kmoonshine

kmoonshine RN

Emergency

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All Content by kmoonshine

  1. IV fluids to gravity, infiltration?

    kmoonshine posted a topic in Emergency

    If you hang 0.9% NS w/o to gravity and the IV site is no longer patent (catheter displaced into tissues, blown vein, etc), would the IV fluids stop infusing or would the fluids continue to flow and...

  2. takotsubo

    kmoonshine replied to caeRn's topic in Emergency

    Try reading through this case presentation (I found it interesting):

  3. Quick question about IV starts.

    kmoonshine replied to CrazierThanYou's topic in General Nursing

    There is a topical cream with lidocaine that works wonders, but as other have said, it takes quite a long time to work (I put the cream on thick over the potential IV site and cover the cream with a...

  4. IM injections -should we massage or not?

    kmoonshine replied to charlie19's topic in General Nursing

    I've never heard or seen this practice. I would think that it would cause more discomfort by increasing leakage into subcutaneous tissue (but that's just my opinion). I use an infant heel warmer to...

  5. Help explaining thyroid panel results

    kmoonshine replied to emsillystudent's topic in General Nursing

    Try relating it to something that the patient understands. Perhaps say something like "TSH levels go up because the pituitary gland is sending out more horomone to get the thyroid gland to respond....

  6. Policy on ED violence

    kmoonshine replied to littleRNthatcould's topic in Emergency

    I can't say much for policies...but, you need to beef up the security to protect staff and other patients. Discuss the use of panic buttons in all rooms, having a locked unit, and implementing a...

  7. How fast do you push metopropolol

    kmoonshine replied to Guest219794's topic in Emergency

    I give metoprolol 5mg IV push over 5 minutes and I wait around 2 minutes before administering another

  8. ED triage woes - advice appreciated!

    kmoonshine posted a topic in Emergency

    please offer your suggestions on how i should deal with some issues that are really getting under my skin. i need to get some of these thoughts off my chest and even though i love my hubby dearly, he...

  9. Long shifts---how long is too long?

    kmoonshine replied to Riseupandnurse's topic in General Nursing

    We have 4, 8, 10, and 12 hr shifts in our ED. I've seen people pull 16+ hrs before. Personally, I think 12-hr shifts would be safe if staff were given a decent lunch break (at least 30 minutes) and at...

  10. drawing blood from picc line

    kmoonshine replied to Ms.RN's topic in General Nursing

    Here's some info: http://doctors.shorehealth.org/nursing/iv/DECLOT%20ACCESS%20DEVICE-3-WAY.pdf Obviously, follow the P&P at the facility you work

  11. VENT: You mean I still have to work when I'm on the clock?

    kmoonshine replied to Penelope_Pitstop's topic in General Nursing

    From the moment you punch in to the moment you punch out - you are working (hence, getting paid). Ms. Ramona needs to punch out when she is done doing her share of work (if she wants to sit in the...

  12. drawing blood from picc line

    kmoonshine replied to Ms.RN's topic in General Nursing

    Before I access a PICC, I ask the pt why they have a PICC in the first place. If they can tell me why they have it and what is capped in the line, then I will access it (however, I am hesitant to...

  13. Than who's fault is it?

    kmoonshine replied to iriska_meller's topic in General Nursing

    The cost of emergency services is high due to the need to staff 24/7 (lab, nurses, docs, radiology, etc). UA and preg, with CBC/BMP, RH, serum Hcg; abd. ultrasound to rule out ectopic - all finished...

  14. Health Provisions Slipped into Stimulus Package

    kmoonshine replied to CinnScorpStudent's topic in Activism, Healthcare

    Just a thought: would these new "rules and regulations" be applied to our president, senators, congressmen/congresswomen etc? I doubt it. We (the American people) should receive the same quality of...

  15. Back Rubs

    kmoonshine replied to Saifudin's topic in General Nursing

    I don't give back rubs in the ED - sorry! When I was nursing student on a med-surg floor, I had a 28 yo post-op hyst pt in severe pain. She looked very uncomfortable, was on Dilaudid PCA (which should...

  16. new admission 45 minutes before your shift is over..what do you do?

    kmoonshine replied to glamgalRN's topic in General Nursing

    :smiley_abNope, no fight-picking here! I totally see where you are coming from, as it seems silly for me to be upset because I want to go home but the floor nurse won't take report, since she is...

  17. Central venous catheter placement in the ED

    kmoonshine replied to iluvivt's topic in General Nursing

    BTW: In the past 6 months I havent had a pt in the ED go for PICC placement. The other pt I spoke of (vomiting, needing antiemetics and IV fluids) was being taken care of by another nurse and is the...

  18. What would your first priority have been?

    kmoonshine replied to DA314's topic in General Nursing

    You were in the middle of a task, so it makes sense to finish it before starting another low-priority task. As others stated, what if the pt became dizzy during PT and needed to lie down? Or what if...

  19. Central venous catheter placement in the ED

    kmoonshine replied to iluvivt's topic in General Nursing

    We do our best to get a line in the pt. We'll even go so far as to use an ultrasound machine to place a peripheral IV. If a pt is stable but needs an IV and we're unable to get access, we'll send for...

  20. new admission 45 minutes before your shift is over..what do you do?

    kmoonshine replied to glamgalRN's topic in General Nursing

    I'm generally happy to help out at the end of shift if there's an emergency or if we're getting slammed. However, this has been happening to me on a regular basis - so perhaps we have a staffing issue...

  21. OK ED nurses, fill me in on the real story.

    kmoonshine replied to eriksoln's topic in Emergency

    In our ED the time that an admit bed is called for, to the time a bed is assigned, to the time that report was called is tracked. If I don't call report, the charge nurse does. I try to keep up on all...

  22. Question about taking BP in lower extremities and forearms

    kmoonshine replied to Bumashes's topic in General Nursing

    What's her lactate? Sepsis can drop your BP due to vasodilation, thus requiring massive volume replacement. Someone needs to figure out a way to get an accurate BP on this lady. Are these BP's...

  23. MRSA legislation in Maine

    kmoonshine replied to Mammy1111's topic in General Nursing

    You know what I'd like to see? I'd like to see a law passed that makes it mandatory for nursing homes/assisted living facilities to disclose a pts "infection" status prior to ED arrival. We almost...

  24. new admission 45 minutes before your shift is over..what do you do?

    kmoonshine replied to glamgalRN's topic in General Nursing

    I had a, 82yo pt come to the ED today c/o dizziness. They arrived around 1130am. I put orders in (EKG, PCXR, CBC, CMP, PT/INR, CKMB, TROPONIN, BNP), had lab draw blood, made sure the EKG was done. I...

  25. IV's in Stroke patients

    kmoonshine replied to VAJenny's topic in General Nursing

    I have put IV's in the affected side of a stroke pt. It's not my first choice, but sometimes you have to go where you can (especially in an emergency). Gosh, I remember having a septic pt with...