deepurple

i want to ask and share something here.. during do my task in ward as an observation nurse which is taking vital sign to all patient.. many of them would said that "my pressure will be high from previous one because i just taking lunch or dinner" My question is.. is that after taking meal will affect our blood pressure reading? if it is so? why? i can't see how it is related to blood pressure can someone explain to me?

Dear nurses.... Is there any differences between taking blood pressure on the right arm and the other arm?

thank you for your respond. Thank you for sharing your ideas. It might be helpful for me. I will try my best to do it.

Been working in cardiac hospital is very busy all day long and also very tough with pediatric and adult cases. With a lot pt and management, till i went home everyday really late in the evening. Plus it was very tiring and can't revise or do short learning in the night. i need some advice from experienced nurse here in managing our time as a nurse.

At first, when i started to work, i really did not expect to get into pediatric congenital heart disease ward. It was totally busy ward with one medical officer in charge in that ward. My heart really disappointed and unhappy got into pediatric ward. i felt very jealous to my friends who got into ccu, cath lab and adult ward. My first impression was i thought i'll be just fine and with full emotion in my heart that i do not like pediatric. I can't cope with pediatric congenital heart disease because i started to dislike it. when i read and involved in case discussion, i cannot focus at all. The interest does not show up at all. The work environment and the staff which i don't think they were cooperative. the feedback that i got, i did not seek for help. How i'm gonna ask for help if there are staff who were very selfish and really does not cooperate. In the middle doing observation, i have to fetch pt from invasive cardiac lab. Then i finish my work after 2pm...it was so miserable. when i'm in-charge nurse, the medical officer which i called crazy doc like to seek my mistake every time. I can't stand in this ward, when i seek for help, they ignored me, then told me that i was not communicate to each other. I do not have break time at all when i worked in this ward, i went home like office hour staff do in the late evening, my body very tired, i can't revise what i learned, and the working cycle went on like this every day. I tried my best but still there must be disruption going on until i fed up. nearly one year, i still not confirmed yet as an employee due to bad feedback, for me if no one saw what's the best that i'd done, i don't mind that kind of feedback, which i don't care at all, i was requested to change ward. Since then, i really hate it, the staff , crazy doc and even the nurse manager. Now they put me in the PALS exam, till now i don't read the PALS book that much, because my heart is totally close for it. I don't want it at all. Now i'm working with staff which more cooperative and i able to remember all pt case, have courage to speak out to doc or call for help, they were really helping me. I am really thankful for that. Now i'm still thinking what i'm gonna do wit the PALS exam? I feel like to fail it. if i fail it i might be regret later on right? how??

How to do atrial ecg? First, the pt must have pacing wire from ventricle and atrial When comes to set up the ecg machine, it become totally mess up. When print the ecg, he normal ecg will be printed not the atrial ecg. When pt do have temporary pacer, we disconnected the pacer when to do normal ecg w/o pacer but still have paced, but at lead II no pace. My question is when do ecg w/o pace, is it only the lead II showed no paced and the rest will showed the paced?

i was talking about career in nursing..not about an english..you are very annoying

i think you the one that do not know what post basic in nursing. Maybe u need to find about it. tq

hi... i'm still new in nursing field and almost one year contribute in nursing career. I'm working in cardiac nursing field for adult and pediatric congenital heart disease. i really need advice from here that in 5 years time i want to further study but i'm wondering which course are really suite with my experiences whether proceed for post basic or degree? I'm planning to further study in UK or australia.

thank you for those replying my question... what i'd been practiced now in my ward which i handling post operative pediatric cardiac surgery. our surgeon was using the disposable bottle drainage which not connected with vacuum. the drainage will drain out follow the gravity. under some circumstances, our surgeon will give order to connect ct to low suction but it's rarely. i'd seen the icu staff did stripping the ct on post op day. which one is the good practice? one more thing...what i had understand about the clamping of chest tube is to prevent back flow of drainage to pericardial or pleural and to avoid air from entering the chest tube if the connection is dislodged. are these rationales incorrect?

hi everyone...i want to ask for help about the care of chest tube. i list the responsibilities of nurses for chest tube care. from your experiences, is there any info to add in the list below from all of you. tqvm, you're most welcome. 1.check dressing at the site of chest tube insertion -ensure the dressing or plaster is intact to avoid the chest tube is slip out. 2.do dressing at the chest tube insertion site to avoid potential infection. 3.check the patency of the chest tube - do milking or stripping along the chest tube to avoid blockage or obstruction of the drainage. 4. observe the type of drainage and amount of drainage. 5. check is there any bubble in the chest tube to to know whether there is pneumothorax 6. change the drainage bottle when 2/3 full of drainage. - if chylothorax - need to change the drainage bottle everyday to observe the progress of the drainage. 7. clamp the chest tube when to move the patient or when to walk to avoid the back flow of the drainage into the lungs or cardial.

