. I would think that since he has an internal bleed, he is at a risk for shock (depending on the severity of the bleed), and MS04 is going to further decrease his respirations.

As far as the original poster, I have to say that I agree with NursiePooh. I think she could've maybe sugar-coated her reply a bit more, but in the real world, things aren't sugar coated. Honestly, it makes me FURIOUS to think that I work so hard to research things and do my own work so that I can have an understanding, which takes time away from my kids and my family, and then other students just expect the answers to be handed out. Why shouldn't you have to work just as hard for the answers as I do? It's not fair to us who put forth the diligent effort.

MS04 pulls fluid from the colon, it reduces motility, and many believe it can cause a spasm of the Sphincter of Oddi. There are simply better drugs vs. Morphine for colon or potential GI problems. My personal favorite (when I'm asked ) is Fentanyl for GI patients although it does still pull fluid from the colon and reduce motility. But many docs would disagree with me but you know what? I'll bet most PharmDs would agree with me. It's a difference of opinion, I suppose. Just like PO Protonix. Many believe it is a wonder drug but most don't know why it doesn't work effectively in a TPN patient. Yet they still prescribe it anyway.

While I agree with you that students shouldn't come here to complete all their homework, sometimes we can give you guys things to think about that you just won't find in the books. I'm not going to spend every free moment answering questions but it actually helps me too. When we teach we learn a great deal. IOW, it keeps me on my toes.

Personally, I'd LOVE to see a section of this forum called, "Stump the Student," or "Stump the Nurse." I think it would be fun to bounce this stuff back and forth. Usually we ALL learn something in those scenarios.

I *just* signed up to take part in a program just like that for ED info. There is a doc working in an ED that is a gem, never met him in person but on line I adore him. He is doing a project he created himself. It's "Reading Group." We all read 10 pages of a specific book weekly and discuss it. It's for Emergency medicine. Everyone is welcome, paramedics, CPhTs, RNs, residents, anyone. But the requirements don't change for various levels of profession. No excuses for not getting tests correct because someone is a CPhT vs. MD. The work is the same across the board and CEs are given. We post questions on the boards and we all jump in and discuss the issues. I don't know, maybe it's nerdy stuff, could be! LOL But I like it because it challenges me.

I just bought the book and I have catch up reading and testing to do, but from what I have read I have learned a great deal. Just little things here and there.

This ER doc doesn't charge for any of this, it's just kind of a hobby of sorts for him. He personally grades all the (open book) tests and writes CE stuff up so we can use it for licensing.

[SKM-NURSIEPOOH, BSN, RN]

bipley you are the type of teacher i admire, you realize that every question is an opportunity for you to teach and expand. thank-you.

nursie pooh, you are right many of us me included have had a long hard road. do not think for one moment you have paved the road for me. you have not. i have worked my way through school and have paved my own road because unfortunately i have had to deal with several nurses like you who like to bring students down, don't worry i 'm probably not going to take your job, not today anyway. you can relax if that is what your problem is with students.

as i read your hostility i realize you either need to research the following quote or remove it from your posts..."an expert at anything was once a beginner." - dr. pat benner, nursing theorist, & kenya, lpn

well miss. cindyrn 2006, i do stand corrected! i've not pave any roads for *you* personally...but i certainly *have* paved the road for many *i've* personally precepted...thx for setting me straight there kiddo...lol :chuckle!

now, it's your turn to stand corrected because i don't bring students down...to the contrary! i sincerely care about students & make it a point to make their experiences positive ones. whenever opportunities rises to teach, i'm right there to do so. i only ask that some effort is shown when questions are asked. not so much at the clinical site, but definitely when it comes to here on the bbs. you see....we've had problems with lots of students in the past coming here looking for answers that had to do with homework assignments. it was obvious that no work was put into the assignment & they *expected* us to just blindly answer. it's pretty easy to spot those students out as they tend to ask more & more assignment type questions when they see their other ones answered...in other words...it became quite *easy* for them...thereby...becoming habit forming. there's a difference in starting thought provoking threads based on something observed in clinical, for example, which is very valid & acceptable; it's another to expect answers just because they're asked without no effort on the students' part.

once again....i've said this before & i'll say it a *third* time....i wish you all the best in school. i wouldn't do so if i wasn't a caring person...dispite your premature conclusion of me.

cheers,

moe

eta: i quote pat benner because i do believe in this theory whole heartedly & wrote a research paper on it! i don't quite understand why it is you feel i need to "research" or "remove" it from my signature. it has nothing to do with the topic at hand.

