diabo

diabo RN

hemo and peritoneal dialysis

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All Content by diabo

  1. Fresh Frozen Plasma During/after Dialysis

    diabo replied to WINDYCITYRN's topic in Dialysis, Renal, Urology

    I've given FFP many times during dialysis in ICU. Gave four unites during a three hour treatment once as ordered by the nephrologist. We used heparin a 1500/1500 and added the volume to the target....

  2. Clamps

    diabo replied to PLTSGT's topic in Dialysis, Renal, Urology

    Fistulas and grafts can be damaged by having too much pressure applied either by clamps or by too tight a squeeze. In most cases clotting is cumulative, and will finish forming with a good bout of...

  3. Holding meds for dialysis patients

    diabo replied to rn undisclosed name's topic in Dialysis, Renal, Urology

    Common sense is really the key. If dialysis pulls it out and the doctor wants it given, then the DOCTOR needs to write orders to give an exta dose if that's what she, or he wants. Obviously, a...

  4. foley catheter placement question

    diabo replied to rileygrl11's topic in Dialysis, Renal, Urology

    The nephrologist really shouldn't give phone orders without fist assessing the patient. I don't take them unless I know the doctor is already familar with the case, and even then he shouldn't give...

  5. foley catheter placement question

    diabo replied to rileygrl11's topic in Dialysis, Renal, Urology

    What in the world is a PCT doing inserting a catheter? Absolutely a no no. Yeah I've worked in places that allow it, but if something happens, like in this case, the one with the license will be...

  6. New Grad interviewing in Dialysis

    diabo replied to 81Bubbles's topic in Dialysis, Renal, Urology

    Will this be your first nursing job? If so, your real education is about to begin. Theres a lot more to good acute dialysis nursing (or any dialysis nursing for that matter)than you might have...

  7. ER nurse accessing Dialysis Cath in Emergency

    diabo replied to Huachuca's topic in Dialysis, Renal, Urology

    Great post, MO MO. Most important points: withdraw 3-5cc and discard. Best to flush with 8cc or so of NS then hook up the fluids. When finished run the fluids at KVO to the port. That way you don't...

  8. Nurse Patient Relationship

    diabo replied to stealth 92's topic in Dialysis, Renal, Urology

    RED FLAG in my book. It's kind of an artificial relationship if it's anything more than good empathetic nursing. I've witnessed several similar situations that in the end ended up hurting the...

  9. pickles or boullion?

    diabo replied to sueinga's topic in Dialysis, Renal, Urology

    When I first read this, I thought it was a kind of joke. Does the doctor know of this practice? Uncontrolled salt intake can be very dangerous to dialysis patients. The majority of them already have...

  10. pickles or boullion?

    diabo replied to sueinga's topic in Dialysis, Renal, Urology

    lowering the dialysate temp by a degree can help support bp. Say 37 to 36. Our Dr. ordered 35.5 on one

  11. Question about leg cramps

    diabo replied to nurscee's topic in Dialysis, Renal, Urology

    Lots of factors can be in the mix and it's impossible to adaquately address this lady's needs in this format. However it could be that she is being pulled too low ie: shakes and dizziness. Severe...

  12. potassium/dialysate bath

    diabo replied to LPN2RNBSN's topic in Dialysis, Renal, Urology

    There are some doctors that still prescribe a 0 K bath for some patients. I think it's dangerous and unnecessary and just plain stupid. The highest serum potassium level I've seen was 8.6. Dialyzed...

  13. potassium/dialysate bath

    diabo replied to LPN2RNBSN's topic in Dialysis, Renal, Urology

    Our doc. told me, contrary to popular belief, that a 2K bath doesn't lower the potassium any faster than a 3K. It's the final potential level that is the concern. He will not use a 1K because the...

  14. dumping the prime

    diabo replied to sueinga's topic in Dialysis, Renal, Urology

    We never dump the prime unless specified by the doctor. We don't re-use any more either. In most cases, it's probably not a big deal either

  15. Uf Goal

    diabo replied to LPN2RNBSN's topic in Dialysis, Renal, Urology

    No rinseback.Hmmmmmm I hope the tech isn't using air to rinseback. Kind if dangerous.

  16. dumping the prime

    diabo replied to sueinga's topic in Dialysis, Renal, Urology

    There had better not be any residual Renalin in the kidney! Even if you dump the prime the patient may get some if there is even a trace left in the kidney. Bad bad. Happened once in our unit...

  17. Clots Clots And More Clots!!!!!!

    diabo replied to dinurse's topic in Dialysis, Renal, Urology

    We use Citrasate for the acid portion. It has no effect on the serum calcium level and can be spiked with potssium like the regular acid. Steven

  18. bevel up or down?

    diabo replied to majestix's topic in Dialysis, Renal, Urology

    Think about it. Sticking with the bevel down means you have to start with steeper angle, and you have to level off quicker so the razor sharp bevel won't slice the bottom of the vessel. That being...

  19. advice on using TPA for catheters?

    diabo replied to sueinga's topic in Dialysis, Renal, Urology

    tPa is fine as long as the correct amount is instilled and aspirated, but the patient is essentially not getting dialysis. Sure you can pull some fluid off, but it's next to zero clearance. Sounds...

  20. Hospital (Inpatient) v. Clinic (Outpatient) Dialysis

    diabo replied to DeLana_RN's topic in Dialysis, Renal, Urology

    There's a song we sing in our church that goes like this: "In quietness and confidence shall be thy strength". People will find out that your'e the real thing without hearing it from you. Unless...

  21. Hospital (Inpatient) v. Clinic (Outpatient) Dialysis

    diabo replied to DeLana_RN's topic in Dialysis, Renal, Urology

    More opportunities will likely open up in the future. Learn a lot and keep a good track record. Glad you got it.

  22. Hospital (Inpatient) v. Clinic (Outpatient) Dialysis

    diabo replied to DeLana_RN's topic in Dialysis, Renal, Urology

    I assume you will clock in as a normal hospital employee? I worked in our hospital owned clinic for 6 years before becoming charge nurse of the acute unit 3 years ago. Although our clinic is a good...

  23. Infiltration

    diabo replied to BJZMom's topic in Dialysis, Renal, Urology

    I ran one yesterday that infiltrated after 2 hours. It happens and we learn and continue to go forward to help our patients. You may have nicked or went through the back side of the vessel, who...

  24. Anyone got their CDN certification

    diabo replied to TELEpathicRN's topic in Dialysis, Renal, Urology

    Don't be. Ralax and think. May not want to have that third cup of coffee though. {;-)~

  25. Treating Hypotension

    diabo replied to sueinga's topic in Dialysis, Renal, Urology

    We sometimes give a half amp of Mannitol spaced an hour apart but not the last hour. Albumin if the lab value is low. There is always a gradient shift in full HD mode that can be another ingrediant...