MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Chest Pain protocols

    MunoRN replied to Lev's topic in Patient Medications

    We don't call a RR, but the RR Nurse is called to evaluate any patients with symptoms concerning for ACS outside of our cardiac floor. I work off a protocol when evaluating a patient with concerning...
  2. MunoRN

    Emailing MDs for orders

    MunoRN replied to delphine22's topic in HIPAA Challenges

    American Messaging's system, called "Intellimessage" is a secure HIPAA compliant system where PHI can be communicated, that's actually it's whole purpose. When Physicians receive these messages on...
  3. MunoRN

    What rate should I infuse at?

    MunoRN replied to ToBeContinued's topic in Patient Medications

    In the nipride example I'd stop the drip and aspirate the lumen it's in until I hit blood, I'd then wait to flush the blood until I had a blood pressure that would allow for whatever small amount of...
  4. MunoRN

    What rate should I infuse at?

    MunoRN replied to ToBeContinued's topic in Patient Medications

    I'd be willing to bet a large percentage would give the same answer you did as on 'off-the-cuff' answer, it's an easy one to rationalize incorrectly. The main thing is that it's probably not actually...
  5. MunoRN

    What rate should I infuse at?

    MunoRN replied to ToBeContinued's topic in Patient Medications

    To finish the infusion at the prescribed rate, you would actually need to increase the "driver" fluid to 15 ml/hr after the medication drip at 4ml/hr is stopped. I don't think there's any reason to...
  6. MunoRN

    Do I have a right to a copy of my employee health file?

    MunoRN replied to Clovery's topic in HIPAA Challenges

    Employers do own the physical copies of the test results which might be confusing them. The information contained in those results however is not something they have sole ownership of, you legally...
  7. MunoRN

    Emailing MDs for orders

    MunoRN replied to delphine22's topic in HIPAA Challenges

    I assume you're using some sort of internal messaging system, and not your personal phone. We've always used full patient names in these messages at everywhere that I've worked, which is fine as long...
  8. MunoRN

    amiodarone and cardizem for a flutter

    MunoRN replied to dms811's topic in CCU, Coronary, Cardiac

    Personally I've found that there does seem to be some sort of antiarrhythmic effect that rate control has, which would seem to make sense if it's possible that controlling the ventricular response...
  9. MunoRN

    If one is treated for MRSA, are they still contagious?

    MunoRN replied to beachmom's topic in General Nursing

    "MRSA" isn't a disease or even an infection, it's just refers to staph bacteria that are resistant to a group of antibiotics. Just like "regular" staff (MSSA) or any number of other bacteria that are...
  10. MunoRN

    Heparin math question

    MunoRN replied to Studentnurse365's topic in Nursing Student Assistance

    You are correct, your instructor is wrong. Your instructor has apparently just flunked themselves out of nursing
  11. MunoRN

    amiodarone and cardizem for a flutter

    MunoRN replied to dms811's topic in CCU, Coronary, Cardiac

    Amiodarone is an anti-arrhythmic, diltiazem is a calcium channel blocker with primarily chronotropic effects and has no established anti-arrhythmic properties. Amiodarone will also lower heart rate...
  12. MunoRN

    Sentinel Events

    MunoRN replied to NYCHikerRN's topic in Patient Safety Issues

    You're thinking of "Duty to Rescue" laws, not good samaritan acts. Except for a single state's good samaritan act, which no longer exists, all good samaritan laws refer to the protections from...
  13. MunoRN

    DKA dx?

    MunoRN replied to dsb_fam's topic in Emergency

    The criteria that's been used where I've worked is primarily based on anion gap; Serum sodium - (chloride+bicarb or CO2) as well as ketone levels. We track pH, osmolality, and of course BG levels but...
  14. MunoRN

    Commute 1 1/2 to work

    MunoRN replied to litebrightgirl's topic in General Nursing

    Personally, I wouldn't. From when you get out of your car in the parking lot to when you get back in it, it's at least 13 hours. Add 3 hours of travel time and now you have 8 hours at home from when...
  15. MunoRN

    Off going or oncoming responsibility

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

    It's the oncoming shift's responsibility, you need to firmly nip that one in the
  16. MunoRN

    What to do: ED physician brought dog to work

    MunoRN replied to skinzvictory's topic in Patient Safety Issues

    There are many cultures where people are taught that various other living things are "offensive and filthy", that doesn't mean we should accommodate those
  17. MunoRN

    Joint Commission is a Joke...

    MunoRN replied to Emergent's topic in General Nursing

    Saline flushes aren't considered a medication by the JC or by the FDA, they are considered a medical device. We've had the JC not allow flushes in pockets in the past, but they were allowed on the...
  18. MunoRN

    Joint Commission is a Joke...

    MunoRN replied to Emergent's topic in General Nursing

    The JC requires that staff be properly trained, maintain appropriate competencies, etc., but they've never established actual staffing ratios that they use as a
  19. MunoRN

    Joint Commission is a Joke...

    MunoRN replied to Emergent's topic in General Nursing

  20. MunoRN

    When Does Life Begin? The Scientific Definition of an Abortifacient ...

    MunoRN replied to cncyana's topic in Nursing Student Assistance

    The SCOTUS very clearly ruled that they do not consider these four drugs to be abortifacient or that such an argument can even be made. The ACA specifically prohibits abortifacients from being...
  21. MunoRN

    When Does Life Begin? The Scientific Definition of an Abortifacient ...

    MunoRN replied to cncyana's topic in Nursing Student Assistance

    There isn't actually any evidence in that video to suggest these four drugs are abortifacients. She does refer to what was not ruled out in these drugs' FDA trials, which is the extent of their...
  22. MunoRN

    When Does Life Begin? The Scientific Definition of an Abortifacient ...

    MunoRN replied to cncyana's topic in Nursing Student Assistance

    I'm not sure where you got the idea that the FDA "labels" these four drugs as abortifacients, maybe you could point me to a source. Are you under the impression that the SCOTUS agreed these four drugs...
  23. MunoRN

    And this is why I hate floating to stepdown...

    MunoRN replied to calivianya's topic in Critical Care

    I would think that referred to what's called "medical tele" at facilities I've worked at, it's regular medical floor ratios but with patients on cardiac telemetry. At my facility diltiazem and...
  24. MunoRN

    And this is why I hate floating to stepdown...

    MunoRN replied to calivianya's topic in Critical Care

    I've worked at one facility where the 'order' went ICU-stepdown-progressive care-medical tele, and another where it went ICU-progressive care-stepdown-medical tele, so I don't think it's all that well...
  25. MunoRN

    And this is why I hate floating to stepdown...

    MunoRN replied to calivianya's topic in Critical Care

    Did you mean that the other way around; No A-lines outside of ICU and CVP's on ICU and