Spider Cat

I've seen lots of input on crocs but has anyone worn Holey Soles?? If so, which do you prefer? Also if anyone can recommend a web site I would be ever so grateful.

Hi all - I'm hoping some of you lab experts out there can maybe give me some insight on my own lab values since I feel like my own health care group doesn't seem to be taking things too seriously. I had a routine annual physical and labs done a few weeks ago and all was well except the total bilirubin which was 2.0. I got called back in for a follow up for it and they had me go for the differential values (I think thats what it is??) At any rate the direct was 0.4 and indirect was 2.0 making the total even slightly higher than it had been about a couple weeks earlier. Liver enzymes and everything else are WNL. Does anybody have any ideas on this?? The nurse practitioner just keeps saying "I hate bilirubin" and I'm hearing the doc that she must have asked about it in the background saying the same thing. I had to call 3 times before anybody would call me back on it and I feel like a serious problem is going to get ignored because everybody "hates bilirubin" and doesn't want to be bothered to figure it out.

I am starting full time nights (5 - 7.5 hour shifts). I was working 3 - 12 hr night shifts and I got by with my sleeping by taking 2 Tylenol PM's on the 3 days I had to go in and slept like a log. Now that I am on 5 days I'm starting to wonder if taking 10 Tylenol PM's every week will cause some long term health concerns. Just wanting some advice from some pharmacology gurus out there.

are the core curriculum and study guide on the site enough to study and pass the exam or should I look for something else to study also? If something more - can anyone suggest something??

I'm so excited to see this forum!! Something I would like some info on is how to "trouble shoot" different things. A few things I have encountered on the floor is being unable to draw blood from a picc line/central line, leaking foleys, foleys that don't drain properly, too much residual with tube feeds, etc. It's so hectic all the time that it's hard to catch someone to enlighten me when things aren't working in text book fashion so to speak. If someone could add some comments on how to trouble shoot anything you might be able to think of I would be in heaven - and on my way to being less stressed out!

Sorry this is a late reply - but how about checking for residual on these??

Can someone give a quick and easy explanation on small bore feeding tubes? Should placement be checked by instilling air, should residual be checked by drawing back (I guess in the same manner as a peg tube would be), and how often should you do this with both a continuous or intermittent feeding administration. I have been told to very carefully instill air to check for placement and don't draw back to check for residual because the tube is so small it could easily be drawn out of place. I guess some are checking for residual though because an amount is documented. But I think I have read you should do both. Hoolahan had a very good reply somewhere here about feeding tubes but it was a very long and kind of complicated reading for someone new and confused like myself !!

Could someone help me finally understand what the ups and downs of PT's, PTT's, and INR's are? When we have someone on a heparin drip their PTT levels are drawn every 6 or 12 hours depending on what their previous levels turn out to be. When INR's are drawn certain levels are considered "therapeutic." What does this all mean????

When we have pts with a fever often times I'm told to have them cough and deep breath and encourage fluids to help bring it down. Can anyone enlighten me on how all of this works to lower a temp??

Can anyone explain to me what this test is?? My lab book just confuses me more than I was to begin with. I guess I shouldn't feel too bad though because the doc that had my pt didn't even know what is was

What are some parameters I should look for in a pts condition when deciding to request a PRN resp treatment??

I live in a very depressed area of the country and am trying to talk my husband into moving "where the grass is greener" so to speak. Any recommendations where this green area might be?? In other words - good money with a reasonable cost of living. A friend's relative just told me Florida hospitals pay about $ 32/hr with a $ 10,000 sign on bonus. But another friend said the cost of living is outrageous which I guess cancels out any gain in salary. Just dreaming of sunnier weather I guess .....................

Can anyone help me understand the theory behind this - I had a pt with a foley that didn't seem to be draining right and the pt was also complaining of "feeling like they had to go to the bathroom." The RN I was with came in and moved the tubing around a little and also said maybe the balloon wasn't inflated quite right. We got about 800 cc's of output after all this and everything seemed ok - ?????

I also would like to look into this but don't know how, what, or who to contact about it. Does anyone have an address, phone #, web site or anything to get info on local reservations? I know there are a couple in the area but have not a clue where a clinic or whatever would be for them.

Another question about Davita - how long is their orientation period and what does it consist of?? For the class room end of things, is it done locally at your own clinic or do you have to fly to their main head quarters or somewhere for it??