lvcrn

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Thanks for the info. Yes, they were 50ml vials. The BP spike took me by surprise, but I'm relieved to know it's commonly given undiluted! I will double check my administration guidelines more thoroughly the next time though!!

Thank you for responding. I've been stressing that I maybe made an error in the way I administered it. She came to me with pH 7.1, bicarbonate around 18 if I remember correctly, and CO2 in normal range. It was decided not to wean her off the vent as we'd hoped, so when the pressure shot up we started propofol (not running due to the attempt to wean post surgery) and gave 5 of labetalol. Pressure was back to normal in minutes and stayed down until I transferred her an hour later, no signs of extravasation. I didn't get another ABG prior to transfer unfortunately, so I'm disappointed to not know what the impact was. Thanks again, being new is stressful, but next time I will double check before I administer something, if I'm feeling unsure about it.

I'm a new grad, working in PACU at a level 2 trauma center. My pt's range from newborns to elderly, outpt to critical care. I had a 9 week preceptorship and have officially been on my own for 3 months (with a lot of support.) But I feel the support waning, and a lot of pressure to know what I'm doing. I know it can take a minimum of a year to feel confident as a new nurse, but I just feel like the expectation on my unit, all of a sudden, is that I should be functioning independently, and I'm just not there yet. PACU is very team oriented, and I feel like I'm dragging the team down, because I still need so much help. Any tips on where my expectations should be for myself right now?

I pushed 3amps of bicarbonate through a midline catheter per doctors orders and about an hour prior to transferring a pt to a different unit. We drew it up in 10ml syringes and did not dilute it. The pt's BP shot up to over 200, but we were able to get it down within minutes. My question is this- after the fact, I've read it should be diluted and given slower. Could I have potentially harmed this pt, and how long after administration would it be clear if she was experiencing adverse effects. I haven't been able to find these answers on online or in my books. This pt was acidotic, on a vent with spontaneous breathing. I'm a new grad and feel lost in these high pressure situations, and don't really know how to manage checking my actions before I perform them when there's really no time to do so, so I end up relying on veterans' advice. I realize this could be very unsafe practice. Our charge nurse is off unit a lot, and I've been told to lean on the veteran resources, but still, if it's my pt it's my butt on the line.