MunoRN RN

Critical Care

Member

  • Content

    8,058

  • Visitors

    94,715

  • Followers

    9

  • Likes

    7,525

All Content by MunoRN

  1. MunoRN

    PICC line blood draw

    MunoRN replied to greyL's topic in General Nursing

    There have been discussions on this topic with Lynn on another site but she has stated directly that she doesn't believe blood sampling increases the risk of thrombosis. (Whether or not the INS or...
  2. MunoRN

    Iv mag or k+ which do I hang first?

    MunoRN replied to JenniferG rN's topic in Emergency

    We don't infuse potassium into the cells, we infuse it into the serum and then depend on good net uptake to improve potassium levels, it's sort of like cells are scooping up potassium with a bowl,...
  3. MunoRN

    PICC line blood draw

    MunoRN replied to greyL's topic in General Nursing

    That certainly seems possible but according the 'experts', INS and Lynn H, that's just a
  4. MunoRN

    Iv mag or k+ which do I hang first?

    MunoRN replied to JenniferG rN's topic in Emergency

    Ideally, you give mag first, although it's not critical to do so. Magnesium modulates the transport of potassium into cells. Low magnesium = decreased potassium uptake which results in more of the...
  5. MunoRN

    PICC line blood draw

    MunoRN replied to greyL's topic in General Nursing

    Not to pick on you, but I hate the "follow your P&P" for questions that have only one truly correct answer. The physics involved in flushing and wasting blood in a PICC aren't altered by the...
  6. MunoRN

    PICC line blood draw

    MunoRN replied to greyL's topic in General Nursing

    Each facility should have a way getting these orders entered, but everywhere I have worked if it's a protocol to hep lock, then you write an order that says "Heparin IV 2ml... Protocol order for Dr....
  7. MunoRN

    PICC line blood draw

    MunoRN replied to greyL's topic in General Nursing

    I'm disturbed how common wasting 10ml is. Keep in mind blood draws and wastes are the main cause of iatrogenic anemia, which is largest cause of blood loss in hospitalized patients. 2-3 times the...
  8. MunoRN

    What do you think about this? Giving narcan to addicts, their friends and family.

    MunoRN replied to Mulan's topic in Patient Medications

    The "call 911 and let EMS handle it" plan is what we already do, and it doesn't work very well, it only takes a couple of minutes of anoxia to cause anoxic brain injury, far less time than it takes...
  9. MunoRN

    Your Experience with Your Hospitals Cath Lab Personnel?

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

    It doesn't actually sound like the situations are that different. Just over half of our STEMI's codes are activated in the field, the remaining 40% are activated in the ER, which is where the...
  10. MunoRN

    Your Experience with Your Hospitals Cath Lab Personnel?

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

    If they can go straight there then send them straight there, if they can't, which is often the case both during the day and at night, do what you can in the down time before they can
  11. MunoRN

    Your Experience with Your Hospitals Cath Lab Personnel?

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

    If it was up to 30 minutes from the Cath code call to having Cath lab staff on the premises, but you are sending them to the cath lab well before that, why are you sending them to a cath lab with...
  12. MunoRN

    Your Experience with Your Hospitals Cath Lab Personnel?

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

    You might consider changing that to be an expectation in the ED, the more that can be done prior to the arrival of the Cath lab team the better, otherwise it's more likely to delay the cath. In three...
  13. MunoRN

    Your Experience with Your Hospitals Cath Lab Personnel?

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

    I've never come across a Cath Lab RN who expected a full bath, but everywhere that I've worked cleaning of the 'boxer shorts' zone has been mandatory, cath code or
  14. MunoRN

    What do you think about this? Giving narcan to addicts, their friends and family.

    MunoRN replied to Mulan's topic in Patient Medications

    More than half of all opiate overdoses are "witnessed", so it can benefit up to more than half of it's "target audience". In contrast, Statins may only benefit as little as 1-2% of people who take...
  15. MunoRN

    What do you think about this? Giving narcan to addicts, their friends and family.

    MunoRN replied to Mulan's topic in Patient Medications

    Chicago has done a pilot project which reduced Heroin/Opiate OD deaths by 20% in it's first year, other programs have seen reductions of up to 50%, I'm not sure how that's a bad
  16. MunoRN

    Your Experience with Your Hospitals Cath Lab Personnel?

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

    I occasionally float to the Cath lab, and yes it a different atmosphere than being on the floor or unit, although it's pretty similar to the "chummy" atmosphere of a GI lab, OR, and pretty much...
  17. MunoRN

    Your Experience with Your Hospitals Cath Lab Personnel?

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

    CVIT (cath lab tech) with a
  18. MunoRN

    Low Census-what's up?!

    MunoRN replied to mom35's topic in General Nursing

    I'll bite, why do you think the ACA is dropping your
  19. MunoRN

    PICC Line Protocols

    MunoRN replied to sdixon22's topic in Infusion, Intravenous

    It's important to keep in mind that "intermittent" tubing doesn't actually refer to intermittent tubing. In my experience people typically interpret "intermittent" to refer to tubing for intermittent...
  20. MunoRN

    JCAHO Requirement

    MunoRN replied to FineAgain's topic in General Nursing

    You can buy them online for about
  21. MunoRN

    rapid response team

    MunoRN replied to murse1015's topic in Medical-Surgical

    I give the Narcan then notify the MD I gave it. Your license is far more at risk for not giving Narcan when by your assessment the patient requires, than you are delaying time sensitive interventions...
  22. MunoRN

    Generic name for vitals machine?

    MunoRN replied to WalterWho's topic in General Nursing

    I assumed "Rosie" referred to the Jetson's
  23. MunoRN

    Generic name for vitals machine?

    MunoRN replied to WalterWho's topic in General Nursing

    That same story exists at everyplace I've worked, it seems like an urban
  24. MunoRN

    Generic name for vitals machine?

    MunoRN replied to WalterWho's topic in General Nursing

    Robo-Nurse
  25. MunoRN

    HIPAA and Advocate for competent patient

    MunoRN replied to akn1563's topic in HIPAA Challenges

    I think you hit the nail on the head, but maybe not in the way you meant. There is power in being the gatekeeper of information, that power is demonstrated far more through denying access than it is...