I have a two nursing degrees, going for a third and have a whole lotta common sense. When I see stupid or hear stupid orders I may or may not carry them out..here are my all time favorites:
1) Male patient with active lower GI bleed...HGB of 5...Hypotensive and tachycardic..has 2 large bore IVs running with NS wide open as fast as it will go...blood bank working as fast as possible to get me my units of PRBCs ASAP...BP barely 90 systolic.
Order from resident: "We need orthostatic vitals on this patient"
Specializes in Emergency, Critical Care (CEN, CCRN).
Yes, I get that; a KCl push is a lethal injection. (Cold KCl is also a cardioplegia solution in open heart surgery - either way you're stopping the heart, so it'd be a lethal injection if the patient wasn't on bypass.)
In that particular instance, even after being told that we weren't going to do a KCl IV push under any circumstances, the resident continued to insist on "crash" K replacement via IVPB over inappropriately short timeframes, and that's what I was attempting to explain. I apologize for being unclear.
pt.'s case is MI; 58 years old; Complete bed rest; the patient have difficulty urinating and full bladder; we did all independent nursing actions but the patient still had difficulty urinating. we called the doctor expecting an order for catheter insertion instead the doctor ordered a condom catheter.
Not that the orders weren't warranted, but I recently had 2 patients that the EDP saw back to back and ordered a soapsuds enema for both of them...30 minutes before my shift ended.
murphyle, BSN, RN
279 Posts
Yes, I get that; a KCl push is a lethal injection. (Cold KCl is also a cardioplegia solution in open heart surgery - either way you're stopping the heart, so it'd be a lethal injection if the patient wasn't on bypass.)
In that particular instance, even after being told that we weren't going to do a KCl IV push under any circumstances, the resident continued to insist on "crash" K replacement via IVPB over inappropriately short timeframes, and that's what I was attempting to explain. I apologize for being unclear.