zacarias

zacarias ASN, RN

tele, stepdown/PCU, med/surg

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All Content by zacarias

  1. Drawing blood from a PICC line

    zacarias replied to rnewmanjunkie's topic in General Nursing

    one big thing is you NEVER directly attach blood culture bottle to the picc. The culture medium in the bottle is deadly if it gets into blood

  2. COPD exac patient- breath sounds

    zacarias posted a topic in Pulmonary

    Hey, I've been a nurse for four years and now while generally I feel pretty good with lung auscultation, sometimes my confidence gets shaken. Like the other night... ER sent me up a patient who...

  3. Insulin question

    zacarias replied to SNlena's topic in Patient Medications

    Some people on this thread have been focusing on why the student needs to look up INR etc. The truth is, this nursing instructor is a quack. She is a drama queen who likes to scare nursing students...

  4. Med Error Question

    zacarias replied to cnolan's topic in Patient Medications

    the problem is, this nurse who reported this error dutifully when many wouldn't have, this nurse is now "labeled" in a way as a risk. Non-punitive

  5. standing orders in your hospital

    zacarias replied to esrun00's topic in General Nursing

    Standing orders are good, but like people have said, you have to be very cautious. For instance a lot of antacids are contraindicated for renal patients and thus a blanket standing order may or may...

  6. interleukins and functions

    zacarias replied to GingerSue's topic in General Nursing

    I never did interleukins in school. Ask any nurse and they won't be able to differentiate the functions. Most docs don't know

  7. Had my first doctor scream at me today

    zacarias replied to TigerGalLE's topic in Patient, Colleague Relations

    That is not to be tolerated. Talk to you manager about how to "write" him up. Most hospitals today are not tolerant of doctor to nurse abuse and have a process to deal with that. Whether you knew...

  8. Nurse fanny packs

    zacarias replied to Sassybottom's topic in Scrubs, Uniforms, Gear

    That denim looking one looks good. I would love to have something to carry stuff with. I don't ever have tape, scissors, or a penlight on me because I would lose it all if I brough it to work in...

  9. 94 y/o with fever after abx

    zacarias posted a topic in General Nursing

    Hey all, Question: I had a 94 y/o LOL last night who was in for chf r/o pneumonia. She was afebrile until about 2230 when she was shivering and shaking quite a bit. I took her temp to reveal...

  10. assessment question

    zacarias posted a topic in Pulmonary

    OK, Last night was a very hard night. I had one guy almost going to code from COPD, but we managed to prevent that. He is SO end-stage COPD. Anyway, besides him, I had another pt with failure to...

  11. Trach capping and suctioning

    zacarias replied to grentea's topic in General Nursing

    I am also new to trachs. I had a patient with a trach that had humidified air initially with inline suction. We would suction him every so often. He was not a new trach. I remember that you're...

  12. Starting IVs on old sick people

    zacarias replied to zacarias's topic in Infusion, Intravenous

    Thanks for all the tips. What do you mean "cause the vein to go flat?" Also, One more question. I notice when I apply a lot of tension under where I'm going to poke, the vein suddenly becomes flat...

  13. Blood Sugar Guidelines

    zacarias posted a topic in Diabetes, Endocrine Nursing

    Hey all, I am confused. I thought that we were really cracking down on blood sugars and prefering FBG to be 70-110 or even 70-100. But i looked at the ADA website and they recommend 90-130 which...

  14. JCL Deer Valley????

    zacarias replied to Curious1alwys's topic in Arizona Nursing

    I believe it's Scottsdale - Osborne, the other Level 1 in Phoenix. I work at JCL-North Mountain and really like it. JCL is a new hospital with great parking opportunites (hey that's a commodity!)....

  15. Not the greatest night...

    zacarias posted a topic in General Nursing

    Hey all, Last night I had a very busy night. Not too many patients but one super duper busy one. He was a hemiplegic with a trach, and was admitted for C-Diff (pseudo. colitis), UTI with a...

  16. Not the greatest night...

    zacarias replied to zacarias's topic in General Nursing

    thanks guys for the great comments. And to CRNI for the article link which was very helpful. One thing to note is rectal management systems (flexiseal) are not approved for use beyond 29

  17. Pulmonary Toilet? Huh???

    zacarias replied to kukukajoo's topic in General Nursing

    Also, some of the RTs use a vest for the patient. It wraps around them and shakes and vibrates their chest while they do nebulizer

  18. Do you love your managers?

    zacarias replied to NoeIssa's topic in Patient, Colleague Relations

    I in a new hospital in a new state with , obviously, a new manager. I think my manager has helped the unit I work on in many ways but I do not feel she will stick up for me. Maybe this feeling will...

  19. Nursing Shortage Where YOU work?

    zacarias replied to pat8585's topic in General Nursing

    Back in Seattle where I'm from, the shortage isn't and probably will never be acute. In Arizona where I am now, it's fairly acute. Tons of travelers staff hospitals and things are fairly

  20. forced vaccines

    zacarias replied to crissrn27's topic in General Nursing

    That happened at a hospital where I used to live. The union came to the rescue of nurses and this was overturned and they didn't HAVE to get the vaccine. I love WA

  21. Taking A Poll for an Assignment

    zacarias replied to beckyrmm's topic in General Nursing

    I don't have insurance and I've been a nurse almost four

  22. Not the greatest night...

    zacarias replied to zacarias's topic in General Nursing

    Thanks guys and thanks Meghan, I had the same patient the next night and they capped his trach. He was able to cough up secretions all the way to his mouth and occasionally I used a Yankauer in...

  23. Looking down on those who take lunch breaks???

    zacarias replied to mismissy69's topic in General Nursing

    I never look down on nurses who take lunch breaks. I sometimes feel irritated (VERY SELDOM) when techs ALWAYS get a lunch break + 15 min break each side of the shift. They're entitled but when do...

  24. What Do I Do With 8 Months Experience?

    zacarias replied to BlueEyedRN's topic in General Nursing

    I just moved to Phoenix from the Seattle area. Nursing jobs EVERYWHERE in Phoenix, you will have your choice. I work at John C Lincoln North

  25. "The last place I worked, we did things differently!" (and correctly)

    zacarias replied to GardenDove's topic in General Nursing

    Ok I will admit something here, I started a new job in a new state two months ago. My preceptor and I didn't hit it off right away. We would "argue" about what to do for patients as far a PRN...