Keysnurse2008

Keysnurse2008

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All Content by Keysnurse2008

  1. Ruptured AVM

    Keysnurse2008 replied to Mommy_of_3_in_AL..RN's topic in Neuro Intensive Care, ICU

    No response to cold colourics...she unfortunately is dead. What the family needs to hear is the truth. In a quiet respectful way. They have to be told about the flat EEG etc etc. But to make it simple...

  2. Fired or Resign?

    Keysnurse2008 replied to iahi_2005's topic in General Nursing

    You know I was a faciltator in a hospital where we intervewed new grads each month during their 1st year to see why most of them were leaving , as they tend to do. The one thing I heard month after...

  3. Fired or Resign?

    Keysnurse2008 replied to iahi_2005's topic in General Nursing

    i HAVE A SHEET i give to new grads that helps them get organized. It is basically a fillin the blank report sheet and a to do list for the shift. If u want a copy PM me and I will send it to you...

  4. Fired or Resign?

    Keysnurse2008 replied to iahi_2005's topic in General Nursing

    critical thinking - use your abc's. airway- what are the sats- how fast are they breathing? if these are below the acceptable ranges notify the md immediately. look at how they are breathing....are...

  5. nonrebreather-how long, and what should be next

    Keysnurse2008 replied to luce2008's topic in Patient Safety Issues

    Hi...to my knowledge there is NO time restriction on non rebreathers. They can stay on it till...whenever. But the next step is not always intubation...they could go on cpap/bipap. And ....it is...

  6. Fired or Resign?

    Keysnurse2008 replied to iahi_2005's topic in General Nursing

    First if all.....did they give you a list of their specific concerns? What type unit do you work on? If the list consists of things that are knowledge deficit related, like specific procedures or...

  7. My 9 year old patient was raped and required surgery

    Keysnurse2008 replied to ssouthernyankee's topic in Patient Safety Issues

    omg......how horrible. what kind of monster does that ? i am so sorry.......i could never do ped's bc of things like this. hats off to the ones that can. she is lucky to have you as her

  8. Meds. via Dobhoff feeding tubes

    Keysnurse2008 replied to MChambers's topic in Patient Safety Issues

    dhts usually float past the stomach...so typically you should not get

  9. Meds. via Dobhoff feeding tubes

    Keysnurse2008 replied to MChambers's topic in Patient Safety Issues

    dht's are for short term use anyway. i give meds all the time through them. if they clog....and btw they wont usually if you crush your meds finely and flush them adequately...but if they did....just...

  10. Respiratory question

    Keysnurse2008 replied to amandajane's topic in General Nursing

    With Atelectasis - you will hear diminished or no breath sounds when they inhale deeply. With pneumonia when they inhale deeply , listen carefully to the breath sounds . At the end of that inspiratory...

  11. fentanyl drip in an IVP or CADD pump

    Keysnurse2008 replied to Zookeeper3's topic in MICU, SICU

    Sorry ...I just saw the diluadid part. Diluadid is always on a PCA at our hospital. Lg glass amps...pharmacy doesnt mix the diluadid...so it goes in the PCA every time. Our pharmacy "allows" us 12 ml...

  12. fentanyl drip in an IVP or CADD pump

    Keysnurse2008 replied to Zookeeper3's topic in MICU, SICU

    Fentanyl drips - 1000mcg/ 100ml ...or in RF patients we do 3000mcg/ 100 ml to limit fluid intake. We just hang our on a regular IV pump, not a PCA. But...we do alot of procedures at the bedside ,...

  13. How high have you titrated levophed?

    Keysnurse2008 replied to racing-mom4's topic in MICU, SICU

    Ps. You did fine. The only suggestion I would have is to have had the ER doc come write you an order to titrate at " X max rate". I reaD where you said you were worried you had done something wrong....

  14. How high have you titrated levophed?

    Keysnurse2008 replied to racing-mom4's topic in MICU, SICU

    amen! the physician should have been present. i say in situations like this....know your facilities policy on that drug...and when they are going down the tubes and the md is asking you to exceed your...

  15. How high have you titrated levophed?

    Keysnurse2008 replied to racing-mom4's topic in MICU, SICU

    Never be afraid to "suggest" adding another pressor. But my best advice is know your facilities policy on levo. Most places the max is 30 mcg . I have titrated up to 40....but I didnt do that till the...

  16. Coverd by doctor order beetwen nurse judgement and and I don't care I am coverd

    Keysnurse2008 replied to zuzi's topic in General Nursing

    Iam so sorry. I hate to say this....but it may be professional jelousy. It sounds like they may be a lil lacking in current knowledge of what can happen when a DVT moves. A PE has a high mortality...

  17. Coverd by doctor order beetwen nurse judgement and and I don't care I am coverd

    Keysnurse2008 replied to zuzi's topic in General Nursing

    Exactly....you are right. Patient ideally should have been started on anticoagulant immediately. But were there other issues? Did they have liver failure/cirrhosis.....were the PLTs crisis level low?...

  18. negligence vs. malpractice??

    Keysnurse2008 replied to driveinstyle2005's topic in General Nursing

    no ...professional negligence falls under malpractice. when you are caring for a patient and you fail to act that is negligence and it falls under the overall scope of malpractice. think of...

  19. Anesthesia Consents- question

    Keysnurse2008 replied to Keysnurse2008's topic in Certified Registered Nurse Anesthetist, CRNA

    absolutely i extremely extremely overexaggerated to make my point. i have had srnas that were more attentive and just as skilled as the attending anesthesiologist....and same thing for the...

  20. negligence vs. malpractice??

    Keysnurse2008 replied to driveinstyle2005's topic in General Nursing

    Negligence is failure to act/ report......an example is your pt's blood pressure keeps dropping from 130/ 70 to now 76/42 as the pt keeps vomiting. You decide to wait an hour to contact the MD and...

  21. Anesthesia Consents- question

    Keysnurse2008 replied to Keysnurse2008's topic in Certified Registered Nurse Anesthetist, CRNA

    like you said the surgeon creates liability for himself when he misleads / aka untruthfully states he will be the one doing the surgery. you see......he had a choice. he could have chosen to tell the...

  22. Why would you place a OGT and give zofran in the middle of a surgery?

    Keysnurse2008 replied to Keysnurse2008's topic in Certified Registered Nurse Anesthetist, CRNA

    hi...no problem. i will answer this. my initial question was "why would you place and ogt intra op and give zofran?". i asked ...bc i wanted to know. i did not know if this was common practice or not....

  23. Anesthesia Consents- question

    Keysnurse2008 replied to Keysnurse2008's topic in Certified Registered Nurse Anesthetist, CRNA

    even in a teaching hospital , you have the right to a say in your care. you have the right to be told truthfully who is participating in your care and to refuse care from a person who is " still...

  24. Anesthesia Consents- question

    Keysnurse2008 replied to Keysnurse2008's topic in Certified Registered Nurse Anesthetist, CRNA

    my wife actually had a procedure done at our hospital too. the anesthesiologist said he was doing her case,...in the end even after we had specifically said "no" to a student srna he let the srna do...

  25. Anesthesia Consents- question

    Keysnurse2008 replied to Keysnurse2008's topic in Certified Registered Nurse Anesthetist, CRNA

    That is probably correct,....it probably does have that his/her associates can do the case. Thanks! But I cant help but think that most people are not reading the fine print there.....and it is kinda...