Nrs_angie BSN, RN

Nrs_angie has 2 years experience as a BSN, RN and specializes in Med-Surg, Tele, Vascular, Plastics.

Nrs_angie's Latest Activity

1. 

   Regular size BP cuff or the "LARGE ADULT" BP cuff??

   Nrs_angie posted a topic in Med-Surg

   When do you decide to go up to the LARGER ADULT size BP cuff?? All throughout nursing school and the time I have worked as an RN... No one has ever mentioned specifics of when the larger one should be used. It was explained to me that you "judge" by looking at the size of their arm... for instance a big muscular guy... or an older woman with more adipose tissue in the arm may need to go up to the bigger size. I have occassionally used the bigger size on my patients but usually, the regular size cuff fits fine. I know that not using the correct cuff can result in false readings... Do you go by the pt's weight? stature? Is there a website or an article that documents the OFFICIAL way?
2. 

   Question about collecting a 24 hour urine sample? Any help from a Renal/Urology nrs?

   Nrs_angie posted a topic in Urology

   Hello, Hopefully one of you Renal / Urology Nurses can help me... I am collecting a 24 hour urine onmyself for my OB/GYN, as I am 34 wks pregnant with proteinuria and elevated BP's. We are testing Creatinine Clearance and Total Protein. I woke up this morning, groggy, since I had not slept at all last night... being so tired I didn't realize that I was supposed to discard the first void... I already put it in the jug. Will this affect the test very much? Should I continue? Should I start it over tomorrow? Also, didn't even think about this until now... I ate alot of Easter Ham on sunday... and Alot of Easter Ham leftovers on Monday... maybe I ate too much... Should I worry this will affect the test... I read that one should not consume more than 8 oz of meat before the test... I probably did have more than 8 oz... im not sure. What to do? Thanks for any help.
3. 

   Question about infusion rate?

   Nrs_angie replied to mstaylor's topic in Med-Surg

   Michelle, Read some of my previous posts. I talk about a hospital that I used to work at where we would give Pre-filled drugs through a Bard Pump.... ect. Check it out, it was interesting
4. 

   Question about orientation

   Nrs_angie replied to mstaylor's topic in Med-Surg

   No problem! Glad I could help... If you have any more situations or dilemas and you want any opinion on how to handle it differently... please feel free to ask or email me. I had the same problem too... I was always running late because my preceptor was never around when I needed to ask a question... If i wasn't sure on a specific policy I couldn't find her and didn't know who to ask... After some time, I started getting more assertive... Also If i knew something was going to come up later on that I wasnt sure on... I started telling the Preceptor that she may want to stick around because I am going to need help with the XYZ or ABC... Keep us updated!
5. 

   16 wks pregnant w/ possible Preeclampsia. Will I be put on Bedrest?

   Nrs_angie posted a topic in Ob/Gyn

   Hello all you L&D girls... Im a med-surg nurse, so Im not very familiar with the pregnancy protocols... At my Belly Check yesteray, I had 2+ protein in urine... First BP check Systole was 142... don't remember the diastole reading... on recheck the Systole was 138... not sure of the diastole reading... I go back again next week for another check. Also at my previous appointment... I had 2+ protein in urine, but the BP was 118 over something... so they did not mention the protein in the urine to me. What are the chances I will be put on bedrest? This is making me nuts, since I had been out of work 6 mos... to take care of my mom who's got Metastatic CA... and I am supposed to be starting a new job next week... I really need to work... I need benefits and I am in major debt... plus the Father went MIA... so I have no help there. I am sooo terrified for the baby's health... and also worried about my ability to provide financial support... If I go on bedrest, that means no job, no money, more debt, and no health benefits... Sorry for ranting... Im just scared... Has anyone else gone through this? Is there any chance that the doctor will allow me to continue working and not go on bedrest???
6. 

   Why do docs give D5 to diabetic patients a lot?

   Nrs_angie replied to Shell5's topic in Med-Surg

   D50 is 50% dextrose as opposed to the D5 which is 5% dextrose... the D50 should be ordered on a PRN basis for all Diabetics on insulin... if their BG drops, and they are unresponsive or unable to take food/drink by mouth the D50 which comes in an amp and its very thick and syruppy is pushed rapidly through an IV line... it acts almost instantly to bring blood glucose up in an emergency situation
7. 

   Poor care post surgery

   Nrs_angie replied to bradleau's topic in Nursing

   12 hour shifts makes more sense now... but im still very curious... when you and your husband both repeatedly asked for pain med... what was the nurse's response? Did she just outright ignore it? Did she say NO? Did she give a reason? I am dying to know the nurse's reason on why they made you wait... then came back much later and said Why didn't you ask sooner? If the problem was because it takes 30 minutes for the orders to come through.. well what about after 30 minutes... it sounds like you waited much longer than that??? If this nurse ignored you with no good reason... it should be a definite WRITE UP!
8. 

