MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Low HR

    Did you notice that the HR was low on a cardiac monitor, or was it an O2 sat monitor
  2. MunoRN

    Fired for holding valium

    As a requirement of your license you are not only allowed, but required to hold medications where you believe it to be unsafe. Unfortunately, your employer is not required to support the decisions...
  3. When this issue is dealt with using a systematic decision making process, the result is typically that the use of vacuum collection devices is actually preferable with PICCs. Manufacturers of PICC...
  4. It seems to only exist in the vascular access world as a myth that requires frequent de-bunking. Where specifically is this view coming
  5. I don't know of any research that determines the actual amount of time it takes for blood to clot in the lumen of a catheter, although we do know it does happen and we unknowingly flush clots out of a...
  6. MunoRN

    creativity in nursing practice

    I guess I'm not getting the basis of your question. Are you asking how nursing could be more creative like medical staff are? One of the main differences between nursing and medicine is that...
  7. MunoRN

    creativity in nursing practice

    Maybe you could give some examples of what you're referring to by 'nursing
  8. MunoRN

    Quad strength Levophed not working

    Since you're using the same dose, just different a different concentration, it should have the exact same effect. Something to consider is how long it might take the undiluted quad strength to reach...
  9. MunoRN

    Quad strength Levophed not working

    As an example consider if you've got quad strength levo running at 5cc/hr and it's y'd into NS at 25cc/hr. Below the point where they are y'd you essentially now have standard strength levo, but as...
  10. MunoRN

    Quad strength Levophed not working

    If you've y'd the quad strength and NS together as a carrier fluid, when you stop the NS you've now got a diluted quad strength in the line downstream from where it's y'd in and that diluted quad...
  11. MunoRN

    Comfort care med protocol?

    Health departments tend to take adequate symptom control at the end of life very seriously and rarely tolerate under-treatment. It's not unusual for physicians to be a little hyper-vigilant in...
  12. MunoRN

    CVICU Machines and Staffing

    I currently work in a large general ICU, so basically we're all float nurses. The same nurse might get a VAD patient, a CRRT patient, an ECMO patient, and a balloon pump patient during their stretch...
  13. MunoRN

    Quad strength Levophed not working

    How did you hook it up? Remember that since it runs at a slower rate it will take longer to get to the patient. For instance, if you've hooked up to a port that has has 3cc of volume between it and...
  14. In my experience the common wisdom is the opposite, why do you think BSN's are "able to learn faster" or that they typically have a shorter training period. I've worked for two different hospitals...
  15. In my experience just adding hours to a position is enough for it to be considered a "new" position, and often according to union rules that would be the "new" position has to posted as such and if...
  16. Maybe I'm misunderstanding, but that's not a
  17. MunoRN

    PICC nurses in the workplace

    In facilities where PICC nurses are willing to cross-train, 24 hour availability isn't that
  18. MunoRN

    APPENDICITIS

    Do you work at a teaching hospital by any
  19. MunoRN

    APPENDICITIS

    In uncomplicated appendicitis we use only antibiotics initially, a portion of those will require surgery but for the majority antibiotics is the only treatment required.Appendicitis Treatment with...
  20. MunoRN

    Decrease in volume of Cath Lab cases?

    You're referring to HCAHPS surveys, which is a component of value based purchasing. While it's certainly deserving of some criticism, I'm not sure how it reduces the number of people getting heart...
  21. MunoRN

    APPENDICITIS

    CT, R/O sepsis/abscess, pain meds, common gut bacteria antibiotics (flagyl, etc). We no longer get a surgical consult as part of the standard protocol since we typically no longer move towards...
  22. MunoRN

    Narcotic administration times

    I'm curious what people do if they don't read this as being just a max dose per period of time. Do you just always give 2 tabs to start with? Do you give one tab and then when that's not effective,...
  23. MunoRN

    Decrease in volume of Cath Lab cases?

    State run medicare is medicaid. There have been no medicare cuts to hospitals under the ACA (Obamacare), medicaid coverage actually increased under Obamacare. Determining what your coverage is...
  24. MunoRN

    Narcotic administration times

    What is your concern with "how it would
  25. MunoRN

    Narcotic administration times

    The only general rules on this is that each facility must have a policy that provides a consistent understanding of how such orders will be interpreted. Generally, the purpose of these orders are to...