queenjulie

queenjulie RN

Step-down, cardiac

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All Content by queenjulie

  1. DMV reporting of unsafe driving

    queenjulie posted a topic in HIPAA Challenges

    Got a dilemma: I am a nursing risk manager at a family practice. PA at our office has a patient who is refusing all treatment for what are probably multiple (now old) strokes. Has fairly serious motor...

  2. petechia/purpura during dying

    queenjulie posted a topic in Hospice, Palliative

    I had a patient recently who was actively dying, and during her last few days, she developed petechiae and purpura essentially all over her entire body. It was more than usual, but I know that...

  3. Selecting syringes

    queenjulie posted a topic in General Nursing

    How do you experienced nurses select a syringe for injections that aren't pre-filled? I'm halfway through nursing school, and as yet have only given insulin and Lovenox injections, which either have...

  4. Reno/Sparks RN salary?

    queenjulie posted a topic in Nevada Nursing

    My husband and I are considering relocating to Sparks to be near family who moved there, and because my husband is retired Navy and interested in working for Tesla. I'm an RN with five years'...

  5. Orders from hell...

    queenjulie replied to Leonardo Del Toro's topic in General Nursing

    I got a new admission one time of a CHF patient, and the family was furious when they asked what diet he had ordered, and I told them it was our low-sodium cardiac diet. They insisted, "He doesn't eat...

  6. Do nurses get fired often?

    queenjulie posted a topic in Patient, Colleague Relations

    It seems like I see people talking on here constantly about how they were fired from their first job, or their last job, or know several people who were fired. Do nurses get fired a lot, especially...

  7. Is this real? Vein light

    queenjulie replied to ladysushi's topic in General Nursing

    Yep, it's real, and I've used it a bunch of times. Whether it's helpful is a mixed bag. It can give you a good view of the location of veins in someone with very dark skin, which is the best benefit...

  8. New cardiac nurse--advice?

    queenjulie posted a topic in Cardiac

    I'm a brand-new RN (yay!), and I just accepted a position on a step-down unit that is almost entirely cardiology. I did lots of clinical hours on the unit during school and I love it (great staff,...

  9. Magnesium for oxygen absorption?

    queenjulie posted a topic in Cardiac

    I got an ER admit today who has COPD exacerbation. The ER nurse reported that she was given 2 g of magnesium IV to help with her oxygenation. I'd never heard of such a thing, and neither had the most...

  10. V-fib refractory to an initial/second shock

    queenjulie posted a topic in Cardiac

    I'm a new grad who has been on a step-down floor for a few months now, and I'm getting ready to take ACLS. I've come across something I'm totally not familiar with, and I'm freaking out because I feel...

  11. Pushing a Cardizem bolus

    queenjulie posted a topic in Cardiac

    How slowly do you push a 20 mg Cardizem bolus on a person with afib with RVR? My patient was an elderly woman with stable BP but HR up to 150 BPM. I pushed her Cardizem bolus over four minutes and her...

  12. blowing veins during IV starts

    queenjulie posted a topic in General Nursing

    I've been a nurse for seven months, and I'm doing well, except that I suck at starting IVs. In school I was almost completely unable to do them, and I've improved to the point that now I virtually...

  13. Lexiscan vs. stress echo

    queenjulie posted a topic in Cardiac

    I'm on a Step-Down tele unit, primarily cardiac, and I just realized that I don't know the difference between a Lexiscan and a stress echocardiogram. Can anyone explain? It seems to be the difference...

  14. Bleedind at PIV insertion site

    queenjulie replied to tg982's topic in Cardiac

    SummitRN is quite right--it's incredibly common to have a little blood leaking around a heparin or Integrilin drip, because they are anticoagulants. Now, if it's bleeding a lot, or the IV won't flush...

  15. Coumadin therapy

    queenjulie replied to IM4patients's topic in Patient Medications

    I'm on a primarily cardiac, high acuity step-down unit. Our Coumadin patients generally get a PT/INR every day or every other day, and if they're new to Coumadin, we refer them to our local Coumadin...

  16. Pushing a Cardizem bolus

    queenjulie replied to queenjulie's topic in Cardiac

    Thank you! I thought I was going crazy when she said that!! I'm wondering if maybe she was thinking of Primacore. That makes me feel so much

  17. PCCN--is it worth it?

    queenjulie posted a topic in Cardiac

    Is getting a Progressive Care certification worth it? If you have one, did it help your career at all? I'm a relatively new nurse on a Step Down unit; I've been an RN for a year, so I'm just now...

  18. Any ADN-BSN programs without ridiculous papers?

    queenjulie replied to adnrnstudent's topic in Online Distance Learning

    Why would a college *not* require you to write papers? Learning to do research and write critical papers is a vital part of a college education--one of the most fundamental parts, in my

  19. Med/Surg Experience

    queenjulie replied to hoverton's topic in General Nursing

    Honestly, our local psych facility is so understaffed that they definitely don't require anything but an RN after your name to work there. I'm sure they prefer med/surg experience or other psych...

  20. Accuracy of Automatic BP machines?

    queenjulie replied to blackvans1234's topic in General Nursing

    We used to have that kind of BP cuff, but our hospital got rid of them because of concerns about infection, so now we have disposable cuffs that come sealed, and we give each patient one on admission...

  21. Accuracy of Automatic BP machines?

    queenjulie replied to blackvans1234's topic in General Nursing

    How do you handle infection prevention doing it manually? Do you just constantly scrub them with wipes? I also work on a cardiac floor, and we have disposable BP cuffs for each patient for our...

  22. blowing veins during IV starts

    queenjulie replied to queenjulie's topic in General Nursing

    How do you hold the skin taut, hold the needle, and release the tourniquet at the same time? I'd need three hands! Seriously, though, I usually try to advance the cath with the tourniquet on or let...

  23. blowing veins during IV starts

    queenjulie replied to queenjulie's topic in General Nursing

    Thank you all for all your advice! This is great. A phenomenal IV starter at work told me yesterday something interesting--she said she always goes in the side of the vein, not down on the top of it....

  24. blowing veins during IV starts

    queenjulie replied to queenjulie's topic in General Nursing

    Actually, at our hospital, we aren't allowed to start IVs in the legs or feet without a physician's order, because of the hazards of diabetic foot ulcers and circulation problems. I figured that was...

  25. blowing veins during IV starts

    queenjulie replied to queenjulie's topic in General Nursing

    Thank you, everyone, for your advice! Yes, I'm getting the vein, getting flashback, but then when I go to advance the cannula, it just goes in a tiny bit and then sort of sticks, and the flashback...