MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Putting "your license on the line" at a job... Please explain!

    MunoRN replied to Nola009's topic in Patient Safety Issues

    Nursing school teaches you how to make an impractically long list of everything that could be done for a patient, it's deciding what will be part of the 90% of that list that won't get done that...
  2. MunoRN

    DNR status and therapeutic hypothermia

    MunoRN replied to MunoRN's topic in General Nursing

    That's more of a transition to comfort care than it is a transition to DNR status since they are two very different things. The argument is that we should stop TH once we find out the patient is DNR...
  3. MunoRN

    Extended Peripheral Catheter Dwell Time

    MunoRN replied to mbtestagrossa's topic in Infusion, Intravenous

    We've done IV site changes as only prn for almost a
  4. MunoRN

    tpa in a small syringe

    MunoRN replied to sistrmoon's topic in Patient Medications

    The issue of whether or not using a 10cc syringe is a legal standard of care came up, a standard of care legally speaking refers to a practice that has overwhelming agreement were not practicing the...
  5. MunoRN

    false raised trop_t

    MunoRN replied to ayla2004's topic in Cardiac

    There's a difference between a false positive troponin and an accurately positive troponin due to non ACS conditions. Troponins can become elevated for a variety of reasons: Elevated cardiac troponin...
  6. MunoRN

    Migraine treatment in er

    MunoRN replied to dsherman's topic in Emergency

    Usually toradol and/or a triptan, sometimes with naproxen added as well. None of our ER docs order opiates anymore for migraines except in very rare circumstances due the the rebound effect. We have...
  7. MunoRN

    Obesity, diarrhea and skin care

    MunoRN replied to DawnJ's topic in General Nursing

    A seemingly contradictory name, but dignicare and flexiseal are two of the main trade names for rectal
  8. MunoRN

    tpa in a small syringe

    MunoRN replied to sistrmoon's topic in Patient Medications

    She contradicted her recently stated views, maybe we have a different version of "backtrack". Her current position still leaves the issue that blood return is actually an effectively useless...
  9. MunoRN

    tpa in a small syringe

    MunoRN replied to sistrmoon's topic in Patient Medications

    I thought that was actually a pretty good attempt to avoid being judgmental. But since you brought it up, no, I don't find her level of understanding of factors involved in infusion therapy to be at...
  10. MunoRN

    tpa in a small syringe

    MunoRN replied to sistrmoon's topic in Patient Medications

    "Normal" hand strength is by no means a standardized measurement. To use any size syringe safely there must be understanding how much perceived pressure = what actual quantifiable pressure, it...
  11. MunoRN

    Dropping tele cables on floor before cleaning

    MunoRN replied to tonytayag's topic in Cardiac

    To be honest I'd be more worried about the tele cables contaminating the floor than the other way
  12. MunoRN

    Train wrecks!

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

    First of all, "train wreck" and "multiple comorbidities" are not the same thing. Multiple comorbidities could refer to a patient with aortic stenosis, alcoholism, varices, and a chronic wound. A...
  13. MunoRN

    RT over-stepping boundaries?

    MunoRN replied to 1RN4Christ's topic in Patient, Colleague Relations

    It depends on what you mean by interpreting. Like Nurses, RT's can't "diagnose", although too often Nurses interpret that to mean they can't discuss test results and educate about what various...
  14. MunoRN

    Pressure sore classification

    MunoRN replied to tkyeung's topic in General Nursing

    It was once the case that all blisters were stage 2, which has since been changed: Update on Blister Pressure Ulcer Staging from CMS for MDS 3.0 Section M: Skin Conditions - Jeffrey M. Levine MD |...
  15. MunoRN

    Pressure sore classification

    MunoRN replied to tkyeung's topic in General Nursing

    Ulcers are defined by the wound bed, so if the wound bed cannot be assessed (if it's covered with exudate, eschar, etc) then it is considered "unstageable". A "suspected deep tissue injury" is also...
  16. MunoRN

    Why not give IVPB alone?

    MunoRN replied to prenurse101's topic in Patient Medications

    I've always thought "piggy back" referred to a secondary infusion and not a y-sited infusion, maybe we need to just abandon the term. Our outpatient infusion which typically gives just a single dose...
  17. MunoRN

    Ambien- FDA Recommendations

    MunoRN replied to sapphire18's topic in Patient Medications

    Ambien has actually always carried the FDA recommendation that it is not indicated for long term use for instance, yet it's frequently prescribed long term. This is because FDA recommendations aren't...
  18. MunoRN

    Nursing students on medication

    MunoRN replied to kjnsweets's topic in Patient Safety Issues

    I agree they should be able to, but technically no, not everyone with a doctorate can use the title Doctor in any setting without specifically clarifying that you aren't actually an
  19. MunoRN

    Nursing students on medication

    MunoRN replied to kjnsweets's topic in Patient Safety Issues

    From the all-knowing Wiki: "As of 2013, only a few states specifically prohibit DNP's from using the title "Doctor" with their patients (Arkansas, Connecticut, Maine, Oklahoma, Oregon), while four...
  20. MunoRN

    Nursing students on medication

    MunoRN replied to kjnsweets's topic in Patient Safety Issues

    I included what I was referring to in my post which
  21. MunoRN

    Use of Cordis

    MunoRN replied to Guest565225's topic in Cardiac

    "Cordis" is medical product division of Johnson & Johnson and produces a variety of medical products, mainly in interventional cardiology, yet it's become synonymous with an IJ
  22. MunoRN

    Use of Cordis

    MunoRN replied to Guest565225's topic in Cardiac

    By "cordis" I assume you're referring to an IJ introducer. AACN recommends that patients with any type of introducer should be in a 1:2 ratio due to the high risk of rapid exsanguination either...
  23. MunoRN

    Nursing students on medication

    MunoRN replied to kjnsweets's topic in Patient Safety Issues

    In my state and many others, a DPT, DNP, D-pharm can only refer to themselves as "Doctor" in any sort of healthcare setting so long as it's clarified in the same statement that they are not a medical...
  24. MunoRN

    Nursing students on medication

    MunoRN replied to kjnsweets's topic in Patient Safety Issues

    Adderall and ritalin are actually controlled stimulants similar to amphetamine (Adderall is actually a type of amphetamine), and don't necessarily provide simply "focus". In those with true ADHD,...
  25. MunoRN

    END-OF-LIFE Ethical Dilemmas

    MunoRN replied to AnnMarie52471's topic in Patient, Colleague Relations

    I got the impression 'extra dose' referred to giving more medication than was needed, not more than what was limited by the range, which can be two very different dosages on comfort care