loafin'

loafin'

PULMONARY/CRITICAL CARE

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All Content by loafin'

  1. Nitrates, Desaturation & pulmonary shunting

    loafin' replied to Toby's mum's topic in CCU, Coronary, Cardiac

    I agree, just adding more

  2. Nitrates, Desaturation & pulmonary shunting

    loafin' replied to Toby's mum's topic in CCU, Coronary, Cardiac

    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...

  3. Ice for a vented patient???

    loafin' replied to OkieICU_RN's topic in MICU, SICU

    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...

  4. Ice for a vented patient???

    loafin' replied to OkieICU_RN's topic in MICU, SICU

    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...

  5. Ice for a vented patient???

    loafin' replied to OkieICU_RN's topic in MICU, SICU

    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...

  6. Ice for a vented patient???

    loafin' replied to OkieICU_RN's topic in MICU, SICU

    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...

  7. ABG rule of 15

    loafin' replied to phiposurde's topic in Emergency

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

  8. assessment question

    loafin' replied to zacarias's topic in Pulmonary

    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...

  9. any CRNAs as mid-level providers in the ICU?

    loafin' replied to blee1's topic in Certified Registered Nurse Anesthetist, CRNA

    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...

  10. ABG help

    loafin' replied to Megsd's topic in Nursing Student Assistance

    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...

  11. ABG help

    loafin' replied to Megsd's topic in Nursing Student Assistance

    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...

  12. please help with these ABG's

    loafin' replied to emmycRN's topic in MICU, SICU

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

  13. please help with these ABG's

    loafin' replied to emmycRN's topic in MICU, SICU

    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...

  14. please help with these ABG's

    loafin' replied to emmycRN's topic in MICU, SICU

    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

  15. please help with these ABG's

    loafin' replied to emmycRN's topic in MICU, SICU

    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...

  16. please help with these ABG's

    loafin' replied to emmycRN's topic in MICU, SICU

    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...

  17. Nashville Hospitals

    loafin' replied to willdgate's topic in Tennessee Nursing

  18. Nashville Hospitals

    loafin' replied to willdgate's topic in Tennessee Nursing

    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

  19. Nashville Hospitals

    loafin' replied to willdgate's topic in Tennessee Nursing

    $19-20/hr

  20. COPD pt's and 2L o2

    loafin' replied to wooosp's topic in Geriatric, LTC

    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...

  21. Status asthmaticus

    loafin' replied to elthia's topic in Pediatric

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

  22. Nashville Hospitals

    loafin' replied to willdgate's topic in Tennessee Nursing

    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...

  23. MSN/NP w/out a BSN

    loafin' replied to ksc0723's topic in General Nursing

    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...

  24. confused! wet vs dry crackles

    loafin' replied to tommytwice's topic in Pulmonary

    what is theoretical? Wet crackles are from fluid and dry are not. your first post was asking how to distinguish between the two, there was nothing about a

  25. confused! wet vs dry crackles

    loafin' replied to tommytwice's topic in Pulmonary

    Yes you can distinguish between wet and dry crackles. Wet with chf or patients who have retained secretions and need suctioning. Dry crackles can usually be heard in bases on late inspiration(due to...