Wednesday, August 24, 2011

Ambulances As Medical Necessities, #Medical #Jokes, #Patient #Humor #eldercare #geriatrics

To subscribe, send a blank email to: nursingjokes-subscribe@topica.com

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...

These are all GENUINE replies from patients asked why they needed an ambulance to and from hospital...

=> I am under the doctor and cannot breathe.
=> I can't walk to the bus stop and my wife is bent.
=> I can't breathe and haven't done so for many years.
=> I want transport as bus drivers do funny things to me and make me feel queer.
=> I am blind in one eye and my leg.
=> I live five miles from the hospital and the postman says I should have it.
=> I have got arthritis and heart failure in both feet and knees.
=> I must have a man as I cannot go out or do up my suspenders.
=> I cannot walk up a hill unless it is down and the hill to the hospital is up.
=> My husband is dead and will not bring me.
=> I cannot drive a car as I have not got one.
=> I hope you will send a man as my husband is quite useless.
=> I can come at any time to suit you, but not mornings as I don't feel too good. I can't come on Mondays or Wednesdays as the home help comes, and not on Fridays as the baker calls for his money. I can't come on Tuesdays as my sister calls.

 

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Overdue Appointment, Medical Jokes, Patient Humor:
http://www.nursinghumor.com/overdue

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The Right Size, Medical Jokes, Surgical Humor:"John was successful in his career, but as he got older he was increasingly hampered at work by terrible headaches."
http://www.nursinghumor.com/size

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Exam Professionalism, Medical Jokes, Doctor's Humor:"A beautiful, voluptuous woman goes to a gynecologist. The doctor takes one look at this woman and all his professionalism goes out the window."
http://www.nursinghumor.com/exam

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Top Ten Signs You Need A New Doctor, Medical Jokes, Top Ten Humor:"- He calls you at two in the morning "just to talk." Instead of rubber surgical gloves he wears oven mitts."
http://www.nursinghumor.com/need

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Taking As Directed, Medical Jokes, Doctor Humor:
http://www.nursinghumor.com/directed

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Christmas Carols for the Psychiatrically Challenged:
http://www.nursinghumor.com/carols

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Too Late, Doctors Jokes, Gallows Humor:"The orthopedic surgeon I work for was moving to a new office, and his staff was helping transport many of the items."
http://www.nursinghumor.com/late

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The Circumcision, Medical Jokes, Kids Humor:
http://www.nursinghumor.com/circumcision

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Able To Play? Operating Room Jokes, Medical Humor:"A doctor has come to see one of his patients in a hospital. The patient has had major surgery to both of his hands."
http://www.nursinghumor.com/play

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Feeling Exhausted, Medical Jokes, Patient Humor:
http://www.nursinghumor.com/exhausted

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Getting Even, Nursing Jokes, Physician Humor:
http://www.nursinghumor.com/getting/

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How Long? Emergency Department Jokes, Medical Humor:
http://www.nursinghumor.com/how

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Virtually Deaf? Getting Older Jokes, Medical Humor:"An elderly gentleman finally invested in a hearing aid after becoming virtually deaf. It was one of those invisible hearing aids. Soon after, he went for a check-up."
http://www.nursinghumor.com/deaf

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She Didn't Make It, Medical Jokes, Emergency Humor:
http://www.nursinghumor.com/it

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New Secretary, Doctor's Jokes, Battle of The Sexes Humor:"Dr. Johnson got himself a new secretary. She was young, sweet, and very polite. One day while taking dictation, she noticed his fly was open."
http://www.nursinghumor.com/secretary

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Auto Enthusiast, Surgeon Jokes, Medical Humor:"A 70-year-old man sat down in the orthopedic surgeon's office. "You know, Doc," he said, "I've made love in more exotic cars than anyone I know. Must be at least a thousand."
http://www.nursinghumor.com/auto

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Blind Drunk, Emergency Department Jokes, Medical Humor:
http://www.nursinghumor.com/drunk

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Stern Sibling, Labor & Delivery Jokes, Sibling Humor:"An old county doctor went way out to the boondocks to deliver a baby. It was so far out that there was no electricity. When the doctor arrived, no one was home except for the laboring mother and her five-year-old child."
http://www.nursinghumor.com/stern

