gradcare LPN

Super glue is not a good substitute for lube. If you forget this and end up gluing your urethra closed, it is probably best to present to the ED early rather than wait until you have not peed for over 18 hrs..

Also it must be remembered that many medications used to prevent stomache ulcers including H2 blockers can alter the pH in the stomache so pH testing can be unreliable (false negatives) additionally listenting and pH testing do not give you a reliabl...

No, insantiy is only relative anyway (your familiy drives you crazy.....just kidding) New Rn's in the critical care environment can and has been done well preveously however there needs to be a massive level of both clinical and social support availa...

Generally we need to remember that noradrenaline (or any other trope) is a poor substitute for adequate fluid reses. That said, in the setting of an adequately fluid loaded patient if you've hit 20 mcg/min with no result then you need to add another...

To junebuggy re step downs using the "milk of human kindness". I'm presuming that these pts do not have an artificial airway and are not vented (that's what step down is to me). Thinking about how the stuff actually works, then using a substance wit...

What sort of ICU are you looking for? Medical / Surgical / Mixed? Once you get your stuff together on the ward environment you can make the switch. Both medical and surgical wards will provide experience that can be useful in the ICU. A CCU or tele...

Have worked with 2 systems. 1 where the MET (RRN) nurse was included in the count but floating (no allocation). And the other where the Nurse had a case load. Response times didn't really differ what did was that the RRN with no case load could tak...

poor gerbal

How do I apply a fecal containment device (bum bag)? please note the instructions have pictures......... Should I call a code on this patient ??? (blue , no pulse no resps..was pink 2 min prior pt for full resus)

Attended pt who was crashing, me my doc ward staff etc with this pt when the pt opposite (in 4 bed bay) buzzes to tell us his obs wer 2 min late!!! Nice to be needed.:chuckle

"I'm feeling very discouraged with nursing after only two weeks of clinical. I'm in my 2nd semester of my BSN program. My clinical instructor thinks that I am way better suited for ICU so I'd love to hear what your day is like (in general) in the ICU...

All units i've been involved in ICU will do CRRT until the patient is stable and able to tollerate IHD (if it is going to be needed post discharge). If the patient is going to need IHD post ICU discharge then the renal people come and do it. So sho...

38 with ccf. bad karma from the get go. You do what you can with what you've got. what was the ecg like? any chance that this was pure pump failure cardiogenic shock)? Any SVO2/ mixed venous / subclavian gases to differentiate between sepsis/ card...

Sounds like u need to either ban linnens or have a place for relatives to sleep. My current unit has 2 "slep rooms" for acute ie 1-2 nites only as we are the only unit with all the specialties for about 1200 km north south and west so many of out pt'...

HIT(S) has been around for quite a while problem is you need to recognise and then test for it. Seen 3 cases in last 18 months, that said we tend not to use the low molecular weight heparins to prevent DVT's and tend to use heparin infusion to prolo...

Of course that all hinges on the estimation of burned area being correct. Have left burns behind me now but started seeing goal directed fluid strategies with the goal being urine output of approx 1 to 1.5 ml/kg/min with parkland being a starting poi...

We've been running on random vanc's for several years now used to to peaks and troughs now just do troughs approx 1-2 hrs prior to next dose. Though there seems to be an algorythm for bloods taken a little earlier.

Have yet to see a "standard rate" of TPN administration as nutritional needs can vary dependent on disease state, weight temp etc. Also fat percentage (eg 10 % vs 20%) can be altered depending on comorbitities and serum triglyceride levels

contraindication purely relative. No access = dead. Hey you get it where you can. Very poor chest so sub clav line probably out, IJ perhaps but sounds like the vena cava was getting a little crowded. Besides you didn't choose where to put the lin...

Some times you feel "dirty" because you are advocating for the patient knowing full well what that entails even if they don't (doing everything for the pt with GVH taking over their entire bodies, watching the disease process head towards the point o...

Have "walked Peep up to 35 cm H2O as part of recruitment manouver On pt with puritan bennet bilevel [hi peep lo peep]. Short term only however (couple min only) BP tends to go "bye bye" as pts tend to be a little vascularly dry and cant deal with t...

Have "walked Peep up to 35 cm H2O as part of recruitment manouver On pt with puritan bennet bilevel [hi peep lo peep]. Short term only however (couple min only) BP tends to go "bye bye" as pts tend to be a little vascularly dry and cant deal with t...

All fun and games till that slow leakin SDH hits critical mass effect then it changes. :chuckle

pa, I don't think anyone is being disrespectful of the individual who has coded. The common theme is that for those who feel challenged in a positive manner by being in a code that it is sad that someone else is in trouble. While we all strive to p...