unsaint77

I work at a nursing home, hence the calling oncall doc and waiting for return call. It took about 15 min for the doc to call back. It is true that I wasn't as freaked out since the death was expected. Probably not related to her impending death, but her legs were mottled and dusky blue when I first met her two days before. I didn't think of the NRB. We proabably have one in the crash cart. My biggest question is this.. If she was not expected to expire and her sat dropped to 68, would you have raised the O2 beyond the 4L as the protocol says? At what level of O2 is usually dangerously risking losing one's own ability to breath? Or does that even apply in an emergency, unexpected situation? Should I have at least change the NC to mask? Perhaps I should have. Thanks for all your input.

I had a DNR/DNI pt, but was not hospice. She was incoherent and lethargic. She was not opening her eyes. We were expecting her to expire soon. Her sat was 80 with 3L via NC in the morning. Doctor was notified of the o2sat and the pt condition. When I took over the shift, her sat was 68. I raised the O2 to 4L. She is not COPD. Our standing order is up to 4L. Pt expired before the on-call doc called me back. Did I kill her by not raising the O2 higher right away? At what O2 level, do I worry about too much O2 suppressing pt's own ability to breathe?

2ml flush???? A teaspoon is 5ml. Can 2ml of water flush anything?

I didn't know a NG tube is not the same as a feeding tube. can you tell me how they are different?

I was administering med through NG Fr 10. The NG was patent and in the right place; I got 15cc residual, heard air woosh through sthethoscope, the catheter length checked out. The HOB was at least 30 deg. The pt was fine when I flushed/pushed 50cc water. But she gagged when I let liquid Ranitidine 10cc drain down from the open syringe. The pt thought the medication reflux is causing her to gag. I asked myself, "If so, why didn't she gag when I pushed 50cc of water a minute ago?" After the med, I again flush with 50cc of water by pushing it. The pt is fine. I let the tube feeding run at 80cc/hr. The pt is fine all night. I had the pt for two nights and same thing happened every time. First of all, why would anything draining down the NG cause one to gag? Can somebody explain this to me? Thanks

[h=2]http://www.healthcare.uiowa.edu/pharmacy/rxupdate/2004/04rxu.html Medications That Should Not Be Crushed Due to Fragility: Mirtazapine (Remeron SolTab®) and olanzapine (Zyprexa Zydis®)[/h] Not all of these come in rapid dissolve form and sometimes has to be given to pts with g-tube when the rapid dissolve form is not available. So, what is fragility? Or why these should not be crushed? Zyprexa I had to give through gtube was NOT enteric coated, or sustained release.

Thanks for the comments. Would TPN have any effect on clotting time one way or the other?

I thought INR would increase since platelet would be more diluted by TPN. But I want to make sure. thanks.

I didn't know this. It's amazing. So, a bladder gets fuller at night. Thanks Skindigo. ADH: The Test | Antidiuretic Hormone ADH secretion increases when a person is standing, at night, and with pain, stress and exercise. Secretion decreases with hypertension and when someone is lying down.

I get it now. thank you.

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Thank you so much for educating me. As you probably notice, i am a new nurse. If you had recognized my recent postings, you would know that my unit is poorly run and has so many things to upgrade. So, I will use kelly clamp. My one concern is the pointy end of the clamp possibly hurting the pt when the pt moves around or confused pt tries to get up out of bed with the clamp in their groin areas. Some of mini clamps that hardware stores is short enough and has rubber coating (I am including a picture. It's 2" long). They are meant to clamp down hard. So I think that would be better than kelly clamp.

I am trying to understand how urostomy (or ileal conduit) works. ureter is a sterile environment. what keeps bowel content from leaking into the ureter? thanks.

Yes, I forgot to mention that the foley we use don't have the port canesdukegirl is referring to. So, I have to do either of these two. (for the sake of discussion let's use the term "catheter" as the rubber part goes into patient, and "tube" for the clear plastic tubing connected to the collection bag) I disconnect the catheter and tube and collect urine from catheter opening. Or do as I mentioned above (of course I alcohol-clean the scissors and the part of the tube being cut, just like I alcohol-clean the catheter opening after I disconnect the tube from catheter. Same degree of sterility achieved.). SbostonRN, when you say you kelly clamp the tubing, you mean you kelly clamp the catheter, not the clear plastic tubing, right?