zacarias

zacarias ASN, RN

tele, stepdown/PCU, med/surg

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All Content by zacarias

  1. My first code ever...(any ideas on what happened?)

    zacarias replied to HappyNurse2005's topic in General Nursing

    Vaso-vagaled. In my experience, people who do this or have a sudden drop of BP can be unresponsive for like 30 seconds. What's their BP/HR stabilizes, they come back. It's still very scary and for...

  2. Nursing Shortage: Fantasy or Reality

    zacarias replied to burn out's topic in General Nursing

    It depends on the facility. I have few complaints about the staffing on my unit at my hospital except this: On tele, we'll have like four or five patients on nights, and at 4am, they send someone...

  3. teamwork and job satisfaction

    zacarias replied to mak2's topic in General Nursing

    Teamwork absolutely affects me on the job. When I'm having a really stressful job and someone offers to help, smiles at me, makes a joke to lighten to mood, I feel like I can make it through the...

  4. Infection

    zacarias replied to Irishgirl's topic in General Nursing

    Blood cx are tricky. My understanding is that even if someone is bacteremic (septic), Blood cx may not grow out anything. Secondly, central lines are notoriously easy to infect. It's a constant...

  5. Quick question re Lopressor

    zacarias replied to Guest717236's topic in Cardiac

    You gave his BP range but what would his BP be without the metoprolol? The other possibility is he takes it to steady his golf

  6. Last night...

    zacarias replied to zacarias's topic in Cardiac

    Wow, it sounds like that guy was even refractory to amiodarone. But for people that are chronically in and out of afib (or have had afib for a while), cardioversion seems like it would only help for...

  7. Last night...

    zacarias replied to zacarias's topic in Cardiac

    This guy was already on dig and his dig level was

  8. A CT not necessary?

    zacarias posted a topic in Neuro Intensive Care, ICU

    Hey, I'm not a neuro nurse by any means, tele here but I have a question. My grandmother who is 91 fell in her bathtub yesterday and was taken to the doctor. He apparently examed her and then...

  9. A CT not necessary?

    zacarias replied to zacarias's topic in Neuro Intensive Care, ICU

    I think she just started her four day period off of it the day she fell. I just can't believe that a doc wouldn't order a CT in her case. Maybe they're more judicious in ordering such a

  10. Best hospitals to work at in north Seattle?

    zacarias replied to seattle06's topic in Washington Nursing

    Bothell is on the Eastside of Lake Washington (Metro Seattle is on the westside). Great area to raise a family here although expensive. On the Eastside, Overlake Hospital and Evergreen Hospital are...

  11. I didn't get all this education to wipe behinds!

    zacarias replied to SeekingNur's topic in General Nursing

    I think that already that basic hygiene and certain other tasks are the responsibility of CNAs, at least the ones I work with. However, I am not above doing those tasks if I'm with a patient that...

  12. Rapid Afib

    zacarias replied to zacarias's topic in Cardiac

    Thanks you guys for your reassurance and suggestions. It turned out that they tried dig again, and then lopressor x 3. The guy apparently was refractory to

  13. blood culture?

    zacarias replied to Ms.RN's topic in General Nursing

    Blood cultures are majorly expensive and I agree probably should be ordered more judiciously. Some docs order blood cultures for any fever of 39

  14. need help getting out of dangerous job!

    zacarias replied to Cali_Nurse05's topic in General Nursing

    Calinurse05, are you in WA? WA has some of the best staffing, nurse satisfaction in the country. I'm eager to know what hospital you are talking aobut. Maybe a small community hospital? I agree...

  15. Oddest things found in a patient!

    zacarias replied to Antikigirl's topic in General Nursing

    I remember a rumor years ago about Richard Gere sticking a hamster into his rectum. I guess that rumor died out along with the

  16. Bullies In The Work Place ! Pt 2

    zacarias replied to buildingmyfaith57's topic in General Nursing

    Yes. Our manager takes bullying very seriously. It's a no tolerance policy. If a manager doesn't, then HR needs to get involved. It's not to be put up

  17. Ruptured Lungs

    zacarias replied to Spritenurse1210's topic in General Nursing

    It sounds like the OP could be referring to a bleb that

  18. about the bird flu......

    zacarias replied to jrring1019's topic in General Nursing

    The threat of a bird flue pandemic is very scary indeed, but I always think about this: If the virus mutates so that it can go from human to human, it also could mutate to a less lethal form....

  19. is this typical?

    zacarias replied to shock-me-sane's topic in General Nursing

    The student mentioned this patient was septic. A truly septic patient would not be discharged from an inpatient unit would

  20. Faxed Reports

    zacarias replied to apushist's topic in General Nursing

    We started doing faxed reports (ER to my tele unit) several months ago. I've gotten used to it and pretty much it tells all that I need to know. Of course I can always call down to ER to ask a...

  21. Tele floor: what is you pt ratio?

    zacarias replied to ZootRN's topic in General Nursing

    it depends on whether your pts are just needed telemetry monitoring or if they're on the tele floor because they are post-op CABG. Either way I think 1:7 is too much. I work on general tele floor on...

  22. Nurses Week

    zacarias replied to jonear2's topic in General Nursing

    Nurses week just started yesterday and will go on till the

  23. Orthostatic Blood Pressure

    zacarias replied to WVUBSN*93's topic in General Nursing

    Generally wait 3-5 minutes after each position change before you check the BP/HR. A person is said to be postural (or orthostatic) if their SBP drops more than 15-20 mmHg. Also, you would expect their...

  24. Bilobectomy quesitno

    zacarias posted a topic in Pulmonary

    Hey all, I had a pt last night who was s/p bilobectomy (RML and RUL) and while he wasn't a difficult patient I do have a question. He had very audible breath sounds on his R side!! The base was...

  25. ultram

    zacarias replied to Ms.RN's topic in General Nursing

    I had a patient the other day who got really confused after they gave him various opiates and so the kidney doc on day shift wrote "D/C narcotics, just use ultram." I told the day shift nurse that...