Bec7074

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 UA came back positive for Many bacteria, WBC, nitra...

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 shift. On nights, All full or part time staff, excep...

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 metabolism (lack of O2 to tissues when you code). As a...

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 took him to IR. I'd imagine all his body systems w...

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 peeing and reading his Kindle....not the kinda pat...

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

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 them at night and more during the day, so yes their...

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 give kudos to all families/patients that know wha...

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 susceptible organ to hypoperfusion. Her kidneys ...

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 acidosis/hypotensive once that her pressure would bottom out the se...

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 specific.

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 listening to their back if possible...sounds are usual...

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 something like frequent PVCs are normal or abnormal for ...

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 thus, cardiac output decreases. I've seen it take a ...

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 cause pulmonary hypertension.

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

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 experience. You'll know when you've gained both of th...

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 spending a lot of money was necessary.

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. And this facility says 2 separate lines is not ok ev...

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 decision (and to each their own) and it's your job...

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 create more pauses By slowing the conduction. Withou...

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 professors? Previous employers? Or, be honest with ur curr...

On a side note I think it's great you care so much about this lady and want to learn. I had many similar situations when I started and still do on occasion. Some pts don't make sense even to docs. What did RRT do!!? Any additional tests or ABG or any...

First of all, low sats are not related to low hgb. This is a big misconception in nursing. I had a doc explain it to me once (cuz I too used to get confused). Low hgb is having less trucks on the highway but they can still carry the same load. Sats ...

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 get a small spreadsheet of information on all the...