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Last Words, Doctor Jokes, Priest Humor:
http://www.nursinghumor.com/last

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Quick Diagnosis, Doctor Jokes, Physician Humor:
http://www.nursinghumor.com/diagnosis

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Come Quick! Medical Jokes, Marriage Humor:
http://www.nursinghumor.com/quick

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Taking Notes, Doctor Jokes, Getting Older Humor:
http://www.nursinghumor.com/notes

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Fine Art, Medical Jokes, Gallows Humor:
http://www.nursinghumor.com/art

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Healthcare Dollars, Medical Jokes, Healthcare Humor:"In reviewing how our healthcare dollars are spent, the following statistics were revealed."
http://www.nursinghumor.com/dollars

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Medical Bloopers Found In Patient Charts, Doctor Jokes, Medical Humor:
http://www.nursinghumor.com/bloopers

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Skin Graft, Medical Jokes, Marriage Humor:"A married couple were in a terrible accident in which the woman's face was severely burned. The doctor told the husband that they couldn't graft any skin from her body because she was too thin. So the husband offered to donate some of his own skin. However, the only skin on his body that the doctor felt was suitable would have to come from his buttocks."
http://www.nursinghumor.com/graft

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Big Words, Children's Jokes, Medical Humor:
http://www.nursinghumor.com/words

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Small, Medium or Large? Doctor Jokes, Marriage Humor:
http://www.nursinghumor.com/medium

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Bad News, Worse News, Medical Jokes, Geriatric Humor
http://www.nursinghumor.com/news

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A Future Physician, Medical Jokes, Parenting Humor:
http://www.nursinghumor.com/future

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Obsessions, Psychiatric Jokes, Medical Humor:"A psychiatrist was conducting a group therapy session with four young mothers and their small children. You all have obsessions," he observed."
http://www.nursinghumor.com/obsessions

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Sun Burn Treatment, Medical Jokes, Patient Care Humor:
http://www.nursinghumor.com/sun

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The Good News, The Bad News, Medical Jokes, Doctor Humor:
http://www.nursinghumor.com/good/

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Isolation Precautions, Infection Control Jokes, Physician Humor:
http://www.nursinghumor.com/isolation

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Not Good Looking, Medical Jokes, Marriage Humor:
http://www.nursinghumor.com/looking

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Practical Jokes, Bedside Nursing Humor, Doctor Jokes
http://www.nursinghumor.com/practical

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This Won't Hurt Much, Medical Jokes, Military Humor:
http://www.nursinghumor.com/much

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Common Forms of Office Illness, On The Job Jokes, Medical Humor,
http://www.nursinghumor.com/illness

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Coffee and Viagra, Medical Jokes, Marriage Humor:
http://www.nursinghumor.com/viagra

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Rusty Tools, Viagra Jokes, Marriage Humor:
http://www.4nursing.com/humor-bedside-nursing-jokes-viagra-marriage-rusty-tools.html

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Top Ten Things You Don't Want To Hear When Regaining Consciousness, Medical Jokes, Operating Room Humor:
http://www.nursinghumor.com/regaining

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Working In The Dark, Psychiatric Jokes, Medical Humor:
http://www.nursinghumor.com/dark

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The Business Trip, Medical Jokes, Patient Humor
http://www.4nursing.com/humor-medical-doctor-patient-jokes-business-trip.html

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Sex Therapy, Medical Jokes, Patient Humor:
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.sex.therapy.htm

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Post-Op Blues, Medical Jokes, Anesthesiology Humor:
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.post.op.blues.htm

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A Star In The East, Medical Jokes, Physician Humor:
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.a.star.in.the.east.htm

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The Forgetful Patient, Doctors Jokes, Medical Humor:
http://www.nursefriendly.com/nursing/humor/the.forgetful.patient.htm

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Diving Right In, Psychiatric Jokes, Medical Humor:
http://www.nursefriendly.com/nursing/humor/psychiatric.jokes.nursing.humor.diving.right.in.htm

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Doctor's Funeral, Medical Jokes, Physician Humor:
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.doctors.funeral.htm

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Buying Condoms, Pharmacy Jokes, Infidelity Humor:
http://www.nursinghumor.com/condoms

