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  1. Doey

    Barretts Syndrome(sp)?

    Hi Jennifer, Here are some websites that I hope you find helpful. http://www.niddk.nih.gov/health/digest/summary/barretts/barretts.htm http://www.barrettsinfo.com/ http://pathology2.jhu.edu/beweb/index.cfm http://www.fhcrc.org/phs/barretts/
  2. Doey


    What I found that works and doesn't require any special equipment but your hands and can be done anywhere, is to apply pressure to both eyes at the same time. I usually do this for about 20 maybe 30 secs. Sometimes not even that long. I do occassionally have to repeat it but it's usually because I haven't held pressure for long enough. Hope that helps.
  3. Doey

    Pot Smoking and Nursing

    Wildhoney, check your BON. In my state a RN is required to report anyone who may be, by their behavior etc. practicing under the influence of alcohol or drugs. My facility also has a "fit for duty" policy that describes some of the behavior that must be reported and the smell of alcohol on someone is one of them. It isn't a pleasant thing to do but first and foremost we have a duty to protect our patients. Also, at least in my state, if harm were to come to a patient because of someone's impairment by drugs or alcohol and it was found that others were aware of this, they too are liable. Secondly, the person involved will be given the chance for some help. This could be the "bottom" so to speak and be the turning point for change. Your co-worker definitely has had a hard life from what you have written and probably has experienced things you will never know. But I think you're right when you say we have to be tough sometimes for things to change or we become the enabler. Good luck.
  4. Doey

    Carotid Endarterectomies

    I work on a cardiac telemetry unit and CEA's do come to us straight from PACU. q1-2hr VS & neuro checks w/parameters for starting neo/nipride if needed. They do very well and are usually d/c the next day.
  5. Doey

    HELP! Suggestions for IV (OR) PO orders?

    We still use paper MAR's. Computerized ones coming soon though. We transcribe these orders just as NurseDennie said. The po in one box and the IV in the one below it with an OR written between them in red and brackets connecting the two also in red. Everything transcribed is written in black ink except the above or specific parameters for meds (HR BP etc) or anything out of the ordinary that we want to draw attention to. Those are signified with red ink.
  6. Hi Rileycat, First of all, congratulations!! I went through something like 6 cycles of intrauterine insemination and 5 cycles of IVF. I was prescribed progesterone in one form or another (supps then injections) for each. Unfortunately I was not successful but all of the women in my support group were also given progesterone and those that did get pregnant had no problems whatsoever and all the babies were born fine. I too was at first concerned after reading about progesterone but did some research and found that it is used extensively (especially in infertility treatment) without any ill effects. Take care, and will keep you in my thoughts.
  7. Doey

    Need answers about cardiac....

    Mickeymom, That sounds awful!! Obviously this is not just a rare thing for you and definitely effects your day to day life. (what da ya mean, you can't stop running on your unit for a few minutes to pass out and puke!! LOL Just kidding) I hope you get some answers at your appointment this afternoon. I don't know what your EP doc is like but don't let him/her get away with the it's nothing/it's not all related/your anxious/nervous/etc crap. I have a feeling you won't!! And do let us know what happens. Will be thinking about you.
  8. Doey

    Need answers about cardiac....

    Sorry Mickeymom, I must've been writing as you were posting. But is your MR caused by MVP? Did you ever have rheumatic fever? Any collagen disorders? These can all cause MR.
  9. Doey

    Need answers about cardiac....

