km5v6r

km5v6r EdD, RN

Acute Dialysis

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All Content by km5v6r

  1. Policy on IV tubing/bag change?

    km5v6r replied to climberrn's topic in General Nursing

    Tubings at my hospital are changed every 96 hours unless it is Albumen, Lipids or Propofol. Manufacturer mixed IV's are changed every 48 hours, again, except the previous, and pharmacy mixed IV's...

  2. 6% "take off" rule

    km5v6r replied to traumaRUs's topic in Dialysis, Renal, Urology

    I have never heard of the 6% rule either. In my experience the only rule regarding UF was to not take more then 2 liters/hour off. A 4 hour treatment could result in 8 liters UFed if tolerated. The...

  3. Hiring new grads over experienced nurses-VENT

    km5v6r replied to nurseMeghan's topic in General Nursing

    I feel your pain. I began to wonder this spring when I was looking for a new job where exactly the nursing shortage was occurring. Everyone hears about "eating our young" but no one talks about...

  4. Difference between Type&Cross and Type&Screen

    km5v6r replied to Lynn4875's topic in General Nursing

    At my hospital, they are pretty specific about the T&S vs. TCM. The T&S means the blood is checked, but a particular number of units of blood is not designated for that pt. The antibodies are...

  5. Giving IM inject in a SQ space?

    km5v6r replied to onehusbandsevenkids's topic in Patient Medications

    The two IM injections were given with an IM needle into the SQ space at a 90degree angle, not the muscle. IM needles; those that are 1-1.5" long given at a 90 degree angle will go through the SQ and...

  6. Giving IM inject in a SQ space?

    km5v6r replied to onehusbandsevenkids's topic in Patient Medications

    How did you give it into the SQ? Was the needle slanted at a 45 degree angle? The needle on an insulin syringe is not long enough to enter the muscle and the syringe is held at a 90 degree angle. A...

  7. Man, I blew it

    km5v6r replied to willdgate's topic in First Year After Licensure

    I worked nights for 18 yrs. Yes, they are hard. Yes, it does take time to adjust. It is manageable and not unusal to have to wait to go to day shift. Sorry, but hospitals are open 24 hours....

  8. How did you felt with your first expired Patient

    km5v6r replied to RNKay31's topic in First Year After Licensure

    I don't mean to sound as callous as this will probably come across but death is a part of life and worse things happen to people then death. Death is not a failure. To be with someone when they die;...

  9. What's your most interesting/scary case?

    km5v6r replied to LizzyL&DRN's topic in Ob/Gyn

    Ok this is funny and old but my Mom tells of being in the final weeks before my brother was born. Her mother was in the hospital and she went to visit. Dad dropped Mom off at the ER entrance while...

  10. You know you are a PEDS nurse when...

    km5v6r replied to HU_nurse's topic in Pediatric

    You know more about the story lines of "That's So Raven" then you do "Sex In The City". Most IVP meds are drawn up in a TB syringe. You waste more of the narcotic ampule then you give. You keep a...

  11. Has the definition of Para changed over the years?

    km5v6r replied to Bonny619's topic in Ob/Gyn

    Ok I also looked at my original reply and realized my dyslexia was showing. I ment to write my follow through Mom was a G3 P0. Nothing like totally screwing everything

  12. Has the definition of Para changed over the years?

    km5v6r replied to Bonny619's topic in Ob/Gyn

    Sorry I wasn't more clear. This Mom was a G3P0 when I met her. She had been pregnant twice before for a total of 3 pregnancies. The first 2 pregnancies ended in still births after 20 weeks so she...

  13. Has the definition of Para changed over the years?

    km5v6r replied to Bonny619's topic in Ob/Gyn

    I graduated in 1984 and OB was my last clinical rotation. My "follow through" mom was a P3G0. Three pregnancies, no live births up to that point. Thankfully she became a P3G1. Funny how I still...

  14. Your Favorite one liner used with patients

    km5v6r replied to scaredofshots's topic in Nursing Humor

    When I have a pt who is post-op kidney transplant or slowly recovering from acute renal failure we become very excited about the "liquid gold" collecting in the bag. One of the pediatric Nephrologist...

  15. Codes-ACLS drugs-reasons for the code

    km5v6r replied to vampireslayer's topic in Emergency

    Ummm, yes, it can. Hypoglycemic patients code frequently. In 23 yrs of CCU nursing I have never seen a pt go into V-fib from hypoglycemia. And if they have, a dose of D50 is not the immediate answer....

  16. How much do your PCT's do?

    km5v6r replied to Nurseinthemaking's topic in Dialysis, Renal, Urology

    Tired Dialysis Nurse is right. PCT's administering Heparin, Lidocaine, Saline bolus, setting UF goals ect. is the INDUSTRY standard. An unlicensened PCT in a chronic or acute dialysis unit has a...

  17. ABGs and Heart Failure

    km5v6r replied to Megsd's topic in Nursing Student Assistance

    Ok school was a long time ago (before oximetry was available even) but here goes. Sats are going to tell you if the pt is receiving enough oxygen but not how well he is able to use the oxygen or get...

  18. Tension between AM/PM shifts

    km5v6r replied to chloeysmom's topic in CCU, Coronary, Cardiac

    I don't know how to respond to these tirades, I don't want to make any enemies, but I also don't want to let people make me feel like sh*t when there's no reason for it. Does anybody have any...

  19. Tension between AM/PM shifts

    km5v6r replied to chloeysmom's topic in CCU, Coronary, Cardiac

    The on going war of night shift vs day shift. After all everyone knows that ALL pt's sleep ALL night with a stable b/p and rythmn. OTOH everyone knows that day shift sits around all day drinking...

  20. Extubated my patient

    km5v6r replied to BlueEyedRN's topic in General Nursing

    The fact that you are questioning speaks volumns about your empathy and compassion. You heart will catch up with your brain but it sometimes does take a while. The truely sad part is that you came...

  21. z-coil shoes, foot pain gone

    km5v6r replied to gonzo1's topic in General Nursing

    I did and they are working on the problem. For the time being they suggest taking them into a shoe repair shop and having the sole treated. I just have to find the time and shoe repair store. I...

  22. z-coil shoes, foot pain gone

    km5v6r replied to gonzo1's topic in General Nursing

    Yes, the shoes are expensive initially but I figured I was spending $40-50 for work shoes every 3-4 months. Having the same shoes for over 2 years works out to be the same. Besides, as someone else...

  23. z-coil shoes, foot pain gone

    km5v6r replied to gonzo1's topic in General Nursing

    I LOVE my z-coils. My first pair last 2 yrs and I only replaced them because the tops started to look a little scruffy. I have an old (20+yrs) achilles tendon injury. Periodically the scar tissue...

  24. bottoming out... on dialysis

    km5v6r replied to timdmb's topic in General Nursing

    She'd come back from dialysis feeling ok but tired, her accucheck would be somewhere in the 200's, she'd eat a good dinner, I'd give her coverage, and then at 9pm for her next accucheck she's be in...

  25. Code/Trauma Debriefing

    km5v6r replied to erdaynurse's topic in Emergency

    The formal name for what you are looking for is Critical Incident Stress Debriefing. At least here the program is managed by the state and was expanded into hospitals. You might also check with the...