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SanFranSRNA

SanFranSRNA

CIC, CVICU, MSICU, NeuroICU
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  1. SanFranSRNA

    Fluid bolus with BP 140s/100s?

    Hello everyone, I love to offer my opinion on this topic. Previous information about myself: 4 years CVICU, 1 year of Neuro and 11 months left in anesthesia school. Personally I would probably would not give 2L of fluid upfront. I understand that rationale for fluid resuscitation for septic patient. This patient still maintain more than adequate blood pressure despite the state of tachycardia. If they are truly concerned for sepsis...blood cultures should be drawn, central line and A line placed. Serial laps and I would guide my fluid management from there. In addition, I am concerned with desatuation. Crystallioid doesn't stay intravascularly more than 45 mins...so if they were to really want to fluid resuscitate this patient..they should be a bit more aggressive. Judging from the clinical presentation, I would do a bit more work up and not rush to give 2 L upfront....1 L..may be but not 2.
  2. SanFranSRNA

    Mag sulphate with preeclampsia

    Magnesium sulfate has many indications. In OB setting, I use magnesium sulfate for tocolytic and seizure prophylaxis. Although the use of magnesium sulfate for the purpose of tocolysis is falling out of favor, the use of seizure prophylaxis is still popular. Magnesium increases the seizure threshold in the case of preeclampsia. Magnesium is excreted through the kidney and renal insufficiency can lead to magnesium toxicity. Therefore, UOP is routinely monitored every hour. In regarding to your original question, I don't think that magnesium has a direct effect the production or excretion of urine.
  3. SanFranSRNA

    Respiratory Care Flow Rates/ Student needs help!

    Hi I am a student nurse anesthetis. I'm going to offer in input but this is from anesthesia point of view. Inspiratory flow rate (IFR) is measured Liter/minute. IFR determines how quickly the breath is delivery. How I determine what flow rate to set is depending on the tidal volume. If I am giving much larger Tidal volume (usually not the case), I will set the inspiratory flow rate a little longer. For example, T.V of 900ml Rate 10 BPM, I:E of 1.3: 2. How that helps. Now on to the second question. The total flow of the system is 12 L/min... If you are using a full cylinder O2 E tank. A full E tank has 660L of O2. If you are running a flow rate of 12L/min it will give you 55 mins. Here is the math. 660L/ 12L/min = 55 min
  4. SanFranSRNA

    New Nurse Needs Orientation Advice

    Hi Silvergem....I used to work in Nevada and the Med/Surg ratio is 1:8 patients with tech assigned. I can't imagine that the facility can justify giving you up to 10 patients. Total care should be taken into consideration and reduce # of pt assigned. In regarding to the h/h question...that's where your preceptor comes in. I understand your concern regarding low h/h and administration of blood thinning medications, however h/h is not usually used as a hold parameter. Some pt lives like that for years so the benefits outweigh the risks. Given that you are new, you won't necessary know that. I have only one advice...get the experience you need and move on. Best of luck
  5. SanFranSRNA

    All Those NPs with No Bedside Experience

    Just curious...what do you think about PA?....no bedside experience..yet function similarly to NP.
  6. SanFranSRNA

    Simple IV Questions

    yup...I agree with Getoverit...Insulin=dedicated line...NEVER EVER piggyback insulin this is not a safe practice. If the patient is sick enough to require IV insulin gtt...then another IV should be started
  7. SanFranSRNA

    Great First Day!!!

    Wow...seems like a great first day. Congratulations. I graduated from RN program in 2005. You reminded me how I enjoyed clinical..... Keep up the great work.
  8. SanFranSRNA

    I am a new grad and got a job as ALF director position!

    I am happy for you. Know your limitations and know where you can seek help. Good luck
  9. Need more info please Dx Type and dose of Inotrope HB? 3 degrees? Brady? What is the dose of beta blocker?
  10. SanFranSRNA

    Accepted to CRNA school w/ Online BSN?

    I am not going to speak of what's going on in the East Coast nor the Midwest. Here in California all three schools produce a little over 70 graduates per year. Most of the senior who graduated in 2010 have already found a job. Like like everything else, CRNA's job market is about supply and demand......and of course the economy. People are not retiring as they should due to the state of the economy. In my opinion, it's like comparing apple to orange when you are talking about job vacancy and admission standards. Neither really have any solid relationships with one another. .......SURE school needs to fill seats...but if they keep on admitting "substandard" students into the program...their pass rates would be affected and that would lead to accreditation problems....school don't want that. SO it would be the best interest to admit the best possible candidate. Just my opinion.
  11. SanFranSRNA

    Accepted to CRNA school w/ Online BSN?

    I am not sure about that....I am currently attending a school in northern California. I know plenty of people with good grades and a lot of ICU experience who didn't even get interview. CRNA application process is extremely competitive. I don't think that they will simply just accept anyone into the program. The majority of people in my program have the average GPA of above 3.7 and excellent GRE scores. To state that if you can't get into a CRNA school today there is something seriously wrong is simply incorrect.
  12. SanFranSRNA

    Who Should Provide Anesthesia Care?

    Thanks for posting this..I'm going to share this in my Principle of Anesthesia Class
  13. SanFranSRNA

    Frustration: CRNA finally within reach... I hope...

    I really think that you will be ok...Apply...and wait and see....
  14. I am not sure about having only one RN on the floor. What about breaks? How do you cover breaks with no RN on the floor. There should be at least 2 RN
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