rarjn5

Congratulations to you on your new position! There are many drugs that one uses in the Critical Care setting. Some common drips that we use are: dopamine, levophed, cardizem, nipride, insulin, heparin, diprivan, ativan, esmolol, nitroglycerin, fentanyl, and dobutamine. This is a list of some of the drips. I'm sure other nurses have a more extensive list.

I have been reading about Neo-synephrine and its pure alpha effects and that it does not effect the heart rate. In what circumstances have you seen it used? I have been asking at my ICU/CCU and nurses have very little experience with this drug. Are you using it in place of Levophed? Any response would be appreciated. Thanks

Congratulations to you! How long did the test take? How many questions? Did you use any of the official CCRN study books or CD study questions? I'm still trying to get my strategy together on how to tackle this TEST so it is encouraging to hear of a recent success story!

Thank you very much and you have helped me with the ongoing learning process of critical care nursing (or nursing in general)! And most of all just having the feedback from other nurses is a great encouragement.

Thank you Papawjohn. So just to recap: inverted T waves don't mean ischemia? Secondly: inverted T waves are not considered reciprocal changes. Thirdly: Do reciprocal changes correlate with specific areas of the heart? Such as anterior vs posterior changes? I don't know if I'm asking questions that I should know or complex questions. I'm fairly new to critical care nursing and work in a small ICU that has limited resources. Any comments are encouraged!

Thank you for all the help. I think I will try Laura's DVD first and go from there.

Thanks Pricklypear! I think my question is more complex to answer then I thought.

specifically, should I buy the Laura's DVD's and the CCRN review book, or what? And where is the best site to buy from?

Thank you Reddy! I started to look at the link and it looks like a lot of good information.

Thank you pricklypear for your response. I appreciate the time put into responding because I know it still takes time out of your schedule. In response to your post, are all reciprocol changes inverted in configuration on a 12-lead? Or backwards. What about opposite of lateral leads? Where would reciprocol changes show up for lateral leads. And why does that happen? I know I have a lot of questions, maybe someone can add comments to assist in understanding. Thank you!

Can anyone help me with understanding inverted t waves in leads say V2, V3, V4 or V5. What does reciprocol changes mean?

I don't know of a card system for IV push meds but I use 2006 Intravenous Medications. Authors: Betty L. Gahart and Adrienne Nazareno. Publisher: Elsevier Mosby. It is the size of a regular drug book but it is spiral bound and very informative. It is also easy for a quick glance and easy to follow. The Nursing Spectrum Drug Handbook does a good job of describing drugs for IV push, rate and dose.

Thank you Lindarn. I sent you a private e-mail. I'm new at maneuvering through allnurse, so I hope you received my private e-mail.

Oh good, somebody who has heard of the adverse effects of paralytics and steroids used together. I my short time in critical care I have not seen a paralytic drip. What I have seen in my small Unit is the use of norcuron as a prn, used in specific situations. That same pt my also be on IV steroids. I wondered if the IV steroid should be spaced so as not to be given close to the paralytic? My other question is have you ever heard of using Train of Four for prn doses of paralytic, which by the way can be given frequently.

Does anyone know where to find the laws for nurse-pt ratio for the critical care (ICU/CCU) areas in the state of California. I have looked but cannot find it. Is it a law or just a guideline? What happens to Units that understaff critical care areas? How are they regulated? I would appreciate any resources or stories on understaffing in the critical care areas.