BrazoriaLVN

So we have a patient with end-stage cirrhosis that always gets back critical ammonia levels. A few days ago he was really woozy and sure enough is ammonia came back at 109. MD ordered another dose of lactulose now and check labs later. My question is...

Well, a one time extra dose. He gets 75mL QID!

Thanks, but I know how lactulose works. What I'm asking is in the absence of a bm after giving lactulose, would mixing MOM with the lactulose somehow negate the ammonia lowering effects of the lactulose or help it along?

Have there been any injuries at your facility r/t toning shoes( shape-ups, etc)? We have had 4 incidents of either aides just falling or dropping residents within the past two weeks. They were all wearing those shoes, and one complained that her heel...

Wow...virus by mail. Didn't they already do that with anthrax? :

I'm sorry...huh?

Or he could just wear a sheet, pour a glass of water on himself, and be a wet blanket...

I saw a thread last week and it was so funny to me, I couldn't believe it! It was great! I can't believe the fantastic experience I had. All the threads on that site are hilarious. I make their lives funnier. Shouldn't they be funnier to me?

Yes! Stadol D/C'd yesterday, Fentanyl patch upped. I'll keep you updated on how it goes but unfortunately no changes so far.

I have a resident at my SNF...rheumatoid arthritis with contractures of upper and lower extremeties. This man is sometimes confused, but mostly with it. Gets Norco, Oxycodone, Soma, Lyrica, Stadol, Voltaren Gel, Baclofen with no relief whatsoever. Sc...

So did you need it single or double spaced?

I agree. With the amount he has going on, I wouldn't have the time anyway!

He actually has had a fentanyl patch for quite a while. His alprazolam is bid so it's given when he is up. The boredom aspect is really something to think about though. He does have extensive family that visits 5-6 hours every day, and he gets up in ...

He gets alprazolam bid and q 6 prn and temazepam @hs.

ahh, yes. because when you have back to back codes, residents falling every five minutes(with lovely ten page incident reports to complete after every event!) and a giant med pass, you will go ahead and take fifteen minutes to keep fetching ice for s...

Ugh. I have unfortunately been in the exact same situation. The defensiveness when caught and all. I started looking in the room when they take their vitals. I can't for all, of course, but it lets them know I am watching...hate to babysit but it see...

:lol2:

Then why would you ask for advice?

That's exactly what I was thinking. If you want to stop burning bridges, put down the lighter!

I left a nursing home in Aug of 2010 making 7.65 as a CNA. I had been there two years. Nobody, even people who had been there 15+ years made over 10. I've never even heard of a CNA making that much. Must be the adjustment for standard of living in di...

I have heard of using coke, ginger ale, meat tenderizer, warm cranberry juice, and lots of other things to unclog Peg tubes. What has worked well for y'all? I was also wondering if there was a way to clean all the gunk out of the inside-we have someo...

So she should lie to get the time off? Ridiculous.

Very punny

How beautiful! You've got me shedding some tears over here