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crzyNP

crzyNP

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  1. crzyNP

    Sink or swim....

    As far as transplants ,since the kidney transplant is not "cure" but a treatment for ESRD which will eventually chronically reject hopefully not until years later. I would always document as "ESRD status post living related(LRT) or Cadaveric(CRT) and then document the GFR. Many transplant patients do not have a normal GFR and will need renal dosing especially with antibiotics and other drugs than can affect their immunosuppression. I use Epocrates the most complete version. It had all the renal dosing adjustments on it and it went on my Palm. Any patient who has ever had any type of renal problem should permanently avoid NSAIDS.
  2. crzyNP

    Sink or swim....

    I was a nephrology NP for 8 years and a dialysis RN for 8 years before an NP. I am now a hospitalist NP. I had a lot of experience going into the nephrology NP role but the docs I started out with had me read and learn the "Primer on Kidney Diseases" put out by the National Kidney Foundation (NKF). It really helped me learn the renal diseases and causes of prerenal, postrenal and the different glomerular diseases. I did function in the dialysis units and also rounded in the hospital and had a CKD clinic. Remember with CKD to just address the main issues of 1) Stage of CKD, etiology of renal disease 2) Hypertension 3) anemia due to CKD 4) secondary hyperparathyroidism from CKD 5) nutrition as low albumins are usually a problem esp with nephrotic syndrome disease states and late CKD. Always remember to tell the patient to avoid NSAIDS, huge factor in preservation of remaining kidney function in these patients and to let any doc who wants to do a dye study on them know of their renal disease in consideration of contrast nephropathy prevention. Prevention of further renal decline and preparation for ESRD are big goals in the CKD patient. Hope this is helpful. Good luck.
  3. crzyNP

    CRNAs Looking Down on NPs

    I don't see how anyone just out of school whether it be an NP or CRNA could possibly have enough cash saved up to pay for a BMW or Corvette unless you are financing it. In my opinion, UGH!! financing it would totally ruin any good feeling of getting the car anyway unless it was paid in full. Screw having a car payment ever.