SierraBravo

I LOVE, LOVE, LOVE this!

At end of life, patients will more often than not spike a severe fever (>40*C). It's likely not due to sepsis but rather the normal physiology of the body during the process of death.

Wow. Just. Wow.

A career in healthcare might not be your best option unless you can manage your disability and become somewhat of a "people person" as being a nurse or physician requires daily interaction with not only patients and families, but also various other members of the health care team.

Nice job. However, the CO2 level is primarily looking at acid/base balance, not necessarily lung and kidney function. The patient might have a mild alkalosis going on, but the rest of the labs look OK. Have you considered why the patient is on both a heparin drip AND warfarin? Remember that heparin drips are titrated based on the patient's aPTT, not the PT/INR. If the patient is on a heparin drip, why haven't they drawn an aPTT level?

I didn't learn this in my BSN program, nor have I learned it in my MSN NP program. To be honest, I don't even understand how you could even possibly palpate a cardiac valve? The aortic and pulmonic valves are underneath the rib cage, so how would you palpate those? This is so bizarre. Did you mean to say auscultate instead of palpate? Because then that would make sense.

I refuse to use the term "this writer" or "this nurse" or anything to that effect in my notes. It irritates the living daylights out of me. Whenever I read those terms in a note, it's like nails down a chalkboard for me.

1. The maximum rate that you can push lorazepam is 2mg/minute. And incidentally, it must be diluted with an equal volume of NS before pushing it. So if you have 1mL of lorazepam to give, you need to dilute it in at least 1mL of NS before pushing it. 2. Ibuprofen is not an anti-pyretic, so do you think this is an appropriate pharmacological intervention for someone with a fever? 3. First of all, you have to give the medication via the route that it was ordered. If you want to give it by another route, your provider must change the order to reflect the new route of administration. Like others said, it's not your call. However, if they do decide to give the furosemide IM, consider ADME (absorption, distribution, metabolism, excretion) with respect to that route of administration. Would absorption be different when giving the med IV vs. IM?

Can I like this 1000%? And I agree with everything everyone has said. Can't wait to finish my Masters and be a NP so that I don't have to deal with being a bedside nurse ever again.

THIS!!!

Do we work on the same unit?

Unless you're going to work in an ICU or step down unit, what would be the purpose of becoming familiar with ventilators? And if you're not working in an area where you will use that skill often, then just learning about it without practicing it often will not be very useful. So I guess I'm confused...

Just out of curiosity... Is this a for-profit nursing school?

If I were you, I would investigate the job market for PNP's before you begin the program. In my area, those jobs are virtually non-existent. You might be better off going for the FNP.

Part of the reason that it's so thick is because it is stored in the freezer in the pharmacy. I don't know how volatile it is in terms of waiting for it to come closer to room temp which might make it less viscous. In any event, while the treatment is undoubtedly painful, it's better than developing complications from untreated GAS.