JIM, r.n

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  1. This is me when I try to read critical care books.

    This is me when I try to read critical care books.

    (Source: thetvscreen)

     
     

  2. (Source: allofyourwaysandallyourthunder)

     
     
  3. The largest internal organ is the small intestine? Mr. Liver isn’t going to be amused by this.

    The largest internal organ is the small intestine? Mr. Liver isn’t going to be amused by this.

    (Source: nurse-on-duty)

     
     
  4. Rewarding myself with fattening and delicious food after 12 hours of taking care of a patient with 29.1 ml CVD Bleed Secondary to MVA who doesn’t have a single vasopressor on board because the family cannot afford to buy one. Fluid challenge was our only choice as substitute to Levophed, Dopamine and Dobutamine. Systolic blood pressure ranges from 63-75 mmHg, heart rate from 50-55 bpm, no spontaneous respiration and very hypothermic. The patient is on full code status to top it off by the way.

    Rewarding myself with fattening and delicious food after 12 hours of taking care of a patient with 29.1 ml CVD Bleed Secondary to MVA who doesn’t have a single vasopressor on board because the family cannot afford to buy one. Fluid challenge was our only choice as substitute to Levophed, Dopamine and Dobutamine. Systolic blood pressure ranges from 63-75 mmHg, heart rate from 50-55 bpm, no spontaneous respiration and very hypothermic. The patient is on full code status to top it off by the way.

     
     
  5. chelshurr answered your question: ICU 1
    Hypoxia

    I suspected that too. Because after my shift her pulmonologist changed the mech vent mode to Spontaneous which she obviously didn’t tolerate. VTE ranged from 200-210 ml only but the ABG results came out normal. Sepsis perhaps? She had 2 consecutive exploratory laparotomy to resect a mass in the descending colon which apparently leaked out thus needing another re-exploration. But the WBC count is within normal range and the post-op site doesn’t show any signs of infection. Or maybe a stroke? The doctors did suspect her to have DIC. Her platelet levels dropped as low as 18,000 and her INR was 2.91. So maybe she bled out during the next 16 hours after my shift.

     
     
  6. Rest well, ICU 1.

    Rest well, ICU 1.

     
     asystole  DNR  AND  icu  nursing  death 
     

  7. ICU 1

    Endorsed to the next shift with a GCS of 11. Sixteen hours later, received patient with GCS of 3. OMG, what happened?

     
     

  8. ICU 6

    *IVF @ Left Arm

    ML1: D5W250 + 4gms Calcium Gluconate @ 15ml/hr

    PB1: PNSS-500 VSS 50ml IV + 50units Humulin R @ 2ml/hr

    ML2: P-Dopamine 400/250 @ 14.1ml/hr

    PB2: D5W250 + 200mg Tramadol @ 10ml/hr

    ML3: Nephrosteril-500 + 50ml D50W @ 25ml/hr

    PB3: PNSS-500 VSS 90ml IV + 100mg Lasix @ 10ml/hr

    *IVF @ Right IJ Catheter (White Lumen)

    ML1: PNSS-1L @ closed

    ML2: D5NSS-1L @ 20ml/hr

    ML3: PNSS-500 + 40meqs KCL @ 40ml/hr

    ML4: D5NM-1L @ 10ml/hr

    *IVF @ Right IJ Catheter (Brown Lumen)

    ML1: PNSS-500 + 1000units Heparin @ 3ml/hr

    *Arterial Line @ Right Arm

    *CVP Monitoring Device in Place

    *2 Antibiotic Drips (Tazocin, Dazomet)


    —Too many IV fluid and drips in one patient. :)—

     
     

  9. (Source: imonit)

     
     
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  11. (Source: brain-food)

     
     

  12. (Source: thebelgianquaffle)

     
     

  13. Give Humulin 70/30 14 units per orem now.

    Ay ambot nimu Mister Resident! Ikaw jud akong patingalon ana sa akong pasyente! Haha.

     
     

  14. ACUTE vs. CHRONIC

    Acute pain is considered a protective mechanism because it warns of present or potential tissue damage or organ disease and lasts less than 6 months. Chronic pain, on the other hand, may be as intense as acute pain but it isn’t a warning of any tissue damage. Don’t look for typical signs of pain because the nervous system has already adapted to its chronicity.

     
     

  15. (Source: cardiac-art)