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I once gave amoxicillin to someone with a penicillin allergy. He went into anaphylactic shock. Luckily, a good shot of epi saved the patient's behind (and mine). We all make mistakes. The trick is to not repeat it.

Why was the patient admitted to hospital? The thing is, if the patient was already on warfarin (with therapeutic INR) AND developed a VTE, the treatment is still UH/LMWH. However, if the INR is supratherapeutic, then you will stop the warfarin (or at least decrease the dose) and allow the INR to return to the target range, but you will still need to give UH/LMWH to treat the VTE. Also, the reason you bridge warfarin with UH/LMWH is that warfarin is a (paradoxically) procoagulant initially (as it inhibits protein c synthesis), and the bridging is there to prevent clots while awaiting the inhibition of procoagulant factor synthesis.

Generally, if the potassium is >3, and patient is asymptomatic, otherwise well (eg no ongoing diarrhoea, no renal dysfunction etc.), with no ECG changes and not on a K-lowering drug, I don't get terribly excited. Just give the patient an extra banana or something :) As a general rule, you will need to intake 100mmol (mEq) of K to raise the serum concentration by 0.3mmol/L, assuming no ongoing losses.

With all due respect, I think you need to find a new pet peeve to 'hate'. Why are you annoyed that certain nursing students are planning on going into medicine? Maybe they started nursing and realised they liked being a MD more? And their career aspirations has nothing to do with you. Would you be annoyed if they said they wanted to be an engineer or lawyer?

I'm BSN (2007) and MD (2012). It's not impossible, you just need to put in the hard yards. One thing that really annoyed me was the cold shoulder I got from my colleagues after they found out I got accepted into med school. During one particular shift, I asked for some help regarding a patient from a senior RN, and she actually said 'why should we help you when you think you are too good for us.' I am proud to be a RN. I am proud to be a MD. I moonlighted as a RN during medical school (and interestingly, still do the occasional RN shift now as a 1st year resident). They are different but complementing professions. To nursing students: please do not say you are going to 'medical school' if you are studying nursing. Be proud you are studying nursing, it is an extremely worthwhile profession and it is by no means second fiddle to MD. To the RNs who want to become a MD, do not let others discourage you, pursue your dreams, you will be an excellent clinician given your dual backgrounds, and your patients will reap the benefits.

The funny thing is that the amount of formal ECG training I received in medical school wasn't actually that much more than what I received in nursing school. The main difference is that I read a lot more ECGs as a medical student (and even more now as an ED resident) than when I was practicing nursing. It really is one of those skills that you rapidly forget if you don't use it. Case in point: I showed a trace to my friend who is a PGY4 radiology resident and he had no idea what the trace was. As a RN, while you do not necessarily need to know the trace is a multifocal atrial tachycardia with posterior hemiblock, you would be extremely useful if you are able to pick up simple abnormalities, such as basic arrhythmias, ST segment/TW changes, and QT changes.

The COX-1 inhibition property of NSAIDs occurs after the drug is digested, absorbed into the blood, then reaches the appropriate cells in the body that produces prostaglandins. So yes, you should still give food (or better yet, PPI/H2B) with NSAID administration via any route.

There is really nothing to dicuss here. You will look after him just as you would with any other patient. You may not like it, but this is what we in healthcare do. You are not a judge or jury.