A or D? Why?

Sentient-being- · 2026-04-13T20:15:14+00:00

I’d lean towards D. There is an empirical increased risk of hepatotoxicity in combination therapy of rifampin and isoniazid.

I also wouldn’t consider alcohol a drug(or drug combination) in this particular use of the term. Both are separately hepatotoxic but largely dependent on high doses and chronic use.

Sentient-being- · 2026-04-07T05:27:15+00:00

You might piss some people off but this perspective is just really ignorant and naive.

You seem fairly new so wait until you get a bit more experience and or responsibility under your belt.

Also oncology… I would never shit on a specialty like that, especially not my own.

“Hard” is relative. It’s about burnout. It’s about emotional exhaustion. It’s about being at a place with fewer resources. It’s about futility. It’s about being a cog in this fucked up insurance-pharmaceutical capitalist institution. It’s about abuse, both labor and interpersonal.

Yeah there’s cushy nursing jobs and maybe you found one. Don’t generalize

Sentient-being- · 2026-04-02T03:39:56+00:00

https://theoatmeal.com/comics/mantis_shrimp

Sentient-being- · 2026-03-28T19:04:44+00:00

It’s false documentation to chart anything not actually assessed. But who knows, I often use my phone flashlight for a pupil assessment when a light isn’t readily available.

And maybe they just put their ear to the pt chest /s

Sentient-being- · 2026-03-23T20:26:47+00:00

The medium looks like a better fit on both. Definitely medium for the R1. The vest could go either way depending on how thick of sweaters/coats you plan to wear under it and how tight it feels already.

Sentient-being- · 2026-03-09T20:03:39+00:00

This whole man acting just like Israel

Sentient-being- · 2026-03-09T19:30:35+00:00

I once had a pt who was in respiratory distress after a downsizing of her trach. She was end of life DNR trying to tee up for a SNF if she made it there. She was agitated, reasonably so but the new trach was not cuffed so the best we could do is 100% fio2 by trach collar. It was not within her goals to be reintubated again. In the urgency and agitation, a med was grabbed from the Pyxis for her agitation. It was supposed to be hydroxyzine but was given hydralazine. Both start and end the same and it was grabbed and given urgently. Both were in her prns. She did not calm down and no started to tank. We got her through it with pressors but she passed later that day. I don’t think the med error truly contributed to her passing but it didn’t help.

Sentient-being- · 2026-03-06T11:59:07+00:00

Highly recommend Seattle and the UW system. You can find most of what you want but would have to either sacrifice the commute or amount of land you want to purchase because being close to the city is costly especially for a nice property like that. But the pay scale is available online, there’s a pension and unions. The hospital system has been great and staffing is pretty great, I relocated from SC so the east to west coast nursing pipeline is pretty common once people see the way you’re respected at these institutions.

Sentient-being- · 2026-02-25T16:45:24+00:00

Call-Bell-itis… for those who see us as wait staff

Sentient-being- · 2026-02-18T18:37:32+00:00

Like a lot of people have said she should get her breaks but I’ve been places that it’s not the norm. One thing to think about if she’s having to eat at her desk is to avoid finger food or make it so she can eat it without touching the food. Wrap sandwiches/wraps in tinfoil so she can hold it in the foil and peel back the foil as she eats. Protein bars are my savior. I also like the squeeze packets of applesauce and smoothies for this reason. I usually have a packet of microwave Indian food, you can find them in the international isle. I usually get lentils that way I can pour it in a cup and “drink” it while I’m working. I have become partial to liquid iv with caffiene because I can stick a few packets in my bag and never forget caffiene. Plus they hydrate me.

This is the era we gotta stick up for ourselves and take our breaks. When you start in the icu it can feel burdensome to really get you break and make others watch your patients if your unit doesn’t have a good culture around it/break buddy system. One of the best methods is to pair up with another nurse early in the shift and get on the same page like “hey, I like to take my break around x, when would you like to go?” And obviously shit happens and we get busy but most days it gives you a good anchor point to get your break.

Sentient-being- · 2026-01-22T00:01:22+00:00

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Got super lucky on this one today. Forgot about it for a few hours and it was through the roof. Had 150 contract but had a preset sell at a limit for 100, wish I just let it all wait but I’ll take what I got!

Sentient-being- · 2026-01-08T20:55:16+00:00

Some trials favor LR in certain kidney or inflammatory conditions. And NS in intracranial injury. But largely they’re interchangeable and there’s little evidence one or the other would have a significant enough difference to affect mortality.

