Catticus11

So I had a patient who was awaiting CABG after an outpatient cath revealed 95% Left main lesions, 90% RCA, and 60% LAD. He was on a Nitroglcyerin gtt and IABP. He started to complaining of chest pain and it revealed 0.7mm ST depression in lateral le...

I'm a critical care nurse at this time, with a total of 3 years of bedside experience. My boyfriend and I want to take a roadtrip around the country. Maybe spending a week or two in different cities. We don't plan to take this trip for a year, so I...

I had a patient come from the PACU after a leg revasc with an arterial line attached to a flotrac sensor/transducer. No vigileo or anything like that. I'm not too familiar with the equipment. What's the point of the flotrac transducer? Did they have...

I responded to a code blue, MD was already at the bedside because he was responding for new symptomatic hypotension. Patient was admitted two days prior for NSTEMI, and there was plan for cardiac catherization but Cr was elevated so plan to cath whe...

I had a patient on Propofol and Fentanyl who began to shake and originally I thought he was seizing, but my charge nurse stopped and said it appeared to be more like myoclonus which can happen from sedation. Can someone help me find more literature ...

No, he originally came in c/o dizziness, so he went to a cardiac telemetry unit where he fell and hit his head. He was transferred to CCU after that, where he began to become Apneic and developed a respiratory acidosis per ABG, so he was intubated. ...

Patient was admitted to cardiac telemetry unit s/p cardiac cath, 1 DES was placed and apparently she was Effient loaded in CCL, and on Plavix cath lab. No baseline CBC or BMP collected per the records, but a recent previous admission showed a Hgb wa...

I had an IABP the other night on a patient awaiting CABG. 3VD, significant RCA and LMain involvement. The patient was slightly hypertensive on the IABP, he normally is on Lisinopril but they discontinued it prior to surgery. His pressures ranged f...

I'm sorry, I forgot to include that his EF per the cath was 50%. Per the CXR the IABP looked like it was in the right place. But waveform could also be affected by inappropriate position? When I put it in a 1:2 it did change, his unassissted pressu...

Hi! I love that an RT is on here. So yeah, when I was speaking with the cardiologist I asked the same thing, and he said his concern was from the fact that he has no history of COPD and that though compensated his CO2 was too high to just leave as i...

I had a patient who needed bipap for an elevated pCO2 in the 80s but compensated. He was on a Bumex gtt for an elevated BNP, and CXR which showed bilateral pleurel effusions. Patient had history of diastolic CHF. Per the H&P, no history of COPD. ...

Yay, I'm so glad! You're always learning in this field, and this website's a great resource for new nurses like myself to discuss things with the more experienced RN, NPs, etc. Best of luck! :)

Thank you so much for the response. Would I treat seizures vs. diprivan induced myoclonus the same?

Thank you so much for your response! So a low diastolic pressure would merit the balloon pump sheerly for coronary perfusion? Is there a particular DBP value that they decide for that? Does the type and grade of lesion have anything to do for an IA...

So an equal assisted and unassisted diastolic is an indicator of poor offloading, in the setting of hypertension? Also, no I haven't tried manually timing. It was briefly reviewed to me by an older nurse (who also probably learned it in 1983 lol) bu...

The Patient I had a patient who was a type I DM who had an Insulin Pump for years. She stated her blood sugars had been running high for the past couple days, but today she was experiencing frequent urination as well, so she came to the ED. She pre...

So I've had patients who have CHF and receive weekly Milrinone infusions. I've also had patients who are awaiting Heart Transplants but weren't on any inotrope, but did have lower-ish BP. I've had patients with new cardiogenic shock who were placed...

Perfect, thank you so much!!

When I asked the nurse about the BP following Bipap placement, she said the BP remained normal. I don't think she was measuring the BP more frequently than q30min at the time, so I'm not sure how fast the BP dropped. So when the BP decreased, I sh...

Oh whoops, sorry about that typo. Thanks for the response!

I had a patient who congenital LQT and was going into recurrent torsades. She initially on Amiodarone but was changed to Lidocaine after the cardiologist realized it was congenital. She had a temporary wire placed for overdriving pacing. She was on ...

St. Peter's Hospital in Albany, NY has a Critical Care Orientation Program that uses AACN ECCO model. You have the option of the Emergency Department, Medical ICU, Cardiac ICU, or CVICU.

I started in my hospital's critical care orientation with a bunch of CVICU nurses. They all had at least a couple years of experience, and came from either the OR, PACU, or cardiac telemetry floors. I was offered a position in our CVICU when I appl...

I just recently went through the AACN ECCO program through my hospital; something that took me off guard was (either the program or my instructor) saying that it was unnecessary to let a provider know if a Troponin is elevated if the previous was one...

My charge nurse stated in passing, "during a code Epinephrine does nothing but vasoconstrict the coronary arteries, thus making compressions more effective." My mind was blown! And then after my mind put itself back together again, I realized that d...