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Reputation Activity by adjappleton

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  1. Like
    adjappleton got a reaction from ChrisT1 in Pre-Requisite Nursing Course with LAB?   
    New Mexico Junior College offers A&P I and II and Micro online - very good classes and very cheap.
  2. Like
    adjappleton reacted to Jedrnurse, BSN, RN in Resigning from my job   
    Take the lead and ask to meet with your manager when she gets back from vacation. Speaking to her in person is the classy thing to do.
  3. Like
    adjappleton reacted to beekee in Scared.....No Nursing?   
    From your previous posts, I've gathered you are very literal and a black/white thinker. Nothing wrong with that; in fact you can use it to your advantage. Try making algorithms for yourself when you get an abnormal lab value. Electrolytes, hemoglobin, WBC are probably the most common abnormal values.
    For example, if you get a low potassium level:
    1. Get a set of vitals.
    2. Assess for the signs/symptoms of low potassium (such as abnormal heart rhythms) and causes of low potassium (such as vomiting/diarrhea). You can make yourself a checklist so you don't forget.
    3. Look at what medications they are taking that might cause low potassium (such as lasix) and that might be adversely impacted by low potassium (such as digoxin)
    4. Make sure you don't have standing orders that address this lab value.
    5. Call physician with your findings, using SBAR format.
    So, your call to the doctor might go like this:
    S: I'm calling because Mary Smith in Room 22 has a potassium level of 2.7.
    B: Her current vitals are: _____. Her prior potassium level was 3.7, taken on November 13, 2018. She is on 40 mEq of IV lasix BID for a heart failure exacerbation.
    A: She is on telemetry and she had 7 beats of v-tach at 0835, otherwise she has been in sinus rhythm. No muscle weakness, myalgia or muscle cramps noted on assessment.
    R: Her creatinine is 1.02 and GFR is 54. Would you like to replace her potassium and recheck her potassium level in four hours?
    You can do this for vital signs out of range too.