mlbdestined

Wow Belgian thanks! That really helps my understanding of the whole picture. I haven't seen these scvo2 catheters yet. Are they like continuous co measuring devices in that they give you a constant update on the scvo2 via a monitor?

thank you both for the responses. It helped. I guess I need to focus on the MODS picture that I'm guessing acidemia/alkalemia causes. I just was confused b/c the specific things I was told was that acidemia causes the heme molecules to give up O2 more readily to tissues, causing a drop in PaO2, but at the same time, not necessarily causing tissue hypoxia (which is what it would look like when just looking at an ABGs PaO2). So I was confused when my preceptor said "Acidosis doesn't cause hypoxia, which is what it looks like," and then later the shift said " the tissue hypoxia that extremes in pH can cause leads to cell death (which also goes along with the abnormalities of electrical conduction)". SO if I knew which one she meant I could say that MODS can lead to death r/t acidemia/alkalemia. So can any of you help me sort this out or confirm that acidosis does or does not cause tissue hypoxia? Thanks again all!

I'm having trouble understanding what effects acidemia and alkalemia have on the body that LEADS TO death. I have scoured the internet to no avail. I was told by my preceptor that both acidemia and alkalemia affects the conduction of the electrical stimulation of the body and they can impact the cellular extraction of oxygen off heme molecules. Is this true? So is it that the worse the pH gets one way or the other than the pt is more prone to arrhythmias and hypoxia? Is there a difference in effects leading to death from alkalemia versus acidemia, or are the effects the same that cause death of these things? Thanks sooooo much for all your help fellow nurses, as I am confused:

I'm having trouble understanding what effects acidemia and alkalemia have on the body that LEADS TO death. I have scoured the internet to no avail. I was told by my preceptor that both acidemia and alkalemia affects the conduction of the electrical stimulation of the body and they can impact the cellular extraction of oxygen off heme molecules. Is this true? So is it that the worse the pH gets one way or the other than the pt is more prone to arrhythmias and hypoxia? Is there a difference in effects leading to death from alkalemia versus acidemia, or are the effects the same that cause death of these things? Thanks sooooo much for all your help fellow nurses, as I am confused:

so the filters are for air rather than particulate? Nice to know thanks all

Hey all, concerning adult patients (no open foramen ovale or anything like that, just regular patients) I know that certain meds like mannitol needs a IV filter on it, but I don't know the reasoning for this? All I was able to see online is that the precipitate can cause phlebitis? Is this the reasoning. I didn't think this was why. Any info? Thanks guys

yeah I know that it's usually tip of nose to earlobe to xiphoid process, but when you aren't going through the nose there has to be some part of that cut out I would think because you're closer to the stomach. You cut all that space out between the nose and mouth. Just wondering

Hi all, I know how to measure for the NGT placement, but my question is for the intubated patients that are getting Orogastric tubes placed. How does the measurement differ? Do you cut out the nose-to-earlobe part of the measurement, or do you still measure it like you were going through the nose? Thanks guys.

so my question is then when the patient leaves, I guess in order to be cost effective the supplies can go with the pt., but we in the icu use a lot of stuff that the floor doesn't, so that's all wasted products...

it's just a set of drawers in the rooms that house all the supplies a nurse would need; for ex.: pre-filled saline syringes, 12 lead stickers, duoderms, 2x2s, 4x4s, yankauers, etc.

Hi All, I have been a RN in a SICU for going on 2 years now. I really want to further my education and go into either a acute care nurse practitioner role or a certified registered nurse practitioner role. I already have done the research for the requirements (1 year icu experience, 3.0 GPA with BSN in nursing, GRE, etc.). My question is two-fold: 1. Would people recommend just getting the core classes out of the way (like advanced patho, research, and pharm) for these specialties and then apply. 2. Does anybody have any arguments that could help me sway my decision. Working in the SICU really lets me see into the ACNP's job role and the pros they have are autonomy and variety in their job. CRNAs obviously make the big bucks comparitively and now with the push for NPs to get their doctoral degree in nursing practice in order to be certified, it's just about more schooling for that than for CRNAs. Any advice? Thanks guys

I am really trying to improve my SICU's hygiene and I think the first place to do so is our nurse servers: When a patient is on isolation precautions for, let's say contact precautions, the clinicians take the appropriate precautions to protect themselves/their other pts they are taking care of by gown/gloves/hand washing. My big concern is THE NURSE SERVERS. When a isolation pt is transferred to the step down units, the rooms are cleaned but nothing is done with the materials in the nurse servers. They are being touched right while the nurses are in isolation and touching the pt then going into the nurse server and getting supplies. Do any of your hospitals/units have ways of combatting this problem? My only suggestion was that nurses take in the supplies they think they will be using that shift in a plastic bag, but then there's always the emergencies where you have to dive into the nurse server... thanks for the suggestions

Is ventricular tachycardia WITH A PULSE shockable? I understand that V-fib and pulseless V-tach are shockable, and that PEA and asystole are not shockable, but I am reading this book on cardiac arrest and it doesn't mention any scenario with v-tach with a pulse. Thank you for any information you can give.

happens all the time in the sicu I am doing my practicum at

thanks for all the replys so far...I was just confused b/c I have heard before that if the BUN and creatinine are elevated then it is time to stop giving lasix. Is that true or is that not the case in this straight-forward scenario? I'm just curious b/c there was another day last week in this same practicum when I was given the orders to hold the lasix dose b/c the creatinine levels were rising from 2.1-2.4 (BUN rising from 22 to 23). My initial though was ohh, I guess if they are having some sort of renal issue, be it ATN/acute renal failure that you wouldn't want to give lasix b/c they may have been thinking that he was too negative in his fluid status and his kidney's were suffering from maybe a low CO, but his pressures were fine and he was overall net 500mL positive for his stay.