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Odds & Ends, Medical Jokes, Physician Humor:
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.odds.and.ends.htm

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Heart Transplant, Organ Donation Jokes, Medical Humor:
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.heart.transplant.htm

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Passing Wind, Medical Jokes, Patient Humor:
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.passing.wind.htm

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Removing Patches, Medications Jokes, Pharmacy Humor:
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.removing.patches.htm

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Top Ten Reasons For Becoming An Anesthesiologist, Medical Jokes, Hospital Humor:
http://www.nursinghumor.com/anesthesiologist

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Screwed Up Laboratory Results, Medical Jokes, Laboratory Humor:
http://www.nursinghumor.com/screwed

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Taxonomy of Medical Professionals, Medical Jokes, Hospital Humor:
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.taxonomy.of.medical.professionals.htm

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The Center of Attention, Medical Jokes, Patient Humor:
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.the.center.of.attention.htm

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Approving The New Hospital Policy, Medical Jokes, Physician Humor:
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.approving.the.new.hospital.policy.htm

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Patient Confidentiality, Medical Jokes, Patient Humor:
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.patient.confidentiality.htm

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Five Benefits of Mothers Milk, Breastfeeding Jokes, Medical Humor:
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.five.benefits.of.mothers.milk.htm

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Arkansas Medical Definitions, Medical Terminology Jokes, Redneck Humor
http://www.nursinghumor.com/

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Anyone Need A Doctor? Medical Jokes, First Aid Humor
http://www.nursinghumor.com/medical

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A Cure For One Man's Cough, Medical Jokes, Drug & Pharmacy Humor
http://www.nursinghumor.com/medical/

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Ambulances As Medical Necessities, Medical Jokes, Patient Humor:"These are all GENUINE replies from patients asked why they needed an ambulance to and from hospital..."
http://www.nursinghumor.com/ambulances

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Viagra Variations, Drug & Medications Jokes, Prescription Medicine Humor
http://www.nursefriendly.com/nursing/humor/drugs.prescriptions.medications.medicines.viagra.variations.htm

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A Grandmother's Insomnia, Doctor's Jokes, Pregnancy & Medications Humor
http://www.nursinghumor.com/insomnia

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Shooting Blanks, Medical Jokes, Physician Humor
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.shooting.blanks.htm

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I Think My Wife Is Going Deaf, Medical Jokes, Marriage Humor http://www.nursefriendly.com/nursing/humor/medical.jokes.humor.my.wife.is.going.deaf.htm

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A Doctor, A Nurse And A Shredder, Nursing Jokes, Medical Humor
http://www.nursefriendly.com/nursing/humor/medical.jokes.humor.a.doctor.a.nurse.and.a.shredder.htm

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He Thinks He's A Surgeon, Medical Jokes, Pearly Gates Humor
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.he.thinks.he.is.a.surgeon.htm

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Near Death Experience, Medical Jokes, Gallows Humor
http://www.nursefriendly.com/nursing/humor/medical/near.death.experiences.plastic.surgeries.htm

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The Aspirin And The Job Interview, Medical Jokes, On The Job Humor
http://www.nursefriendly.com/nursing/humor/medical.jokes.humor.the.aspirin.and.the.interview.htm

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A Work of Art, Medical Jokes, Patient Humor
http://www.nursinghumor.com/work

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Multiple Specimens, Medical Jokes, Doctor & Patient Humor
http://www.nursefriendly.com/nursing/humor/medical.doctor.physician.patient.jokes.multiple.specimens.htm

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Perfect Shape Considering Your Age, Medical Jokes, Physician Humor
http://www.nursefriendly.com/nursing/humor/medical.perfect.shape.considering.your.age.htm

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Six Months To Live, Medical Jokes, Physician Humor
http://www.nursefriendly.com/nursing/humor/medical/six.months.to.live.htm

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It Hurts All Over, Medical Jokes, Physician Humor
http://nursinghumor.com/hurts

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Actual Medical Quotes From Patient Charts, Medical Jokes, Physican Humor
http://www.nursefriendly.com/nursing/humor/medical/actual.medical.quotes.from.charts.htm

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First Proctology Exam, Medical Humor, Doctors Jokes
http://www.nursefriendly.com/nursing/humor/medical/first.proctology.exam.htm

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A Short History Of Medicine, Medical Jokes, Physician Humor
http://www.nursinghumor.com/medical/a.short.history.of.medicine.htm

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Anyone For Pasta, Medical Jokes, Marriage & Infidelity Humor
http://www.nursinghumor.com/pasta

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Professional Courtesy, Medical Jokes, Physician Humor
http://www.nursinghumor.com/medical/professional.courtesy.htm

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The Difference Between Doctors & Veterinarians, Medical Jokes, Veterinary Humor
http://www.nursinghumor.com/medical/the.difference.between.doctors.and.veteri...

