jeddyl

Calling a doctor to follow hyperglycemic protocol of noncompliant patient with blood sugar over 400...... MD: "Oh, smack her in the head with a baseball bat!" Nurse: *crickets followed by nervous laugh*

The vanco came diluted (pharm does it for us) and I piggybacked it onto 500ml NS, yes. This patient also had IV NS with 40 of K+ ordered, so I had an entirely different set of primary tubing for that, and reconnected her after the vanco was finished. Maybe they didn't like that I had a second primary tubing hanging by the pump? The Phenergan- at the time I was giving it, I thought it was to be given IV. By the time they came to talk to me about giving it, it had been quite a few days since I've had the patient and she was already discharged, so I don't know if/how they can go back to check.

I am a new nurse, I've been on my own for about two maybe almost three months. I work on a med/surg floor and I thought I was starting to get the hang of things (sometimes). Lately I've been a little disheartened- I had a charge nurse stop me before I left about a week ago to talk to me about a medication from a week prior..I had a patient with Phenergan 25mg ordered. The first night I could have sworn it was to be given IV so I diluted it in NS labeled the bag and hung it. No harm. The next night in report I was told she had IM Phenergan 25mg, so I made sure to give it that route- I thought the doctor changed the order, but am not so sure because it had been a while. Anyway the charge approached me because of the IV route from the one day and also because of the dose- I didn't know we couldn't give 25mg IV although that was the order. This was my first mistake. Now, I worked last night and got a phone call from a nurse who works with the new hires to check up on them during and after orientation. She wants me to come in and meet with her and my nurse manager because of something I did with an antibiotic. She said the patient was fine and not to worry- but thats all the detail she gave me. I know I hung IV Vanco last night. But thats the only thing I can think of. Everything was scanned, and I can't imagine what I may have done wrong? I am so nervous. And they want to know my reasoning and thought process.... I know I hung it was a 500ml bag of normal saline incase it was burning while going in (the patient was 80). Unless I made an error more than one shift ago? Anyway I don't know what I'm going to say, and unsure of the situation thus far, and am so so nervous I'm shaking. Any thoughts or advice??? Thank you!

I am trying to write one of my last care plans for this rotation and I just feel out of whack! I have a pt with liver cancer, COPD, hyperlipidemia, history of smoking and low RBC, hct, and hemoglobin. She is on 1-2L nasal cannula. The (second) best diagnosis I can think of is ineffective tissue perfusion, but for some reason the wording just doesn't sound right to me. Is there a better diagnosis out there for low hemoglobin? That is what I am really trying to focus on for this diagnosis! Thank you!!

Thank you everyone! I have been googling and flipping through powerpoints and multiple textbooks all day long! Hopefully I will find out the answer tomorrow in class and be able to get back to everyone.

Hello! I am a nursing student in my first semester so I do not have very much experience yet. Today, we had a question on our exam that went something like "A nursing student is giving a 25mg IM injection with a 50mg prefilled syringe. When should the clinical instructor step in?" Answers included: 1. Student wastes the first 25mg in the syringe 2. Student re-caps needle when finished injecting 3. Student places needle in trash can 4. (Don't remember full answer) Student was or was not using some sort of machine or technique that started with a C or Ch I picked 2 because you should never recap a needle.....what are your thoughts? What are the complete steps to using a prefilled syringe with more medication than you are administering? What are you not supposed to do? All of the answers seemed to need instructor intervention!