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SierraBravo has 3 years experience.

SierraBravo's Latest Activity

  1. SierraBravo

    Welcome To The Hospital - From Your Nurse

    I LOVE, LOVE, LOVE this!
  2. SierraBravo

    What do you know/have you been taught about Sepsis?

    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.
  3. SierraBravo

    Failed, nclex rn 5 times! Help?!?!

    Wow. Just. Wow.
  4. SierraBravo

    EKG help!

    What exactly are you struggling with?
  5. SierraBravo

    BSN vs MD?

    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.
  6. SierraBravo

    Blood pressure and heart rate

    Systolic BP is driven by cardiac output (CO). CO is the product of stroke volume X heart rate. Stroke volume is determined by preload, afterload, and contractility. Diastolic BP is driven by norepinephrine.
  7. SierraBravo

    Proofreading Lab Values and Meanings

    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?
  8. SierraBravo

    Palpate Cardiac Valves IRL?

    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.
  9. SierraBravo

    online organic chem at OSU

    I give you alot of credit for attempting to take this class online. I had no idea it was even offered online. I actually took a year of organic chemistry for my first Bachelors degree and I can't even imagine attempting to take this class online. Also, there must not be a lab component if the class is online which may or may not affect the CRNA school accepting that class as a valid pre-requisite.
  10. SierraBravo

    narrative documentation and use of "this nurse"

    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.
  11. SierraBravo

    Need advice about unethical nurse

    A nurse witnessing the waste is signing for exactly that, they are witnessing that the other nurse actually wasted the unneeded amount of drug from the pyxis. In no way, shape, or form is the witnessing nurse liable for what the initial nurse does with that dose. Of course, unless they actually tell you that they're not going to give it to the intended patient, they are stealing it, etc... In that case I could see the witnessing nurse being held liable for something since they had knowledge of the initial nurses intent to deceive. In this case, I wouldn't witness waste with that nurse just because you have a bad gut feeling about her honesty and integrity.
  12. SierraBravo

    Medication Calc/Administration Help!

    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?
  13. SierraBravo

    Price of Patient Satisfaction

    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.
  14. SierraBravo

    What do you think? Unprofessional?

    Do we work on the same unit?
  15. SierraBravo

    Vent Training

    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...