MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Denture (dental) Adhesive - provided by your hospital or not?

    MunoRN replied to deweydecimal13501's topic in General Nursing

    It's been provided at every facility I've worked at, typically stocked along with toothbrushes and
  2. MunoRN

    So confused about IVPB

    MunoRN replied to AbigailJo's topic in Patient Medications

    In every place I've worked I've never seen an MD order a rate, they only order the dose, except for maintenance fluids or fluid resuscitation, in which case the rate and or volume to be given is...
  3. MunoRN

    Well, there goes our bonus!

    MunoRN replied to T-Bird78's topic in General Nursing

    It certainly could in the future if CMS decides to include satisfaction scores in the 'quality' section of MIPS, but at least based in their currently active and proposed methodologies, CMS doesn't...
  4. MunoRN

    Did I cause this rapid response?

    MunoRN replied to ns808's topic in General Nursing

    The insulin certainly didn't help, but your description suggests hypercapnia may have been involved ('jittering' and initial anxiety is a common symptom of elevated CO2 levels). You said his oxygen...
  5. MunoRN

    Research Results are in: To Suction or Not To Suction, End of Life & Hospice Patients

    MunoRN replied to NickICU-RN's topic in General Nursing

    If the patient is medicated adequately then there is no need for suctioning. Subjecting the patient to the torture suctioning involves to "relieve the family" is inappropriate, and fails the patient...
  6. MunoRN

    Well, there goes our bonus!

    MunoRN replied to T-Bird78's topic in General Nursing

    CMS doesn't require that outpatient clinics be reimbursed based on value based purchasing, so the scores won't be affecting reimbursement. CMS is going to start requiring that outpatient clinics take...
  7. MunoRN

    Well, there goes our bonus!

    MunoRN replied to T-Bird78's topic in General Nursing

    CMS doesn't do satisfaction surveys for clinics, and reimbursement isn't tied to it. There are private companies such as Press-Gainey that offer customer satisfaction surveys as a service, these...
  8. MunoRN

    I gave an IV medication that the patient is allergic to

    MunoRN replied to 19rma's topic in Patient Medications

    No medication error occurred, when an allergy is reported by patient then the ordering physician reviews the reported allergy, evaluates whether or not it is an allergy, and then weighs the reported...
  9. MunoRN

    Blood specimen from iv sites.

    MunoRN replied to omotee's topic in General Nursing

    There never was any evidence to support q72 hour changes, the change to IV site rotation based on assessment is because it reduces the risk of complications, since the majority of complications are...
  10. MunoRN

    Blood specimen from iv sites.

    MunoRN replied to omotee's topic in General Nursing

    Drawing labs from a peripheral IV, even if it wasn't just inserted, is actually the current recommended practice over drawing from a central line or PICC based on Infusion Nursing Society...
  11. MunoRN

    Research Results are in: To Suction or Not To Suction, End of Life & Hospice Patients

    MunoRN replied to NickICU-RN's topic in General Nursing

    Impaired airway protection is one of the ways that people die as a result of their disease, that's like saying someone who has a flaccid airway due to a neurological injury and who is comfort measures...
  12. MunoRN

    Working as RN for the state vs hospital

    MunoRN replied to NewNurse1997's topic in General Nursing

    It depends on what you mean by "working as an RN for the
  13. MunoRN

    mixing pain medications with a flush

    MunoRN replied to painmeds's topic in General Nursing

    You shouldn't initially assess for patency with a smaller syringe, but was patency has been confirmed there is no reason not to use a smaller
  14. MunoRN

    mixing pain medications with a flush

    MunoRN replied to painmeds's topic in General Nursing

    You would go halfway between the 10 and 9.5 marks on the flush for 0.25ml, I'm not sure that's really excessively complicated for a nurse to be able to figure
  15. MunoRN

    As a nurse, have you ever seen Hantavirus Pulmonary Syndrome?

    MunoRN replied to Nsco2018's topic in General Nursing

    There is no antiviral approved for use in the case of hantavirus, although there may be effect against hantavirus when using with influenza-approved antivirals. It's unlikely though that they would...
  16. MunoRN

    As a nurse, have you ever seen Hantavirus Pulmonary Syndrome?

    MunoRN replied to Nsco2018's topic in General Nursing

    Clinically it's essentially the same as influenza. Similar symptoms, similar treatments, which is mainly just supportive care. Like influenza, it has a fairly set duration as well, so basically you...
  17. MunoRN

    Med carts with no drawers

    MunoRN replied to Astral Walker's topic in Patient Medications

    I've never seen a med cart where you can load it up with multiple patient's meds in a hospital setting, typically you have to go to the Pyxis and pull meds for patients individually, so it would seem...
  18. MunoRN

    I don't think i can be around this co-worker anymore.

    MunoRN replied to fulitarn's topic in General Nursing

    As a guy, I can say that this is way beyond any sort of innocent flirting behavior or just a misinterpretation, engaging in an uninvited backrub in a storeroom is deserving of HR involvement at the...
  19. MunoRN

    mixing pain medications with a flush

    MunoRN replied to painmeds's topic in General Nursing

    Even if all you have is 10ml syringes then you've still got graduation marks which are at least every 0.25ml, even 0.2 with some manufacturers. If you have smaller syringes, then you have the ability...
  20. MunoRN

    mixing pain medications with a flush

    MunoRN replied to painmeds's topic in General Nursing

    I'm not sure what point you're getting to there. Why do you consider it necessary to dilute a medication to give it slowly? Whether you're giving a diluted medication in a 10ml syringe or the...
  21. MunoRN

    Tube Feeding And Hemodialysis

    MunoRN replied to Chisca's topic in MICU, SICU

    Maybe I've been out of the loop, but I've never come across the practice of habitually putting tube feedings on hold during dialysis, we even let them eat meals PO during
  22. MunoRN

    mixing pain medications with a flush

    MunoRN replied to painmeds's topic in General Nursing

    It's actually quite common to return the waste to a patient, particularly in settings where VAMPs are used, the belief that blood can never leave a patient and then go back into a patient is more...
  23. MunoRN

    mixing pain medications with a flush

    MunoRN replied to painmeds's topic in General Nursing

    A 10ml syringe doesn't prevent excessive pressure in the lumen and doesn't produce less psi than a smaller diameter syringe, all it does it does is produce less psi than a smaller syringe given the...
  24. MunoRN

    Voiding!

    MunoRN replied to ohsosarah20's topic in General Nursing

    As with pretty much everything, it's patient specific. Even if they're getting IV fluids I don't necessarily expect all everything that went in to come right back out if the purpose of the IV fluids...
  25. MunoRN

    Alternative sites for peripheral IV access

    MunoRN replied to MacDSlim's topic in General Nursing

    I don't know that you'll be able to find any surgeon willing to perform spinal surgery without IV