clementinern

clementinern

Critical Care

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All Content by clementinern

  1. May be repetitive thread;going to ICU from Medsurg

    clementinern replied to RNHURT's topic in CCU, Coronary, Cardiac

    My best advice would be to NEVER NEVER NEVER be afraid to ask questions, even if you think it is a "stupid" question. Please, trust me when I say that most ICU nurses would much rather have you ask...

  2. How long do you apply pressure when d/c a balloon pump

    clementinern replied to faithmarie's topic in CCU, Coronary, Cardiac

    In our facility manual pressure is held for at least 20 minutes, and then a femostop is applied for 1-3 hrs in most

  3. Advice on pt with open chest Please!

    clementinern replied to sweetart4988's topic in CCU, Coronary, Cardiac

    You are correct that a pt with an open chest does bubble most of the time. It's precisely because the chest is open, so you pretty much always have a leak. Regarding Maevish's post about how there...

  4. therapeutic hypothermia

    clementinern replied to Phylis's topic in CCU, Coronary, Cardiac

    Yes we use the Arctic Sun at my facility and I have seen no issues with skin integrity related to the

  5. SVR too low!!

    clementinern replied to HeartRN80's topic in CCU, Coronary, Cardiac

    Also i wonder why the docs would have you go up so high on Epi and add vasopressin without increasing Dopa or adding Levophed first? Vasopressin usually works in conjunction with Levo....seems like...

  6. SVR too low!!

    clementinern replied to HeartRN80's topic in CCU, Coronary, Cardiac

    Was the pt an AVR in addition to CABG? Sometimes those pts are used to really high SVR's pre-op and the suddenly competent valve can have a hard time adapting to the decreased afterload. I also find...

  7. Blood pressure drop while giving albumin bolus

    clementinern replied to luckyou's topic in CCU, Coronary, Cardiac

    My only thought is that you ran the albumin through the same line as propofol or something else that could drop bp and the sudden infusion of albumin gave them a little bolus. Otherwise, it just...

  8. IABP and CPR

    clementinern replied to Tornadochaser's topic in CCU, Coronary, Cardiac

    Definitely don't need to shut off the IABP during a code. Generally we put it in pressure mode, as others have said. The only possible rationale I can think of to leave it in EKG mode is that the...

  9. PRN fluid boluses post open heart?

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

    We have free reign to give up to a liter of LR and a liter of Albumin, and then we are supposed to call; but the understood rule of thumb is that up to 3 liters is generally considered ok. Our docs...

  10. Amiodarone and Lidocaine drips for VTach

    clementinern replied to deemo21's topic in CCU, Coronary, Cardiac

    I don't actually recall running both together, but lidocaine is generally indicated for polymorphic VT over

  11. What is a good sedative for a hypotensive patient?

    clementinern replied to nursingdude78's topic in CCU, Coronary, Cardiac

    I've found versed to be the best, but you said your facility doesn't use it. That's too bad; it works great. Fentanyl typically works well too. Also, 250cg of Neo is over the max dose! Yikes! I'm...

  12. Lowest H/H I ever saw...

    clementinern replied to my2sons's topic in CCU, Coronary, Cardiac

    Many years ago i had a pt who had a HCT of 9!! Yes, the HCT!!! He was a jehovah witness and was refusing blood products. I can't remember what happened to him or what the scenario

  13. IABP blood pressure question

    clementinern replied to NeuroNP's topic in CCU, Coronary, Cardiac

    It depends on the doc, some docs will titrate drips to augmented BP and some will titrate to IABP mean. We document all of the #'s on our sheet, including peripheral A line BP's. The IABP #'s will...

  14. Top 10 CT-ICU drugs

    clementinern replied to CABGx4's topic in CCU, Coronary, Cardiac

    Well, I can't say specifically what drugs your unit will use- but I can take an educated guess based on what we use in our CVICU. Propofol Dopamine Lasix Neosynephrine Precedex Angiomax Calcium...

  15. IABP

    clementinern replied to BellaInBlueScrubsRN's topic in CCU, Coronary, Cardiac

    Also, I think the first person to respond to your post- CABG patch kid- maybe have been confusing augmented diastolic with assisted diastolic. You WERE correct that assisted diastole should be lower....

  16. IABP

    clementinern replied to BellaInBlueScrubsRN's topic in CCU, Coronary, Cardiac

    I think the way you worded your question made it a little tricky to understand what you were asking. You didn't actually have a "negative afterload reduction", but you are correct in saying that you...

  17. Calcium Chloride vs Calcium Gluconate

    clementinern replied to Manurse715's topic in CCU, Coronary, Cardiac

    the hypocalcemia you see with post op cardiac surgery pts is related to fluid shifting from the actual bypass pump and, as you mentioned, from blood products. also being cold can alter electrolytes....

  18. Calcium Chloride vs Calcium Gluconate

    clementinern replied to Manurse715's topic in CCU, Coronary, Cardiac

    In my facility, we typically use Calcium Gluconate to replace a low ionized ca

  19. How To Document Sleeping On Night Shift

    clementinern replied to Iggy123's topic in General Nursing

    I always say, simply, "pt is resting

  20. A-fib + metropolol + diltiazem gtt + soft bp

    clementinern replied to buddiage's topic in CCU, Coronary, Cardiac

    To be honest with you, I think I would have looked to treat the cause of the rate- despite the AFib, the pt had a lot of other potential reasons to be tachycardic and hypotensive. Was it anesthesia...