Amy2005

When a patient is on droplet & contact precautions and the specimen results are not yet back (the patient has a respiratory infection) - this means that anyone entering the patient's room must wear gown, gloves, mask, goggles. Why is it okay for a visitor to put on all of these, and then to take their purse in when visiting the patient?

Keep those references - believe me - they come in handy at a later date. Even now, for me, I am using as many of my written references and evaluations for another purpose.

before getting involved with any educational facility, find out everything about the program. Find out about the clinical components - like when will clinical occur? (some of these programs have terrible arrangements for their clinicals - so you end up waiting endlessly because they can't always find preceptors).

When a patient is competent, then the patient can accept or refuse treatment. What source actually explains the circumstances of a patient right to refuse or situations when health care providers or other authoritiy would have the right to insist that the person have treatment? I've read about Supreme Court decisions. How to find the laws about this? Google has lots of information and various examples, but how to find the local laws about this topic?

how about 'impaired physical mobility r/t painful joint" - does he have self-care deficit? Or chronic pain? Or risk for imbalanced nutritional status: less than body requirements?

This is the test for checking torn meniscus. I have been searching Google to find a more detailed description of how the test is performed. My textbook has a short description, but I am not certain about how to "push a valgus (inward) stress on the knee". The leg is rotated exernally, the hand is placed with fingers on the medial side as the leg is extended. How is the push inward done? Am I supposed to press with the hand, placed on the medial side, so that I'm pressing from the inner side, or am I supposed to be pressing so that the leg is direced inwards as it extends? (that would mean pushing from above the knee). Hopefully someone could clarify. Thanks

Actually, this is a patient who went to ER from home, then was sent from ER to LTC. Such an abrupt change, no longer able to go back home, and asking "what was the cause of the problem?" I don't know what the medical staff said or did not say re: informing this patient of their health condition. Maybe there is some information or a form that came from the hospital to the LTC? Will check.

Thanks. For the patient to request the chart/diagnosis - who to ask? Ask medical recoords? Sounds reasonable to send a letter.

When an elderly patient, transferred to a long-term care facility, wants to find out their diagnosis (that caused them to go into hospital emergency), unsure if the doctor saw them while in the hospital, how can the patient find out the diagnosis?

okay - and this would mean using another bag of NS (emptied in order for it to receive the backflush from the NS that is already hanging). It would probably be okay then to just use that new NS and hang it, to replace the blood unit empty bag, and let it flulsh the line, so there is no blood in the tubing? Simpler (same result, still uses a second bag fo NS).

The blood administration set can be used for 2 units, as long as they are given in rapid succession and the tubing is flushed with saline in between. When using the blood admin set that is specifically the kind with the cassette for the infusion pump, how is the upper line to the blood unit cleared of blood? The saline would run through its upper line, then through the filter and along the distal line. So that means that the portion of the line from the filter downwards would be cleared with saline. How is that upper section of line for the blood unit supposed to be cleared? Inexperience and lack of equipment to practice with is part of the reason that I don't know how to do this. I would therefore probably get a new admin set for the second unit. Any suggestions? My searching on google did not provide the answer (yet). thanks

check with the College of Nurses (located in Toronto on Davenport Road)

The textbook that I am looking at says to assess carotid, renal, ischial, or femoral bruits. Where is an ischial bruit found, if there is one? The others that are mentioned are ones that I have instructions about, but not for ischial. My searching on google hasn't produced an answer.

This is a request for ideas for some activities that an older confused adult could participate in, during the day, while sitting in a wheelchair. It was suggested by one person that folding towels/facecloths is something that they could do. Any more idea? Thanks

What is meant by "domiciliary oxygen"? I've been checking on google for an explanation - haven't found a clear definition. My book mentions it in terms of its being used for fifteen hours/day and to achieve SaO2 greater than 90%

Still trying to get all the steps included. After a medication is given (using a minibag or Bard mini-infuser), then is the tubing flushed? This would flush the lock too. Then the tubing would hang with a cap (filled now with sterile saline). Or is just the lock flushed? (this would mean that the tubing has the old medication solution still in the tubing - but it would probably lose its potency). If the medications are compatible - is the tubing flushed between medications? Or just the lock? If the medications are incompatible - they would have their own tubings? If only one medication is being given to the patient, is the tubing flushed before and after administration, or just the lock? My manual speaks only of flushing the lock. What about the tubing? Or would it be a flush for tubing and then another flush for the lock?

Why is ASA to be chewed when given for angina or heart attack? I've tried to find how this works - the ASA should reduce the severity of heart attack, it should help reduce clot formation. How does it work when chewed?

After one IV medication has been completed, and the tubing sits, still attached to the minibag, then is the tubing or just the saline lock supposed to be flushed before the next medication is started? If the medications are compatible - then it seem to be okay to flush only the lock. If the medications are incompatible - then would different tubing be used?

after the urinary catheter has been inserted and is draining urine, the maximum amount (according to agency policy) that can be drained is 750 mL. If urine is still draining, then the catheter would have to be plugged or clamped. For how long would it have to be plugged until draining can be continued?

This is a question about when to change the sterile gloves. After cleansing the stoma, the outer cannula, the face plate, the inner cannula, replacing the inner cannula, and applying the new trach dressing - are the gloves then removed before applying the new ties? Or should the nurse remove the gloves before applying the new ties?

Thanks for this topic about PCAs. I don't know the answer to your question - if it is just a med error or if the nurses should be fired. All I can offer is my opinion - that I consider this to be a situation from which all can learn (an educational opportunity). I've been doing some reading about PCAs, and some sources explain that these pumps do have risks and that staff who work with the PCAs should be trained re: how to use them. Risks of overdosing, risks because of mis-programming. Just my opinion - don't fire the nurses, but use this as an opportunity to educate.

I'm asking - in order to go through the steps in detail, to make sure that I have thought this through: 1) gather specimen container and put the label on it first 2) wear mask and gloves 3) bring a little plastic bag (this is for the container once the specimen is collected) 4) have the patient produce 15 - 30 mL of sputum and collect it in the container (maybe have the patient hold the container or nurse wearing gloves holds the container?) 5) if the patient holds the container, then the nurse can put the lid on the container once the sputum is collected, or if the nurse was holding the container then put the lid on 6) if the patient was holding the container, then the nurse's gloved hand could have the plastic bag open and ready for receiving the container with its lid now on. Nurse can hold that plastic bag with the one gloved hand that has never been near the possibly contaminated container. 7) if the nurse was holding the container and puts the lid on - then the nurse's gloved hands are possibly contaminated. How will the nurse manage to put the container into the little plastic bag if the nurse now has contaminated gloved hand from holding the container? Maybe the nurse could put the container onto a paper towel, then put on new gloves, then have the plastic bag open and ready, then pick up the container with one gloved hand. Any ideas? thank you

thankyou - doesn't seem to be any instructions in the link for use of the PCA. Still searching. Any more ideas about where to find instructions?

thanks for the links, the ones that I saw did look like the one in the first linK. What make is it? -

I've not had instruction in the use of PCAs, and this is a device frequently used in the hospital. Although there was some opportunity to observe the use of them, and several opportunities to practice aspects of their use - it would be helpful if there was some instruction manual to better explain how to use them. I've been googling for information, but haven't yet found this type of information. Can anyone guide me to a source that has maybe some pictures to show the buttons, with explanation? Thanks