MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Possible error in judgement?

    MunoRN replied to Kcanno13's topic in General Nursing

    Pulse and Heart Rate by EKG are two different things, typically the two match up but particularly with tachyarrhythmias they may be completely different. 'Pulse' is the number of detectable perfusing...
  2. MunoRN

    Is this a Med Error?

    MunoRN replied to AllyRN's topic in General Nursing

    The only way to clarify how the prescriber intended for the order to be interpreted is to ask the prescriber. That being said, there's no reason to assume this order was written incorrectly, and this...
  3. MunoRN

    Nitro drip

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

    The big reason would usually be an active infarct affecting the right ventricle, in which case nitroglycerin is contraindicated. But in non-RV infarcts you have a valid point, if there is good...
  4. MunoRN

    It's That Time of Year Again: Preparing for Influenza Season

    MunoRN replied to Melissa Mills's topic in Nursing News

    It's certainly not fun, but on the bright side a strong immune response to the shot is what makes it work. No immune response = likely ineffective vaccination. Since vaccine doesn't confer immunity,...
  5. MunoRN

    Suicide by chronic pain sufferers after opioids reduced

    MunoRN replied to Emergent's topic in General Nursing

    I would agree the pendulum has probably swung too far in some areas, but there are also totally appropriate changes that need to happen. One thing we know is that we have been prescribing excessive...
  6. MunoRN

    Pediatric resp distress

    MunoRN replied to Lbu's topic in General Nursing

    As Peak and Wuzzie pointed out, you're not going to do better than the vent, it isn't going to fix any of the common issues that should be assessed first, yet it can potentially cause further harm....
  7. MunoRN

    Discussing salary with co workers

    MunoRN replied to Dawnkeibals's topic in General Nursing

    Nurses absolutely should discuss their pay rates, and nurse's who feel uneasy doing so should consider getting over it. Particularly in non-unionized employment, one of the main things that...
  8. MunoRN

    Bipolar Nursing Clinicals False Drug Positive

    MunoRN replied to sodapopgirl's topic in Nurse Disabilities

    First, let me point out that I completely get the desire to keep one's health history private, particularly mental health history, and almost always a person's health history is nobody's business but...
  9. MunoRN

    Gave Tylenol to patient with elevated AST and ALT

    MunoRN replied to Imanurse123's topic in Patient Medications

    There's not actually any reason to hold Tylenol just based on the AST and ALT levels, not a med
  10. MunoRN

    Pediatric resp distress

    MunoRN replied to Lbu's topic in General Nursing

    I wouldn't be so quick to bag them if they're on the vent, unless you're reasonably sure there's a failure with the vent or circuit, taking them of the vent and bagging them is going to do more harm...
  11. MunoRN

    Is this a Med Error?

    MunoRN replied to AllyRN's topic in General Nursing

    TID is not the same as q 8hrs. For scheduled medications, TID means the medication is scheduled for the defined times for that medication, which might be 0900, 1300, and 2100, as an example. TID prn...
  12. MunoRN

    Bedside Nurses: Undervalued, Poorly Retained and What Experts Say

    MunoRN replied to J.Adderton's topic in General Nursing

    I'm not sure where you're getting that I said all of the research relating to shift length is wrong. There isn't research available on the risk of errors specific to each hour of a shift, but there...
  13. MunoRN

    How would you handle this ....

    MunoRN replied to RUBICON's topic in General Nursing

    I agree with both of you on the terminology issue, I was only references the two terms to avoid the wrath of the terminology police. The details and context of the situation as described negate the...
  14. MunoRN

    How would you handle this ....

    MunoRN replied to RUBICON's topic in General Nursing

    A patient can be experiencing some level of ICU delirium and still have decision making capacity, or 'mentally competent'. There is certainly a subgroup of patients experiencing ICU delirium who also...
  15. MunoRN

    Bedside Nurses: Undervalued, Poorly Retained and What Experts Say

    MunoRN replied to J.Adderton's topic in General Nursing

    I am referring to data, including those that originated the U of Maryland including Roger et al 2004 and 2006, Trinkoff, and Geiger-Brown 2010, as well as other studies such that of Stone et al 2006,...
  16. MunoRN

    How do you feel on displaying your certification credentials on your badge?

    MunoRN replied to choksantos's topic in General Nursing

    Correct. As an example, replace nursing expertise with the ability to juggle ten tennis balls with your eyes closed. In order to do that, you need to: (a) possess ten tennis balls, (b) be able to...
  17. MunoRN

    Bedside Nurses: Undervalued, Poorly Retained and What Experts Say

    MunoRN replied to J.Adderton's topic in General Nursing

    I agree that the hospitals and hospital consulting groups that push for a transition to 8 hour shifts based on supposed cost savings are incorrect in believing it will save costs, but there are...
  18. MunoRN

    Bedside Nurses: Undervalued, Poorly Retained and What Experts Say

    MunoRN replied to J.Adderton's topic in General Nursing

    Everybody's different, but in general 12 hour shift staffing has been shown to reduce fatigue, errors, burnout, etc. This is mainly due to the effects of 8 hour shifts on night shift workers compared...
  19. MunoRN

    How do you feel on displaying your certification credentials on your badge?

    MunoRN replied to choksantos's topic in General Nursing

    Knowledge base is a vital component of expertise, experience plays an important role as well, but these should not be confused for nursing 'expertise', these are very different
  20. MunoRN

    How would you handle this ....

    MunoRN replied to RUBICON's topic in General Nursing

    The presence of delirium does not automatically mean the patient lacks capacity to decline treatment, including leaving AMA. In order to have the capacity to chose to leave AMA, the patient only...
  21. MunoRN

    Quick K+ question

    MunoRN replied to HappyMonkey's topic in General Nursing

    There used to a practice of adding lidocaine to the bag, although that's fallen out of favor due to safety issues. Buffering the KCL isn't going to help much since it isn't all that acidic, peripheral...
  22. MunoRN

    IV Push Meds

    MunoRN replied to AlmostThere19's topic in General Nursing

    https://www.ismp.org/resources/some-iv-medications-are-diluted-unnecessarily-patient-care-areas-creating-undue-risk
  23. MunoRN

    Ethical Dilemma: Is it ever ok to mislead a patient?

    MunoRN replied to RNjuice's topic in General Nursing

    I think the bigger question is whether or not providing anything other than purely palliative treatment to patients with advanced dementia is really "the best medical treatment and personal care...
  24. MunoRN

    How do you feel on displaying your certification credentials on your badge?

    MunoRN replied to choksantos's topic in General Nursing

    Certifications don't convey your level of practice, using Benner's stages of nursing practice model, the most a certification by itself gets you is to the "competent" stage, which is halfway up the...
  25. MunoRN

    How do you feel on displaying your certification credentials on your badge?

    MunoRN replied to choksantos's topic in General Nursing

    I get the frustration that physicians have usurped the term "Doctor" in the clinical setting as a term for a physicians licensure rather than as an academic degree reference, but as frustrating as...