riRN16

Thank you so much for taking the time out to explain this to me!! I feel I understand it much better now. And you've only been an RN for a year?! I sure hope I'm able to piece things together and to explain as well as you in a years time.

So, because she was taking more than her regular dose, the patient became dehydrated. The fluid that she did have started to move from the cellular to the extracellular space. And so the lower dose was given to prevent further dehydration at once but administered more frequently to try and pull out that fluid? If the patient came in taking a dose that was less than prescribed would treatment be similar? I'm thinking her creatinine would also be up in that situation because she's getting fluid buildup and they would also have to put her on a diuretic, right?

I just started working on my own last month and occasionally I have an issue fully grasping my patient and the rationale behind their plan of care. For example, yesterday I had a patient admitted with a creatinine almost double her baseline, though her BUN was WNL. She has hx of CHF and she said that for about a week she was accidentally taking 160 mg of Lasix daily instead of the 80 mg of Demadex she was prescribed. So was the creatinine high due to dehydration? But the patient had 1+ edema and reported having decreased urine output, but isn't that odd if she was taking so much Lasix? The doctor then put her on 20 mg of IV Lasix BID, which I again I don't quite understand- but after receiving 2 doses her creatinine did go down by 0.2. If such a high dose of Lasix put her in this position, why are we pushing more? Her BNP and cardiac echo were normal, but are we just being cautious because she has hx of CHF and don't want fluid overload? I really don't get it haha any help making sense of it?

Nothing here yet either

I COMPLETELY agree about the scenario questions. I drew a blank and did not know how to respond at all But of course, the second my interview ends I can think of a million things to say regarding the questions... Just glad to know I wasn't the only person to feel that way!

Hi everyone :) Congratulations to those who got an interview, and good luck! To those of you who have it on Monday/Tuesday, please let me know how it goes. I have mine on Wednesday and I am beyond nervous just thinking about it.