[xokelly2]

the arrogance of some :angryfire !!! first of all...i'll address the op, ebethluther.

my initial post was one meant for encouragement. you posed the question 6:37 pm & *nobody* even bothered to respond to it until i did approx 2.5 hours later. didn't that fact strike you just a bit strange? i was politely letting you know *why* it was nobody responded! i also stated in my reply that nurses here don't mind *helping* students out*after* they've showed us they've done *some* independent research of their own. this site is not here to give out homework *answers* for students at will....we've all seen it countless times before. we all been students before as well & know what you're going through! no...what i'd was tactfully stating was that you'll learn better by actually doing the work as best *you* can for yourselves. after you've done that...& you're *still* stuck...then you can either do a few things. a) do a topic search first....you'll find that you're not the first students coming here for answers to all sorts of topics. b) you can form study groups with other students & post in the student's forum...this will help others who may have similar problems...why not help each other out. c) or simply befriend a season nurse or two & pm them privately for suggestion, advice, etc. that would be the responsible thing to do. your response is typical of people who feel they're entailed to something...anything in life. you should've learn this by now but here goes...."nothing worth while in life will come easy!" nobody said they were perfect here...just giving you some valuable advise that you'll be able to apply in your nursing school career, god willing, your nursing career, or just to be applied in life period. i've read your profile & other post & noticed a pattern...you've started threads/questions that pertain to an assignment or two & am asking for "help." quite a few responded to your questions regarding diabetes. licensed nurses here are rather wary when it comes to students such as yourself. you come here to *ask for help*...but really want us to do your homework! when you are told to do so (because it only takes a few "i need your help" post by students) before somebody come down on you. i've taking the most tactful way...but you've gone & blown out of the water by your entailment attitude. people will read you're reply & know just where you stand. anyhoo...i still want to wish you the best with school...just do your own work .

now as for miss cindyrn 2006's reply to nenern or mine...i've got just one thing to say....humble pie. nobody said that nursing students were idiots!!!! as nenern stated that the op didn't know that answer as evidenced by their initial question!!! all that nenern was saying is that it isn't enough to just have an answer posted...there are rationales that go behind the how, what, & whys. by posting quick answers the way that you've done simply rob the op from such rationale(s). it's pretty darn dangerous nursing practice to seek information as important as medication administration from a bb site....don't ya think? would you want to practice beside someone who cheats or take the short cut in their nursing practice? how on earth do you feel about staying up those extra hours to prepare for clinicals the next day while someone else comes here & get answers from the bb? in the future...don't be soooo quick in being defensive when people who care are giving valuable life's advice. it took a long time & for many, a hard road in order for them to obtain their nursing diploma/degree/licensure for others to come here & take the "easy road." please do have *some* respect for those who've came through school & pave the way for you. not everything is about "eating your young." i really do want to wish you luck in school as well ...

cheers,

moe

i think (hope) the tone of your responses are coming off unintentionally wrong, because i'm even taking offense to some of you remarks. for starters:

~i think the original post was an innocent question. of course if anyone wanted to look up something as simple as a kcl po med, they could google it and get just as reliable of a response as they could here. why assume it was a homework question? secondly, it is not as if the original poster is going to use this simple answer as the basis of their entire career. entitlement? hello, i did not get that impression at all reading that post!!!! are you assuming again that they are lazy and unable to look the answer out elsewhere and will never be able to function as a nurse without simple responses from allnurses.com to their questions?

~ are you saying anyone who has a question has to word it approriately to accomodate you responding? the question was not directed at you. if they did not ask in a method in which you prefer don't respond!

~ dangerous to ask a po kcl question here???? hello she was not asking "now during a pea code do i want to give 1mg of epi or 10????"

~ i have had the need to ask various questions as a nurse, and i would be appalled if someone decided to lecture me on my research skills rather then help me out. it was not as if the original poster said: i have these lists of questions for school, anyone want to answer them for me, or does anyone want to write this paper for me?

but basically, if all you want to do is wish well, and encourage students then start a new post offering people the opportunity to get bullied into asking questions the hard way for "encouragement".

if you feel the need to change the world in your demeaning way, don't do so to someone who isn't directly asking for it.

you go nursing students, it isn't only you guys who can't stand the mean nurses out there. get use to it, it doesn't get any easier when you have to work beside them!!!!! hugs and kisses.......