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Dehydration, Medical Jokes, Physican Humor
http://www.nursinghumor.com/medical/dehydration.htm

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Making It Look Easy, Doctor Jokes, Medical Humor.
http://www.nursinghumor.com/medical/making.it.look.easy.htm

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Breastfeeding Technical Support, Medical Jokes, Obstetrics Humor
http://www.nursinghumor.com/breastfeeding

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The Doctor's Visit, Medical Jokes, Physician Humor:
http://www.nursinghumor.com/doctors

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Screening Medical Students
http://www.nursinghumor.com/medical/screening.medical.students.htm

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A Cure For One Man's Stuttering:
http://www.nursefriendly.com/nursing/humor/medical/a.cure.for.one.mans.stutte...

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My Elbow Hurts!
http://www.nursinghumor.com/elbow

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Five Doctors Go Duck Hunting
http://www.nursinghumor.com/duck

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Do You Have A Dentist Appointment Tomorrow Too?
http://www.nursinghumor.com/too

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Who Makes the Best Patient?
http://www.nursinghumor.com/best/

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Eye Surgery, Operating Room Jokes, Medical Humor:
http://www.nursinghumor.com/eye

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GDU College of Medical Fraud:"GDU refuses to offer a degree in medicine out of concern that some cost-conscious hospital will hire someone with one of our diplomas, and let them perform surgery. However,GDU does offer programs in medically-related fields"
http://www.bandersnatch.com/med.htm

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Medical Humor:
http://www.swcbc.com/medical.html

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Patient: Doctor, I think I need glasses.

Teller: You certainly do! This is a bank.

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A man walks into a Doctors. He has a cucumber up his nose, a carrot in his left ear and a banana in his right ear.

"What's the matter with me?" he asked.

"You're not eating properly." replied the Doctor.

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"Doctor, I've had problems with silent gas emissions. At home, work, or at church I get lots of silent gas emissions. As a matter of fact I've had three sitting here talking to you. What are we going to do?"

"The first thing we're going to do is check your hearing"

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A man goes to doctor and says:

'Doctor, I have a problem. When I drink tea, my eye aches(sp?) and when I stop, it stops too. Can you help me?'

Doctor says:'Take the spoon out of the cup!'

--

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For Health Information you can use, Follow, Connect, Like us on (Most Invites Accepted):
http://www.nursefriendly.com/social/

Google Plus (if you're not a member, e-mail me for an invite)-info@nursefriendly.com
http://www.nursefriendly.com/google/

Twitter!
http://www.nursefriendly.com/twitter

Facebook:
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What's New:
http://www.nursefriendly.com/new/

Blogger:
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Linked In:
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Nursing Entrepreneurs, Nurses In Business
http://nursingentrepreneurs.ning.com/

StumbleUpon,
http://www.nursefriendly.com/stumbleupon
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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

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http://www.nursingentrepreneurs.com
http://www.nursingexperts.com
http://www.nursinghumor.com

Saturday, August 20, 2011

A Nurse's Wish, Nursing Poems, Caregiver Stories

To Receive our inspirational stories as we post them subscribe to our mailing list by sending a blank e-mail to inspirationalstories-subscribe@topica.com


To be a nurse requires dedication,
with years of study and preparation.
I pray for guidance and humbly ask
that I will do well at this chosen task.
When illness strikes or pain demands,
and a life is placed within my hands,
give me compassion, knowledge and skill
to do the things that comfort and heal

Suffering makes patients' fears grow worse
and they seek reassurance from their nurse.
Help me see things from their point of view
and always know what is best to do.

May I have a part in some small way,
in restoring good health to someone today.
Let my work be all that I want it to be
I ask the Great Healer to work through me.

