lovingRN2009

one thing to note is if your taking antibiotics for uti or anything else use back up birth control. antibiotics interfere with birth control pills.

just wondering if anyone else's place of employment offers benefits as follows: 6 recognized holidays, no sick time, vacation = to days worked in 2 week pay period, no retirement, 300$ monthly health insurance for part time-4 days a week.

with amiodarone having such a long half life, what is an appropriate time to wait between stopping amiodarone, starting diflucan and restarting amiodarone?

no problem- had you ever heard of it before looking it up just now?

thanks, i was able to find this info online. what i'm trying to find out is if this is common knowledge to the majority or if nurses see these given together without reservation.

ever heard of these two meds together a big no-no?

thank you all so much, i feel better.

dr was notified and incident report written up.

to make long story short. had order to dc picc and culture tip. wbc up and picc insertion site leaking. dc'd picc forgot to clip for culture. no good reason other than busy day - a lot on mind. nothing i can do now and dreading work tomorrow. sure i will have to explain myself to don and ordering dr. upset. anyone with similiar experience?

to answer some questions - no dangerous behaviors, he is in late fifties , i believe. no previous mental history.

pt. today is post ankle fusion, hx of djd/oa. woke up with left arm pain. xray of elbow, forearm and wrist negative. not real sure of whats going on, but thats not my question. what i want to know is your opinion of this - pt had previously been confused at times - not aggressive or trying to get out of bed, but saying off the wall comments. so the dr. at that time decreased percocet and tegretol dose, has since been more clear - still says weird , random stuff , has a strange sense of humor so hard to determine what he is serious about , due to the extreme pain he is c/o the dr wrote for morphine 2mg im q 2hrs as needed, lpn - primary nurse- this is team nursing felt this was inappropriate due to previous confusion - that we are unsure of the cause but possibly percocet. she felt motrin was a better choice. barely touching that man caused extreme pain that his now 1 percocet was not even touching. i feel like since we don't know if it was percocet, tegretol, or something else, that we should at least try the morpine. just because percocet makes someone confused doesn't necessarily mean morpine will and he still deserves pain control untill ortho consult tomorrow and the origin of this pain is determined and fixed. what do you think?

it's for a patient who had, had an infected tha removed and an articulating atb spacer placed. according to previous facility progress note: originally hemovac ordered for suction and apparently quite a bit of drainage took place, hemoglobin in low 7's, 2 units prbc infused, followed with order for drain to be to gravity only. just asking because i had never seen hemovac to gravity only, neither has any coworkers. called ortho to verify, which it was - no activation of suction. pt is on coumadin but still seems like it would be likely to clot off without suction, to me. and also seems like if that blood isn't sucked out, it would/could form an abcess. agree?disagree?

have any of you seen a hemovac ordered to gravity only? meaning not to activate the hemovac to suction.

Thank You

1. i have been seeing a lot of negative ua's - completely wnl, and then the culture will come back posititve. can anyone explain how this may happen. contamination at some point? 2. since regular insulin lowers serum potassium by driving it into the cell, does anyone see chronic hypokalemia in insulin dependent diabetics, because i have never. and is it only regular insulin that does this?

a fellow nurse told me that after dcing a picc line their was red "hair like" matter along it. the pt arm that it had been removed from was edematous. an ultrasound was negative for thrombosis. no one at work has seen that before, just wondering if any of you have. she was getting tpn at one time and is now being treated for sepsis, the pt. is of oriental decent. thanks

if a patient is recieving tpn through a triple lumen picc line, is it necessary at any time to flush the two lumens not in use?

as a nurse i do know when to hold a medication. in the facility i work at i need a physician's order to hold any medication. so when this situation comes up for you, you hold the medication even if the md wants it given, and there are no repurcussions?

i draw blood off a picc the same way as you, using a syringe and transfer device because i was taught putting the transfer device directly on the picc puts too much pressure on it, although i have seen other nurses do it that way.

diabetics do need insulin. however, 20 units of novolog for a blood glucose of 140 is ridiculous. she has been at the facility i work at for over a month, believe me, i know her blood sugar trend. also, i hope he was not striving for the 58 she dropped to, and thank goodness the patient refused the ten units the dr. wanted her to have at that point!

when measuring the picc line while doing the dressing change how many centimeters difference does there have to be, before you are concerned of migration? is a new onset of pink without drainage at a picc line insertion site alarming to you?

had a patient with blood glucose of 140, had not been eating well. patient was due for 10 units of novolog, made call to md to check if dose should be decreased or held. md decides to order 20 units of novolog. (md had recently been out of town and covering md had decreased scheduled novolog from 15 with additional novolog based on meal intake to 10 units)can u believe this? 2 hours later patient had blood glucose of 58. after being notified he orders 10 units scheduled after meals with additional novolog based on meal intake, says even if patient does not eat with blood glucose of 58 give patient 10 units of novolog. i don't think so , this was happening right at the end of my shift. nursing was trying to find med director/administration to notify