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This pt had been on the unit for a few days. Had been on tinza and asa since admission to the unit. Start of shift, first day with him. He was c/o mild chest pain and bit of sob. A bit diaphoretic too. His SpO2 were fine but I cranked up the O2 a bit anyway. Paged the resident. Came in within 5 min and assessed the pt. Came out and told me he sounded crackly and that pt pain has subsided. Ordered 1 time dose of IV Lasix. NOTHING else. I was expecting maybe a nitro spray or chest xray or whatever. I came in next day...found out pt had a full code late in the night shift and passed away. Code team notes stated probably PE attack. I don't know...been almost a week and been thinking this death could have been avoided.

Had a pt where she was hypoglycemic (below 2-3) and hypokalemic (2.2) simultaneously. She was still alert and talking. We hung dextrose 50% 25g and 10mmol K+ minibags...quite a # of them. Those were resident's order which I feel wasn't an enough drastic intervention. I'm not sure what came out of it since when I left, bgm still 2.9 and k+ 2.4 after 4 K+ minibags and 5 dextrose bags. So what's the relationship between those two conditions? I know that insulin is given during hyperkalemia to stimulate the Na+K pump. Could it be her pancreas was producing lots of insulin?????????????

http://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC4205066&blobtype=pdf

I've been asked to take on a preceptor student again but I thought perhaps I can improve on some things (especially something that I'm not aware of or conscientious of). Anyone know of any peer-reviewed articles that provide insight on how to better a preceptor-preceptee relationship? One that I've found somewhat useful is titled "Challenges and Strategies for Building and Maintaining Effective Preceptor-Preceptee Relationships among Nurses" I thought perhaps some of you out there would know of others

Maybe a dumb question but: After I get a flashback, I attached a saline flush and pull on the syringe. Sometimes I don't get any blood back . When I flush it, the IV doesn't seem to be interstitial. I proceed to use the IV with IV fluids. Still no sign of the IV being interstitial or a bump developing. So why would I not get blood sometimes when I pull on the saline syringe..but the IV is good?

Was accessing them through nurseone.ca until that website decided to discontinue free access to those DBs back in beginning of Jan. Are there any other ways to access those without paying? I try to keep my knowledge updated or refreshed by reading peer-reviewed articles

It's been a long time since I've worked night shifts as I am a day shift person. And even then, I've probably worked less than 15-20 night shifts during my nursing career. I have no problem getting up early (5 am) but I tend to hit the sack by 9ish pm (maybe I'm just old?). I have 8-hr day shifts (07-15) for this Fri and Sat. I have 12-hr night shifts (19-07) for the coming Mon night and Tues night. Need some advice how I can go about surviving those two-in-a-row 12-hr night shifts without me being discovered with my head on the computer station at 4 am in the morning? And yes I'm definitely going to try to take a snooze during the one+ hr or so break.

Is it true from the recent new collective bargaining? Can't find any info on UNA website Can't seem to find a true definite answer from colleagues at work either

To me, it's assisting a patient to AMBULATE. I often find myself with so much crap on my plate throughout my shift that ambulating a patient gets the least priority.

I guess nursing candidates who are considered FAT shouldn't be hired either...whether it be genetics or eating too much junk food or little or no physicial activity. Fat nurses set bad examples for patients...

Today was the first time I came across a pt that requires me to use the following for the Baxter IV pump: Extension Set with 0.22 micron high pressure extended life filter and 1 INTERLINK injection site 6" from male Luer lock adapter http://www.ecomm.baxter.com/ecatalog/browseCatalog.do?lid=10001&hid=10001&cid=10016&key=10c55e55db25fd594c79724ed21073db&pid=459154 The pt has patent foramen ovale (PFO). My understanding is is that people with PFO have a higher risks of stroke and TIA. But I am not sure why a filter needs to be in the IV tubing somewhere for people with PFO? Are there particles in IV fluids/meds that would cause stroke and TIA???

I seem to recall of this site that has pdf translation sheets which have various languages of the common words we use with pt (such as BM, void, pain, etc). The pt would be reading the word in his/her own language and then just point. The word would have an english word translated beside it. Does anyone know what the site is?

When I see what I think is a stage 1 pressure ulcer, I would slap on a Coloplast comfeel dressing and make sure the pt is turned q2h. Correct me if there are better options. If you see a stage 2 (skin tear, bleeding) on a pt, what would you use before the wound care nurse has a chance to see it and provide recommendations?

It seems like 90% of the patients in my internal/acute med unit gets acetaminophen (325, 500, 650, 1000) that is scheduled tid or qid. I never found out what the rationale behind it is???? Is it just a proactive way to manage pain? The ones that usually don't get them are the ones with liver failure

Passed the CRNE in June. My current 6-month GN permit expires in Dec. Should I wait until towards end of Sept to apply for my RN? Or should I do it now? I'm just trying to figure out a way to save money on the fees. BTW, I get retro pay from my employer once I get my RN status.