MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    To Suction or Not To Suction, End of Life & Hospice Patients

    MunoRN replied to NickICU-RN's topic in General Nursing

    Again, the "no-bite" suction catheter does not in any way make suctioning less traumatic, if anything it makes it more traumatic. All the "no-bite" part of it does is prevent the patient from being...
  2. MunoRN

    Two sample NCLEX questions

    MunoRN replied to psu_213's topic in General Nursing

    Keep in mind these books aren't written using actual NCLEX questions, and sometimes the authors of these books aren't all that bright. As a general rule, NCLEX questions are written to determine if...
  3. MunoRN

    Confusion over pain med administration

    MunoRN replied to HarmonyStewart's topic in Pain Management

    Proper nursing judgement according to professional practice recommendation is to base the timing of reassessments on both the onset and the duration of action. And while the JC used to recommend...
  4. MunoRN

    Post-arrest status myoclonus

    MunoRN posted a topic in General Nursing

    I've come across varying views on futile care at different places I've worked, but one issue that always causes a lot of friction between doctors and between doctors and nurses is when a post-cardiac...
  5. MunoRN

    Confusion over pain med administration

    MunoRN replied to HarmonyStewart's topic in Pain Management

    You have a policy says pain reassessments can only be done at 1 hour? A common time to reassess pain aside from when you would expect it to take effect is when you would expect it to no longer be...
  6. MunoRN

    Confusion over pain med administration

    MunoRN replied to HarmonyStewart's topic in Pain Management

    They found differing interpretations of range orders, which then requires that the facility establish a common understanding, the JC does not dictate what that understanding must be. You will...
  7. MunoRN

    Post-arrest status myoclonus

    MunoRN replied to MunoRN's topic in General Nursing

    The neurologists have come right out and said that they would rather wait longer than is probably necessary so that it doesn't weigh on their conscious, yet also ask that we withhold all analgesia and...
  8. MunoRN

    Post-arrest status myoclonus

    MunoRN replied to MunoRN's topic in General Nursing

    That actually refers to Lance-Adams syndrome which is a type of myoclonic disorder but is separate from anoxic status myoclonus, Lance-Adams is well known to have a potential for recovery. Patients...
  9. MunoRN

    Confusion over pain med administration

    MunoRN replied to HarmonyStewart's topic in Pain Management

    Based on that logic, if the order hadn't said to reassess the patient's pain and give the remainder of the dose if needed, you would interpret the order to mean that you would given one tab, then not...
  10. MunoRN

    Confusion over pain med administration

    MunoRN replied to HarmonyStewart's topic in Pain Management

    The applicable JC version of CMS regulatory requirements relating to range orders is MM.04.01.01 "Medication orders are clear and accurate" which states that a facility must ensure that there is...
  11. MunoRN

    Confusion over pain med administration

    MunoRN replied to HarmonyStewart's topic in Pain Management

    If it said "if second tab not required at 1 hour, may not give remainder of range dose until 6 hours after the first tab" then you'd have a point, but it doesn't say that. I'm my facility's liaison...
  12. MunoRN

    Confusion over pain med administration

    MunoRN replied to HarmonyStewart's topic in Pain Management

    I think you're confusing an instruction to reassess in one hour and give the second tab if needed as an instruction that this is the only time the pain can be reassessed and the remainder of the range...
  13. MunoRN

    Confusion over pain med administration

    MunoRN replied to HarmonyStewart's topic in Pain Management

    It asks that the patient be reassessed at one hour and the second tab be given if needed, it doesn't state that this is the only time the second tab can be given, I'm not sure where you are getting...
  14. MunoRN

    Confusion over pain med administration

    MunoRN replied to HarmonyStewart's topic in Pain Management

    I'm not sure how you're getting that from the order. The MD wants the pain reassessed an hour after giving the initial dose, but does not prohibit given the second half of the range at a time other...
  15. MunoRN

    To wash or not to wash?

    MunoRN replied to sunflower3,RPN's topic in General Nursing

    I agree that a lot of nurses undervalue the importance of baths, oral, and peri-care in their overall prioritization, but I also come across an equal number of nurses that inappropriately prioritize...
  16. MunoRN

    Confusion over pain med administration

    MunoRN replied to HarmonyStewart's topic in Pain Management

    The order states "1-2 q 6hrs" so I'm not sure what's unclear about that, the patient can have up to 2 tabs in any 6 hour period of time. I agree there's the potential for under controlled pain since...
  17. MunoRN

    Fired Due to Not Being Able to Get to Work

    MunoRN replied to Studentworker's topic in General Nursing

    Healthcare workers are exempt in pretty much every single restricted travel event that occurs, healthcare workers are classified as "essential personal". From the standard MA state of emergency...
  18. MunoRN

    Fired Due to Not Being Able to Get to Work

    MunoRN replied to Studentworker's topic in General Nursing

    People get to work in adverse weather conditions all the time and all over the country, not everybody has the luxury of always commuting in a car and in nice
  19. MunoRN

    Fired Due to Not Being Able to Get to Work

    MunoRN replied to Studentworker's topic in General Nursing

    They aren't illegal in any state, you can't legally use them when there is no indication for using them (dry roads without snow or ice), but there are no broad prohibition of tire chains, maybe you...
  20. MunoRN

    Doppler during Code

    MunoRN replied to eastcoastrn586's topic in General Nursing

    Responders to a patient in arrest incorrectly assessed pulses by palpation 22% of the time, potentially leading to withholding CPR in 14% of the cases: Reliability of pulse palpation by healthcare...
  21. MunoRN

    "Breast Is Best": A Mantra to Promote Infant Health? or Stigmatizing Adage to Guilt Moms

    MunoRN replied to cjcsoon2bnp's topic in General Nursing

    Except the incidence of post-partum depression is generally lower in breastfeeding
  22. MunoRN

    Confusion over pain med administration

    MunoRN replied to HarmonyStewart's topic in Pain Management

    There is no set definition to this sort of thing, the requirement is that the ordering provider and the person interpreting the order have a common understanding of how the order is to be followed....
  23. MunoRN

    Doppler during Code

    MunoRN replied to eastcoastrn586's topic in General Nursing

    ACLS doesn't limit assessment of ROSC to a palpable pulse assessment, and actually the purpose of using the term ROSC to take the focus off the sole use of palpable pulses, ACLS protocol specifically...
  24. MunoRN

    Doppler during Code

    MunoRN replied to eastcoastrn586's topic in General Nursing

    It's long been known that palpating pulses during a code is unreliable and can cause excessive delays in pulse checks and can lead the cessation of CPR when no pulse has actually returned. When used...
  25. MunoRN

    Visitors never wear gowns, gloves

    MunoRN replied to Grobyc82's topic in Infectious Disease

    If you're talking about contact isolation (ie for MRSA) then it's not actually indicated to have visitors wear gloves and gowns. The purpose of having staff wear gloves and gowns with a MRSA patient...