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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 re-rationalize with transfers, after a surgical pro...

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 pt's to 1 nurse, then I'm not really sure that pulli...

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 gone before MN on the day of surgery. You need ...

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. Personal opinion of course, but we were both quite...

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 thinking.

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 elevated HR and BP, hypoxia can cause it such as in a C...

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 over the last 13yrs (several as a Student working ...

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 worked, they've kept the arterial line on a transd...

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 really doesn't have kidneys to be too worried about,...

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 are.

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

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 the RV, then the RA also becomes enlarged. Sometim...

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

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 should be fine.

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 your orientation, you may have a little of the goo...

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 due to some of the hypoxia that they may have due...

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 really has gone by the wayside since the advent of Ph...

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 patients who have severe hypoglycemia often times have i...

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, thanks!!!

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. VS were stable, and things were looking pretty goo...

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 weren't 100% sure what they were doing. We've come ...

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 code when the dr. decided on 3 amps of calcium, gues...

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 code when the dr. decided on 3 amps of calcium, gues...

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 the patient where you found them, only alert, orie...

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 things that must be considered. But generally the ...