Saturday, May 21, 2005

Phlebitis and Infiltration and Anaphylactic Shock! Oh my!

Had clinicals this week. Surprise! It was fun! Attitude is everything and I had a couple of patients with incredible, postive, goal-oriented attitudes!

My favorite! A post-op patient who knew the get-back-on-your-feet checklist by heart! She gave me an update on her deep breathing and Incentive Spirometer (the tube with the hose you inhale from to give your lungs a workout) every time I walked into the room. And half the time I met her in the doorway -- on her way out for a walk with her daughter or husband or grandkids.

This patient was recovering from colon surgery, NPO (non per os -- nothing by mouth). You've just had your colon resectioned to take out perforations or a cancerous growth, you don't want to start cramming stuff down your pie hole to force that poor colon to grind and squeeze and do peristalsis (the wavelike muscular contractions of the alimentary canal which contents are forced onward towards the glorious light at the end of the tunnel). So the patient was getting TPN (total parenteral nutrition -- TPN will drip through a needle or catheter placed in your vein). In this case, the patient Aminosyn. Now she was getting the lowest possible dose of it, 3.5% (a lower amount of amino acids in the fluids), so she could get it through a peripheral vein (higher %s get it through a vein next to their heart). But Aminosyn can do tissue damage even at that low level. And since her Phosphorus was low, we were putting some of that in the IV bag, too. And Phosphorus burns as well. So every time I went in her room, I took a look at her IV site. Sure enough, it started to swell and turn red.

Ahhhhh! Phlebitis! More later...

4 Comments:

At 9:43 AM, Blogger d.K. said...

Hey,
Thanks for the tip on the Norwegian-American girl's blog. Can't wait to check it out. (I'm from Norsk country in Wisc. where we're all lutefisk eaters ;)
Yours is funny too - I'll be back.Catch you later!

 
At 7:49 AM, Blogger boabhan sith said...

Hey, I ran across your blog from your profile.

I'm a nursing student as well.

I'm hoping that after I get my RN I can soon start working towards getting a masters in nursing.
...ah, but it seems so far a way.

Nice blog, by the way.

 
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hey if you don't mind...I'm going to link to ya.

 
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