MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Clean off the dead skin!

    MunoRN replied to Gizmopup1's topic in General Nursing

    I completely agree that debridement is a good thing, however in my experience the majority of wound care nurses will scold and even threaten 'regular' nurses for doing anything they consider to be...
  2. MunoRN

    Vistaril 25mg and Percocet 10/325mg , usual frequency MD's order them? Q 4 prn is okay?

    MunoRN replied to mjake101's topic in Patient Medications

    Percocet is often given every four hours since it's half life is about 3.5 hours, vistaril however is usually every 6 hours or even just twice a
  3. MunoRN

    Patient is a sex offender with a tracker on his ankle

    MunoRN replied to Alex_RN's topic in General Nursing

    What you chart should be information relevant to his care and treatment, it would be worth communicating to the social worker or care manager for instance as it would affect discharge placement if...
  4. MunoRN

    IVDU pt kept asking for pain meds. Managment kept saying to just give it to her.

    MunoRN replied to ella2990's topic in General Nursing

    I would encourage you to re-think your post-op pain control practices and beliefs. Keep in mind that intentionally under-medicating pain in post-op patients results in higher cumulative opiate use...
  5. MunoRN

    Vistaril 25mg and Percocet 10/325mg , usual frequency MD's order them? Q 4 prn is okay?

    MunoRN replied to mjake101's topic in Patient Medications

    Vistaril is often combined with opiates for illicit use, as vistaril potentiates the euphoric effects of
  6. MunoRN

    Jahi McMath is back in the news

    MunoRN replied to OrganizedChaos's topic in Nursing News

    According the article, Dr. Shewmon is claiming Jahi is not brain dead, although it also states Jahi has not yet undergone any of the tests that define brain death (not since her previous brain death...
  7. MunoRN

    Stubborn CNA in ICU

    MunoRN replied to AnnoyedNurse's topic in General Nursing

    As far as the diaper-free concept goes, it's not accurately broadly described as being best practice. The end-goal is to keep the skin as dry and clean as possible, which is sometimes better achieved...
  8. MunoRN

    Stubborn CNA in ICU

    MunoRN replied to AnnoyedNurse's topic in General Nursing

    I don't think there is any recommendation to not use absorbent pads, moving moisture away from the skin is actually a commonly recommended intervention for skin protection. The study you've sited...
  9. MunoRN

    Stubborn CNA in ICU

    MunoRN replied to AnnoyedNurse's topic in General Nursing

    I think it's more demeaning to suggest that "diapers" are only for infants, "diaper" is the correct term, a "brief" is not something intended for incontinence and "incontinence briefs" are different...
  10. MunoRN

    Antecubital vein for chemo

    MunoRN replied to sporush's topic in Oncology

    There are two contradictory views on infusing chemo using a peripheral IV that could be used to argue both for and against using the AC. The first is that areas of flexion should be avoided as...
  11. MunoRN

    IV Medicine Question

    MunoRN replied to saddor223's topic in General Nursing

    If your intention is to infuse all of the medication including what's in the tubing then I would suggest running it as a primary/secondary infusion, or hang a separate bag of flush after the...
  12. MunoRN

    IV Medicine Question

    MunoRN replied to saddor223's topic in General Nursing

    It partly depends on what you mean by "filter" since that is often used to describe particulate filters, one way valves, and air removal devices. Are you trying to run the tubing completely
  13. MunoRN

    IVDU pt kept asking for pain meds. Managment kept saying to just give it to her.

    MunoRN replied to ella2990's topic in General Nursing

    And as a side note, having a normal BG at the time it's due isn't by itself a reason to hold lantus, lantus is not a correctional coverage, if the lantus is dosed correctly the patient's BG will be...
  14. MunoRN

    IVDU pt kept asking for pain meds. Managment kept saying to just give it to her.

    MunoRN replied to ella2990's topic in General Nursing

    You're correct that nurses are not only allowed but expected to not follow orders they deem inappropriate, but there does have to be valid reasoning that it is inappropriate. Hypotension might be a...
  15. MunoRN

    Y-porting potassium IV - what's your policy?

    MunoRN replied to sarmrn's topic in Medical-Surgical

    It sounded like you were saying you were diluting it beyond 10mq per liter, which would have been more than 4 liters per 40meq, I
  16. MunoRN

    Y-porting potassium IV - what's your policy?

    MunoRN replied to sarmrn's topic in Medical-Surgical

    So to infuse a 40meq dose, you're infusing more than 4 liters of
  17. MunoRN

    Y-porting potassium IV - what's your policy?

    MunoRN replied to sarmrn's topic in Medical-Surgical

    While I've heard this theory before I don't think there's any reason to believe it's true. If your goal is to avoid extravasation then increasing the rate of the combined infusion by y-siting it...
  18. MunoRN

    First Lidocaine gtt

    MunoRN replied to Catticus11's topic in CCU, Coronary, Cardiac

    Lidocaine gtt is generally only considered effective for drug induced long-qt ventricular arrhythmias, it is of little benefit in congenital long-qt syndrome which is treated with magnesium and...
  19. MunoRN

    Repealing ACA

    MunoRN replied to OnceMorewithFeeling's topic in Activism, Healthcare

    The "EMBRACE" proposal is essentially identical to a "medicare for all" single payer system, it's only the semantics that are different. The EMBRACE proposal is a system overseen by a board that is...
  20. MunoRN

    IVDU pt kept asking for pain meds. Managment kept saying to just give it to her.

    MunoRN replied to ella2990's topic in General Nursing

    This seems to be the gist, by itself the frequency that a patient is receiving a med isn't really a useful predictor of overmedicating a patient. Giving a patient x dose of opiate A every hour is no...
  21. MunoRN

    IVDU pt kept asking for pain meds. Managment kept saying to just give it to her.

    MunoRN replied to ella2990's topic in General Nursing

    If you're concerned about your license then you should be just as concerned about holding indicated meds without any apparent rationale other than what appears to be a personal bias. I get that it...
  22. MunoRN

    Swan-Ganz Usage

    MunoRN replied to Cvepo's topic in Critical Care

    PA caths feed our thirst for numbers, but even proficient management of those numbers doesn't change patient outcomes in most of the patients we've used PA caths for. Many years ago they were common...
  23. MunoRN

    Police investigating use of opiates in comfort care case

    MunoRN posted a topic in General Nursing

    This particular case involves an anesthesiologist medicating a patient through a terminal wean (extubation to comfort care), although in my experience this is usually done by a nurse. An 8-year-old...
  24. MunoRN

    Allergy IV's?

    MunoRN replied to VanessaTitoyan's topic in General Nursing

    You're injecting your sister with dietary supplements you got from
  25. MunoRN

    Can you refuse to give care to a resident in LTC?

    MunoRN replied to CNA2016:)'s topic in Medical Assistant, CNA/MA

    I think there's growing acknowledgment that we are on the receiving end of more verbal and physical abuse than we should be. Some states have taken small steps, such as requiring training on...