[SKM-NURSIEPOOH, BSN, RN]

i think (hope) the tone of your responses are coming off unintentionally wrong, because i'm even taking offense to some of you remarks. for starters:

~i think the original post was an innocent question. of course if anyone wanted to look up something as simple as a kcl po med, they could google it and get just as reliable of a response as they could here. why assume it was a homework question? secondly, it is not as if the original poster is going to use this simple answer as the basis of their entire career. entitlement? hello, i did not get that impression at all reading that post!!!! are you assuming again that they are lazy and unable to look the answer out elsewhere and will never be able to function as a nurse without simple responses from allnurses.com to their questions?

~ are you saying anyone who has a question has to word it approriately to accomodate you responding? the question was not directed at you. if they did not ask in a method in which you prefer don't respond!

~ dangerous to ask a po kcl question here???? hello she was not asking "now during a pea code do i want to give 1mg of epi or 10????"

~ i have had the need to ask various questions as a nurse, and i would be appalled if someone decided to lecture me on my research skills rather then help me out. it was not as if the original poster said: i have these lists of questions for school, anyone want to answer them for me, or does anyone want to write this paper for me?

but basically, if all you want to do is wish well, and encourage students then start a new post offering people the opportunity to get bullied into asking questions the hard way for "encouragement".

if you feel the need to change the world in your demeaning way, don't do so to someone who isn't directly asking for it.

you go nursing students, it isn't only you guys who can't stand the mean nurses out there. get use to it, it doesn't get any easier when you have to work beside them!!!!! hugs and kisses.......

if you had of read my *first* reply to this thread...it's tone was one of advice...there were several views but nobody responded until i did some 2.5 hrs later. that was because we've seen this type of behavior over & over with other students & *this* particular student was also starting this same pattern of quick questions to answer things that should be looked up first. all i was doing was giving the reason for the non response & why. in fact...all of my post were that of advice. but what you'd (& a few others) decided to do was to take my second post which was a response to the way both ebethluther & cindyrn 2006 reacted....out of context. apparently, you nor they didn't read my (or nenern's) original post & took it for what it was...advice. you simply got angry & reacted with snaky replies as evidenced by your remark of some nurses being mean...etc. that's what i meant by the arrogance of some...it was their attitude.

sure anybody could google anything....that would at least shown *some* effort. but alas...that's not what i'm talking about is it xokelly2? if you stop & read the message i've been conveying...you would know exactly what i & many other nurses here are saying. i never said....don't ask any questions! nor did i accuse anybody of being lazy either!!! but what i *did* say was...i noticed a pattern with certain student posters & them coming to this bb asking us to answer questions that is obviously assignment based. i don't know how long you've been a nurse xokelly2 because your profile still list you as a student. perhaps you might not like the message because you're one of those *students?* i don't know...but i wish you all would stop with the accusations of me (& others nurses who happen to agree) being "mean" nurses. again...you don't know me like that & to say so is an out & out lie just because *you* don't "like" the message i made.

we all can agree to disagree about the topic of coming to the bbs for quick info that's really design for homework...& that's fine. but once we've resorted to generalizations & name calling (such as "mean nurses"), then we've lost all professionalism & creditability!

cheers,

moe

[xokelly2]

I understand your point and respect it, I was insinuating youre tone was what threw people off and distracted from you response.

.....I no more generalized that you were mean, then you generalized the original poster was taking the easy way out and "entitlement". (real professional and credible????)....

.....They've only had four posts, not much of a pattern.....

......I'm a new grad for 6 months now.... thanks for the correction......

My only point is if you don't like someones question, don't feel compelled to respond, you can't change the world. (Unless maybe you just like to argue, as do I, So please understand all my posts are all in good fun!!!! )

...take some hints from bibley, (great job!)... conveying the same message as you but tastefully....

you sure can dish it but........

I'm done, have a great day!!! No hard feelings, just defending the little guys because I was there not too long ago and I know what it feels like.....

Hey students...there are also some really great nurses out who are nice and helpful!!!!! I'm not being sarcastic either.........

[NRSKarenRN, BSN, RN]

After Administrative review, this thread is being closed as allnurses.com will not tolerate bashing of new posters, especally students.

I am suggesting to older bb members that when you see a post on a subject for the fifth or tenth time:

a. just skip over it, instead of responding negatively "I've seen this before"

or

b. Place search link in thread or link to previous post.

Allnurses desires to nuture future generations. We support students and nurses in professional growth. No question is dumb. Our Mod team will respond to most posts usually within a few hours.

Thanks for your understanding.