CareGiving

ambgirl2nurse, thank you so much! It makes total sense now. I just had to see it worked out, but I will know how to work a problem like this if I see it again! Once more, thanks!

I am hoping there is a smart "mathy" person out there who could help me with this problem: The physician has written an order for Dobutrex 500 mg in 250 mL of D5W to infuse at 10 mL/hr. The pt weighs 90 kg. How many mcg/kg/min will the pt be receiving? I have never seen a problem like this, and I'm trying to prepare for my complex math test this week. Any help would be greatly appreciated!!

So far it seems like the answer to my question is divided down the middle. I appreciate your honest answers (I would expect nothing less here! :)). It's on the west side of the city, off of 38th street. Indy thanks you for the compliment, btw! I moved back here in '04 after being away for 10 years and it is a great place to call home-- and nurses can still get hired here!

Thank you for your comments! Keep 'em coming! :) I guess I assumed most large cities would have a D.O. hospital or perhaps a larger D.O.-run facility, but I can see by the question marks that this is not the case. In Indianapolis where I live, there is a D.O. hospital called Westview.

I am very interested in hearing anybody's thoughts on nursing in a D.O. hospital. I'm attracted to the philosophy of osteopathic medicine, as it claims to support the body's natural ability to heal, uses non-pharm methods along with pharm, looks at the patient as a whole rather than system by system, etc. I'm wondering if, in practice in a hospital setting, this is the case. Is there really a difference in overall philosophy and/or culture? Or even if you have worked with a D.O. in a "regular" hospital setting... did he/she go about care in a different way than an M.D.? I would greatly appreciate your responses!

This is a great thread! How fun to read everybody's inspirational thoughts! I just finished my first year of nursing school (yesterday!!). I guess the quote that has run through my mind a lot is, "This too shall pass," in the sense that nursing school is just a chapter of my life. If all goes well, it's a chapter that will unfold with time into a great story about how I become a great nurse. I realize that I will not necessarily be a great nurse just because I graduate... that honor comes with experience. So I just aim to finish this chapter. I can say for sure that the first year flew by-- as tough as it was, it went by fast!! I will be finished one year from now, and then the REAL learning can begin! :-)

All your thoughts are much appreciated, thank you! It's pretty amazing to have this community of nurses to be able to glean knowledge from. Since my patient is not on lithium, the question still remains, why was he being given Synthroid?? The prophylaxis idea was a very interesting one, but he was being given Reglan which has the effect of increasing peristalsis. The dose ordered was 0.05 mg/1.25 mL if that helps spur ideas. I'll continue looking into this, and post if I learn definitively why this pt was receiving this drug.

Thanks for your reply, PacificNWNurse. No, the pt wasn't overweight at all, and was in quite good health prior to this hospital visit. I definitely understand the importance of knowing why a patient is receiving a med if I am giving it. I was not passing meds that day, and it was a question I didn't get to ask while I was at the hospital and now I'm home and kicking myself for it!

Oddly, I could not find thyroid function labs in the chart anywhere, and I scoured the Labs tab and the pt's history!

Hi AllNurses, I just had my second day of clinicals on the med surg unit and my patient had been in for 11 days. Pt was admitted to have a rectal mass removed, and received a new ileostomy. The surgical wound became infected by a leaking ostomy appliance, so pt was being treated for that. I'm now working on the care plan, and I am perplexed by the order for IV Synthroid. I did not see anything in his history indicating hypothyroid, nor that he was on Synthroid prior to this hospitalization. Are there unlabeled uses for Synthroid that might be related to this condition? A little more on pt's diagnoses... pt is recovering from post-op pneumonia, is bipolar and autistic. Labs normal except for the hematology labs being slightly below normal. Any thoughts would be greatly appreciated!