ghmccart

ghmccart

ICU/CVICU

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All Content by ghmccart

  1. IV Methylene blue post OHS vasoplegia

    ghmccart replied to RN12345656's topic in CCU, Coronary, Cardiac

    sounds like a protamine reaction that i have seen in the past, interesting that the epi was at just 0.2 mcg/ min, could have gone up to 10 eh>? and the vasso could be at 0.4.. interesting

  2. Lopressor drip

    ghmccart replied to traumagirll99's topic in CCU, Coronary, Cardiac

    I wonder about using nicardipine for vasodilation, never used metop gtt, wouldn't, that night RN let it fly way to long, but good job dealing w it. thats why good thorough saftey checks always pay...

  3. Pulling Sheaths on a Cardiac Stepdown

    ghmccart replied to ItalianRN's topic in CCU, Coronary, Cardiac

    it sounds like you are at one of those crossroads in life where you will be making a choice which will take you down two different paths. If you take the ethical stance in the sake of pt safety and...

  4. Primacor drip

    ghmccart replied to Genista's topic in CCU, Coronary, Cardiac

    this positive inotrope is also a prodysrhthmic so watch for that! it vasodilates especially in the pulmonary vasculature, and is often used for folks who have pulmonary hypertension and are in need...

  5. Transvenous Pacemaker

    ghmccart replied to juraviel's topic in CCU, Coronary, Cardiac

    we turn our patient with TVP's per policy q2 hrs, just make sure that their line is secure and locked, watch it close, and you know you dont have to turn them too much, just a little but to shift the...

  6. Mediastinal Bleeding and Turning

    ghmccart replied to SH18D's topic in CCU, Coronary, Cardiac

    if we have MT bleeding > 100 ml/hr x2 hr or >200 ml/hr x1 we call, then most likely check serial coags/cbc, consider underlying cause medical or surgical, then consider tight BP control,...

  7. chest tube removal

    ghmccart replied to corkyrn's topic in CCU, Coronary, Cardiac

    I pull mediastinal tubes in my OHS patients, not pleural tubes however. Try to pay attention to the difference on XR or communicate with

  8. Book for CV-ICU

    ghmccart replied to CoCo612's topic in CCU, Coronary, Cardiac

    I was A new grad into ICU two years ago, and have since trained into the CVICU, I use Bojar's manual of perioperative care in adult cardiac surgery, fouth addition. If you are looking for a complete...

  9. where did i go wrong? please comment

    ghmccart replied to BandEmom's topic in CCU, Coronary, Cardiac

    what an experience, First off, if you still like being a nurse, and you want to, then dont let one experience where you DID advocate for the pt get you too down, but I too would have felt bad about...

  10. CHF question

    ghmccart replied to haji's topic in CCU, Coronary, Cardiac

    in one word optimize this pt maybe has an ef of 23 lets say, bad pump=all the things you listed. diuretic would be good as a part of the therapy, but this pt could possible benefit from an...

  11. iabp

    ghmccart replied to Feldner's topic in CCU, Coronary, Cardiac

    just like most things in real critical care, it depends on the situation. could be 1:1 if unstable, or 1:2, I would not do more than

  12. What do you never leave home without?

    ghmccart replied to RNCRNA2BE's topic in CCU, Coronary, Cardiac

    one bag w/three ring binder for educational stuff, couple crit care refs, chapstick etc, gum for bad breath, other things work in and out of the rotation. on my person I carry crit care ref. and very...

  13. Milranone and B/P

    ghmccart replied to MacNurse's topic in CCU, Coronary, Cardiac

    my concern is that you did not look up the medication and anticipate that before you gave it, it is a serious cardiac medication and should be given by knowledgable hands. asking us hear on this...

  14. Right Ventricular Infarct--thing I thought I knew...

    ghmccart replied to papawjohn's topic in CCU, Coronary, Cardiac

    msybe the pts MI allthough inferior maybe stable and not in need of so many fluids, and with the mitral regurg. preload and pacing are still good for RV

  15. Hemodynamics question

    ghmccart replied to nursing4him's topic in CCU, Coronary, Cardiac

    It is important to know the physiological diff between cardiogenic shock, and septic scock, and throw in anaphylactic, hypovolemic, and neurgenic shock. taking the time to get these straight in your...

  16. Really getting nervous now! Did I make a big mistake?

    ghmccart replied to HillNPStudent's topic in CCU, Coronary, Cardiac

    god will be with you , you dont need to worry about what an uncompassionate person thinks or says about you, they need company in their

  17. Central Lines

    ghmccart replied to chloeysmom's topic in CCU, Coronary, Cardiac

    assess frequently to head off the nasty complications, and while you may work with them very frequently do not forget the seriousness of them, and the risks they carry, imagine it was in

  18. map & dbp question

    ghmccart replied to chaosRN's topic in CCU, Coronary, Cardiac

    how do the labs look? na+, h/h, bun, etc? help w/fluid status and r side consideration. w/2 vaso dilators running maybe only one would be able to manage sbp while allowing for an improved dbp. i would...

  19. Can you help a student understand PCWP?

    ghmccart replied to mandana's topic in CCU, Coronary, Cardiac

    someone earlier said it perfectly. when in the wedge position and with an open mital valve you get a clear shot to the LV. SO how bout this, with out the ballon in wedge how can we tell roughly what...

  20. Blood Stream Infections

    ghmccart replied to brutuss7's topic in CCU, Coronary, Cardiac

    what do you mean by that, do you mean bacteremia, sepsis, severe sepsis, septic shock? that is a veryt broad and lay way to ask that question, perhaps you can focus it.

  21. Phenytoin

    ghmccart replied to angelique777's topic in CCU, Coronary, Cardiac

    why dont you just look it up and empower

  22. Codes and note taking

    ghmccart replied to Holly27's topic in CCU, Coronary, Cardiac

    time event time event time event time event time event time event time event time event time event time event time event time event time event time event time event time event time event time

  23. retro-per. bleeder

    ghmccart replied to Bethy-lynn's topic in CCU, Coronary, Cardiac

    dont want the stent to occlude do you. I would rather give blood and fluid until bleed controlled, what about surgical repair. I always tell me PCI"D gramma, don't stop taking the

  24. Which pressor to use???

    ghmccart replied to cardiacRN2006's topic in MICU, SICU

    study your meds, and research them, it is up to

  25. S.Arrythmia Vs PACs

    ghmccart replied to cardiac.cure03's topic in CCU, Coronary, Cardiac

    PAC should have a compesetory