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kataraang BSN

critical care ICU
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kataraang has 4 years experience as a BSN and specializes in critical care ICU.

kataraang's Latest Activity

  1. kataraang

    DKA/HHNK

    Wow. That patient should have been started on fluids the second they rolled through that door. We have a DKA/HHS protocol in place. It's really useful.
  2. Baltimore MD. 3 years experience. $34.85; night diff 4.59. Weekend diff 2.50.
  3. kataraang

    What does the floor really think of nursing students?

    I love students! I have rarely had a bad experience with one. To see their excitement when they learn a new skill or see something they learned about in "real life" is awesome. I'm actually getting my masters in nursing education.
  4. kataraang

    Can I get into the ICU?

    Hello, I came from a telemetry/intermediate care before I switched to a medical ICU. I stayed at tele for 2 years before applying for ICU. I found that it gave me enough time to really get my assessment/basic nursing skills up to par to handle a critical care environment. I believe it helped me. You don't necessarily have to wait 2 years, but it may be beneficial to wait until you hit 1 year from my experience.
  5. kataraang

    Who is watching the monitor?

    We have monitors along the walls throughout the unit, not just at the desk. Each hallway has 2 monitors at each end. From any computer, you can see monitors. No patient names, just room numbers.
  6. kataraang

    Nursing with RA

    Hello, I was just diagnosed with RA in March. I am a full time ICU nurse. I've been in practice about 2 years now. RA affects individuals very differently so it kind of depends. For me, I was wearing a boot on my ankle and needed PT (while still working full time). It was rough. I have the pain in my fingers too, but I am slowly finding what works for me. Don't let it discourage you from nursing! Not all nursing jobs are super physically demanding. You can find the right fit. RA tends to come in flares so you may feel good for a couple weeks, then like complete crap another week, until meds can stabilize. Message me if you need, good luck.
  7. kataraang

    hypothermia in C6 Spinal injury

    Altered mental status. He had infected wounds needing debridement and IV antibiotics. He was a little altered during this time, not as responsive as baseline, HR dropping to 40s occasionally. The next day after rewarming he was more interactive.
  8. kataraang

    hypothermia in C6 Spinal injury

    Patient with C6 spinal injury from 10 years ago with autonomic dysreflexia. MAPs ranging from 40s to 80s, HR as low as 45. His documented temps had been normal but when I came on shift it was 32.7. I tried it oral, axillary, rectal (though he has flexiseal). I had another nurse double check with me, used 2 thermometers. I only went to those lengths to check because this was the first documented temp this low. His skin felt cool/cold. I gave extra blankets and turned his room temp up. My instinct was bair hugger so I asked the resident and he said no. He said it was normal for his autonomic dysfunction and not to treat. Isn't it still necessary to treat, regardless of cause? I'll see if the intensivist had any input from rounds today (since I'm on nights). Just curious of your experiences.
  9. kataraang

    Med error and Pyxis

    ***Always check policy, asking a manager would be a good idea. Proper practice vs. what actually happens varies. But in my experience, there are times where I don't return to the pyxis..Like if a patient decides after I have opened the med that they won't take it. There's also no way to document that I dropped a med on the floor. And I have on very rare occasion came home to find a senna in my pocket. Obviously with controlled substances you must always return through Pyxis with a witness.
  10. kataraang

    Nurses with SelfHarm Scars

    I have never been asked before, but I have a feeling they have been noticed. Fluorescent light is the WORST for making them visible. I think they are probably worse looking to me than to most others. 99% of people probably don't care. But I notice I do think about it at least once every shift. It really sucks that I had to go through it 15 years ago now...but it's my past and I've overcome many obstacles to be the nurse I am today. I am proud of my progress :) I hope you can be too!
  11. kataraang

    Stepdown / IMU

    I work in the IMCU. It's a 1:4 ratio. Vitals q4. Most patient on tele but occasionally one isn't (usually med-surg overflow, or patients who have stabilized enough and are near discharge). We do some drips (such as nitro, dobutamine, lasix, amio, diltiazem, milrinone) but no pressors. No vents. In my experience the difference between IMCU, stepdown, progressive care, or telemetry isn't usually significant. But at our hospital we only have the IMCU and a cardiovascular stepdown.
  12. kataraang

    Does anyone really read all this charting?

    Yep, this!
  13. kataraang

    Heparin drip

    It's okay, that happens sometimes. No harm came to the patient, and you recognized it before you left for the day. Also, my facility uses anti-Xa to titrate heparin, not aPTT. I wonder if either one has benefit over the other.
  14. kataraang

    heparin med error

    You did the right thing by reporting. You let someone know, you monitored your patient, followed their labs, and have now learned an important lesson. I guarantee you won't do it again. Being new is hard! I held lovenox for a stupid reason (in retrospect, there was NO reason to hold it) and I got in trouble with the doctor and had an occurrence report to sign. Patient was fine but I never take DVT prophylaxis lightly anymore. Every time I give a shot of heparin or lovenox I think back to my first mistake. You won't lose your job.
  15. kataraang

    UMSON RN-MS fall 2017?

    Decisions are out! I got in :) Anyone else?
  16. kataraang

    Extreme brady with strange rhythm

    Background: patient in for a pacemaker. He has complete heart block as well. Elderly, in his 90's (that's all I knew). I work in a telemetry unit. It wasn't my patient but I was by the monitors when I noticed a patient's HR in the 40s. It was heart block, as we knew already from the ED report (he had just arrived on unit). As I watched a moment longer, it dropped into the 30s, and then it was 28. I quickly walked into the room where I saw a conscious man sitting up in bed, in no apparent distress getting his vitals taken by another nurse. I asked, "are you feeling okay?". He told me yes. I said, "nothing is bothering you at all?" He said he was fine. I just couldn't believe that a man with a HR in 20's felt "fine". I verified the HR (now in 30's) by taking his pulse. There was a doctor in the room at this point. I stepped outside to the hallway monitor again and saw a QRS complex with a period of v-fib looking activity before the next QRS. It was not artifact, because it was very clearly defined. Was it a-fib? Below is a google image search of the closest thing I could find: I'm used to very high ventricular rates in a-fib. A-flutter, then? Sorry if it's a dumb question. I'm still learning the difference between textbook and real life for many concepts. I now very quickly returned to the room. He was still alert and conversing. A rapid had been called by this point, but I was just baffled by how he presented given his vital signs/heart rhythm. Any ideas? Have you seen a patient with a HR so low that was asymptomatic? I'm a new nurse 5 months into my first job, so I haven't gained enough experience to know these things. He was sent to CCU externally paced before he could get his implanted.
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