MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    No Nurse Deserves to Die in the Lobby of the Emergency Room

    MunoRN replied to Nursekalu's topic in General Nursing

    I'm sorry for your loss. I think your last line said it best; "No Nurse deserves to die in the emergency room waiting to be attended to! Actually, No one does." If an ER is dysfunctional, the...
  2. MunoRN

    To blood sugar or not to blood sugar. That is the question.

    MunoRN replied to lkoch002's topic in MICU, SICU

    Generally "euglycemia" refers to the defined range for "normal" BG which currently is 60-100. About 10 years ago there was a single, small study with questionable methods that appeared to suggest...
  3. MunoRN

    BP Med/Transfusion Question

    MunoRN replied to FloatFNP-C's topic in General Nursing

    In a patient who might be continuing to bleed I'd be more worried about the 150/85 than the 95/38. It varies depending on the type and source of the bleed, but typically you want the BP normal to low...
  4. MunoRN

    PICC Care- cap change

    MunoRN replied to layla-13's topic in General Nursing

    Generally PICC lines without clamps, such as SOLO PICCs have no clamps because they are valved, so no, clamping should not be necessary in theory when changing the cap. That being said, I wouldn't...
  5. MunoRN

    4 Point Restraints in the ER. Is that Abuse?

    MunoRN replied to Vickymay's topic in Emergency

    The use of restraints need to be for a valid purpose (to facilitate treatment, to protect the patient, to protect staff, etc) and the least restrictive form of restraint that is still effective needs...
  6. MunoRN

    1st nursing job, Do I disclose condition?

    MunoRN replied to Loxam10's topic in Nurse Disabilities

    Employers are free to test for both prescribed and non-prescribed drug use; if they can argue that a medication can affect your ability to do your job safely then they can screen for it, prescription...
  7. MunoRN

    HCAHP Scores

    MunoRN replied to channel_egg's topic in Nursing Professionalism

    If "usually" is a common response to that question in all hospitals then your hospital won't lose any reimbursement if your patients also answer "usually". Even if patients at your hospital...
  8. MunoRN

    HCAHP Scores

    MunoRN replied to channel_egg's topic in Nursing Professionalism

    Here's another way to look at HCAHPS; should patients receive information about new medications they are given in the hospital? Should hospitals that fail to provide that information at a...
  9. MunoRN

    Deep Suction for comfort with trach at end of life?

    MunoRN replied to BryceBehrens's topic in General Nursing

    The use of any sort of suctioning in a patient on comfort care depends on the patient's wishes in balancing distress and avoiding artificially prolonging death, but the default position for comfort...
  10. MunoRN

    IVP vs Drip

    MunoRN replied to Matt8700's topic in Emergency

    Why not just put it in the line ahead of the bag and not mess with need to add a secondary
  11. MunoRN

    HCAHP Scores

    MunoRN replied to channel_egg's topic in Nursing Professionalism

    Hospitals are free to try and improve their scores in whatever they want. If they chose to do something that is unlikely to improve their scores or even make them worse then they get penalized...
  12. MunoRN

    HCAHP Scores

    MunoRN replied to channel_egg's topic in Nursing Professionalism

    Personally I am all for CMS creating an incentive to staff properly and provide adequate support to nursing staff. What the HCAHPS questions are basically asking is whether or not the hospital is...
  13. MunoRN

    Emergencies and the Ironhorse Culture

    MunoRN replied to CamillusRN's topic in Emergency

    I've worked ED in a town where a prominent 1%'r group was headquartered and cared for many of it's members and it's no different than caring for anyone else, nor should it be. We treat them with the...
  14. MunoRN

    IVP vs Drip

    MunoRN replied to Matt8700's topic in Emergency

    2mg dilaudid is still 2mg of dilaudid whether or not you dilute it. It can be given over 10 minutes either by putting in the line and running it at a rate that infuses it over 10 minutes (diluted for...
  15. MunoRN

    wounds and arguments

    MunoRN replied to ItsnurseA's topic in General Nursing

    I personally don't see any issue with just reinforcing the drainage absorption layer by adding an extra absorbent pad. At least in the practice environments I've been in, that's well within the scope...
  16. MunoRN

    Setting up standing orders in EHR

    MunoRN replied to Maddie's mommy's topic in General Nursing

    You can enter order sets into the EHR which will make it easier for the Physicians to write or enter their orders for patients, but every regulatory body I'm aware of doesn't allow what you seem to be...
  17. MunoRN

    Just ignore it or have a discussion?

    MunoRN replied to dudette10's topic in Patient, Colleague Relations

    I have no problem with, and freely welcome any input someone has about what might benefit a patient (or me). There are different nursing environments out there; some are very individualistic and...
  18. MunoRN

    Incorrect medication prep

    MunoRN replied to ARN1992's topic in Patient Safety Issues

    There's not really any reason to just routinely make all patients with a headache NPO out of concern they dont' have a safe swallow. You would need more specific information to be concerned enough to...
  19. MunoRN

    Changing iv bag question

    MunoRN replied to Communitynurse365's topic in General Nursing

    If it's through a pump and the pump is stopped then it doesn't really matter how you change the bags since a stopped pump has the same effect as a clamp. If the pump is still running then so long as...
  20. MunoRN

    Changing iv bag question

    MunoRN replied to Communitynurse365's topic in General Nursing

    Is the tubing through a pump? Are you asking about a bag on a primary line or a secondary line? Was there air in the
  21. MunoRN

    Incorrect medication prep

    MunoRN replied to ARN1992's topic in Patient Safety Issues

    If there is no reason to believe he's had a new stroke, and hasn't had pre-existing dysphagia that prohibits him from being able to take pills after his previous stroke, then there is no reason why a...
  22. MunoRN

    Incorrect medication prep

    MunoRN replied to ARN1992's topic in Patient Safety Issues

    You would need some sort of basis for treating the patient as though they had a stroke, we don't assume all new admits have had a stroke until it's been ruled out by imaging even if there are no S/S...
  23. MunoRN

    Incorrect medication prep

    MunoRN replied to ARN1992's topic in Patient Safety Issues

    If the patient has been able to take pills since their stroke then you did nothing wrong, a "history of a stroke" by itself in no way means the patient can't have pills. Even if they were being...
  24. MunoRN

    IVP vs Drip

    MunoRN replied to Matt8700's topic in Emergency

    Putting into a bag doesn't make it a "drip", a drip is a continuous infusion that is usually titrated. It is well within the scope of an RN to use their nursing judgement in managing how an IV is...
  25. MunoRN

    But you're a nurse, you could've done this....

    MunoRN replied to Madras's topic in Patient, Colleague Relations

    Police have certain indications to call an ambulance to evaluate people in a car accident, and it doesn't sound like he felt there was any need, but you being a nurse he thought he would ask your...