TennRN2004

TennRN2004

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All Content by TennRN2004

  1. New grad in need of wisdom

    TennRN2004 replied to OcramRN2be's topic in MICU, SICU

    Lots of things to consider, and some will be the old hindsight is 20/20 whenever you make your final choice b/c there will always be things you didn't factor into the equation when trying to decide...

  2. Infiltrate treatment question

    TennRN2004 replied to butofcourse's topic in CCU, Coronary, Cardiac

    Like I say, I don't know the hard evidence to support doing it. However, it is our hospital policy when administering it to change the needle. My response above was based on why it makes sense to me...

  3. Tandem Heart.....

    TennRN2004 replied to CardioTrans's topic in CCU, Coronary, Cardiac

    I'll ask our head surgeon about these. We have exactly some of the pts you describe that could benefit from these it sounds like. We all cringe when you hear of one come in as a redo with a crappy EF,...

  4. Want to Discuss Hearts?

    TennRN2004 replied to nedanurse's topic in CCU, Coronary, Cardiac

    Ouch, don't you just feel helpless in those situations? You need to do 20 things at once, and you can't get any of them done fast enough. It never fails to amaze me that in spite of all the trauma we...

  5. Want to Discuss Hearts?

    TennRN2004 replied to nedanurse's topic in CCU, Coronary, Cardiac

    Not sure what you mean exactly by "ignore the monitors" but I can tell there are cases where you keep one eye on the monitor and one eye not that worried about what you see. For example, had a pt that...

  6. reality check me(long)

    TennRN2004 replied to cardsRN's topic in CCU, Coronary, Cardiac

    Probably part of the problem is this. If the patient is truly ready to be extubated,stable hemodynamics, ABGs look okay, you do a CPAP trial for usually 30-45 minutes. If you can keep the patient...

  7. Who does your IABPs

    TennRN2004 replied to TennRN2004's topic in CCU, Coronary, Cardiac

    The arrows are the only ones the surgeon I originally mentioned will use. The only catch to them is with the fiberoptics, if perfusion is not dead on when they set them in the OR, you'll still have...

  8. Tandem Heart.....

    TennRN2004 replied to CardioTrans's topic in CCU, Coronary, Cardiac

    Looks like a pretty nifty piece of equipment Trans. We only use abiomeds at my hospital, and those are only 1 every year or two, we've only had one since I've been in my unit. Do you use these where...

  9. Who does your IABPs

    TennRN2004 replied to TennRN2004's topic in CCU, Coronary, Cardiac

    ours are always 1:1 when they roll from the OR. The only time they are not is (a) staffing sucks and they have to be 1:2, although if they're sick enough the charge RN will take them and someone else...

  10. CAB Patient Observation

    TennRN2004 replied to TennRN2004's topic in CCU, Coronary, Cardiac

    I hate these situations. So sad. When you're giving/getting report you label them to each other and say she'll be back in a week b/c her resp status sucks b/c you can't get her to do what she needs to...

  11. Who does your IABPs

    TennRN2004 replied to TennRN2004's topic in CCU, Coronary, Cardiac

    I agree totally on the RTs with IABPs (they are busy, big pt loads, not always at the bedside,etc), that's why I said in the OP that I was suprised to hear it happened some places. I may have...

  12. Tmr

    TennRN2004 posted a topic in CCU, Coronary, Cardiac

    Are any of your surgeons doing TMR on patients? We've seen an increase in it lately. It's an interesting concept, and has been used on a few of our patients who need bypass but have no viable

  13. Tmr

    TennRN2004 replied to TennRN2004's topic in CCU, Coronary, Cardiac

    Yes, we recover them exactly the same as our other heart surgeries. The only difference is typically they have what the docs call a "sluggish myocardium". The laser stuns the heart muscle for a few...

  14. Tmr

    TennRN2004 replied to TennRN2004's topic in CCU, Coronary, Cardiac

    One of the nurses on our unit is in grad school, and she's doing a presentation on it for a class. It was interesting b/c I was talking to one of the surgeons the other day asking questions. I told...

  15. Dobutrex

    TennRN2004 replied to TennRN2004's topic in CCU, Coronary, Cardiac

    This is a good explanation. But, our docs still use Trasylol (in spite of the new england journal's article), which really cuts down on the inflammation process/response post op. The IABP also causes...

  16. Dobutrex

    TennRN2004 replied to TennRN2004's topic in CCU, Coronary, Cardiac

    That was what got me. The day nurse tells me as I'm leaving "oh my bp is better b/c I've halfed the Dob and pt isn't so dilated out now". Just out of curiosity I looked at the flowsheet and I had the...

  17. Infiltrate treatment question

    TennRN2004 replied to butofcourse's topic in CCU, Coronary, Cardiac

    I don't know the actual hard scientific rational, but from a common sense standpoint, I think the reasoning for switching needles before each injection is to ensure you have a clean needle with just...

  18. HIT in CABGs

    TennRN2004 posted a topic in CCU, Coronary, Cardiac

    Are you guys seeing a lot of possible HIT patients now? How are you treating it? Our surgeons were taking a wait and see approach for a lot of these pts we were trending decreasing platelets on. We...

  19. VAD and the Nurse Practice Act

    TennRN2004 replied to nedanurse's topic in CCU, Coronary, Cardiac

    Same here, we have a primary RN that does the charting/paperwork, secondary RN does all the running, hanging bloods/meds, whatever is needed in addition to help the

  20. Infiltrate treatment question

    TennRN2004 replied to butofcourse's topic in CCU, Coronary, Cardiac

    Regitine given in 10 SQ injections around the infiltration

  21. Dobutrex

    TennRN2004 replied to TennRN2004's topic in CCU, Coronary, Cardiac

    No, even when I had the dopamine going, it was early enough in my shift if it was going to make a difference, I should have been able to see a result. It didn't change anything significantly that I...

  22. CAB Patient Observation

    TennRN2004 replied to TennRN2004's topic in CCU, Coronary, Cardiac

    Hmm...never thought about the nerve endings before, but it does make sense. I wonder though in a young diabetic if that holds true. You would think even that young if they've had diabetes for 10-15...

  23. Crash cart items

    TennRN2004 replied to ark-two's topic in CCU, Coronary, Cardiac

    We have a code box we take to floor codes. It is a small sized box so you can run without it getting in the way. It has those handy drugs that aren't available on the crash cart. The ICU RNs are...

  24. Starting out in the SICU

    TennRN2004 replied to fishinNbanjo's topic in MICU, SICU

    Agree with all Dorimar says, it's good advice. Also, see if you can find out what the top most common surgeries/diagnosis are in your unit. Pull up the standing orders for those surgeries so you'll...

  25. Want to Discuss Hearts?

    TennRN2004 replied to nedanurse's topic in CCU, Coronary, Cardiac

    Our nurses and respiratory therapy manage vent wean to extubation. If post op ABGs look okay, we'll get an order to wean for extubation. Generally our goal is 6 hours also, but you have some who are...