Wednesday, January 17, 2007

Awww...poor whale

Another humpback whale washed ashore in Daytona because it was dying.  It's beginning to be a common sad.  They don't know why they are dying. 

I'm watching the news...looks like Texas is getting snow.  I didn't know they got snow.  The weather is so wacky.  It's 37 degrees in Atlanta, yet warm in Orlando...weird!!!  I'm not complaining.  I prefer the warmth - just not too warm.  60-70's is perfect.  It'll be 78 tomorrow...nice!

I worked Sat, Sun & Mon.  I already told you about my busy Sunday night...Monday I had the same patients plus I volunteered to take a direct admit right at the change of shift.  I'm nice like  Of course I volunteered before finding out the diagnosis...I may have thought twice on that one, but it turned out somewhat ok.  It was an older woman being admitted because her potassium level was 5.8.  Normal range is 3.5 to 5.0.  The usual treatment for a high potassium level is a medication called Kayexelate.  It's not a favorite word of mine because it is designed to cause the patient to have many, many bowel movements - in order to get the potassium out of the body.  Luckily this patient was continent & able to get to the bedside commode as needed.  She was also admitted for weight loss.  She has lost 37 lbs in the last year without trying.  Why doesn't that happen to me??  I can't even lose that much when I do  She came from a group home & personally, I don't think they are feeding her as much as they should.  This patient was on a lot of psych meds & I was told she doesn't sleep at night & has a lot of hallucinations.  Lovely.  She also told me I was a nice old  Gotta love my patients!

The good thing is...she did sleep.  Well, until I had her drink the Kayexalate - which she drank down as if it was chocolate milk.  She loved it.  She was able to sleep for a few hours, but from about 1 am on, she was awake.  She did have some hallucinations.  Kept telling me there were snakes in the room & some man was bothering her.  She kept me busy, but it wasn't bad & I was thankful it wasn't critical stuff like the night before. 

My other patients...they pretty much slept the entire night without any problems.  Heart rates were ok as well as blood pressures.  Except for my patient with the small bowel obstruction.  When I got there, her heart rate was in the high 130's, low 140's.  The cardiologist showed up a short time later.  He's new to the hospital, but I really like him.  He explains everything to us (the nurses).  It's like he does his thinking out loud.  He's open to questions.  So unlike most of the doctors who just want to get in & out of there...which I don't blame them.  They work a lot of hours as well as being woken up all night long with phone calls. 

Anyways, he gives me an order for Digoxin IV.  I administer it & her heart rate went from 142 to 139 & stayed there.  Not quite the results I was hoping for.  About a 1/2 hour later it was at 135.  So I called the cardiologist & told him.  He replied "Oh, that's fine.  It takes some time to work."  Hmmm, ok.  It took about another hour, but eventually it came back down into normal range & stayed there the rest of the night. 

I'm off the rest of the week...yay!  Back to work Sunday night.  Have a good week everyone!!!!



lacaza3 said...

yeah we get snow every now and then.. It was mostley sleet....I hate it...we get it so random that we dont have cold weather clothing. I was walking around in my crocs with socks on lol
Donna In TEXAS

firewolfrn said...

Enjoy your days off. :o) I like your journel and doesn't it always seem the kayexalate patients and incontinent patients are one and the same. LOL

FireWolfRN aka CheyFire