NHSbaseball32

I work at a hospital in alabama. Working nights make 24.25. I work just weekends 7p-7a fri sat and sun, just for working weekends you make 37.75.

i have not seen the documentation after extubation, according to the md his sat's were good maintaining 98% with a good pleth, i did ask them about that and his po2 was fine on the abg. he was just not able to blow his co2. does anyone know the full effects of a high co2 and low ph on the cv system? he did go into pea and i know a acidic blood can cause the heart to stop, but what other effects does it have on the cv system? i just got finished visiting him and they had to bronch him today due to a small mucus plug, appears to be doing much better at this time. all pressors remain off, and this am he was just on some pressure support ventilation for about 5 hours then he got a little tired and had to go back on ac. thanks for everyone's thoughts and prayers!!

I know that his pH was that practically of a dead person, its just a miracle that he has no neurological deficits from this and apparently no organ failure at all. Its absolutely amazing.

About the sedation wearing off that was my first thought, but the more I thought about it I started thinking that maybe this was the case: Since he was oxygenating well the entire time with sats 98-100% RR was well from my understanding, but just very shallow breathing. The recovery room nurse didn't attempt to try to arouse him until it was a little too late and I thought that maybe the blood being acidic caused the arrest. I guess it is one of these things that I will never know what happend just speculate on what happend.

He was coded for bradycardia that soon resulted to PEA. He never had bloody secretions of any sort.

Where I work in ICU if there is a direct admit from the dr office the patient most of the time comes with orders, if it is a direct admit from a different hospital then most of the time they don't and then we have to call to get orders. Pissy dr's is common where I work and don't like to be called for anything. you did the right thing by calling its your job and the doc will have to get over it. :)

Well for me I have always been fascinated with the human body, the way it works etc. I had the urge to go to med school but I didn't go for one reason: time. I wanted to go ahead and get my life on track with a career ASAP and thats why I chose this instead. I am intending on going back soon to a CRNP program some where. Tony, RN

We normally wait about an hour depending on the doc. The rationale for waiting is to give the pc's plenty of time to circulate and mix in with the blood already in the circulatory system. Drawing an h/h too soon could possibly give false results.

I didn't really think about a PE because he was oxygenating well the whole time. They never did take him to CT because he was too critical at the time. The only type of prophalatic DVT he is on currenlty is SCD's nothing else that I am aware of. Oh yea something else I forgot to mention earlier is that he had 3 stents placed a few years ago and has been on plavix/aspirin since, he stopped taking these a week prior to the surgery and started him on heparin 5000 units bid. I just went to visit him and he seems in good spirits and they now placed him on a dilaudid pca and he feels like he is on cloud 9 with it :)

His baseline ABG's a week prior to surgery were a ph of 7.4 co2 44, po2 was 80. Heck of a lot better than i would have assumed considering his COPD, and his age is 64 if this adds any other useful information.

The school i attended required a GPA of 2.5 to even apply to the program. If you had a 2.5 or higher then what they took into major consideration was math class/english/sciences. Good luck.

I am an ICU RN and currently my father is in ICU following right upper lobectomy for cancer. A little history on my father is that he is a ex-smoker with a 1 ppd x 35 years, has COPD. Doctors stated that the surgery went well, minimal blood loss. They woke him up in the OR he opened his eyes sat up and looked around a little then went back to sleep (According to the Doctor's). He was extubated in the OR and sent to the recovery room. 15-20 minutes after being in the recovery room they couldn't arouse him. Blood gases were obtained which indicated the following ph 6.9, pco2 143, po2 112. Other labs were obtained and the only abnormal was a K+ that wasn't critically high. He was reintubated at this time. Few minutes later he went into PEA and ACLS was performed. Throughout the day he coded a total of 5 times. He was placed on levophed, epinephrine, vasopressin, all of which were maxed out trying to keep a MAP bp of >65. Throughout the day MI profiles have been obtained mulptiple times with no indicating evidence of an MI but was taken to the cath lab anyways. Heart cath was negative. About 12 hours after all of these events he woke up and now is following commands and writting notes, and he appears to have no neurological deficits all body systems appear to be normal. All pressors are turned off and remains on a vent at this time. My questions is how can a co2 level get so high in such a short period of time and what you guys thought caused the cardiac arrest to begin with? Keep him in your prayers! Thanks.

Pharm was a soo soo area for me. Everyone told me not to stress out about pharm. There will be drugs on the test that you will have no freaking clue to what the drug is. A lot of them will not have the prefix or sufix that we tend to know them by. My advice would be to look at other stuff and if you get a pharm question: just take some deep breaths, and take your best educated answer. Thanks what I did, and it worked :) Just as long as you are familiar with your more common drugs, you will be fine

WOW, I don't know how!!! Maybe its a messup. But according to the BON I PASSED!!!!!!!!!!!!!!!!!! So if you don't get a lot of prioritization questions, there is still a hope. I had mainly teaching, every other one was teaching!!! So for those that are wondering teaching are higher level questions, evidently. I took 75 questions and was for sure that I failed!!! THANKS soo much everyone for the support!!! Tony, hey....... should be like this now..... Tony RN

Well I took NCLEX July 1st, out of 75 I had about 6 who would you see first, and the rest was TEACHING!!! I don't know if that is a good sign or not will find out tomorrow. Best of luck.