All Content by grambograham
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Help with insulin question!! Please!
agreed... answer is D
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reality shock
Heart rates, if regular can be counted for 30 seconds or maybe 15 seconds. Newborns need a full minute at all times. They do not breathe or have a heart rate which is regular. They change second by second.
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canadian lpn not a "nurse"?
Hi, I'm a degreed nurse. I believe LPNs are nurses and I believe the CLPNA states the same. The LPNs are a great help and definately lighten the workload. Most are clever and perfectly capable of caring for semi-complex patients. To avoid stuffing my foot in my mouth, I will stop there.
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CRNE Prep Guide...am in second year now..so..
I wrote mine in June and didn't study. The questions are very specific to different areas ranging from ICU to STD nursing. Different than what I was told. It is not a general knowledge test. I'm not sure if studying will do that much.
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Titrating drugs: dosages or CC's
Look at it this way. You have a patient running 50mcg/hour of fentanyl which equates to 10cc/h. The next nurse you take report from says that the patients rate is now 5cc/h. What she hadn't told you is that she double strengthed the bag to lower the rate. The dose didn't change but the rate did. Dosage titrations are more exact.
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Phenytoin
I'd probably say 3rd degree AV block.
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Suggestions of New Stethoscope?
There is a notable difference between the Littmann Cardiology Master and the Cardiology III. I owned a master and now a cardiology III. I find the cardiology III is good but find the difficult quieter sounds harder to hear.
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Gcs
The verbal portion of this must be left out and therefore be out of 10. Assume a patient is A/O x 3 and is mumbling answers, but can write them down. GCS would not be 15. Verbal means Verbal. If the patient cannot verbalize, eg. dumb, or intubated, the 5 points are excluded and a "T" takes it's place.
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about digoxin level?
D is what I would choose.
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Croc shoes Worth it? Or forget it??
I don't where them as I am a man. I have heard nothing but good things about them. The one thing to be careful with is that dress protocol in hospitals often calls for a full heal and closed toe... Crocs often don't have these features.
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which shift do you prefer 3-11 or 11-7?
I work 0700-1900 or 1900-0700 in an ICU setting. I don't mind either. If I was in your situation, the 11-7 would be ideal.
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NS for CO
We use NS for our Swan.
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Titrating drugs: dosages or CC's
We use dose rate calculators. They are easier to adjust safely and can save a lot of time. This also allows you to "double strength" some medications to easily lower your fluid intake. It is important to be able to use dosages.
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Essentials of Critical Care Orientation via AACN online...
It was a great program. Sadly my region never kept up payments and I never got to finish.
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Level 1 too much for new grad?
ICU generally does not help with IV insertions. We rarely start them as most are given central lines when they get to the ICU or have numerous IVs when we admit them.
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Meds to know for the New Grad in ICU
Also look at phenylephrine, amiodarone, adenosine, furosemide, insulin, midazolam, pancuronium, succinylcholine, roccuronium and NMJBs in general. I probably duplicated a couple meds but I tried not to.
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EKG training and ACLS
I self-taught rhythms.... they are pretty simple. I am slowly learning the ACLS algorhythms. I think that they don't want to overwhelm you as ACLS is actually, as far as my experience goes, a small portion of the job. I will be attending codes to help my learning but will not take a lead role until I have taken and passed ACLS.
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Do you hire new grads in you ICU?
Yeah... and you are talking to one. I had to be screened and preceptored prior to working on my own. I had to prove competence and confidence in caring for vented patients, removing lines, sedating, paralyzing and all sorts of other things. It sounds as though the new-grads in your ICU either weren't meant for critical care or just never got the same support I did. I take no offense to your post... just answering.
- Why did you take up nursing? What's your story?
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What is "orientation?"
It depends on the unit you are in. ICU and the same provide longer and more in depth orientations than surgical or general medical floor. Mine lasted a couple months.
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Male Nursing
Male nurse... I despise the term. What makes nurses so different if they are men than if they were ladies. I am an ICU nurse and don't usually get that response. L&D wasn't bad but maternity was horrid. It was extremely boring and the same questions are asked at the same time every day.... yuck.
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What is Telemetry?
Just as the others said. Telemetry is hooking the patient up to an EKG of some sort and having that attached to a radio transmitter which can be read in a central location. Most likely the CCU or ICU.
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"Those who can, do. Those who can't..."
I hated medical, maternity and surgical. I found my niche in the ICU and pediatrics. Eventually, I will combine the two and move to a PICU. Keep looking, your niche is out there.
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RN to MD
I have thought about going to medical school. I may yet. I just enjoy nursing in the ICU too much right now. I think that my experiences as a nurse in critical care will help me if I become a doctor. I will understand the frustrations of nursing and how patients react. I will get a "gut feeling" of what patient outcomes are going to be.... etc..
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OB Clinicals
I don't agree that females don't like male nurses. The women I have cared for seem to like me being "their nurse." I have also talked to other women outside of the hospital and they claim that they like males more because they tend to be gentler and care more.