Helen Bush

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For Health Information you can use, Follow, Connect, Like us on (Most Invites Accepted): http://www.nursefriendly.com/social/:

Twitter! http://www.nursefriendly.com/twitter

What's New

Blogger: http://4nursing.blogspot.com

Facebook: http://www.nursefriendly.com/facebook

Linked In: http://www.linkedin.com/in/nursefriendly

Nursing Entrepreneurs, Nurses In Business, http://nursingentrepreneurs.ning.com/

Posterous.com, http://nursefriendly.posterous.com

StumbleUpon, http://www.nursefriendly.com/stumbleupon


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After Breast Cancer: A New Normal or a New Perspective?

After Breast Cancer: A New Normal or a New Perspective?:"Every Monday night at 9pm EST there's a terrific chat on Twitter about “the intersection of breast cancer and all things social media” (#BCSM). If you've never used Twitter, it limits users to 140 characters, including blank spaces, which forces you to make your thoughts concise and to the point. Perhaps the best thing about Twitter is that it allows you to have dialogs with people from all over the world, people you wouldn’t ordinarily meet."
After Breast Cancer: A New Normal or a New Perspective?

Friday, August 19, 2011

Site Citations, Mentions, Nursing & Healthcare Directories on: The Nursefriendly

Site Citations: Our efforts to make the nursefriendly a useful resource have panned out. We are cited often by other websites and publications including:

Attitude indicator and activity monitoring device, United States Patent 6611783, Freepatentsonline.com:"Abstract: An attitude indicator device for detecting, indicating, and/or logging the positional attitude of an individual in response to deviation from a set of one or more reference angles. By way of example and not of limitation, the device is mounted on the thigh of a patient and measurements are taken from an acceleration sensor within the device. The acceleration measurements are communicated to a receiver when the measurements deviate from acceptable thresholds, whereby the receiver indicates an alert condition. The device may be employed within numerous medical related applications, for example, to facilitate preventing patient egress and the prevention/detection of patient falls."
http://www.freepatentsonline.com/6611783.html

US Patent 6611783 - Attitude indicator and activity monitoring device, Patentstorm.us:"An attitude indicator device for detecting, indicating, and/or logging the positional attitude of an individual in response to deviation from a set of one or more reference angles. By way of example and not of limitation, the device is mounted on the thigh of a patient and measurements are taken from an acceleration sensor within the device. The acceleration measurements are communicated to a receiver when the measurements deviate from acceptable thresholds, whereby the receiver indicates an alert condition. The device may be employed within numerous medical related applications, for example, to facilitate preventing patient egress and the prevention/detection of patient falls."
PatentStorm Pierce School Lofts 1375 Maryland Ave. NE Loft B Washington, DC 20002 http://www.patentstorm.us/patents/6611783.html

Sites that link to us include:

Case Study Nursing
http://www.righthealth.com/topic/Case_Study_Nursing

Righthealth.com, Hematochezia : Symptoms:
http://www.righthealth.com/topic/Hematochezia/Symptoms

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Follow us on:
Facebook: http://www.nursefriendly.com/facebook

Nursing Entrepreneurs, Nurses In Business, http://nursingentrepreneurs.ning.com/

Twitter! http://www.nursefriendly.com/twitter

StumbleUpon, http://www.nursefriendly.com/stumbleupon


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Inspra, Eplerenone, Blood Pressure Pills, Antihypertensives, Hypertension, Aldosterone Blockers

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Eplerenone, How Does it Work, DrugDigest.org:"Eplerenone works by blocking aldosterone, a chemical that causes water and salt retention that can increase blood pressure. By blocking aldosterone, eplerenone causes the kidneys to get rid of unneeded water and salt from the body in the urine."
Expresscripts.com
Burstyn, Lance
521 Alton Rd #208, Miami Beach, FL 33140, US
http://www.drugdigest.org/

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Eplerenone, Indications and Warnings, eDrugInfo.com:"Contraindicated in patients who are allergic to eplerenone or hyperkalemic (potassium level greater than 5.5 mEq/L); also contraindicated in those with type 2 diabetes with microalbuminuria, in those with creatinine clearance less than 50 ml/minute), and in those with creatinine level greater than 2 mg/dl in men or 1.8 mg/dl in women. Also contraindicated in patients taking potassium supplements or potassium-sparing diuretics, ketoconazole, or itraconazole.

