loafin'

I agree, just adding more info.

Actually, with nitrates and topical anesthetics that you mentioned as well as others can cause methemoglobinemia. They can change the structure of hemoglobin to where it cannot hold o2, thus causing sats to rapidly decrease. If methemoglobin levels a...

Well SuperRT, I just happen to be a RRT and a RN. This has gotten way off topic, it's supposed to be about whether to give ice to an intubated patient. Nobody has mentioned giving a patient all the ice they could hold. As I stated in previous posts t...

If the cuff pressure is high enough to hinder swallowing then the patient has tracheal malacia and/or the trachea in necrosing. Ask your RT if he/she has ever heard of a chronic home ventilator patient who's trached and eats solid foods and drinks l...

Where is your info coming from? When we suction the vent alarms high pressure, it has nothing to do with losing the cuff seal. No, it's not easy to swallow with an ET tube in your mouth. Where do you think the natural oral secretions that a patient p...

Why not give ice? The airway is protected and pt's can't aspirate unless the et tube cuff blows or et tube comes out. On any intubated pt there are secretions setting on top of the et tube and that's one reason we tell them to cough as we extubate as...

it is actually called winter's formula. bicarb x 1.5 + 8= expected paco2 +/-2

I will address your question regarding the respiratory meds. Both xopenex and albuterol are both beta2 agonist or sympathomimetics. The medications bind to beta2 receptor sites in the bronchial smoothe muscle causing relaxation. I will explain the di...

Vanderbilt University has an acute care NP program that after graduation you have an option for early interview to anesthesia school at Middle Tennessee School of Anesthesia. You will be able to practice as both. Vandy is the only one that I've check...

alcohol level, smoking hx, any chemistries done, how much 02 client has on, if any. sometimes it takes a bit more than an abg to figure out exactly what is going on.

I know this, but thank you for clarifying that oxygen does play a very inportmant role in pH. A lactate level would be drawn of course,but we would know that it was lactic acidosis just by doing a venous gas with the p02 being virtually the same as t...

Actually oxygenation does affect pH. The most profound acidosis I've ever seen was on a client who had cyanide poisoning who had a pH of 6.6. He had a normal p02 and sat with abg. I drew venous gas and was vertually identical. He was in anearobic met...

BabyMO1, PM me if my reply to asoldierswife05 still did not explain enough.

You understand exactly. There is a formula called winter's formula for expected pco2 with a given hco3. The abg and client on bipap is a big clue Remember HCO3 compensates slower than co2. And actually the bicarb might be slightly lower than client's...

The experienced RT and charge RN were correct. The K+ was low due to the client hyperventilating and lower the hydrogen ion concentration and subsequently pushing K+ from extracellular to intracellar.

I gave my explanation, what is yours. People who have a high bicarb do not slow down respirations to compensate. this is client is a chronic hypercapnic. I don't need any other hx besides abg's to know that.

Actually this is quite simple. I've seen it hundreds of times with chronic hypercapnic's who are very anxious(especially fighting Bipap). You will see the same thing with a client who is a chronic hypercapnic who is place on vent with too high rate....

At Centennial if you live >50 miles you can stay at a hotel for $10/night and the hospital pays the rest of the bill, they also have nice apartments for the same rate.

$19-20/hr

I don't understand where the info comes from regarding o2 liter flow and client's with COPD. Just because you have COPD doesn't mean that you are a chronic hypercapnic. You can be a chronic hypercapnic and not have COPD. It's not about the Fio2, i...

elthia, with status asthmaticus subcu epi could have been given or mag sulfate iv. itsybitsy spider, what do you mean PEEP? how was it used?

I work at Centennial Medical Center and love it. It is a 600+ bed hospital and I work in the 32 bed MSICU. They also have a CVIVU and CCU. The ED nurses and floor nurses seem to like their job too. I haven't heard otherwise. Usually people are happy...

Yes it is possible to be NP or CRNA w/out BSN. Vanderbilt has a MSN NP bridge program for AS/AD to MSN and a bachelor's in any field(without prior RN degree) to MSN. There are also CRNA school's that will accept RN's with bachelor's in another field...