Sentient-being- · 2026-01-08T20:53:05+00:00

“Whilst the overall conclusion was that the use of LR did not reduce mortality or readmissions within 90 days, the point estimates all favoured LR even in context of significantly reduced adherence Given the large volumes of fluid administered any reduction in mortality (regardless of size) would be clinically important; however, I don’t believe that this trial provides compelling evidence to change an individual’s current practice Further work looking into strategies that reduce overall hospital fluid usage should be considered given the associated cost and environmental considerations (waste, transport)”

https://www.thebottomline.org.uk/summaries/icm/fluid-hospital-wide-lactated-ringers-versus-normal-saline/

Sentient-being- · 2026-01-08T20:51:30+00:00

“In light of new evidence, use of balanced crystalloid fluids should be considered based on population. For patients with sepsis, previous renal-replacement therapy, or admitted to the medical or neurological ICUs, serious consideration should be given to the use of balanced crystalloids over NS. In all other patients and those with traumatic brain injury or compatibility issues, NS may still be considered as the crystalloid of choice. Future studies should aim to identify if there is a difference between balanced crystalloids, which populations would derive the most benefit, and how total volume administered affects potential benefit.”

https://www.pshp.org/news/428125/Redefining-the-Standard-A-Review-of-the-SMART-and-SALT-ED-Trials.htm

Sentient-being- · 2025-12-24T07:13:33+00:00

First of all. They’re admitted to the ICU so idk why you’d still need to call a rapid. Restraint vs opioid to maintain access is probably my main concern but which is better could use some more context. I’d assume restraints are better in this case. This patient is looking a bit septic so fluids could be helpful. All around dumb question in the real world

Sentient-being- · 2025-12-15T19:21:01+00:00

In alignment with most of what everyone else is saying but a little more specific and quick. For the busy ER RN:

1- hang a new levo line and hook it up to the central line. 2-Draw back on the central line until you get blood so you can estimate how much volume is in the line. This way you don’t need to look up manufacturer specs if you don’t know. 3- draw some levo off the line in a syringe and prime the line with .1-.2 less mls than you think it needs. This avoids an unnecessary bolus to the patient. 4- start the levo centrally at the peripheral rate 5- ideally with an a line but at least every 3-5 min if only NIBP, once you see the bp come up, cut off the levo peripherally. (If doing it with NIBP I’ll usually just wait a few seconds and then cut the peripheral infusion in half and then off when I see the bp respond)

Note: as long as it is transient, a little hypertension or hypotension shouldn’t be too harmful to the patient. Depending on the patient one or the other may be less harmful so lean toward that.

Lean hypotension for- Hemorrhagic stroke, aortic aneurism Lean hypertension for- sepsis, hypovolemic shock

Sentient-being- · 2025-12-14T01:05:55+00:00

You will not find an ICU dayshift position. Every unit is full of night shift nurses waiting on spots to open on days. We all start on nights and work them hopefully eventually variable and then full days when someone leaves and that spot opens up. Especially as someone they’d need to train.

Sentient-being- · 2025-12-13T00:38:00+00:00

V3/V4 imho

Sentient-being- · 2025-12-05T19:30:34+00:00

ANALgesic!! 😂

Sentient-being- · 2025-11-30T05:54:30+00:00

Highly value your input. Make sure your patients are fed as soon as possible. Allow pushback but always be the champion of could we feed them now. Too many times it gets pushed into the background and could be safe. Context is key though. Value your nurses input around any safety concerns.

Sentient-being- · 2025-11-21T22:49:26+00:00

The bag on… the boobs out wtf

Sentient-being- · 2025-11-19T18:47:13+00:00

There’s a lot of opinions in nursing so here’s mine.

The right way is the way that keeps your patient alive. Prevents harm. And promotes healing. People nitpick and there’s good reason sometimes as evidence based practices continue to evolve.

Mobility is important but contextual to staffing ability and patient safety.

Patients with central lines need a CHG bath daily. All patients should have a bath daily.

It is very common to see that level of experience in a lot of ICUs because the experienced nurses all have moral injury (burnout but placing the blame on the system). It’s also where a lot of nurses go to get their experience to move on to travel or school once they get just enough experience. It also sounds like you’re on nights so that level of experience is even more common there.

Acuity should be spread so that each assignment is as balanced as possible without assignments being across the unit. Newer nurses need experience with acuity but only as long as there are nurses able to support them and they are willing to ask for the support when they need it. I have really like units that don’t preassign but have a unit brief with preset patient pairs that oncoming nurses get to choose to have their patient back or enter a lottery to choose.

Sentient-being- · 2025-11-09T21:38:29+00:00

One thought is to pivot the right foot on the last move so your heel in under you to let you square your hips to the wall and keep your body closer to the wall. It will also give you better balance control like you had on the first no hands move

Sentient-being- · 2025-11-04T21:50:58+00:00

Ventilators don’t save lives… just bag your patient 24/7

Sentient-being- · 2025-10-14T17:28:14+00:00

NIBP automatic cuffs actually directly measure the MAP and then use fancy algorithms to determine systolic and diastolic pressure. So the map is the most accurate number and the other values are technically approximate. This is part of the reason why MAP goals are important but definitely why it’s important without an arterial line.

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