tyrese

there is basically no specialties in nursing which you can "sleep" on the job...you are taking care of human lives here...pardon me...but how could you even ask such a question??? I am in the gastrosurg area for 8 years now...and I'm still learning new things always...I have never dreamt of coming to a point where I can "sleep" on the job..perhaps what you are asking is which specialty you can adpat well without a need for constant adaptation tochanges....in my opinion...its never possible..not in nursing....cos the medical field is always on an advancing phase......just my two cents worth...not trying to sound condescending here,,,,

HI I wonder if this is the right forum to ask this question.... What's the downside of working as a nurse in perth, Australia?.... I'm currently getting my work visa approved...but have been like hearing some stuff from a friend who's working at freo..So hope you guys could help me out... Is is true there's no one at all to help with bathing or bed bathing a patient ? Do local stuffs tend to go for "many frequent" breaks unofficially during work hours and get non local staffs to cover for them?? anyway...I understand that each country will have its own kinda pros and cons in the nursing culture... So I really hope someone can enlighten me on these issues...Just wanna know the truth so that i am prepared to face it when i come over to work... Anyone working at charlies????

if you would really like to know where the tube is really located at...why not try asking the doctors in charge???...is there any operative notes in the patients case file which you can actually look up?.....

BTw...in regards to T-tube....my pt has the tube with him for 183 days already.... IT functions like that of a normal drain...just that you could actually flush it....probably for long term useage according to my doctors... The t-tube might be actually darining at the duodenum/jejunum site...whereby...it is near the bile duct...as such...bile and intestinal fluids are usually drain out form the t-tube....the pt which i am taking care of still has draingage from the t-tube at 300 to 590 mls daily...yeah!!!...

J-tube is usually placed at the jejunum area and not at the esophagus. IT is usually placed at a position after the anastomotic site. The NGT usually goes into the esophageal region...they might even further introduce it the to the gi...but it is defintely not at a region lower than the J-tube. PUrpose : Fluid collection can occur after such a procedure.....especially bileous fluid....(I have a patient who is at his 183rd post surgery day with the Nasogastric tube still in situ,,,,and still has at least 20- 80 mls of ngt aspirate per day)) and it might take some time before it clears up....NGT also serves as a purpose to monitor for any leakage or bleeding if the anastomotic site gives way..... at present we are giving meds via NGT and feeds via j-tube...purpose to prevent clogging up of jtube. TPN usually administered only if there is a significant anastomotic leak or fissure that might have fomred post surgery. He's porbabaly in pain/diaphoresis due to setting in of infection/ gaping wound sites.... pain might pccur due to overactive bowel movements...loose stools/almost diarrhea like is exepected..you are right to say its dumping synddrome... what kinda feeds is he on?..you might want to refer him to a dietician to review his feeds....fori nstance..instead of full strength supplemnt feeds...change it to half strength...etc... Although loose watery stools are comoon expected effects of gastrec...do monitor for signs of dehydration.... Care of trachea is utmost impnt...active chest physio is needed to prevent onset of pnuemonia... PLAN : wound care to prevent further wound breakdown/further infection Tracheal care to maintain patent airway, minimise infection MOnitor for signs of sepsis occuring Active chest physio. Pain relief ( do u have a pain care team to review analgesias ?) MObilization as soon as pt is fit to do so. moniter jp drains for unsuall chyle like fluid - might indicate leak at anastomotic site...

iadditionally a mesentric angiogram might be done if no source of bleeding is found in the lower GI. IN regards to your dad's dizziness...its probably due to having a LOw HB, possible postural hypotension....but anyway...the nurse ought to have checked his bp for baseline. Serving the meds is not the point...as it only hleps to ease his symptoms... frankly..he should be RIB(rest in bed) and given bedside toilet priviledges. Anyway....hope your dad is better by the day. Take care

hey there..just for your info... Usually pt's with lower BGITs are monitored on hrly vital signs...and having their Full blood count taken usually once a day every monring subject to results obtained. Fluid challenge or blood transfusion are usually needed if too much bleeding occurs, HB blood serum is low, significant hypovolaemic state. pt 's are usually put on NBM(nil by mouth) and iv drip. Usually we insert an NGT and catheterise the pt. IN addition, a colonoscopy would usually be done either the next day if pt's condotion is stable or done as urgent. Usually to locate area of bleed..and source of bleed... pt would usually be placed on iv losec(omeperazole) conitnuous to protect the gi mucousal lining in view of a possible bleed due to ulcers.