    That's what I was thinking too, MVPS. I've had a couple of patients with the symptoms you've mentioned. Apparently the syndrome consists of MVP,NCS,headaches,fatigue,chest pain,palpitations,SVT,PVCs. Some physicians will say that none of the symptoms are related because there are many who have MVP and have no symptoms whatsoever, and there are those who have these symptoms with no MVP. I think it could be because we have not yet found the physiological connection between everything. And of course there are the physicians (and others) who just see a hysterical woman, and because nothing concrete can be found, it must be all in your head. I have seen pacers used with NCS that have been successful in controlling the symptoms and I have also seen it used where it hasn't. That alone tells us there is something else going on that we haven't put our finger on yet. (implantation of a permanent pacemaker is generally a very safe procedure. But as Matt stated there can be complications but these are rare). With one patient, the doc ordered Florinef, TED stockings, and increased fluid intake and it worked. Dehydration, even mild, can exacerbate the condition for some. It sounds like you've had appropriate diagnostic tests, but have you ever had a tilt table test? That is supposed to be the gold standard for diagnosing NCS. Beta blockers are used because of the increased adrenergic activity that accompanies this syndrome, hence the PVCs or SVT. In NCS there is a malfunction in the nervous system. No matter what, I feel that if you present to the ED with CP etc. you should still be treated as a r/o MI and have the same diagnostics as everyone else. But that's just me. Along with the beta blockers, SSRIs (like Prozac,Zoloft) maybe ordered. Now don't freak out, it doesn't mean you're crazy. The SSRIs have been found to work in some with controlling the symptoms. Here are a few sites I found that ight help you out. At the very least you'll know you are not a crazy,hypochondriac female. http://www.mvprolapse.com/ http://www.ilovejesus.com//myhome/mcpeg7/MitralValveProlapse.shtml http://www.aafp.org/afp/20000601/3343.htm http://mdchoice.com/searchframes.asp?sURL=http://www.postgradmed.com/issues/1998/01_98/grubb.htm&rURL=http://mdchoice.com/index_content.asp? Good luck, and keep us updated.
  10. Doey

    recurring dream

    zumalong, I have had the same type of dream only in my dream I'm usually at work and have to pee really bad. I keep finding bathrooms that are in the middle of the unit so everyone can see or that have no doors on them and my coworkers are wandering in and out, or like you, bathrooms that are disgusting. I too will awaken having to run to the bathroom. Only on one occassion when I had the dream I did finally find (after I thought my bladder would burst), a nice clean, private bathroom with a door, and ended not waking in time and did pee the bed!! My hubby was laughing hysterically and doesn't to this day hesitate to tease me about it. Well at least he has a good sense of humor. Helped me change the bed all the while cracking up.:)
  11. Doey

    pregnancy don'ts

    Where I work we don't have anyone who's pregnant care for pts with shingles even if they have had chicken pox themselves.
  12. Doey

    body removal...

    "we drag them down the hall yelling....let this be a lesson to you... " thisnurse, I just read your post in another thread (your incontinent pts), and was cracking up then read this and really lost it. Almost peed my pants! We use the "morgue stretcher" like PRN described also.
  13. Doey

    please help me with ABG's

    When I first started learning about ABGs I would get confused too. For me it was a matter of repeatedly going over information. Dealing with actual patients helps to bring it all together too. I would jot down a pts ABGs and any other pertinent info along with what was ordered/done etc. and go over it at home until I understood what was going on. Here's a few sites that might help you. http://www.vh.org/Providers/TeachingFiles/abg/ABGHome.html http://www2.kumc.edu/instruction/nursing/n420/unit2/abg.html http://www.int-med.uiowa.edu/education/abg.htm#Specific%20Acid-Base%20Disorders%20and%20Diagnoses http://virtualnurse.com/er/abg.htm
  14. Doey

    Noting orders

    Where I work the secretaries take off the orders, putting labs etc into the computer, calling MD's offices for referrals/consults and any notifying any other departments as needed. They write in the meds on the MAR (computerized ones coming soon), and rx's etc in the kardex checking off each order in red. They then sign the order sheet in green with the date, time, their name and title. The primary nurse, not the charge nurse, then checks all the orders, writes in the correct times for medication administration on the MAR and in red signs the order sheet as noted with the date, time and their name. I too agree that whoever signs off the orders is responsible for following through. As for 24hr chart checks, each nurse is responsible for doing their own including the MAR.
  15. Doey

    Needleless intravenous device and iv therapy.

    Love the CLAVE. Haven't heard about the spikes before though. Sounds good. Think I'll mention it.