MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    What's Your Longest Lasting PIV?

    MunoRN replied to bgxyrnf's topic in General Nursing

    The practice of routinely changing out EMS starts is a bit outdated as well. There once was good evidence that these IV's were problematic, although that was based on 2 studies from the early 80's...
  2. MunoRN

    What's Your Longest Lasting PIV?

    MunoRN replied to bgxyrnf's topic in General Nursing

    The reflexive desire to change things that don't need to be changed isn't new, we used to do the same thing with Ventilator circuits as well, it just 'felt' right to change then frequently, as it...
  3. MunoRN

    Telemetry patient ratio

    MunoRN replied to styx876's topic in General Nursing

    At least based on my understanding of the California law, you should max out at 1:4 if there is even one telemetry patient in your assignment. Your employer seems to be confusing telemetry patients...
  4. MunoRN

    Transgender patient and a dilemma

    MunoRN replied to CBlover's topic in General Nursing

    I would just ask the patient, "would you prefer a male or female caregiver to...", although I don't really get the purpose of having security standing outside the door, and usually if they will be...
  5. MunoRN

    Apical pulse 61; gave metoprolol and held Digoxin

    MunoRN replied to knotizer12's topic in General Nursing

    Digoxin has a long half life, up to 2 days, so once they reach a steady state metabolism there won't be much if any of a peak in effect. Each dose just continues the HR lowering effect that you are...
  6. MunoRN

    Comprehensive Stroke Units: What is your staffing matrix?

    MunoRN replied to Rin287's topic in Neurological

    There are Comprehensive Stroke Certified (CSC) facilities, but not individual units. There are CSC facilities that have dedicated stroke or neuro units, but there are no standardized criteria or...
  7. MunoRN

    ICU floating to stepdowns/magnet status

    MunoRN replied to lisacammel's topic in Critical Care

    Other than how it affects staff retention and nurse satisfaction, floating policies aren't specifically addressed by Magnet criteria. In general I've never found Magnet status itself to be a reliable...
  8. MunoRN

    What's Your Longest Lasting PIV?

    MunoRN replied to bgxyrnf's topic in General Nursing

    Current recommendations are to only replace PIV's when clinically indicated based on assessment. There never was actually any evidence to support changing PIV's every 3-4 days in the first place, and...
  9. MunoRN

    "That's a myth about nursing"

    MunoRN replied to Emergent's topic in General Nursing

    I've never understood why nurses are so convinced that any talk of a shortage is a myth. We seem to think that if you don't get your dream job right out of school then job prospects aren't that...
  10. MunoRN

    Anyone Knowledgeable Here About Medicare/Insurance?

    MunoRN replied to Kooky Korky's topic in General Nursing

    If it this point she cannot live independently and requires some level of nursing home placement and has too many current assets to qualify for Medicaid coverage for nursing home then she would have...
  11. MunoRN

    Pt fell and I think its my fault

    MunoRN replied to Jen and Larry's topic in LPN, LVN Corner

    It's not uncommon for places where medication administration isn't charted at the bedside, where your choices are to chart it before you go in the room or after you leave the room, to have a policy...
  12. MunoRN

    Neuro exam, following commands vs mimicking?

    MunoRN replied to Angelllau's topic in Critical Care

    The ability to follow commands includes the ability to mimic since that's basically what we're asking patients to do either verbally or visually. This is particularly true in an intubated trauma...
  13. MunoRN

    BS 94, Lantus 20 units, give HS snack?

    MunoRN replied to knotizer12's topic in General Nursing

    The purpose of an HS snack for diabetics isn't to prevent hypoglycemia, it's to prevent hyperglycemia, as well as to reduce excessive ketone production at night. In theory at least, an hs snack helps...
  14. MunoRN

    Thai cave boys in hospital

    MunoRN replied to Emergent's topic in General Nursing

    If a US hospital knew ahead of time their patient care was going to get the same type of coverage, they'd probably all be on ECMO, CRRT, Total hearts, etc, at the very least we would make sure the...
  15. MunoRN

    Cna incident investigation

    MunoRN replied to Nnb07's topic in General Nursing

    If you're nursing-home-bound depending on a crane to get you upright only to then somehow fall out of it and break your hip, 'the end' has clearly already begun before that
  16. MunoRN

    Curos caps for foleys?

    MunoRN replied to dawdlingsquid's topic in General Nursing

    The purpose of Curos caps is to remove some of the variation that occurs in cleansing a leur-lock port prior to accessing, it essentially makes the port continuously aseptic so that inadequate...
  17. MunoRN

    My cousin who is run at the direction of her mother acted as hospice

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

    Morphine is a totally appropriate medication to give a COPD patient who just wants to be comfortable or even full treatment end stage COPD patients that want some reprieve from air hunger, it reduces...
  18. MunoRN

    Thai cave boys in hospital

    MunoRN replied to Emergent's topic in General Nursing

    That might be because none of them had any inability to eat or drink to fix either of those problems, and they had no indication for
  19. MunoRN

    Blood Transfusion and Infusion Pump use - Revisited

    MunoRN replied to toasterja's topic in General Nursing

    I can't find any manuals for pumps currently on the market that state they shouldn't be used for blood, the ones I've found specifically state they can be used for blood and have been tested for...
  20. MunoRN

    Allergic to latex and other vaccine allergies

    MunoRN replied to Jlynn85's topic in General Nursing

    Tetorifice vaccines with latex free packaging are not only available but fairly common, I would revisit this with your physician and ask about latex free formulations, if your physician isn't aware...
  21. MunoRN

    Didn't scan a narcotic at bedside

    MunoRN replied to Hailbop16's topic in General Nursing

    Unlike hospitals/facilities, pharmacies, and prescribers, nurses are not overseen by the DEA, so it's unlikely the DEA will care that you didn't scan a med. So long as you gave the medication to the...
  22. MunoRN

    Dropped Pill - Do you give it?

    MunoRN replied to applesxoranges's topic in General Nursing

    I remember as a student during clinicals a patient dropped their pill onto their dinner plate, the patient picked it up and was about to put it into their mouth when the nurse told them not to take...
  23. MunoRN

    Epic Charting

    MunoRN replied to newvillemom's topic in General Nursing

    Epic is a base platform and versions vary widely by facility/organization, but I've yet to see one where you could delete or alter another nurse's charting, typically it's grayed out when to try and...
  24. MunoRN

    Bradycardia vs Tachycardia

    MunoRN replied to hanakimi4's topic in General Nursing

    "Neither" and "Both" are equally correct. Both of those terms simply refer to a HR within a common range or outside of a common range. Depending on the factors affecting a patient's perfusion and...
  25. MunoRN

    When they're SO sure they're right...

    MunoRN replied to Jedrnurse's topic in General Nursing

    Generally urine is actually sterile, but it's also true that if you're sending it for culture then it's because there's sufficient suspicion it's not. We're allowed to tube urine because generally...