seks

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?

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.

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.

Let's say someone initially got their 6 months GN permit towards end of Dec. Wrote the CRNE in Feb but failed it. That person decided to rewrite the CRNE in June...and also renew the GN permit since he/she wouldn't be getting the CRNE result until July at the earliest. But I've heard that CARNA will not let you renew your GN permit (which means you can't work at all) until you get the CRNE result (pass)? Is that true?

I am not sure. I am just not convinced that I actually fail this exam

it's in my title/subject header of my thread

Devastated and shocked. Failure was never an option during my schooling. Should I pay for the re-check/re-score service?

1. The only PICC lines I've dealt with so far are the ones that are inserted in the AC (proximal to the elbow bent). Is that the only location that they can be found? 2. The policy here in this region is that PICC lines are locked with 5 ml of NS then with 3 ml of Hep. It also indicated that a 10 ml syringe has to be used for the hep even though all units have 3 ml syringes. What is the reason for the 10 ml syringe to fill up only 3 ml of Hep? 3. How can you tell the difference between open-ended and close-ended?

Just curious how you guys do it? I was watching this video I do understand the need to use a syringe and attach the syringe to the lower port to aspirate that air (which is a huge amount). But after that, the people in the video mentioned that those little bubbles that they started pointing to aren't problematic to patients.

...accept (if interviewed and offered) a 1.0 FTE position (GN/RN) that is at a different city (few hrs drive) and relocate, study crne, and work FT? My preceptorship is ending in a few weeks. Any thoughts and advice? That's my dilema.

Can someone provide a brief list or summary of what kind of tubes are there and how/where they fall under certain categories? I am in what seems to be a GI surgery unit (but the unit is consider a general surg) for my preceptorship and I've been encountering different tubes and tubes names/abbreviations on patients and on the cardexes/charts. Please give me the full names instead of abbreviations. It's bad enough that abbreviations are abundant in a clinical setting and I always had to ask what they stand for... Googling doesn't seem to yield me much unless I know exactly the full names.

Any tips? I've seen people being able to draw almost all of the med up into the syringe and within seconds. I could never get that down properly. Sometimes I would spend about 1 min trying to draw the med up with 25% or so remaining in the ampule (so far I haven't had to administer the whole ampule to a patient).

So are you all saying my past clinical instructors are incompetent and don't know what they were thinking? So who is right or wrong or too anal or giving unecessary steps in this situation? My current preceptor or my past clinical instructors/buddy nurses? That is my MAIN question. It really is frustrating when you get different opinions on a technique and I don't know who to believe or abide by. Guess that is part of the so-called "reality shock"

Actually I didnt' argue with her. I just said something like "oh..no..didn't know that would be non-sterile" Well, if she happened to be my side when I prime another IV line, should I do it MY way and let her criticize me again?

The hospitals in this city use the Alaris pump and this kind of Alaris infusion set: Prior to my preceptorship, I've always twist that end cap a little bit so that the IV solution can dribble out while priming. However, during my first shift of my preceptorship, my preceptor didn't agree with my method. She said just to let the IV solution flow to just before the end of the line, put in a threaded cannula and then let the solution dribble out. She mentioned that my method would cause the end to be non-sterile????? Can someone shed some light on this as my previous clinical instructors have seen me prime IV lines and they never had a hissy fit about the way I do it.