km5v6r

km5v6r EdD, RN

Acute Dialysis

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All Content by km5v6r

  1. CRRT training.

    km5v6r posted a topic in PICU, Pediatric

    How does your facility handle training for CRRT? Who is responsible for the set up, take off and hourly balances? Do you ever change the rates? Do you have parameters? Who provides the training?...

  2. Dialysate temperature in hemodialysis

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

    I agree in an ideal world the room temp would be high enough that the pt is comfortable without additional blankets etc. Unfortunately I have to work in the room with the pt. I have to wear a full...

  3. incontinent NH pts

    km5v6r replied to 3cdn1usa's topic in Dialysis, Renal, Urology

    Keep in mind that an Art line has a continuous flow of fluid INTO it from a pressure bag. A dialysis needle has to have the ability to withstand the continuous PULL of blood through the needle at a...

  4. Has anyone EVER seen a patient come off CRRT alive?

    km5v6r replied to rph3664's topic in Dialysis, Renal, Urology

    CRRT is continous renal replacement therapy. It is a long slow dialysis. Pt's in renal failure, either acute or chronic, who are to unstable to tolerate hemodialysis may be started on CRRT. Instead...

  5. dumping the prime

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

    Do you ever give Albumen as a prime for unstable pts or pediatric

  6. dumping the prime

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

    You should check the package insert that comes in the box of dialyzers to see manufacturers instructions. I know that the Optiflux dialyzers insert specifies that the prime be dumped prior to HD to...

  7. Has anyone EVER seen a patient come off CRRT alive?

    km5v6r replied to rph3664's topic in Dialysis, Renal, Urology

    I have seen both adult and pediatric pt's survive CRRT. Granted the ones that don't far out number the ones that do but some do survive; especailly with the adults. We currently have several peds...

  8. Can CNA do an accucheck?

    km5v6r replied to QuigRN's topic in General Nursing

    All of the hospitals in this area have the CNA's do the accu-checks. They report the results to the nurse who then act on the results. The hospital provides the training for the specific machine...

  9. Transplant in Elderly

    km5v6r replied to Pam RN's topic in MICU, SICU

    Your MIL probably developed a heptaorenal syndrome pre-op and it is continueing post-op. When the kidney's are "shocked" or stressed they may quit function for a time and take a while to recover....

  10. Help! I need a BLScard ASAP!!!

    km5v6r replied to fostercatmom's topic in General Nursing

    Check with your local American Red Cross about a class. The AHA does do initial classes also; you may have to check with some of the local schools or the local ARC office. The only difference I...

  11. I'm Taking a Poll

    km5v6r replied to NotReady4PrimeTime's topic in PICU, Pediatric

    Almost 90 on Tuesday and snow today. Typical. This type of weather in March though is scary. Probably means the summer will be hiddously hot and long. The CPR class was short and good. I am...

  12. I'm Taking a Poll

    km5v6r replied to NotReady4PrimeTime's topic in PICU, Pediatric

    Good Grief!!! Makes me even happier to be where I'm at. We are slowly converting over to computer charting and things like the Braden are already on the computer. We just don't have enough computer...

  13. I'm Taking a Poll

    km5v6r replied to NotReady4PrimeTime's topic in PICU, Pediatric

    Interesting. The rational behind nasal intubation makes sense but the sinusitis would be a major deterent. We rarely have an incident of VAP. Many times our kids do have an NGT in one nares and an...

  14. CVVH/CRRT ques.

    km5v6r replied to first_lobster's topic in MICU, SICU

    Sorry to be so slow responding. I have been bogged down working. Where would replacement solutions be running? We generally run replacement both into the arterial chamber prefilter and into the...

  15. I'm Taking a Poll

    km5v6r replied to NotReady4PrimeTime's topic in PICU, Pediatric

    Sorry I can't help with the heart surgery aspect as we don't do any heart's. We do the major bowel and liver transplants. Some of our kids will be on the vent for months; one for neary a year before...

  16. CVVH/CRRT ques.

    km5v6r replied to first_lobster's topic in MICU, SICU

    I have done SLED with both the K machine and the older H machines with the additional CRRT chip. What kind of details are you trying to sort out? At this facility the Nephrologist orders the amount...

  17. Question re: NPO and meds

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

    I work in a transplant facility. The cardinal rule around here is NEVER hold the transplant meds. They have to be given as ordered at the times they are ordered no matter what. There is no safe IV...

  18. Sharps Containers in Public Restrooms?

    km5v6r replied to GardenDove's topic in General Nursing

    The local Shopko's and casino's have well secured sharps containers in the restroom's around here. I does make sense. What struck me recently is that many malls and stores have "family" style...

  19. Scheduled induction???

    km5v6r posted a topic in Ob/Gyn

    My daughter is expecting her first child next month. EDC is March 25 or there abouts. Dates aren't terribly accurate because she was switching between the pill and Depo Provera for birth control. She...

  20. Scheduled induction???

    km5v6r replied to km5v6r's topic in Ob/Gyn

    Would your daughter allow you to go to an appointment with her to discuss the risks/benefits of this induction? My daughter and son-in-law live over 4 hours away and I still work full time. I may see...

  21. "Funny Codes"?

    km5v6r replied to burn out's topic in General Nursing

    Then when one of them asked her to check for a radial pulse, she blanked out and said, "what's a pulse?". Poor thing, she made it through school fine though:chuckle . I worked with a nurse once who...

  22. "Funny Codes"?

    km5v6r replied to burn out's topic in General Nursing

    I was working in CCU and it was our turn to have the code pager. We had just finished report when it went off for the PCU and I took off. Arrived in PCU to find both shifts still giving report...

  23. dumping the prime

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

    All the companies I have worked for required "peeing" the lines before hooking up the pt. Even those with a dry pack dialyzer. "Peeing" the line consisted of dumping about 500 ml of saline through...

  24. dumping the prime

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

    In the acute unit we would dump the prime on someone in massive pul edema that we were dialyzing to keep off the vent. If the pt was frothing that extra 250 ml of fluid could be to much. We would...

  25. Clots Clots And More Clots!!!!!!

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

    In the acute setting with pt's who have developed Heparin induced thrombocytopenia we could not use Heparin. We would plan on rinsing the system with at least 100 ml of NS every 30 mins and planned a...