MunoRN RN

Critical Care

Member

  • Content

    8,058

  • Visitors

    94,710

  • Followers

    9

  • Likes

    7,525

All Content by MunoRN

  1. MunoRN

    To give or not give insulin

    MunoRN replied to Twisted Nurse's topic in Medical-Surgical

    There are very different types and reasons to give insulin, the insulin dependence of the patient must also be considered, in some patients it might be wise to hold a dose, in others it might be...
  2. MunoRN

    Hyperkalemia a ticking time bomb?

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

    I wouldn't be too concerned that they didn't kayexalate initially, it's been removed at least as a first line treatment for hyperkalemia in many treatment algorithms. There's little to any evidence...
  3. MunoRN

    Hyperkalemia a ticking time bomb?

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

    Many references list the "panic value" of hyperkalemia as being >7. It's certainly not unheard of for dialysis patients to get above 6 as that they get farther out from there last treatment....
  4. MunoRN

    Nurses Notes: Guidelines On What Not To Chart

    MunoRN replied to TheCommuter's topic in Patient Safety Issues

    Maybe it shows how fickle court rules and health department findings can be, but we've had the opposite experience recently. In one case, a patient's refusal of treatment wasn't sufficiently...
  5. MunoRN

    Accused of withholding pain medication

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

    There are no set rules on this, the closest thing is the JC's rule that facilities must have a policy to clarify how such orders should be interpreted. Without anything to limit the interpretation,...
  6. MunoRN

    Seventh Day Adventist and working on Sabbath???

    MunoRN replied to NeoNatMom's topic in Spirituality, Religion

    I don't think the Bible is really that clear that not working on the sabbath is an absolute. After all, it was Jesus who argued it's a silly rule in Luke 13 and 14, one of a few places in the Bible...
  7. MunoRN

    Would you give PRN percocet and scheduled Oxycodone together?

    MunoRN replied to lunaro16's topic in Patient Medications

  8. MunoRN

    C. Diff in the hallways!

    MunoRN replied to dubspot's topic in Patient Safety Issues

    Patients who have not been found legally incompetent are allowed to refuse diet restrictions, as their nurse it's your job to make sure there right to refuse is honored, not to enforce the
  9. MunoRN

    C. Diff in the hallways!

    MunoRN replied to dubspot's topic in Patient Safety Issues

    The CDC doesn't have an explicit recommendation, but does recommend that CDI patients stay in their room "as much as possible". Because it's their home, LTC's do tend to be less militant about this,...
  10. MunoRN

    wasting of narcs in pacu

    MunoRN replied to Jaesim's topic in PACU

  11. MunoRN

    Would you give PRN percocet and scheduled Oxycodone together?

    MunoRN replied to lunaro16's topic in Patient Medications

    It's quite possible the same thing happens at home when the patient takes them herself (RR down to 7 and SBP down to 90), they just now happen to have someone checking these things while they are...
  12. MunoRN

    Would you give PRN percocet and scheduled Oxycodone together?

    MunoRN replied to lunaro16's topic in Patient Medications

    Percocet is a trade name for ocycodone/acetaminophen combinations. An "overdose" is not really a well medically defined term, but in general refers to the effects of a dose, not the size of the dose...
  13. MunoRN

    The Death Knell Of Hospices Everywhere

    MunoRN replied to chordringer's topic in Hospice, Palliative

    Maybe someone can help me understand what this issue is as someone who isn't all that knowledgeable about the 'business' of hospice. My understanding is that what CMS has said is that you can't...
  14. MunoRN

    Oral care in patients

    MunoRN replied to boomshakelaka's topic in General Nursing

    This is the unfortunate, but predictable, result of when our plan of care/hospital policy meets the basic physical laws of time. Long ago, time studies were common; the amount of care that was...
  15. MunoRN

    Nurses Notes: Guidelines On What Not To Chart

    MunoRN replied to TheCommuter's topic in Patient Safety Issues

    Then chart that. Pt reports MD was notified, and further assessment of pain etiology is
  16. MunoRN

    vent about work assignment

    MunoRN replied to treeye's topic in General Nursing

    There are CDC guidelines on exposure precautions for pregnant HCWs, in general it would appear you've placed far more restrictions on yourself than the CDC does which is going to make it hard for you...
  17. MunoRN

    Nurses Notes: Guidelines On What Not To Chart

    MunoRN replied to TheCommuter's topic in Patient Safety Issues

    I assume this isn't what you meant: "Do not chart that a patient is in pain unless you have intervened. No prudent nurse would even think of documenting "Patient complains of radiating chest pain"...
  18. MunoRN

    NPO

    MunoRN replied to babaloo's topic in Medical-Surgical

    Starting alternative forms of nutrition is recommended for many patients starting on day 2 because the lack of nutrition can begin to have clinically significant effects after two days, not that...
  19. MunoRN

    After the Evidence

    MunoRN replied to NCineas's topic in Nurse Management

    Maybe it's not what you meant, but "managing people" better describes the old-school view on management. The more progressive view is that managers manage barriers to good care, problems,...
  20. MunoRN

    I need help- Do I have rights?

    MunoRN replied to Amg563's topic in Nursing Career

    What does you job description say? Typically, you get hired not strictly as an "admission coordinator" but as a "Nurse", who might be hired with the role of "admission coordinator" in mind, but not...
  21. MunoRN

    After the Evidence

    MunoRN replied to NCineas's topic in Nurse Management

    They're really two different things. To "manage" someone is to "control, exert power over" someone. Which probably isn't the most accurate way to describe current evidence based management...
  22. MunoRN

    HELP! I'm being pressured to lie at work...

    MunoRN replied to Dana1969's topic in Patient, Colleague Relations

    What kind of "training" are you referring to? From your description it sounds like you are referring to signing that you have read/are aware of a new policy, so I guess I'm not sure why you don't...
  23. MunoRN

    Do you have a process if you disagree with discharge of a patient?

    MunoRN replied to Codeblue1982's topic in Patient Safety Issues

    I've worked at a place with a similar issue and the 'policy' was to discharge the patient directly to the
  24. MunoRN

    Should pts w/ + sputum cultures be on droplet precautions?

    MunoRN replied to Twisted Nurse's topic in Medical-Surgical

    Positive for
  25. MunoRN

    Nurse giving discontinue medications to other patients

    MunoRN replied to Nurse Amy Jolie's topic in Patient Medications

    That's true when assisting with self-administration, which is different from administering meds. You often can't use an e-kit to replace missing meds for assisted self-administration meds and a...