thank you for those replying my question... What i'd been practiced now in my ward which i handling post operative pediatric cardiac surgery. Our surgeon was using the disposable bottle drainage which not connected with vacuum. The drainage will drain out follow the gravity. Under some circumstances, our surgeon will give order to connect CT to low suction but it's rarely. I'd seen the ICU staff did stripping the CT on post op day. Which one is the good practice? One more thing...what i had understand about the clamping of chest tube is to prevent back flow of drainage to pericardial or pleural and to avoid air from entering the chest tube if the connection is dislodged. Are these rationales incorrect?

Hi everyone...i want to ask for help about the care of chest tube. I list the responsibilities of nurses for chest tube care. From your experiences, is there any info to add in the list below from all of you. TQVM, You're most welcome. 1.Check dressing at the site of chest tube insertion -Ensure the dressing or plaster is intact to avoid the chest tube is slip out. 2.Do dressing at the chest tube insertion site to avoid potential infection. 3.Check the patency of the chest tube - Do milking or stripping along the chest tube to avoid blockage or obstruction of the drainage. 4. Observe the type of drainage and amount of drainage. 5. Check is there any bubble in the chest tube to to know whether there is pneumothorax 6. Change the drainage bottle when 2/3 full of drainage. - if chylothorax - need to change the drainage bottle everyday to observe the progress of the drainage. 7. Clamp the chest tube when to move the patient or when to walk to avoid the back flow of the drainage into the lungs or cardial.

Thank you for your advice...i try my best to do it....

dear janfrn i had a problem when taking blood pressure with blood pressure machine. i'm still new i pediatric ward. there must be some tips or technique in taking blood pressure for them. the most important thing is i want to know how to put the cuff blood pressure at the right position at the leg.

Dear all I had a problem when taking blood pressure with blood pressure machine. I'm still new i pediatric ward. There must be some tips or technique in taking blood pressure for them. The most important thing is i want to know how to put the cuff blood pressure at the right position at the leg.

Thank you so much janfrn..you are really helping me.... What should i call you? May i know your name?

Thank you for your explainations and to janfr, maybe like you said i was over-thinking. and maybe what u had gave that's what i want..the range of spo2 for cyanotic and acyanotic...TQVM for all...

Thank you for sharing this knowledges with me....It is really helpful. The syringe also must be free of bubble to right? have you see some nurses connected the syringe first and syringe out ...to see whether there is bubble or not.If there is bubble come out, they will syringe out the bubble then they flush the line.

i want it because the congenital cardiac disease have acyanotic and cyanotic. In my ward, we need to do 4hourly observation for all patient to monitor pt whether for pre op or post op pt. That's why i need some information about spo2 reading for different diagnosis or post operative surgery. Of course after Tetralogy of fallot correction, the spo2 will 95% and above..but for example post operative blalock taussig shunt, the spo2 will not reach 85%.. it will 70% - 80% because it is palliative surgery not curative. There are a lot of procedure and surgery that had been done and it have different reading Spo2..

these are part of important things in pediatric congenital cardiac disease. But there must be information about the Sp02 reading for pediatric congenital cardiac disease. i'm looking for that but still couldn't find yet. It is important when i'm doing 4hourly observation. Because different congenital cardiac disease has different Sp02 reading.

Many case for paediatric congenital cardiac disease. When i'm doing 4hourly observation including pulse oximetry for preoperative and postoperative cases, i'm confused about the oximetry reading for congenital cardiac cases. I'd been searching for oximetry reading for congenital case but couldn't find up until now. Someone can help me where i can find information for oximtery reading for congenital cases.

One of my senior staff nurse who taught me how to avoid injecting the air into the line. I think like what you have said, lock the syringe into the stopcock and point upwards 90 degree and tap the syringe so that the air is going upward and then the bubble will not go into the line. Isn't it?

how about this book,the title is the pediatric cardiology handbook by Myung K. Park. What do you think? have you heard about this book?

Thank you for your reply...and thank you for sharing your personal practice, it would be nice if i can see how you do it rather than you explain to me...well it's okay...i really appreciate it. That child had undergone tretalogy of fallot correction and ventricle septal defect closure. today is post-op day 9.