TakeBack

TakeBack

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All Content by TakeBack

  1. potassium level and fluid replacement

    TakeBack replied to dan_dfc's topic in CCU, Coronary, Cardiac

    Agree, there are transcellular shifts that occur w/ changes in extracellular fluid status that will cause K levels to vary, but with normal renal function the serum level should hover in the same...

  2. why we can't give IV Atropine for 2nd degree heart block type 2?

    TakeBack replied to erintiong's topic in CCU, Coronary, Cardiac

    Actually, I never said it only works at the AV node. (???) The relevant point to the OP (AV block, not sinus dz) is that it speeds AVN conduction. It's action at the SAN is irrelevant b/c the...

  3. why we can't give IV Atropine for 2nd degree heart block type 2?

    TakeBack replied to erintiong's topic in CCU, Coronary, Cardiac

    Second degree type II (Mobitz II) block generally occurs in the fascicles below the His bundle. Recall the sequence of conduction fibers Sinus Node - Atrial Fibers - AV Node - His Bundle - Bundle...

  4. Adjusting a temporary pacer

    TakeBack replied to aCRNAhopeful's topic in CCU, Coronary, Cardiac

    A pt w/ an underlying rhythm should not be left in async for the R on T risk. Never fear pausing the device to check rhythm and the associated hemodynamics. I've seen several unnecessary codes from...

  5. Anybody ever see an IABP balloon failure?

    TakeBack replied to catshowlady's topic in CCU, Coronary, Cardiac

    The balloon should cease immediately due to a failure in pressurization; it should be pulled right away and replaced via the same sheath. If the pt is sick enough to require the IABP I wouldn't leave...

  6. IV bolusing a fluid overloaded patient

    TakeBack replied to kanzi monkey's topic in CCU, Coronary, Cardiac

    Just for the record, not all the time. There are several conditions (TR, constrictive pericarditis, pericardial effusion, RV failure) where an elevated CVP does not necessarily reflect intravascular...

  7. Cardiac Monitoring/ 5 lead system

    TakeBack replied to Caroline11's topic in CCU, Coronary, Cardiac

    This is probably referring to the modified chest lead (MCL), which is also sometimes called MCL1 or V1. IF this is what they are referring to, it is placed roughly at the 4th RICS (similar to where V1...

  8. Post MI care and expectations

    TakeBack replied to BeachGirl08's topic in CCU, Coronary, Cardiac

    This person has been through an incredible stress- the neuro effects are mutlifactorial- diffuse anoxia from the arrest, encephalopathy from the cooling, and likely an element of delirium from the...

  9. Don't Hate Me, All....

    TakeBack posted a topic in Nurse Practitioners, NP

    I have been following your discussions here on the recent media coverage of the primary gap, and NPs place in it. I posted this on another forum that I moderate, and felt it was only fair to give you...

  10. IV bolusing a fluid overloaded patient

    TakeBack replied to kanzi monkey's topic in CCU, Coronary, Cardiac

    b/c postops third space- the issue is not the total volume of lfuid given, but the portion that remains in the intravascular

  11. Don't Hate Me, All....

    TakeBack replied to TakeBack's topic in Nurse Practitioners, NP

    I'm not arguing really any of what you mention here; of course all pts deserve to know all members of their care team and what their tx is, possible pos/neg outcomes etc. When I say our own interest I...

  12. Don't Hate Me, All....

    TakeBack replied to TakeBack's topic in Nurse Practitioners, NP

    Patients call me doc all the time, despite the introduction, and the name tag, and the embroidered title on my coat. Same story. I don't doubt your personal experience but I can't say that the use of...

  13. Don't Hate Me, All....

    TakeBack replied to TakeBack's topic in Nurse Practitioners, NP

    Agreed! I wonder how often than full descriptive is used by non physician clinical doctors,

  14. Swan freestyle: Does Mean PAP Exist?

    TakeBack replied to sonnyluv's topic in CCU, Coronary, Cardiac

    The significance is that the mean pressure is the driving pressure gradient which creates forward flow. Factors which affect the above equation alter it. Pressure = Flow X Resistance Changes in flow...

  15. Don't Hate Me, All....

    TakeBack replied to TakeBack's topic in Nurse Practitioners, NP

    Because that's not

  16. Don't Hate Me, All....

    TakeBack replied to TakeBack's topic in Nurse Practitioners, NP

    To me there seems to be some subtlety to it that deserves notice. I respect wanting to push the envelope professionally, but that must be done in the context of what times we are practicing in....

  17. Don't Hate Me, All....

    TakeBack replied to TakeBack's topic in Nurse Practitioners, NP

    It is the stance of PAs, and is written in our state regs, that PAs may not misrepresent themselves as a physician. As a bedside provider introducing yourself as Dr Smith, the average patient would...

  18. Don't Hate Me, All....

    TakeBack replied to TakeBack's topic in Nurse Practitioners, NP

    Cute. Almost like doctor nurse. Understand the training and role for clinical doctorate PAs is limited- so much so that it seems unlikely that it will expand to all PAs. Most of these PAs (DHSc) are...

  19. Don't Hate Me, All....

    TakeBack replied to TakeBack's topic in Nurse Practitioners, NP

    The DNP is not making it seem this way. This may be more semantics like practicing "nursing" instead of "medicine", but wanting to be a primary care provider, with independent practice, billing at the...

  20. Bsn degree vs. Physician assistant certification/licensure??

    TakeBack replied to KAzurinM.Twin1's topic in General Nursing

    Actually, they (I!) do. Actually, you don't really know what you're talking about. Certification is a nat'l issue. Licensure is satewide, and license varies

  21. Bsn degree vs. Physician assistant certification/licensure??

    TakeBack replied to KAzurinM.Twin1's topic in General Nursing

    PAs have their own

  22. Bsn degree vs. Physician assistant certification/licensure??

    TakeBack replied to KAzurinM.Twin1's topic in General Nursing

    State by state variability re: requirement for physician/BOM involvement Pearson Report, pg 18

  23. IV bolusing a fluid overloaded patient

    TakeBack replied to kanzi monkey's topic in CCU, Coronary, Cardiac

    I wouldn't give the D5 if she had another glucose source (PO diet), and not necessarily the KCl if she had adequate K intake from diet or PO supplements. So NS, or NSOL/LR if she had a mild met...

  24. IV bolusing a fluid overloaded patient

    TakeBack replied to kanzi monkey's topic in CCU, Coronary, Cardiac

    Is she is hypoalbuminemic, she needs oncotic tone. You can mke the case to not give her colloid (albumin or PRBC) if the fluid overload is not causing resp failure, and manage conservatively w/...

  25. Bsn degree vs. Physician assistant certification/licensure??

    TakeBack replied to KAzurinM.Twin1's topic in General Nursing

    Not sure I understand the question- working in what capacity? As an RN/PA, you are likely to make more as a PA except the lower end paying PA jobs compared to, say, travel nursing. BTW it's Physician...