kmoonshine

kmoonshine RN

Emergency

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All Content by kmoonshine

  1. quick cap change question

    kmoonshine replied to sweetieann's topic in General Nursing

    I don't change caps often (I usually just prime the caps when initially placing a central line in the ED, or I will change the cap if someone comes to the ED with an indwelling line that has dingy old...

  2. Admit orders

    kmoonshine replied to JD228's topic in Emergency

    I will complete all the ED orders to the best of my ability (if there's 2 antibiotics ordered and the first one is still infusing, I obviously can't start the second in the ED; but I'll send up the...

  3. Question on O2 therapy

    kmoonshine replied to chacmool's topic in General Nursing

    ok, i'm not an expert...but here's what i use: nasal cannula (nc): can handle 0.5l - 6l (anything past 4l is very noxious though, as it easily dries out nasal passages). i use these for people on...

  4. nursing student with severe hearing loss

    kmoonshine replied to metfan's topic in General Nursing

    There are options out there for nurses with hearing loss: http://www.allheart.com/electronic-stethoscopes.html Perhaps see if an audiologist can help, since the equipment is so

  5. Curious about your job

    kmoonshine replied to Vtachy1's topic in General Nursing

    Wow, that sounds so nice! Sometimes I'll get a break (only 30 min unpaid for both 8hr and 12hr shifts), but if I don't get a break I "cancel lunch" on the time clock. If I only get 10 minutes, I also...

  6. Can an employer penalize you for calling-in due to illness?

    kmoonshine replied to NursingAgainstdaOdds's topic in General Nursing

    We work around sick people all day and we are not expected to get ill. Plus, if your job is a real "drainer", you're not going to want to go to work and must resort to taking "mental health" days....

  7. How much pain medication is "too much pain medication"?

    kmoonshine replied to Phillygryl's topic in General Nursing

    The hospital I work at is REALLY big on pain control in the ED. I almost always get orders for morphine 4mg IVP up to 12mg total if needed, and I also frequently have orders for dilaudid 1mg IVP up to...

  8. Alternatives to Strangling

    kmoonshine replied to AngelfireRN's topic in General Nursing

    Sounds like those kids are being emotionally neglected and they're acting out for attention - negative attention is better than nothing, especially if you're starving for some type of social...

  9. Med admin help

    kmoonshine replied to squirtle's topic in General Nursing

    I hope what I wrote made sense! If you have any other questions or if you'd like me to explain anything else, just email or PM me - I'm happy to

  10. Med admin help

    kmoonshine replied to squirtle's topic in General Nursing

    here's what i'd do: think about what meds you're giving and why. then figure out what should be given first. with the above drugs, i'd probably give dilaudid first (treat their pain), then protonix,...

  11. $1000 Gift ---> How to spend it.

    kmoonshine replied to Slobgob's topic in General Nursing

    Adopt a family for the holidays and use the money to buy them groceries and items they need (clothes, school supplies, etc). We all have $15, so I think its somewhat selfish to divide up the lump...

  12. Many RN's administer IV meds wrong.

    kmoonshine replied to Guest219794's topic in Patient Medications

    I'm in the ED so our rules are a bit "loose" for hanging IVF (I don't need an order). Anyways, I try to hang IVF and hook it up to the pt's IV if I'm pushing meds (I use the IV tubing with the...

  13. Disgusting conditions on my floor. What would you do?

    kmoonshine replied to lsvalliant's topic in General Nursing

    When the inspectors come through, make sure to have an abundance of mouthwash all over the place (bathrooms, pt rooms, nurses station, etc). Make sure to mention the new, "fresh" method of cleaning...

  14. ED shortage?

    kmoonshine replied to solneeshka's topic in Emergency

    Very rarely are we sent home. Its usually always busy and if it is slow, it doesn't stay slow for long. And when you send people home, 5 minutes later you get a PNB coming in...so it ends up biting...

  15. Your patient fell? You need to be disciplined!

    kmoonshine replied to casperx875x's topic in General Nursing

    I thought that the JCHAO's school of thought was to use restraints/sedation in extreme circumstances - it would be preferrable to have a pt fall than to be restrained. Not saying that its good for pts...

  16. What more could I have done?

    kmoonshine replied to locolorenzo22's topic in General Nursing

    Kudos for checking a blood sugar! Getting this pt to an ED is the #1 priority, ASAP. Depending on their history, they may qualify for TPA if the symptom onset was within 3 hrs (contraindications...

  17. Allergic to tegaderm?

    kmoonshine replied to stunner127's topic in Patient Medications

    I've seen some nurses uses sterile gauze over the IV insertion site, followed by tape. I know this won't allow for IV site inspection, but I'd be nervous about applying non-sterile tape over an IV...

  18. Elevated K+--insulin?

    kmoonshine replied to EJSRN's topic in General Nursing

    This is from a previous post I did awhile back...hope it helps: Insulin is needed to allow glucose to cross into muscle cells. K+ crosses cell membranes whenever insulin is present. insulin &...

  19. DNR question

    kmoonshine replied to nord11's topic in General Nursing

    I don't think that DNR status would affect medicare payment if the pt requires ICU care. I've sent DNR pts to ICU because they required higher-level nursing care (chest tube and bipap, septic, etc);...

  20. Zofran ODT in kids

    kmoonshine replied to bjaeram's topic in Emergency

    Zofran does not carry a black-box warning for children. It is approved for use in children as young as 2 yrs old and we snap the ODT in half to give to the child - it also comes in a...

  21. *Weird* Patient Allergies

    kmoonshine replied to cherrybreeze's topic in General Nursing

    Epinephrine = palpitations. Morpine = "messed up". Reglan = nausea. Aspirin = "can't handle it". Ambien = "very

  22. List of Narcotics to be Double Locked

    kmoonshine replied to jacesmom2's topic in Geriatric, LTC

    Quick sidenote: narcotic refers to opiates, not benzos. "In a legal context, narcotic refers to opium, opium derivitives, and their semi-synthetic substitutes."...

  23. Post-mortem care

    kmoonshine replied to ProfesseureTournesol's topic in General Nursing

    I have no clue. Could it have something to do about keeping everything in one place (belongings, jewelry, body, etc)? Should there be mysterious circumstances surrounding the pts death, one room is...

  24. Hypothermia

    kmoonshine replied to beachgirl17's topic in General Nursing

    In the ED we have several liter bags of 0.9%NS kept at 102F - this is used more for pt comfort, slight chills, or frail elderly with little subq (these pts get chilly really fast, especially in the...

  25. ED staff not checking blood sugars

    kmoonshine replied to ChocoholicRN's topic in General Nursing

    We do stat fingersticks on diabetics with symptoms (such as dizzy, increased urination, etc). If we get a pt who is confused, has a decreased level of consciousness, is having seizures, etc - then we...