Use cautiously in patients with hepatic impairment. Use cautiously also in pregnant and breast-feeding patients."
Lippincott Williams & Wilkins
P.O. Box 1600, Hagerstown, MD 21741, USA.
In the US, dial 1 (800) 638-3030 http://www.lww.com/

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Eplerenone, Drugs and Foods to Avoid, Genesis Health System:"Make sure your doctor knows if you are also using erythromycin (Erythro-Tab), verapamil (Calan), saquinavir (Fortovase), fluconazole (Diflucan), lithium, blood pressure medicine (such as Accupril, Altace, Avapro, Cozaar, Diovan, Hyzaar, Lotensin, Lotrel, Monopril, Prinivil, Vasotec, Zestril), or pain or arthritis medicine (such as ibuprofen, Advil, Aleve, Daypro, Motrin, Orudis, Relafen).

Do not take any medicine with potassium while you are using eplerenone. This includes salt substitutes and some vitamin or mineral supplements."
Genesis Health System
1227 E. Rusholme Street, Davenport, IA 52803
563-421-1000
http://www.genesishealth.com/

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Eplerenone (Systemic), Pregnancy, MEDLINEplus:"Eplerenone has not been studied in pregnant women. Before taking this medicine, make sure that your healthcare professional knows if you are pregnant or if you may become pregnant.

Breast-feeding-It is not known whether eplerenone passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their healthcare professional.

Children-Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of eplerenone in children with use in other age groups."
Office of Communications and Public Liaison
National Library of Medicine
8600 Rockville Pike Bethesda, Maryland 20894
Phone: (301) 496-6308 Fax: (301) 496-4450 email: publicinfo@nlm.nih.gov
http://www.nlm.nih.gov/medlineplus/

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Eplerenone, Mechanism of Action, MosbysDrugConsult.com:"Eplerenone binds to the mineralocorticoid receptor and blocks the binding of aldosterone, a component of the renin-angiotensin-aldosterone-system (RAAS). Aldosterone synthesis, which occurs primarily in the adrenal gland, is modulated by multiple factors, including angiotensin II and non-RAAS mediators such as adrenocorticotropic hormone (ACTH) and potassium. Aldosterone binds to mineralocorticoid receptors in both epithelial (e.g., kidney) and nonepithelial (e.g., heart, blood vessels, and brain) tissues and increases blood pressure through induction of sodium reabsorption and possibly other mechanisms.

Eplerenone has been shown to produce sustained increases in plasma renin and serum aldosterone, consistent with inhibition of the negative regulatory feedback of aldosterone on renin secretion. The resulting increased plasma renin activity and aldosterone circulating levels do not overcome the effect of eplerenone on blood pressure.

Eplerenone has relative selectivity in binding to recombinant human mineralocorticoid receptors compared to its binding to recombinant human glucocorticoid, progesterone and androgen receptors."
Elsevier, Health Sciences Division
11830 Westline Industrial Drive, St. Louis, MO 63146
1-800-545-2522 http://www.us.elsevierhealth.com/

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Using eplerenone (Inspra), Dear Patient, NursingDrugGuide.com:"Your health care provider has prescribed the antihypertensive drug eplerenone to treat your hypertension. This drug works by blocking the effects of aldosterone, a hormone normally found in your body. The results of this block may be an increase in urination and an increase in serum potassium levels. The name of this drug is Inspra."
Lippincott Williams & Wilkins
P.O. Box 1600, Hagerstown, MD 21741, USA.
In the US, dial 1 (800) 638-3030 http://www.lww.com/

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Eplerenone, Indications and Dosage, RxLIst.com:"INSPRA is indicated for the treatment of hyper-tension. INSPRA may be used alone or in combination with other antihypertensive agents.

