Protoman2050

The California Board said yes, she has to.

I was talking about acute right heart failure, like an inferior wall AMI that affects the right ventricle. Everything's fine until your right ventricle infarcts and can no longer pump well. And, since inferior wall AMIs can also cause acute MR, it'd be very interesting to see how you'd manage a pt with a right ventricle infarction and acute MR. They need fluids to maintain LV preload, but since the MV is regurgitating, most of it will go back into the lungs, and cause pulmonary edema. Probably give fluids very cautiously, usingSwan-Ganz catheter to titrate to PCWP, w/ Lasix at the ready.

Thanks!

We know she needs to take the NCLEX-RN again. What prep courses do you recommend?

What's an average day like? Are Swan-Ganz catheter pts on telemetry?

Well, I can't use my Mom's, which is over 20 years old, hot pink (I am NOT running around the hospital wearing that!), and falling apart (the tube is nearly corroded). I'll probably also get a chance to work on telemetry, b/c my program director says EKG techs (for the first two semesters, we're working towards our EKG technician certification and learning cardiovascular pathophysiology and pharmacology as well; the next two semesters we start ECHO training. At the end, we earn our AS in Cardiovascular Technology and become registry-eligible). What's it like? Is it 90% boredom, 10% sheer terror? By your picture, do you work in CA, FL, or Hawaii? I'll be working in CA, hopefully at LB Memorial Heart and Vascular Institute.

How much does it cost, $500? I'd need an electronic one b/c my ears get distracted by outside noises. I basically need one for detecting heart murmurs and lung sounds, so I can perform a brief H & P on my patients before I perform the echocardiogram. The presence of wet rales can seriously impact a cardiac patient's E & M, and lend credence to a finding of increased left atrial pressure, meaning that it's so high as to cause the pulmonary capillaries to leak from increased hydrostatic pressure. Which generally means the patient either needs to be put on Lasix, or their dose needs to be upped.

I'm a cardiovascular technology student, and I'd like to know what type of stethoscope I should buy for clinicals. I'll be dealing with cardiac patients (obviously), so I'm considering the Littmann Electronic Stethoscope Model 3200. Any experience with this model? Thanks, Doug

Which is more useful for maintaining left ventricular preload in the setting of acute right heart failure, vasopressin or IV fluids? Why don't doctors write med orders "per pharmacy"? Make use of the highly-trained PharmDs, they're not just pill-counters. Thanks, Doug

My Mom's RN license lapsed after 18 years of not practicing (she had to quit her job when I was born, b/c I was extremely ill). She wants to retake the boards to get relicensed so she can work again to help support the family when I move out. What prep courses do you recommend? Btw, I'm training to be a cardiac sonographer at Orange Coast College. I hope to work at either Long Beach Community or Memorial Hospital, b/c I admire the NICU nursing staff there who took care of me when I was critically ill...it was born 16 weeks early, Apgars were all zero all three times, and I had a massive PDA causing PAH and right-to-left shunt. The NICU nurses had so much fun with me...they'd dress me up, take me across the NICU to a brthday party, etc. They made me want to get into the medical field. I plan on someday going to St. George's University School of Medicine in Grenada to earn my MD after completing my BS in Echocardiography online at Oregon Institute of Technology. I want to become an interventional cardiologist. Btw, why do I keep hearing stories of RNs who abuse med students and residents (abusing your future boss is not a good way to build a working enviroment, esp. a hospital); almost al of the RNs I've been around have been so nice. And why are NPs under the board of nursing, and not the board of medicine...if they're diagnosing and treating, they need to be under the board of medicine. Nurses should stick to nursing, which is what they do best, not try to practice medicine. We have PAs for physician extension. Sadly, I've heard stories from my friends who saw an NP who was incompetent, and who prescribed antibiotics for colds or something like that. The student health clinics at the college gave him a hard time when asked to see the physician. Thanks, Doug