Maria1308

Hello was wondering if I could get someone to help me understand blood cultures and contaminants. I’m a fairly new nurse working in the hospital setting and took care of an adult patient who was admitted to the hospital for bacteremia. Pt was admitted for fever (unsure of the temp), back ache, and headache. A set of blood cultures were drawn and the patient was discharged on amoxicillin. Well patient was called to come back bc the second blood culture grew out gram negative cocci. The patient no longer had any of the ssx she’d originally came in for with the exception of HA and back pain but was admitted anyway bc of the blood culture and receivers antibiotics. All other labs were normal and she remained afebrile. The night nurse came in and after giving report to her, she stated that she felt that it may have been a contaminant bc it was gram negative rods. My question is how do you determine if a blood culture is a contaminant?? Is gram negative rods a rare blood culture result. Attending thought the same and reordered a blood culture draw. Blood cultures always confuse me.

Working at a clinic as a nurse. There is an older lady (I think 64 yo) that would comes in complaining of high blood pressure readings at home (especially early mornings upon awaking), lower back pain, and occasionally upper abdominal pain. and we recently discovered that she had a positive test (*3) result of occult blood (stool). I feel so bad for this lady because she has no family and have a hard time hearing or understanding our doc. Our doc increased her dosage of beta-blocker and losartan and ordered a EGD but not a colonoscopy and sent her home to follow up in four weeks. Well she came back for her scheduled office visit and our doctor found out she went to see an allergist three days ago who gave her antibiotics and sinus spray for a sinus infection. Well our doc basically scolded her (like literally made her feel like a child) for seeing another doctor. Long story short she came out teary eyed and basically asked to cancel all future appts as she no longer wished to see our doctor. Well I left out the fact that this woman lives about two houses down from me. I’m wondering what can be going on with her as to why her blood pressures are still high. I feel that she definitely needs a colonoscopy and a egd. Any idea. I honestly don’t think she’s going to go to any doctor from the sound of it and I’ve been trying to convince her to at least see someone else. I also wonder if the losartan she has is one that have been recalled.

Wanted to ask if anyone knew any effects of issuing a blood transfusion too fast besides the obvious ones that are easily found or included in text. What happened is my patients was admitted for a Hemoglobin level of 3.2. This was his first time to receive a blood transfusion. Only 1 unit was transfused at a time over four hours. I ran it at 50 over the first 15 minutes and patient had no issues. Turned it up to 90 ml/hr and after it was done his hemoglobin ( after two hours h&h was done) it only went from 3.2 to 4.7 after a unit of blood or (250 mls) were given. Couod there be a reason why it only went up so little.

Thank you 🙏🏾 so much. I'm always confused as to if the bolus would cause the iv to go bad or being that the patients are small, fluid volume overload can occur.

I'm a new nurse tech in the pediatric department. Normally the nurses do not like to run fluids on infants or newborns at a high rate because these patients veins are small and the risk of blowing the vein is high when the rate is high. I'm a little confused as to what happens when an infant would need a bolus of fluids for rehydration. Wouldn't the rate for the bolus be higher. The bolus is normally given prior to the patients admission in the pediatric area. Was wondering how is it done at other facilities?

Yes, it was mg not grams! Which in my opinion 2mg was ok for a 310 lb patient. Sorry for the typo and I sincerely appreciate your response.

Was wondering if someone could provide me with some good advice as I am concerned about something that happened at the hospital where I work. Hx: I have been a nurse for a year now. I participated (for the first time) in assisting in a lumbar puncture on a 17 year old patient who came in with HA. They dx'd this patient with peusdotumor cerebra. What happened: During the LP procedure, I was told to administer 2 grams of Versed iv push (1 gram at about 40 minutes apart) to the patient to help calm her, as the procedure was traumatizing. Unaware of the policy regarding the areas Versed could be administered, I gave this med to the patient. The patient was not on a monitor, however I did take vital signs before/after the LP procedure and the patient was stable. The patient was transferred 20 minutes later to an icu for close monitoring. Concern: After procedure, the next day word got out (apparently by my co-worker who worked with me that night, but didn't know the policy either) that the physician (who none of the nurses like) ordered me to administer Versed on my floor when it should have been administers in the PICU where the patient should have been on a monitor during administration. Now word has gotten out to everyone in my area and PICU area about what happened. Most of the nurses feel I should report the ordering physician to administration, (not only bc they felt it was unsafe but more so because they want to get this physician in trouble. Adamant about not reporting the doctor, I felt by me reporting the event, I would also be held accountable and get in trouble bc I didn't know the policy. Well, one of the nurses who wasn't even present during the event took it upon her self to not only go to the manager of our area but also discuss what took place to the CNO (chief nursing officer). Now in my opinion, it makes it seem as if I was hiding or keeping them from knowing what happened, because I didn't report it to anyone. Im not really sure what I should do next and it's really stressing me out.

Was wondering if someone could provide me with some good advice as I am concerned about something that happened at the hospital where I work. Hx: I have been a nurse for a year now. I participated (for the first time) in assisting in a lumbar puncture on a 17 year old patient who came in with HA. They dx'd this patient with peusdotumor cerebra. What happened: During the LP procedure, I was told to administer 2 grams of Versed iv push (1 gram at about 40 minutes apart) to the patient to help calm her, as the procedure was traumatizing. Unaware of the policy regarding the areas Versed could be administered, I gave this med to the patient. The patient was not on a monitor, however I did take vital signs before/after the LP procedure and the patient was stable. The patient was transferred 20 minutes later to an icu for close monitoring. Concern: After the procedure, the next day word got out (apparently by my co-worker who worked with me that night, but didn't know the policy either) that the physician (who none of the nurses like) ordered me to administer Versed on my floor when it should have been administered in the PICU where the patient should have been on a monitor during administration. Now word has gotten out to everyone in my area and PICU area about what happened. Most of the nurses feel I should report the ordering physician to my manager, (not only bc they felt it was unsafe but more so, in my opinion, because they want to get this physician in trouble). Adamant about not reporting the doctor, I felt by me reporting the event, I would also be held accountable and get in trouble bc I didn't know the policy. Well, one of the nurses who wasn't present during the event, took it upon herself to not only go to the manager of our area but also discuss what took place to the CNO (chief nursing officer). Now in my opinion, it makes it seem as if I was hiding or keeping them from knowing what happened, because I didn't report it to anyone yet. I'm not really sure what I should do next and it's really stressing me out bc I hate confrontation. I also don't want to get anyone in trouble, especially since the patient was ok afterwards.