Lev MSN, RN, NP

Family Nurse Practitioner

Member

All Content by Lev

  1. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    35 y.o. female comes in with c/o of chills, malaise, sore throat, right neck/ear tenderness x4 days. "It hurts to swallow and I can't open my mouth all the way." VS as follows T: 38.5, HR: 97, BP:...
  2. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    57 year old female - comes in with right lower extremity pain, swelling, and redness x 1 week, which is gradually getting worse. "I tripped and fell and scraped my leg 2 weeks ago." VS as follows: T:...
  3. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    Severe pain/distress does not automatically warrant an ESI 2. If this is a patient you know who comes in with the same complaint and presenting symptoms every time and she is A&Ox4, I would triage...
  4. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    Even with diffuse abdominal pain that is not unilateral and no lady partsl
  5. Lev

    Can lungs be clear AND diminished?

    Lev replied to Cvepo's topic in Critical Care

    Clear and diminished - totally
  6. Lev

    new grad, confused, discouraged, overwhelmed, nervous, 2nd guessing

    Lev replied to AnnaBanana60137's topic in General Nursing

    I would not bring up what you heard from your SIL with your preceptor or management. It can backfire. I would do like BTDT said and ask for weekly meetings with your preceptor and educator. I would...
  7. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    Meningitis I guess is always possible. I guess the kid could catch pneumonia. Or some sort of untreated lady partsl infection in the mother that passed on to
  8. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    I think a more accurate way to judge a patient's spo2 is are they maxed out on nasal cannula (6L) and has an spo2 less than 90%. They will need at least a venti mask which depending on other factors...
  9. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    I agree. Also if she has copd let's say (she was older) and has been intubated 3 times already if she had the presentation of your patient, then she would be an ESI. It's always good to find out if...
  10. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    Yup, any fever >38c in an infant 30 days and younger is an automatic high risk situation. For infants and young children older than 30 days inquire about vaccination status to determine
  11. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    Here's one. Two weak old infant. Fever of 102. VS otherwise
  12. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    How SOB is she? Is she able to speak clear sentences or is she having difficulties. This will help determine if she is an ESI 2 or 3. Also, what is her oxygen
  13. Lev

    What do I do now.

    Lev replied to MissouriRN13's topic in General Nursing

    I think I smell a
  14. Lev

    Nervous about starting nurse externship

    Lev replied to ajanec's topic in Nursing Student Assistance

    What a great opportunity! As much as you miss your friends and family know that this is a step in the right direction for YOU and your career and it will help you when you graduate. You will make...
  15. Lev

    Thinking about switching to ED

    Lev replied to Koalified's topic in Emergency

    You will get all of those patients and then some but at least you won't have to deal with them for a whole shift (unless they are boarding in the
  16. Lev

    Recent transfer to ED from MS

    Lev replied to Beffers81's topic in Emergency

    Plan ahead. Make sure you are well rested and hydrated before your shift. Bring along an energizing drink that you can sip throughout the shift. Work on getting the story as quickly as you can and get...
  17. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    Ok here's one 38 year old male smoker, c/o of cough up yellow phlegm. not short of breath. Mild chest pain when he takes a deep breath. Temp 102, HR 127. No medical history. no
  18. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    I would say an ESI 1 but this may be triaged by many people as an ESI 2. Why do I say ESI 1? - Altered mental status (AVPU) Don't know how altered he is but if he does not open his eyes when you talk...
  19. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    if he was a smoker and around 20-40 then that would make me suspect it even
  20. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    ESI 3 unless she is having other symptoms that can indicate ACS. Also diabetes history makes a
  21. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    I think according to ESI if they are symptomatic like that - brady or tachy they should be an ESI 1. However, an ESI 2 could also be argued. You bring up a good point. Just because this patient has a...
  22. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    That would be an ESI 2 - concern for spontaneous
  23. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    78 year old comes in c/o palpitations.Hx afib. HR 176. BP 126/72. Feels "lightheaded and dizzy" No
  24. Lev

    ESI practice thread

    Lev replied to Lev's topic in Emergency

    ESI
  25. Lev

    Ratios changing in my department

    Lev replied to montecarlo64's topic in Emergency

    Some of those patients in the "non-acute" side sound like they should be ESI 2s. Maybe you have a triage problem. I have found that a 4:1 ratio is pretty typical in most ERs and 3:1 is a "sweet