SEOBowhntr

SEOBowhntr

Cardiac, Post Anesthesia, ICU, ER

Member

  • Content

    180

  • Visitors

    4,809

  • Followers

    0

  • Likes

    2

All Content by SEOBowhntr

  1. Jcaho Medication Reconciliation

    SEOBowhntr posted a topic in Patient Medications

    Recently our facility have implemented a plan of MEDICATION RECONCILIATION in which the nurse is required to provide rationales for why a physician did not continue a patient's home medications, and...

  2. Pulling Sheaths on a Cardiac Stepdown

    SEOBowhntr replied to ItalianRN's topic in CCU, Coronary, Cardiac

    Good Post, pretty much sums up my thoughts. Having been pulling sheaths for just over 13yrs, I've seen quite a few go very easy, and I've seen quite a few go terribly wrong. If you're staffed 5-6...

  3. What to expect after CABG

    SEOBowhntr replied to Mommy_of_3_in_AL..RN's topic in CCU, Coronary, Cardiac

    Mom'o'3, You can expect your Dad to have all of those things you mention, vent, drain tubes, even probably a couple of epicardial pacing wires. But MOST of the time, the ET Tube and Vent will be long...

  4. A Good CCRN Prep?

    SEOBowhntr replied to Flightline's topic in CCU, Coronary, Cardiac

    Med-Ed has a pretty good review course that they offer various places. I attended one for my PCCN, and my wife for CCRN, and we both like "Cammy" House-Francher a little better than Laura Gasparis....

  5. Does your facility aspirate blood before removing a sheath?

    SEOBowhntr replied to ALCCRN's topic in CCU, Coronary, Cardiac

    In all honesty, I think it's more likely "Dumb School." I can't imagine what a lot of people are thinking, then there are some I can't imagine are capable of

  6. elevated troponin cause

    SEOBowhntr replied to JessicRN's topic in CCU, Coronary, Cardiac

    Most people don't really understand Troponin. Troponins can elevate anytime the heart is overstressed and may become mildly hypoxic or poorly perfused. Cocaine use can cause it d/t the extreme...

  7. Does your facility aspirate blood before removing a sheath?

    SEOBowhntr replied to ALCCRN's topic in CCU, Coronary, Cardiac

    Not really necessary but it's not going to hurt anything to do it. Having someone keep negative pressure with a syringe while another pulls sounds a bit ludicrous to me. I've pulled a BUNCH of them...

  8. arterial & venous sheath

    SEOBowhntr replied to boknoy26's topic in CCU, Coronary, Cardiac

    Several good suggestions. I always had the NAVY thing as well, but I agree, they can be difficult to determine, especially if the physician sticks them right on top of each other. Most places I've...

  9. What would you do for this patient?

    SEOBowhntr replied to UM Review RN's topic in CCU, Coronary, Cardiac

    and you have your answer here, you just don't realize it!!!! angie, the first thing we should worry about in a patient with prolonged hypovolemia is damage to the kidneys. since this patient...

  10. IV cannula size/ overtesting

    SEOBowhntr replied to rjrule's topic in CCU, Coronary, Cardiac

    I've yet to have a patient that I couldn't sufficiently give whatever I wanted through a 20ga IV, not including trauma or acute hemorrhage type patient. Think about what bore most central line lumens...

  11. Lasix gtt

    SEOBowhntr replied to brissie's topic in CCU, Coronary, Cardiac

    I've checked at both q4 and q6, but always had the option to check more often if rhythm changes

  12. asthma - cardiovascular effects

    SEOBowhntr replied to rjrule's topic in CCU, Coronary, Cardiac

    Ditto this, except the LEFT sided effect. Often times with severe COPD, Pulm HTN, the Left side of the heart is without any major problems, but you may start seeing Rt BBB due to the enlargement of...

  13. Question about unresponsive patient.

    SEOBowhntr replied to poohbear1968's topic in CCU, Coronary, Cardiac

    Confirm "pulselessness" in two leads???? Me thinks you're a little

  14. ER nurses taking over Chest Pain Center Duties

    SEOBowhntr replied to TraumaNurseRN's topic in Cardiac

    i believe with that much experience you should be fine. you should already know how to read ekg's, and know the s/s of an ami, keep in mind what the ultimate goal for each patient should be, and you...

  15. New Grad on Cardiac/Stepdown Floor

    SEOBowhntr replied to BrayaRN's topic in Cardiac

    this is a very valid point.... i agree that it is nice to have set preceptor so you can get adjusted to things, but capture the opportunity to learn from a variety of staff, and once you've completed...

  16. Atrial Bigeminy?

    SEOBowhntr replied to javajunkie's topic in Cardiac

    Atrial Bigeminy is a pretty common arrhythmia in post-CABG or valve replacements, and can often times precipitate into Atrial fibrillation. I've also seen it in quite a few patients in PACU, probably...

  17. Pccn?

    SEOBowhntr replied to cndzz's topic in Cardiac

    I took it, passed it, didn't think it was too bad. I have a couple study guides, but much of it was "old hat" stuff. I had 3 questions regarding the administration of IV Dilantin, something that...

  18. Question about unresponsive patient.

    SEOBowhntr replied to poohbear1968's topic in CCU, Coronary, Cardiac

    actually, in my practice, i've found that pac's seem to be more associated with hypoxia than pvc's. the pvc's may be a key clue, because if you've ever watched a monitor, you might notice that...

  19. Ethical ? about AIDS....

    SEOBowhntr replied to Nacki's topic in MICU, SICU

    cutie, check out the bullets of the link siri gave you, there is a requirement for notifying partners... there is some more definitive answers on pg. 21-23 of the document. good info siri,...

  20. Sometimes you HATE being right....

    SEOBowhntr posted a topic in MICU, SICU

    I was working last night (Friday) and a patient I'd taken care of a couple days earlier in the week seemed to be doing better when we came in, he was up to a chair, and getting trial feedings, etc....

  21. Nurses Defibrillating???

    SEOBowhntr replied to rgroyer1RNBSN's topic in MICU, SICU

    This is WHY older nurses need to keep up on CONTINUING EDUCATION!!! I worked with a nurse several years ago that remembers the first archaic defibs when they lit people on fire because they really...

  22. Insulin during cardiac arrest?

    SEOBowhntr replied to kimmie518's topic in MICU, SICU

    the key here is that it lasts longer. certainly in acute management, calcium is optimal, but how long will it last, and at what point does too much calcium become problematic. i was involved in a...

  23. Insulin during cardiac arrest?

    SEOBowhntr replied to kimmie518's topic in General Nursing

    the key here is that it lasts longer. certainly in acute management, calcium is optimal, but how long will it last, and at what point does too much calcium become problematic. i was involved in a...

  24. Use of Narcan in cardiac arrest

    SEOBowhntr replied to patricia_abrams's topic in CCU, Coronary, Cardiac

    actually it depends on your goal..... in europe, it's common practice to treat an acute overdose on the scene with enough narcan to bring them back to "planet earth," then administer 2mg im and leave...

  25. Cardio-respiratory arrest w/respiratory acidosis

    SEOBowhntr replied to poohbear1968's topic in CCU, Coronary, Cardiac

    Excellent post, and I agree 100%. Poohbear, The only answer that accomplishes what you are trying to accomplish is INCREASING ventilation. Now if the acidosis remains, then there are a couple of...