licha

This might be a common sense question or perhaps anatomy 101. Had a patient scheduled for Hemodialysis; prior to dialysis urine PVR was 250cc Dr order was to straight cath if PVR greater than 300. So I left it alone and told dialysis tech to start the HD tx. 2hrs past HD completed I again did bladder scan and to my surprise PVR resulted with 00cc of urine in the bladder. Where did the urine go? Patient did not void. No urine output noted at all. So what happened? Did the Dialysis remove the urine from the bladder? Im confused. I thought dialysis is like a big electronic kidney. Does it serve to remove all fluid from the body including urine?

I work daily with the elderly and what has helped me alot is the fact that nurses in our hospital became responsible in drawing labs (phlebotomy) in other words our RN 's carry out the orders to the max we draw the blood and start iv's. So being fresh out of school I was hit with this. Thanks to this my IV skills maximized:smokin: So my advise to you is to learn what a vein feels like and when you find a vein be gentle hold the vein (with your free hand) and proceed the secret is to take your time sit down next to patient and relax as you feel. Learn to feel the vein. The elderly are very fragile so you need patience and of course the technique of mastering the way a vein feels will help you a whole lot. (Also it helps alot to say a little prayer and be thankful when you finally are successful;))

I have been working as a RN in a Sub acute skilled facility. This is my first job as a RN. I encountered a dilema in my first week of work. I don't know if I did the right thing or if I used poor judgment please someone with more experience clear my mind whether I did the right thing. Here is the scenario: 76 yr old male class II, had a morphine 30mg order tid QD rectally. The two preceding doses had been given by the previous nurse. When it came time for me to give the third dose I chose not to administer due to his condition and present vital sings which were 99.8, 28, 110, 98/79 on 4L oxygen SATs @74 was lethargic with audible bilat lung crackles. Four hrs later his SATs were at 70 bp @ 96/54. Should I have given him the morphine?? Please someone help me out did I make it worse for him