Mrsjonesgilbert

Thank you so much, luv this site

I am a fairly new nurse with 3 years experience of cardiac surgery. I have always been interested in hemodialysis and since my floor is becoming extremely heavy and overwhelming I think it's time to move onto something new, plus I'm a mom of two toddlers and would like steady hours...In a hospital setting where I work I know there will be in and out-patients. What is a typical day like? You weight the patient, compare that weight with the previous weight in order to tell how much they've gained. How much fluid do you remove? Is it you that determines it or the doctor? How often are you doing bp checks? The dialysis machine looks extremely intimidating the only thing I know is that you have to heparin it and I think I remember seeing bottles of sodium bicarbonate?? Do your sterile kits come pre-packaged or do you have to prepare them? I know time management is a biggie because if you have 4 patients per 8 hour shift then you don't have a minute to spare especially when problems arise...Anything you could tell me about the unit would be much appreciated and be detailed please. I did a stage about 6-7 years ago for 3 weeks but don't really remember anything about it. I know I have to go to the medical library and pull out the big book of nephrology. I am really trying to do my research here and asking people at the hospital how it really functions. I think my ward is bad but I don't want to jump out of the frying pan into the fire either..lol

Hi Scott can you reply to my post below I have another question for you. Thanks

Wait a minute, Scott you said sotolol can also affect the Qtc. But sotolol is a beta blocker just like metropolol. Can you clarify?

Thank you so much

On report I was told that the morning dose of Amnio po was held because the qtc was elevated. An EKG was ordered and done. (NSR) I calculated the qtc to be 0.49 The patient was scheduled to have another dose of Amnio at noon. I informed the nurse practioner and she d/c ed the Amnio because a high qtc is 0.50 The patient was also on Metropolol. Why didn't she d/c that too? Dose only anti-arryhmia affect the qtc and what does it do?. I tryed to google it but the language was too confusing for me. I'm glad I had this patient because now I will always calculate the Qtc, something I am not use to doing.

Thank you for your responses. I understand it so much clearer now. The last I heard about the patient was that he was in ICU with a balloon pump (IABP) for low cardiac output following the surgery. So I gather that he wasn't doing too good. Well after ICU I hope to see him back on the floor soon post-op. thanks again you nurses are amazing. I luv this site.

I am preparing my patient for CABG in AM: EKG done,bloods drawn (CBC, chem7, Coags, & crosshatch for 4units, type and screen) CxR done, 1st shower with antimicrobial soap done, Swabs done( MRSA,VRE,etc), Weigh patient, Set up telemetry, NPO @ Midnight, Echo to do in am..... So now I get to my medication list and find out that patient received Effient drug in emerge this morning. (This drug is the equivalent to PLAVIX). Now I know that it's supposed to be stopped 7 days before OR on our floor. I call the doctor to tell him, thinking that the OR will be cancelled but he agrees to go ahead with the surgery anyways. I made sure to document it in my notes. I was told that the reason you stop Plavix days before surgery was to decrease or prevent post-operative bleeding. So my question is this I've seen patients scheduled for CABG in A-fib on a heparin drip till 6am. (2 hours before surgery). AREN'T THEY AT INCREASED RISK OF POST-OPERATIVE BLEEDING Too? Why all the big fuss about Plavix. Why is more importance put on the patient who is not suppose to Be taking PLAVIX pre-op. I know it's an anti platlet but doesn't it also act as an anticoagulant/blood thinner? To prevent clot formation or platlet aggregation? Please enlighten me......Thanks

Ok I'm a new cardiac nurse, so not familiar with urology procedures at all. My patient came to me with a right double j stent. History of colon ca and ovarion ca. The nurse that gave me the report said that the tumor is probably obstructing the ureter. Now since I didn't know what a double J was, I had to look it up. Now my question is this. If a tube is inserted into the ureter to drain the urine into a foley bag, does the patient still have the ability to void. I thought no, but then the patient ask me to use the bedpan to pee? I guess it is possible to void because she has only one tube going into her right ureter. Her left ureter is probably functioning fine to allow the urine to flow to her bladder on the left side....I'm really not sure. I googled it and some sites said it all depends on what kind of tubes the patient has??.....What does a double J stand for. I thought it went to both ureters but it doesn't. Can somebody with some experience on these tubes help?? Also the doctor didn't re-order Iv fluids. When I looked up on-line it says to hydrate patient post 0-24h after the procedure. The patient came to me with a practically empty bag of NS via gravity. I put a new bag up of NS via the pump and ran it at KVO(30cc/h) This patient came to me at the end of my shift so I did as much as I could and informed the next nurse of the orders or there lack of and she would have to call the M.D for the remaining issues. Your responses are much appreciated, thanks in advance.

Patient going for an angiogram who is allergic to Iodine on our floor must be given 2 doses of Prednisone before and after the procedure. I looked up prednisone and under the label it says that this drug can be used to treat allergic reactions but I do not fully understand the pathophysiology. I know that Prednisone is a corticosteroid and that it decreases inflammation in the body. But I don't understand the relationship between giving this drug to stop anaphalytic reaction or skin reaction. Can someone break it down to me?