While conducting several informal interviews of some family members and coworkers about medication knowledge and the medications they each take, it was actually quite surprising from what I gathered. My parents are very aware of the medications they each take. My father takes medications for DM type 2, high cholesterol, and for thyroid replacement. My mother takes medications for DM type 2 and dysrhythmia. My father sometimes forgets the generic names for the medications he takes but my mother on the other has a medical background and knows exactly the names of all the medications she takes including trade, brand, and generic names. They each know the side effects, adverse reactions, and safe doses they should be taking. My coworkers each work in a hospital so they are very aware of all the medications they take since most of them are nursing students anyways. Many geriatric patients on the other hand just know the shape and color of their medications they take on a daily basis but do not even remember the names of them which is quite dangerous because if someone gives them a medication and they just take it because of the shape or color, then the result can be quite severe. Medication knowledge is key to being informed of side effects, adverse reactions, safe dosages, and routes of those medications.
Every hospital across the United States has different policies and procedures and standards of practices. Because I work in patient transport I routinely transport patients from ICU to different departments and have seen many practices being done in ICU when I am there for sometimes 1-2 hours getting a patient ready for transport. I have asked respiratory therapists about sedation vacation in the past and many have mentioned how positive it is not only for the patient’s results but for overall quality care. An article written in 2012 by Soraya Smith discusses in detail that patients who require mechanical ventilation are at risk for developing ventilator associated pneumonia. Nurses adherence to sedation vacations has a direct impact on the development of ventilator associated pneumonia, because sedation vacations have been shown to reduce patients’ average duration of mechanical ventilation and length of stay in the intensive care unit. (Smith, 2012).
In addition to this article, RT’s have told me that the use of sedation is needed if a patient cannot breathe on his/her own. If the patient is fighting the ventilator rigorously, then the intensivist and respiratory therapists discuss extubating patients and seeing if they have the ability to breathe on their own. There are numerous medications that I have seen being used for sedation which include Propofol, fentanyl, versed, ketamine, and precedex. The infusion rate is usually based on the patient’s status and weight. A patient who weighs 300 pounds vs 120 pounds will require a different infusion rate of propofol or precedex. Nurses and respiratory therapists collaborate on a daily basis on the best strategies for each patient. Respiratory therapists are there to monitor the ventilator settings routinely and check patient statuses. If a patient needs to be extubated, the respiratory therapist, nurses, and Intensivist make that decision together. Everything involves collaboration when dealing with patients in the ICU setting.
When interviewing my parents about what cardiopulmonary arrest means to them, I was kind of surprised and happy with the responses I received. My mother remembers some pathophysiology from when she took classes for dental school so she responded by saying it is basically a heart attack and it happens when the heart stops pumping and blood flow is stopped to the rest of the body. My father just mentioned heart attack which I was happy he basically had the right answer. My mom knows what an “MI” is because he mother passed away from a severe MI and she remembers some of the symptoms from the first MI her mother had before she had the second fatal MI. My mom mentioned how she remembers that during an MI, there is muscle damage due to ischemia.
When I had asked my parents about their knowledge of what occurs during CPR, all they responded with was that it involves chest compressions that need to be delivered at a certain rate and manual respirations are given. They have never seen CPR being performed so I educated them on how to do CPR and what to do if they are by themselves and the steps of performing CPR. Because of my experience in nursing school, my parents have learned a lot more of disease processes and conditions that affect millions of people across the globe and I was once again glad that I was able to educate them on some symptoms of an MI and how to recognize someone else might be having one and the correct steps of CPR.
This week I tried to limit my sodium intake drastically to just 1000 mg. Salt intake in addition to fat intake is only on the rise and it is a significant issue when it comes to heart health. My goal from now on is to really watch what I eat and record how much salt and fat I consume. It is not an easy adjustment to make by cutting my salt intake that much but it is something I should do to start watching my health and maintaining a healthy diet. This Monday I made a log of everything I ate and how much salt I consumed.
3 soft boiled eggs with no salt added
2 protein bars: 400 mg sodium
1 Bagel with cream cheese: 100 mg sodium
I chicken salad: 100mg salt
2 avocados with chips: 200mg sodium
2 tacos: 200mg salt
1 bowl butternut squash soup: 300mg salt
1 bowl fruit salad
4 oz steak no salt added
1 protein bar: 150 mg salt
I did not meet my goal of the 1000 mg for the salt intake but compared to how much sodium I was consuming prior, it is a big improvement. Heart.org mentions that the body only needs 500mg to function properly which means Americans have a long way to go in rder to cut back sodium intake. Processed foods and pre packaged meals have an enormous amount of sodium and convenience makes it harder because we as a country love to eat pre -packaged meals even though they are filled with a lot of salt. 1 teaspoon of salt has 2300mg according to Heart.org
I have been waiting for such a long time to finally begin my final semester of nursing school and am so excited it has finally come. I am ready to get to learn about more complex patient cases and get to actively interact with patients once again in the hospital. I prepared a lot over winter break for this semester and can’t wait to see what is next to come.
Who? (Who gets it or what disease process)
Patients with nososcomial pneumonia or Community acquired pneumonia, acute bacterial sinusitis, skin and skin structure infections, chronic bacterial prostatitis, UTI’s, acute pyelonephritis,
What? (Class? Pharmokinetics? How does it work)
Levaquin is in a group of antibiotics called fluoroquinolones . Levofloxacin is a antimicrobial that fights bacteria in the body. It inhibits bacterial cell synthesis by inhibiting DNA gyrase enzyme. Half-life is 6-8 hours
Every 24 hours
Where? (Chronic home med – Acute care – both?)
Depends on the route, but can be taken at home and in hospital setting.
Why?(Reason – Action)
Same as reason for who
How? (Dose, Route, Safety)
Route: PO or IV
Dose: 500-750mg PO, 250-750 mg IV
Safety: Associated with increased risk of tendonitis and tendon rupture. May exacerbate muscle weakness with patients with myasthenia gravis. Watch out for hepatotoxicity.
Today was an exciting day as we had our first lecture class and learned about the new technology we will be using in class. I was quite nervous using a new website other than CI learn to post discussion comments but I am excited for this semester and to be able to have my own blog that will be out there on the web for others to view!!
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