Chisca RN

Dialysis

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All Content by Chisca

  1. Chisca

    patients coding in dialysis

    Chisca replied to ffliper27's topic in Dialysis, Renal, Urology

    Don't confuse crashing with coding. 1 out of 3 patients are going to significantly drop their blood pressure during treatment. This is related to where fluids are in the body( out in the tissue, not...
  2. Chisca

    Preventing Extracorporeal Clotting in the Acute Setting

    Chisca replied to westieluv's topic in Dialysis, Renal, Urology

    TEGO caps have a design flaw that I don't like in that the thread for the leur lock is not complete, it is two little nubs that the tubing threads on. This can easily become disconnected under...
  3. Chisca

    patients coding in dialysis

    Chisca replied to ffliper27's topic in Dialysis, Renal, Urology

    More codes on Monday than any other day of the week. At some point every pt has to go two days without dialysis and some can't make it. Try to include that in patient teaching so that if patients are...
  4. Chisca

    Pre-filter versus post-filter replacement fluid in CVVH/CVVHDF

    Chisca replied to DRCCRN's topic in MICU, SICU

    Replacement fluids would have to be accounted for (increased) in UF removal rates, if not where do you think that extra fluid is going to go? Also convection is enhanced by increasing the dialysate...
  5. Chisca

    Why does a dialysis machine turn yellow?

    Chisca replied to HappyWife77's topic in Dialysis, Renal, Urology

    If you are talking about the filter turning yellow it is caused by bilirubin staining the membrane. I would suspect liver
  6. Chisca

    Nurse brutally beaten in a Brooklyn Hospital

    Chisca replied to HGTVrn33's topic in Nursing News

    Unfortunately we are on the frontline for any disatisfaction a patient or family feels whether it's the food, a rude doctor, the insurance company, or what some other nurse did. I will pray for this...
  7. Chisca

    Preventing Extracorporeal Clotting in the Acute Setting

    Chisca replied to westieluv's topic in Dialysis, Renal, Urology

    Priming the circuit with albumin before the treatment might help in those patients that you know are prone to clotting. The albumin carries a negative charge and readily coats the plastic surfaces...
  8. Chisca

    When to Give Epogen and Hectorol?

    Chisca replied to westieluv's topic in Dialysis, Renal, Urology

    Neither is removed by dialysis but I can see how epogen might be timed towards the end of a treatment due to hypertension. If someone's BP is already high the epogen could cause it to get worse if you...
  9. Chisca

    Removing needles---help!!

    Chisca replied to schnookimz's topic in Dialysis, Renal, Urology

    If you have soaked through you need to change the dressing. Roll the old one off as you roll the new one on and press a little harder. Always know where the puncture hole is because that is where you...
  10. Chisca

    Removing needles---help!!

    Chisca replied to schnookimz's topic in Dialysis, Renal, Urology

    Direct manual pressure with your hand in a C clamp position, one 4x4 sponge with enough pressure to stop the bleeding but not so much to occlude the graft. At least a couple extra 4x4's. No peeking...
  11. Chisca

    Open visitation during acute dialysis

    Chisca posted a topic in Dialysis, Renal, Urology

    What is the policy of the hospital you dialyze in towards visitors during the treatment in the ICU? Is it whatever the ICU unit policy is or something different? My hospital is open vistitation and...
  12. Chisca

    What is the difference between ultrafiltration and sequential filtration?

    Chisca replied to Mz.Roz's topic in Dialysis, Renal, Urology

    Or "dry UF". The blood is still traveling past a semi permeable membrane but there isn't any dialysate flowing by on the other side. Water from the blood can still pass through based on the...
  13. Chisca

    Davita drug testing

    Chisca replied to Dakotamom's topic in Dialysis, Renal, Urology

    From their website: " All applicants, including rehires or reinstatements, who have received a conditional offer of employment must pass a drug test before they are hired by and/or begin working for...
  14. Chisca

    Hep B infection control practices in hospital based hemodialysis programs

    Chisca replied to Lana Kay's topic in Dialysis, Renal, Urology

    30 day period is from CDC guidelines and after looking at the CMS regs they refer back to the CDC. It appears there are some variations as the hospitals and clinics locally test at 6 month intervals....
  15. Chisca

    Hep B infection control practices in hospital based hemodialysis programs

    Chisca replied to Lana Kay's topic in Dialysis, Renal, Urology

    There is not going to be any variation in hospital practice concerning Hep B as this is dictated by CMS guidelines. Essentially Hep B status checked every 6 months, hep B psoitive machines internally...
  16. Chisca

    Preventing Extracorporeal Clotting in the Acute Setting

    Chisca replied to westieluv's topic in Dialysis, Renal, Urology

    One of my patients yesterday was admitted with a GI bleed but also had a history of clotting his circuit during treatments. He always needed heparin and insisted we at least prime the circuit with...
  17. Chisca

    What do Dialysis Nurses exactly do?

    Chisca replied to jadabraxton96's topic in Dialysis, Renal, Urology

    Schnookimz left out the part where she had to figure out what plumbing adaptor would fit that faucet because the hospital couldn't possibly standardize the sinks in the building, or deal with the...
  18. Chisca

    Seeking advice regarding Ultrafiltration rates

    Chisca replied to Foleynurse2008's topic in Dialysis, Renal, Urology

    Any UF removal more than 7-10cc per kg/hr is associated with hypotension and poor mortality. The problem is if that criteria is adhered to treatment times have to be increased or an extra treatment is...
  19. Chisca

    As the Holidays Approach, Remember the Dialysis Patients!

    Chisca replied to madwife2002's topic in General Nursing

    Bill Peckham talks about this on his blog From the Sharp End of the Needle. 3 x a week dialysis is the bare minimum for life, it leaves you with a GFR of about 15. If 4 times a week became the norm...
  20. Chisca

    Unable to take fluid without cramping????

    Chisca replied to mxems's topic in Dialysis, Renal, Urology

    Sodium modeling or lengthening the treatment time. 5 + kg weight gain between treatments is really killing their heart but what are you going to do? One of the reasons dialysis patients have a high...
  21. Chisca

    Ever had your coffee confiscated?

    Chisca posted a topic in Dialysis, Renal, Urology

    Dr Joel Topf posted on his blog today how he is "going outlaw" on the subject of coffee drinking. As someone who has had his coffee seized by an infection control witch I am in total agreement but...
  22. Chisca

    Indiana University Nursing vs Davita Management of Nursing

    Chisca replied to NDXUFan's topic in Dialysis, Renal, Urology

    "In the United States, for profit dialysis ownership of dialysis facilities, as compared with not for profit ownership, is associated with increased mortality and decreased rates of placement on the...
  23. Chisca

    Questioning the nurse during clinical

    Chisca replied to motay68's topic in General Students

    Don't get caught up in the "social truth" of any situation. Just because you have grown friendly with a nurse you feel is a great nurse doesn't mean she couldn't be wrong. Especially hard to do once...
  24. Chisca

    starting Acutes dialysis without experience.

    Chisca replied to ffliper27's topic in Dialysis, Renal, Urology

    Alot depends on what prior nursing experience you have. Any ICU, ER, procedural area experience? How mechanically inclined are you? Setting up a machine and troubleshooting water issues can be...
  25. Chisca

    Indiana University Nursing vs Davita Management of Nursing

    Chisca replied to NDXUFan's topic in Dialysis, Renal, Urology

    The future is now. This device weighs 4.7 kg. Debiotech and AWAK Enter into Joint Agreement for the Development... -- LAUSANNE, Switzerland and SINGAPORE, October 31, 2013 /PRNewswire/