INSPRA may be used alone or in combination with other antihypertensive agents. The recommended starting dose of INSPRA is 50 mg administered once daily. The full therapeutic effect of INSPRA is apparent within 4 weeks. For patients with an inadequate blood pressure response to 50mg once daily the dosage of INSPRA should be increased to 50 mg twice daily. Higher dosages of INSPRA are not recommended either because they have no greater effect on blood pressure than 100 mg or because they are associated with an increased risk of hyperkalemia. (See CLINICAL STUDIES .) No adjustment of the starting dose is recommended for the elderly or for patients with mild-to-moderate hepatic impairment. For patients receiving weak CYP3A4 inhibitors, such as erythro-mycin, saquinavir, verapamil, and fluconazole the starting dose should be reduced to 25 mg once daily (see CONTRAINDICATIONS)."
RxList - The Internet Drug Index: Searchable drug database. RxList LLC
500 3rd Street Suite 530
San Francisco, CA 94107
707-747-0985 fax: 708 575 8638
info@rxlist.com
http://www.rxlist.com/

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Eplerenone, How should this medicine be used, SafeMedication.com:"Eplerenone comes as a tablet to take by mouth. It is usually taken once or twice a day, with or without food. To help you remember to take eplerenone, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take eplerenone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of eplerenone and increase your dose after 4 weeks.

Eplerenone controls high blood pressure but does not cure it. It may take 4 weeks or longer before you feel the full benefit of eplerenone. Continue to take eplerenone even if you feel well. Do not stop taking eplerenone without talking to your doctor."
American Society of Health-System Pharmacists
7272 Wisconsin Avenue Bethesda, MD 20814
301-657-3000
http://www.safemedication.com/

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Eplerenone, What is eplerenone, Web Md Health:"Eplerenone blocks the actions of the hormone aldosterone in the body. Aldosterone is important for the regulation of blood pressure.

Eplerenone is used to lower high blood pressure.

Eplerenone may also be used for purposes other than those listed in this medication guide.
WebMD
1175 Peachtree Road, NE, Suite 2400, Atlanta, GA 30361.
212-624-3700service@webmd.net
http://my.webmd.com/content/drugs/

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Eplerenone, What happens if I miss a dose, YaleNewHavenHealth.org:"Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose."
Yale New Haven Health System
789 Howard Avenue, New Haven, CT 06519
Tel.(203)688-4608, Fax (203)688-3774
http://yalenewhavenhealth.org/

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4nursinguniforms.com

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Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

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Wednesday, August 17, 2011

Nurse Sued For "Too Many Sticks" How Many Attempts Is Too Many?

Clinical Nursing Malpractice Case Studies, January 29, 2002
Coleman v. East Jefferson General Hosp., 747 So.2d 1044- LA (1999)

Summary: Starting Intravenous Lines and Performing Venipunctures are basic nursing skills in the Acute Care or Hospital settings. In this case, a female patient would accuse a male nurse of negligence and causing a resulting injury when he needed three attempts to successfully start an intravenous catheter.

The female patient came to the hospital with vague complaints of abdominal pain and was evaluated in the Emergency Department. The physician’s orders for treatment included intravenous medications for which a line would need to be started.

“Up to 90% of patients who require health care services need some form of I.V. therapy. Unfortunately, many hospitals have done away with I.V. teams, so you may be responsible for inserting and maintaining I.V. lines even if you're inexperienced or have limited opportunities to keep your skills sharp.”2

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Sidebar:

Venipuncture and the insertion of intravenous catheters are basic nursing skills. If a nurse has not learned these skills in Nursing School, it will be often be learned “on the job” in the early months of orientation at an acute care facility.

As with most nursing skills, it is one that improves with practice. The prudent nurse will attempt once or twice and then ask another nurse to give it a try.

In rare cases, you will come across patient’s that are “a difficult stick.” In this case, if there simply are “no veins” the physician should be notified or an expert nurse should be called in.

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A male nurse was assigned to the patient when the Intravenous Catheter was to be placed. The nurse was having difficulty finding veins in the woman’s arms. He then attempted twice to start a line in her hand and was successful on the third attempt.

It was the policy of the hospital at that time, that a nurse may attempt an intravenous catheter insertion no more than two times before calling for assistance.

For the remainder of the patient’s treatment at the hospital, it would be documented that the patient complained of discomfort at the IV site and tolerated it poorly.

Pain or discomfort at the site of an IV insertion should present a “red flag” to an experienced nurse.

When combined with redness, swelling, puss or exudates at an IV site, pain can signal one of many potential complications of Intravenous Therapy including extravasation of IV fluids/medication, infection of the site or a dislodging of the catheter.

