Bec7074

Bec7074

Trauma, Critical Care

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All Content by Bec7074

  1. Ordering antibiotics!?!

    Bec7074 posted a topic in Patient Medications

    So today I cared for a gentleman who became febrile at 38.7. I called the doc and pan cultured him as ordered, including a UA. The patient was not on antibiotics and was admitted for a lung AVM. The...

  2. Holiday rotations...

    Bec7074 posted a topic in General Nursing

    Just curious as to how holidays are handled on your units as I am very unhappy with the holiday policy for mine and would like to restructure it. We ideally staff 12 RNs (10 minimum) + charge per...

  3. Acidotic Questions

    Bec7074 replied to tnelso150's topic in CCU, Coronary, Cardiac

    I'll speak to the second question. Read up on lactate, lactic acidosis, and base deficit. Those are related concepts especially in sepsis or after a cardiac arrest. It has to do with anaerobic...

  4. PEA arrest

    Bec7074 replied to MLB55's topic in CCU, Coronary, Cardiac

    It's hard to say....I think I would wonder the same thing. His SvO2 was 50 the day before...not fantastic so maybe an early indicator that he was going to get worse regardless of whether or not you...

  5. Hypoglycemia Mystery Theater

    Bec7074 replied to solneeshka's topic in General Nursing

    I'm kinda perplexed by a few things in this scenario. First, why does someone who got only 1 cardiac stent need Neo???? Was this a cath-lab patient? He sounds super stable given that he's eating and...

  6. May 2013 Caption Contest: Win $100!

    Bec7074 replied to Joe V's topic in News, Announcements

    Nothing says 'Happy Nurses Week' like a few close calls with bodily

  7. Advanced practice nurses in trauma?

    Bec7074 replied to manda691's topic in Critical Care

    I worked in a Level 1 trauma center and we have all NPs at night and one attending in house. The NPs who work with the trauma service are all ACNPs (acute-care nurse practitioners). There are 4 of...

  8. Blue about Code Blue

    Bec7074 replied to barbaralynn's topic in First Year After Licensure

    Medical staff and patients, and patients and their loved ones need to have clear ideas of the pt's end of life wishes whether the patient is coding or is just unable to make decisions on their own. I...

  9. Increasing creatinine

    Bec7074 replied to MLB55's topic in MICU, SICU

    Not that it's a good answer, but did the lasix increase her UO? If so, then it was the right choice for her. I look at your patient Ike this...she was severely hypotension in OR. Kidneys are the most...

  10. calcium chloride

    Bec7074 replied to Andrea2107's topic in Critical Care

    CaCl is also a buffer for acidosis if that's what they think part of the problem was. It's a typical part of the "high K" cocktail that coincides with acidosis. I had a patient so...

  11. Insulin drip/hourly BG checks

    Bec7074 replied to Elvish's topic in Patient Medications

    I worked on a med surg that took insulin gets with 1:4 ratio. Insulin ggts we're more common in the PCU I worked in with 1:3-4. I think it's very much facility

  12. Lung auscultation question

    Bec7074 replied to lauderek's topic in General Nursing

    Diminished lung sounds are what we call it when we don't hear much air moving. Lungs can be both clear and diminished. Are you sure you are placing your stethoscope the in correct location? Try...

  13. ICU nurses assisting in monitoring Med/Surg Telemetry Rhythms

    Bec7074 replied to sara525's topic in Critical Care

    This sounds awful for pts and nurses. Part of your assessment is assessing the rhythm. The ICU nurses are not caring for these patients and can't quite possibly know or have the time to see if...

  14. how to make it clear when call doctor

    Bec7074 replied to neurontin's topic in CCU, Coronary, Cardiac

    The pt may have been a symptomatic at a rate of 130 only temporarily. In afib > 120, the heart loses its "atrial kick" (the small portion of blood ejected from the atria to the ventricles) and...

  15. Nebulized flolan for severe ARDS

    Bec7074 replied to sunnycalifRN's topic in MICU, SICU

    We use inhaled Flolan in our ARDS pts as a last-ditch effort. Usually they are on Bi-Vent (bi-level or APRV) and a prone bed already. To me it makes sense. ARDS causes pulmonary edema which surely can...

  16. Tips for becoming a solid CC nursing candidate...

    Bec7074 replied to TheBlackDogWaits's topic in MICU, SICU

    Critical thinking skills, motivations, and the ability to admit you don't know it all and aren't afraid to ask for

  17. Gaining skills. What is important?

    Bec7074 replied to CrystalSSA's topic in General Nursing

    I did med surg to PCU to ICU in 3 years. I love ICU and will never go back. I admire the med surg nurses who juggle all those patients. I did it, but not very gracefully. You need confidence and...

  18. Gifting my orientators

    Bec7074 replied to exit96's topic in General Nursing

    Sure. I wrote Thank-You's to all my preceptors at my current job just thanking them for their help. I got my main preceptor a $5 gift card to the coffee shop in our hospital. I didn't feel like...

  19. Simultaneous Electrolyte Administration

    Bec7074 replied to sarahc331's topic in Critical Care

    Here are my thoughts (although to be clear I fully disagree with this facility). 1. It cannot be an IV compatability issue since we all know Mg and KCl are compatiible. Hell, they're both in TPN....

  20. Did I do enough?

    Bec7074 replied to unique05's topic in MICU, SICU

    I am of the opinion that there are many things worse than death. Anoxic brain injury combined with STEMI sounds like one of those things. Death does not mean you failed. It means the family made a...

  21. How to choose which PRN blood pressure med

    Bec7074 replied to vashtee's topic in Patient Medications

    Just came across the thread but wanted to add: I don't think more than 1 anti-hypertensive prn is weird. If the pt is having sinus pauses do not give any beta blockers!!! Scheduled or prn. This can...

  22. How to leave a good situation for a new hospital back home... advice needed

    Bec7074 replied to Peerless's topic in Nursing Career

    You could just tell the new managers you don't want your current manager to know. They should get that. Are there any peers that could serve as references that would keep quiet for you? Any...

  23. Getting patient information before shift

    Bec7074 replied to AikoRN's topic in General Nursing

    I think it depends on where you work and how you get your assignment. I work in an ICU. We are split into teams. Each team gets a group report and hears the basics of each patient on their team. We...

  24. CCRN Practice Tests

    Bec7074 replied to DaughteroftheKing's topic in CCU, Coronary, Cardiac

    I passed the CCRN first try doing lots of practice questions. I did the Pass CCRN CD and the cardiac was hard. I prob did 50%on the CD and 85 on the legit exam. Remember they make the CCRN for ALL...

  25. Blood Stream Infections (BSI) in your unit

    Bec7074 replied to traumasurgRN's topic in Critical Care

    "Scrub the hub" for 15 seconds with alcohol, change IV tubing and caps q4days unless it's propofol (q12 hours), change central line dressings q7days unless there is a gauze over the insertion site...