sueinga

Do you apply and let dry prior to cannulation? Or have them wash their arm before they sit down? Either way I wil try it- thanks for the input!

Hi, I have a patient who develops extremely irritated, scally skin around her access- it has happened around a catheter dite and also over an AV access in both arms. The CVC area responded to a bactroban on gauze debridement ( of the scales) and vaseline gauze for a dressing. It took 2-3 weeks to get it to heal up- now the same skin condition exists overlaying her forearm graft. I suspect an allergic reaction to Chloraprep and alcohol- but what can I use to de- germ the skin prior to cannulation that is both antibacterial and hypoallergenic without drying? Anyone else seen this and and any advice appreciated Susan

Hello, I'm interested in travel nursing- but do I need to obtain a license in each state I'm interested in? How does that work? Thanks anyone Susan

Hello, We draw our monthly and midmonthly labs from the arterial lumen of CVC patients and normally first withdraw the indwelling heparin of course- at least 3ml- 5ml There has been a debate as to whether the P.T./INR would be accurate anyway if drawn the same way or if a peripheral stick should be done. My latest instructions are get the pt on the maching and draw from the arterial port on the blood tubing---any opinions? thanks anyone Susan

Georgia lets you license by endorsement. I applied to the state of Virginia to take state boards and then took them in Atlanta. Its all computerized so you do not have to physically go to another state to test. After I got my Virginia license - I got my GA license by endorsement- not a big deal

Focal segmental glomerulosclerosis is scar tissue that forms in areas of the kidney that filter certain things out of the body. These areas are called glomeruli. The help the body get rid of harmful or unnecessary substances. Each kidney has thousands of glomeruli. "Focal" means that some of the glomeruli become scarred, while others remain normal. "Segmental" means that only part of an individual glomerulus is damaged. The cause of focal segmental glomerulosclerosis is usually unknown. A small number of cases result from reflux nephropathy. The condition affects both children and adults. Males are affected slightly more often than females, and it also occurs more frequently in African Americans. Focal segmental glomerulosclerosis causes about 10 - 15% of all cases of nephrotic syndrome.

Hello, I worked as an LPN for almost 30 years and used Excelsior to get my ASN. I've been an RN for a year now working in Dialysis. In my opinion it was far less stressful and expensive to use Excelsior for this- you just need more motivation and discipline for self study. It was way more convenient as well doing it at your own pace and in your own home basically. I plan on trying for my BSN soon. I would recommend it only to LPNs with at least 2 or more years experience - having that base experience counts for alot especially when you go for the CPNE. There are alot of online yahoo groups for student support that also help a great deal. Good luck to you!

Hi, Everyone pretty much agrees that when accessing a new fistula to use 17g x 2 weeks then 16g x 2 weeks and ultimately 15g unless otherwise ordered..........but I've heard conflicting views on what size needle to use when accessing a new graft, what is your rule of thumb regarding needle size and also pump speed with a new access? Thanks anyone Sue in GA

What are tipstops? We used sureseal bandaids for awhile but they were cost prohibitive- now we use superstoppers and most pts and staff love them- and they're cost effective

Hello, I live in NW Georgia area and just finished my first year as an RN in dialysis. I was an LPN for 25 years and then got my RN thru Excelsior. Look forward to hearing about other areas of care as I'm not sure this is my forte. Sue

When a patient c/o cramps anywhere ( legs, hands, abdomen, back) I turn the UF off , give 100 to 250 of saline and see how they respond- then its a judgement call as to if and when to turn the UF back on. I know its a sin to send a pt out with fluid weight on but if they are cramping??? Thing is- most peoples weight fluctates on a daily basis so is this not also true- even moreso with dialysis patients so that there EDW fluctuates probably more than it is changed?

Hi, In Georgia it is supposedly mandated that 1 RN to 10 dialyis patients is the limit. We run 16 patients on first shift and 15 on second shift. There is supposed to be 2 RNs but one comes late chronically (agency). I have been the only nurse a few times with more than 10 on a machine- once an entire day. I feel my license is being put on the line when the ratio is higher than mandated. I can say no more patients on after the limit of 10 until another nurse is in the buidling or I can do whats really expected it seems and that is that I "play it cool" and just let all 16 on without saying anything to anyone----What do you do when this happens? Btw, I only have 8 months experience at this point, FM does not get involved much and when I say I am alone- I mean the only RN in the building at the time-

Hi, In Georgia it is supposedly mandated that 1 RN to 10 dialyis patients is the limit. We run 16 patients on first shift and 15 on second shift. There is supposed to be 2 RNs but one comes late chronically (agency). I have been the only nurse a few times with more than 10 on a machine- once an entire day. I feel my license is being put on the line when the ratio is higher than mandated. I can say no more patients on after the limit of 10 until another nurse is in the buidling or I can do whats really expected it seems and that is that I "play it cool" and just let all 16 on without saying anything to anyone----What do you do when this happens? Btw, I only have 8 months experience at this point-

Curious- what is "chevron tape" ?? I've not heard that term before

We all have pts who are hypotensive post treatment and we don't want to give back too much fluid. Of course sodium variation, profiling and adjusting EDW as first options but after that? One nurse has suggested that by experience- giving either some boullion to drink or pickles to eat (combo of sodium & vinegar) raises the bp - whatdaya think? any other suggestions?