kmoonshine RN

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 cause infiltration? I like to hang 0.9% NS to gravit...

Try reading through this case presentation (I found it interesting): http://www.flightweb.com/forums/index.php?showtopic=618&hl=takotsubo&st=0

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 transparent dressing; I then put a warm compress ov...

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 increase absorption of some meds, such as morphine ...

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. Kinda like trying to call someone by phone but they ...

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 2-visitor/patient rule (visitors must check in at triag...

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

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 doesn't truly understand the frustrations i am hav...

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 least two 15-min breaks to step away from pt care...

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 at.

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 break room at 2310 until the end of her shift at 2330...

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 access PICC lines if it's used for chemo, since it is ...

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 in 3 hrs isn't too bad. I've delegeted things befor...

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 health care as our elected officials. Afterall, we p...

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 have been increased by the primary RN per MD orde...

: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 going home too. However, I went out of my way to do a...

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 only pt that I've seen go for PICC placement in the...

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 there was some urine on the floor and the pt slippe...

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 a PICC. This rarely happens. We recently had a p...

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 that needs to be addressed? The last shift I work...

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 my pts; it would be easier for me to hold onto th...

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 taken manually? Is she tachy?

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 always (over 90% of the time) get a phone call from t...

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 gave meds, kept the pt on continuous cardiac monito...

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 left-sided paralysis; she was so dehydrated and had terr...