eiwneon

I'm a new nurse, and I have a couple questions about running secondary IV infusions: When I hang a medication to be given via piggyback infusion, I usually use my IV pump to backprime the secondary tubing first, and then start the piggyback medication. This is the way I was taught. And it's also the way I was taught to back flush in between two different secondary medications. Anyway, I've noticed that some people also do this, but others prime the secondary tubing with the medication itself, then attach the secondary tubing to the secondary port on the pump cassette and start the pump. Thoughts? The other part of my question has to do with VTBI. I always program my VTBI as exactly the amount that is in the secondary piggyback medication bag. But now I'm wondering, does the fact that I primed the secondary tubing with primary fluid mean that I'm not giving the patient the entire dose of medication? I assume that for the first few minutes of the secondary infusion, the patient is just receiving the fluid that was primed into the tubing. Even if I were to prime the secondary tubing with medication like some nurses do, the bottom half of the IV tubing that is common for the primary and secondary lines is filled with primary fluid and that's still what the patient is getting for the first few minutes. Not sure how much the tubing holds I will have to check the packaging but still. Do you see my confusion? So I'm wondering how you approach that. If you're still with me.... I imagine there would be some residual in the secondary bag still. And the last part of my question goes off of that - I'm worried now that I might be always undermedicating my patients, because isn't there always residual secondary fluid? ie there is always some fluid left, if not in the minibag itself at least in the secondary line ie we don't run it dry. by this logic should we really be flushing the secondary line? but I've never heard of this... One more thing. I see "overfill" listed on the label of some IV medications prepared by pharmacy. like the label will say 117 mL plus overfill. What do you program then? What's the rationale? How much overfill?? And therefore what do you set as the VTBI? Not sure where to look for answers. Thanks for helping me think through this.

are you saying that medical air is used in conjunction with pure oxygen in order to "fine tune" the FiO2 the patient receives?

what are the indications for each of these?

Nursing student here - just wondering about head-to-toe assessments and what your practice is around them. I have just been introduced to the term focused assessment as well. I guess what I'm wondering is when do you generally perform a full head-to-toe in your practice? And when do you do a focused assessment? I'm always trying to think about how to best order my assessments so as to be efficient and thorough...so another question I have for you is: Would your focused assessment generally be performed at the beginning of your head-to-toe or do you tend to fit the focused assessment into your standard head-to-toe sequence. It sounds like I'm over-thinking it but I've really been wondering about this. Any insight or resources would be great!

Nursing student here - I wanted to become more familiar with gloves in general eg choosing the right type for the right job so I feel more comfortable at my placements around that. But I am having a hard time finding information. Wondering if anyone can help me out? Also, what's your practice around gloves? I have spoken to a couple people about it and it seems some people choose to wear them for just about any patient encounter and others are on the opposite end of the spectrum, even giving bed baths without them! I'm just looking for any thoughts/resources I could look at so I can feel more confident choosing when to don gloves and which type. Thanks:)

Why is that? Thanks for the feedback.

Hi everyone, I am a nursing student (BScN/RN) and I must choose either medical OR surgical for my next clinical placement. At this point in my nursing program, I have only really just begun to learn about the basics in terms of practical nursing skills. So... I am wondering what you think would be a better environment for me that will help me to develop the basic nursing skills that will benefit me going forward. Do you think that one or the other would be a better introduction to hands-on nursing skills (medical or surgical)? Or would they be about equivalent that way? ANY input would be so greatly appreciated. I haven't had much in the way of exposure to either medical or surgical nursing so I'm feeling very unsure! Thank you.