Beech1184

What helps is to keep in mind how acid is produced in the body and how it's excreted, in relation to the patients clinical diagnosis. The lungs excrete approximately 150 mEq of acid per day in the form of carbonic acid.( Co2 + H20 ). The kidneys only excrete aout 50 mEq of acid per day. Because the lungs excrete more acid when the respiratory system is compromised acidosis occurs more quickly. Generally speaking there is usually little compensation for respiratory acidosis other than tachypnea and perhaps tachycardia if 02 is low., because the kidneys try to compensate but that compensation is slower and limited. The lungs can compensate for metabolic acidosis by blowing of more C02 so, although the patient is acidotic the C02 will be low, hence a compensated metabolic acidosis. There is a really good algorithm that I used to use when I was teaching Critical Care that you might find online. Unfortunately all my teaching info is packed away in boxes or I could send it.

Hi, I'm a CCRN now retired after I was in a high speed MVA 5 years ago when the driver of a crew cab pick-up ran a red light. I have herniated discs at C 6, 7, T2, 5, & L3 all with moderate spinal stenosis. My major concern is movement of C7 as much as 2 inches to the right when I tilt my head forward and 1 inch to the left when I've been upright for a period of time. I've been told by a chiropractor that if it moved that much I'd be"quadriplegic or dead" ;by a physio that it's within normal range; by my GP "I don't know who can help you with that"; by an ortho regarding radicular symptoms in my arms and hands, "I don't know what that is". I know that most physicians won't commit themselves because they don't want to go to court. I have not yet settled with the auto insurance corporation. I do have a report from a neurologist that there were no radicular symptoms 2 months prior to the accident, and a Medical Legal Letter from a GP Back Specialist that I had radicular symptoms after the accident and which persist to today. I am in constant pain, can't do conventional exercises because what works for one area excerbates pain in the others. I'm particularly concerned about my neck. If I try to read a book or keep my head in a constant position , I get increased pain and pounding in my head. I haven't slept a full night in 5 years. Any suggestions would be appreciated. Thanks from A frustrated Canadian

I worked in the Planning Department of Tertiary Referral Hospital of 1300 beds many years ago as the Nursing Representative. We used a Room Data Sheet for every type of room. Here you list all of the normal activities then all the urgent or emergent activities, need for privacy, that will take place in the room and identify how many people will be involved and what equipment will be required, whether the equipment should be out in the open or stored in a drawer, closet othe other fashion. We looked at ambient lighting & ventilation, Task lighting, special lighting, such as red lamps that give you enough light to see the patient but not really disturb them if they are resting. privacy curtains should be just inside the entry door leaving the room free for activities. the you just have to convince the powers that be to spend the money to build it right. Good Luck Once you have all the information you can not only design the room but identify what the room is to be used for as compared to othe rooms. We looked at a shared equipment closet between two rooms with appropriate negative pressure air circulation to prevent cross contamination between the two rooms. When you have your room data sheet completed you can identify how much space, equipment and furniture you need for the different activities

Make yourself a grid sheet, along the left margin put all the tasks in order of priortiy, along the top, put a skills required score 1 being low and 5 being high. This will help you determine what to do yourself or delegate to others. You can also do a time grid so that you manage yours and others. If a series of tasks you take on requires more time than you have it means you must delegate it to someone else. Hope this helps.

I think you want to look at post Partum Depression rather than PTSD. There is a huge difference for women after childbirth. Though it does not seem to be fully acknowledged and well treated in the US it is fully recognized as a serious complication of Pregnancy and Delivery in most countries.It's not a question of a traumatic delivery, it's a question of hormonal imbalance which can last for months and may not present itself for several weeks after delivery. It is a treatable condition.

As a professional nurse you cannot sleep on work time. You can do anything you want on your break time. If you sleep more than about 3o minutes you will wake groggy and somewhat disoriented but if you sleep for 20-30 mins on your break you will feel refreshed.

I think you made the right decision in your situation. You must be pretty dedicated to commute 3 hrs per day on a regular basis.

It was tested and proven in a hospital in Canada but like most Nursing interventions it wasn't written up in a professional journal. Best answer for skeptics is to do a comparison test: use a large cuff on the upper arm and a regular cuff on forearm and compare the readings.

Ours requires basic CPR Ceritification and Povides a Course on Neonatal Resuscitation. I was well schooled and used to teach CPR but the Neonatal course was quite different as their needs and responses are different.

You don't need a special kit. It's been proven that you can take blood pressure accurately on an obese patients forearm. You then use the stethscope over the radial artery. This works with automatic BP machines too.

Having done lots of interviews when hiring nurses, the main thing is answer honestly. Use examples to identify your skills, don't inflate your experience, be very honest, express a sincere desire to learn and how you plan to do it, identify your strengths, be knowlegable about the unit you are applying for and identify a skill you can bring to the team , for example positive attitude, great interpersonal skills etc.

The main thing to remember is that the lungs are the major way we dispose of acid products of metabolism in the form of CO2 and water vapor or CO3. 13,000 meq of acid are excreted versus 50 meq for the kidneys in 24 hrs. Anything that causes hypoventilation will thus cause acidosis. It can be life threatening especially in the very young and the old. Respratory alkalosis is usually self limiting and much less common. The most common cause is hysteria.

Take good food to work., and snacks. Try to have a 20 min nap on your break, take an alarm clock or timer. You wake rejuvinated for the last couple of hours of your shift. Eat breakfast when you get home, uplug phone, darken room and sleep as long as you can. Get exercise or activity during day then schedule a couple of hours sleep before work. Thay way you arrive fresh and fool your body clock that it's not bedtime!

It may not work foryou but I worked nights too and I had ordered a taxi but it didn't show so I called the Ambulance service, non emergency line, to see if they had a trip going by my house.The crew was at the hospital and knew that every nurse was needed so they came and picked me up. You could also try Law inforcement and Fire Dept. as they too, understand how staffing shortages in bad weather complicates things.

Clinical assessment is the most difficult, that is using your eyes and ears and sense of touch to make an initial assessment of the patient. Noting color, respiration, tissue turgor, sweating, cold skin, ability to communicate, etc. Train youself to take all of this in while you are talking with the patient . You'll pick up clues that others will miss.