Kidagora

That makes sense. Thanks! The risk/AEB advice came from a med/surg teacher but our psych teacher argued against it frequently using AEB in every diagnosis she would cite. Students in class raised the question but.....the cross-chatter gets confusing. Everything seems to be very "by the book" so when I don't see a "unstable blood glucose" diagnosis anywhere in our textbooks, I'm hesitant to use it. Thanks again!

Does this diagnosis sound correct? Risk for unstable blood Glucose r/t infection AEB elevated WBC count, and glucose >180. Doing a care plan for a patient. In all the books I've noticed deficient knowledge, dietary intake, management, etc. as risk factors but nothing specifically on infection. There is one about "physical health status" but I thought that's too vague. I know DM II affects immunity which can lead to infection. And I know infection, as a stressor, elevates glucose levels. Is stressor a more appropriate risk factor? Risk for unstable blood Glucose r/t physical health status???? Also, some professors are suggesting that a "risk" diagnosis needs no AEB. Is this true?

The only IV I know he was on was vancomycin. Seems like everyone on the floor is on it. He also had a history of pancreatitis and was on methadone for opiod/EtOH/benzo withdrawal. I thought it might be related to that but still thought that any vomiting nixed administration of docusate. Is it a special case?

Is there ever a circumstance where a patient would continue to receive docusate despite having signs of nausea and vomiting? I know it's contraindicated and supposed to be withheld but it was given by another student. The patient recieved ondansetron earlier in the day for nausea. He was also collecting vomit per doctor's orders and I guess being frequently monitored. I said the symptoms suggested holding the med but they said the ondansetron took care of the nausea and that they were being monitored so it was okay. It wasn't my patient and didn't know much about it so I let it drop. Thoughts?

I saw a med combo during clinical and was curious so I found this thread hoping someone might be able to clue me in and help explain the details. A patient is on 100mg of docusate sodium (t.i.d.) and 2 tabs of doc-q-lax (q.d.). Is the docusate sodium the same docusate used in doc-q-lax? I couldn't quite understand why two different types of docusates were being used. If they're the same and one just has the laxative, is there any reason why there aren't separate orders for a stool softener and a laxative? Is it just a doctor's preference or specific to the patient? A classmate suggested that the docusate sodium might draw more water in than the other (because of the osmotic properties of sodium) but I thought it's just a surfactant, not a osmotic agent. Also, is there a difference in effectiveness between docusate sodium, calcium, and potassium? Is there any reason why one would be used over the other? Any help is appreciated!

Aren't aerosol droplets another mode of transmission for influenza? And don't you become a vector 1 day before exhibiting symptoms? So it seems handwashing would have little effectiveness in that instance if someone infected is coughing, sneezing in a general vicinity and you're in direct care of them. Wouldn't the vaccination be all the more effective if you can't tell who is in the early stages? Or you could just walk around with a mask all day and wait till someone is diagnosed a week after becoming ill? Just wondering.

A very complicated question and I don't think I have an answer. So I'll fumble my way to a conclusion as I write. I think as a private party, any employer is well within their constitutional right to define requirements for employment (from a purely libertarian ideology) even though I may disagree with those requirements and however they may infringe upon an individuals desire for employment with that institution. Discrimination, bias, etc. is another subject up for discussion. I don't think it's my place to expect an employer to conform to all my demands nor do I think it's my employers place to expect me to conform to all their demands. That's where negotiation of contract terms comes in. At that point it seems to be an issue between two private parties. If you don't like the terms, walk and find another position (which seems to be what many have expressed). Ethically, I do not think it's is not right to force or coerce someone to contradict their personal beliefs, autonomy, impose risk, or punish them for being who they are. I do think everyone should have the right to refuse someone else for whatever reason be they employee or employer or client. I understand the perceived benefits of having staff in high risk positions vaccinated and I can see why someone may want to make it mandatory. I think the whole "it's unproven" argument is false. I have not seen anything to suggest this is any less safe than the seasonal flu shots. Scare tactics, urban myths, unfortunate isolated instances, conspiracy theories, and government paranoia appear to have trumped empirical evidence, statistics, case studies, and historical evidence of vaccinations. Maybe someone can give specifics with regard to what vaccinations are/were problematic in the past and cite some sources and stats. I'm curious. I really don't know of any offhand. Someone posted earlier with a very convincing argument citing hypocrisy in mandating a vaccination but at the same time upholding the patient's bill of rights, ANA code of ethics etc. I agree. But at the same time I wonder about OSHA precautions and the use of protective equipment in any workplace setting (gloves, helmets, coats, glasses, etc.). Is it really that different because you're putting something in your body with one preventative measure and the other you're simply wearing protective gear for the other? Neither is 100% effective but I guess the fact one is a medical treatment makes all the difference. But I think the scare tactics and the culture of individualism blinds us to a more socially responsible answer. As for vaccinating the public, it would be a governmental mandate for public vaccination which I think is dangerous. Understandable in terms of a serious, deadly epidemic as guidelined by the CDC. But once again as a private party with a small employment base interacting with a large public, I think it makes more sense (to me) to use the limited resources to vaccinate a staff (smaller population) that is in direct contact with infected (larger) population and at risk for greater transmission to immuncompromised patients. I'm tired of writing now. That being said, I don't really have an opinion but I understand both sides. Please, don't flame. This a first post and a serious attempt at a thoughtful analysis of a controversial, polemic topic. The key to this whole question is "should". Not "Can H1N1 vaccine be mandatory.." or "Is H1N1 vaccine mandatory...". I don't see a right or wrong answer here. Like most things, it's a matter of perspective. If I was a hospital director I would be concerned about staff and patient population and say yes. As a student nurse I am concerned with personal responsibilities, code of ethics, and autonomy and I say NO.