   Poor care post surgery

   Nrs_angie replied to bradleau's topic in Nursing

   im just confused... there's alot of mention about the night nurse... I am assuming she didn't start her shift until 2300... so where was the evening nurse that received you immediately post-operatively following PACU... shouldn't the evening nurse been giving you meds during her shift?? ... if you did ask for pain meds and your husband asked for pain meds... What was the nurses response??? Did they just ignore the requests... or did they give a reason for not giving them... I wasn't there, so I can only speak from my experience... When I was on evening shift, I had gotten alot of post-op patients... first I would check to see what meds they got in the OR & PACU to see if enough time had passed btw pain meds and if it was appropriate to give another dose at the time they requested... if it was too soon, I would explain that and tell them what time exactly they could have another dose? Did that NOT happen?? Im very confused why the previous nurse said nothing/did nothing... and why the night nurse had to come talk to you?? Is there something I am missing here? I also agree that IM morphine is outdated... It should have been IV morphine since you already had a patent line with fluids running all through that time... that's so weird they were giving IM. Not to make light of things... but it's too bad you weren't nauseated and vomitting everywhere... If you were vomitting all over the place, I'd bet they would run to get some Zophran so they wouldn't have a mess to clean up. hehe. Again, im not making a joke of your pain... just saying that it seems people work faster when it comes down to having a mess to clean up. Anyway... Im sorry that you suffered in pain so long... Hope you are doing better now. Happy Holidays, Angie
9. 

   Changing a patient's diaper while they are standing ?

   Nrs_angie replied to EmBeMap's topic in CNA/MA

   I dont work in LTC, but I work in a hospital... I guess it all depends on the situation... Once a very confused and weak patient was told not to get out of bed with help. The bed check was alarming all night. Once, I went in and she was attempting to get out of bed and already had one foot on the floor. She had a bad diarrhea episode. It was running all over the place, looked like a **** explosion. Me and the tech asked her to get back in bed several times so we could clean her. But with her being confused, she didn't understand and insisted on walking to the BR. The **** just kept coming and coming and we had no choice but to let her walk in the BR and stand while we cleaned her up... fortunately, she wasn't as weak as I thought she was... she stood there the whole time... I was afraid she'd fall but she was fine. Now that situation aside... I dont recommend this as a standard practice... if the BM were to drip or fall on the floor and the patient stepped in it.. they would slip, fall, and break a hip. Not good! It's just that much easier to have them lay in bed, and roll side to side as they are cleaned and the old brief is taken out and a new one put on.
10. 

    Canadian nurse needs tips on passing the NCLEX (I failed it 2X's)

    Nrs_angie replied to Hieb's topic in NCLEX

    FOCUS ON ABCs AND SAFETY. WHEN YOU NARROW IT DOWN TO TWO CORRECT ANSWERS.. ASK YOURSELF IF EITHER RELATES TO AIRWAY, BREATHING, CIRCULATION OR SAFETY. THOSE ARE VERY HIGH PRIORITY TO THE NCLEX TEST MAKERS.
11. 

    drugs encountered in NCLEX?

    Nrs_angie replied to angel wifey's topic in NCLEX

    Hey CT... You are absolutely right... I already posted my experience with Cyalis before I read your post... Honestly... I dont remember having any med questions... If I had to guess... I would say that I had 3 or 4 out of 75 questions... but the one I remember was Cyalis. Too bad I never studied it in school... I guessed at the answer and have no idea if i was right.
12. 

    drugs encountered in NCLEX?

    Nrs_angie replied to angel wifey's topic in NCLEX

    i took the test 2 years ago... but i really don't remember having alot of drug questions... most of mine were critical thinking types and patient scenarios one weird one that stood out was a question about cyalis...not sure of the spelling... i never gave it while in school and never learned about it... i just saw the ads on tv... its the erectile dysfunction drug... thats all i knew. have no idea if i got the question right or not...
13. 

    Calculation

    Nrs_angie replied to redneckrn2b's topic in Student Assist

    nn nn nn
14. 

    Calculation

    Nrs_angie replied to redneckrn2b's topic in Student Assist

    Thank you... I was starting to feel OLD ewwwww
15. 

    Metformin

    Nrs_angie replied to Toothbrushx2's topic in Endocrine

    49 sounds like hypoglycemia to me personally I would hold the metformin and any other oral hypoglycemic meds doesn't matter how long acting the med is... it will cause a further drop in blood sugar if blood sugar comes back up to the 100s around lunch time... then I would give it
16. 

    Would you give 25u Reg Ins IV?

    Nrs_angie replied to Shell5's topic in Endocrine

    I am sure that he meant SQ not IV.... im pretty sure the rule for SQ is you can give up to 30 u of regular insulin SQ. So I would call to clarify the order and route. but actually I work on Med-surg where they do hang Insulin drips... so yes it does happen. but, but, but, 25 u IV is kinda high unless the patient weighs 550 lbs.... initial treatment for DKA is a IV bolus dose of 0.1u /kg followed by a drip of 0.1u/kg/hr a 220 lb person would get a bolus of 10 u... and then followed by 10 u/hr drip also with HHNS the glucose can be much higher than with DKA... even then the initial insulin dose is no more than 10 u/hr Oh I just noticed that you said the patients glucose was 400... thats not DKA yet... DKA usually begins around 600 or 700 and HHNS usually begins around 800 or 900 So, for a glucose of 400... 25 units of SQ insulin (not IV) is probably acceptable... but I would start by giving only 10 at a time... and recheck in an hour... if still high give another 10 and recheck in an hour... then call the doc and get an order for a BMP lab.