When pain or potential complications are reported, the site should be thoroughly evaluated for signs of a problem. If symptoms persist, the placement of another line at an alternate site should be offered for continued Intravenous Therapy.

There was no indication in the hospital record, that other signs/symptoms of a complication existed other than the pain/discomfort. This may have been positional due to the location of the IV site in the patient’s hand.

There was no indication that placement of another line was either offered to, or refused by the patient.

“When an I.V. lawsuit is argued in court, top-notch I.V. skills don't mean much unless they're backed up by appropriate, accurate, and concise documentation. Unfortunately, documentation is where many nurses fall short.”2

Following her discharge, the patient would file a suit alleging negligence on the part of the nurse and hospital. Specifically, she claimed a poorly performed catheter insertion caused her to develop Reflex Sympathetic Dystrophy in her right hand.

“What is Reflex Sympathetic Dystrophy Syndrome?

Reflex sympathetic dystrophy syndrome (RSDS) is a chronic condition characterized by severe burning pain, pathological changes in bone and skin, excessive sweating, tissue swelling, and extreme sensitivity to touch. The syndrome is a nerve disorder that occurs at the site of an injury (most often to the arms or legs). It occurs especially after injuries from high-velocity impacts such as those from bullets or shrapnel. However, it may occur without apparent injury.”3

Summary judgment was entered for the hospital finding that no negligence was evident.

The patient appealed.

Questions to be answered:

1. Was the nurse negligent in his catheter insertion technique? Were certifications and hospital policies/procedures adhered to?

2. Were standards of care, specific to Intravenous Catheter Insertions adhered to.

3. Was it plausible, that the patient’s “Reflex Sympathetic Dystrophy” may have resulted from the multiple catheter insertion attempts that day?

On review of the chart and following expert testimony, no deficiencies in technique could be found in the placement of the catheter. By his employment record and training, he was fully qualified to place intravenous catheters as a part of his scope of practice as a licensed nurse.

It was noted that the hospital’s standards, allowed for a maximum of two attempts before calling for assistance. The nurse in question, attempted three times.

On further review, the “community” standards, which was the measure used for this case, allowed four insertion attempts. By this standard of care, the nurse was within reasonable limits by trying three times.

Expert Testimony addressed the issue of “causation” of the patient’s “Reflex Sympathetic Dystrophy.”

In statements made, no direct causative link could be established between the starting of an intravenous catheter, and a diagnosis of Reflex Sympathetic Dystrophy.

At best, the plaintiff’s expert stated that it was a slim possibility, that a link could be made. The physician offered no support to the claim that the plaintiff’s alleged injuries were caused by the catheter insertion.

The appeals court affirmed the judgment of the lower court.

It should be noted that Intravenous Therapy, while a basic part of nursing practice, is extremely prone to complications and resulting malpractice & negligence actions.

Related clinincal Nursing (Malpractice) Case Studies:

August 8, 1999: Pregnant Prison Inmate Complains of Miscarriage, Corrections Nurse On Duty Ignores Symptoms?
Ferris v. County of Kennebec, 44 5. Supp.2d 62 –ME (1999)
Summary: Nursing assessment skills are one of our most valuable assets. They allow us to effectively evaluate our patients and communicate significant findings to physicians and other members of the healthcare team. In this case, a pregnant woman with a previous history of miscarriage complained of vaginal bleeding and abdominal discomfort. The assessment performed by the nurse fell negligently short of the required standard of care.
http://www.nursefriendly.com/nursing/clinical.cases/080899.htm

August 1, 1999: Nursing Duty To Patient, "Does Not Guarantee" Safety Or Quality Of Care.
Summary: When a nurse accepts report and responsibility for the care of a patient a duty to the patient is also accepted. This duty is to provide a reasonable standard of care as defined by the Nurse Practice Act of the individual state and the facility Policy & Procedures. In this case, a post-op abdominal aneurysm repair patient was injured after falling from his bed to the floor. When a lawsuit was filed the court initially mistook expert testimony to imply the role of the nurse includes a guarantee of safety.
Downey v. Mobile Infirmary Med. Ctr. - 662 So. 2d 1152 (1995).
http://www.nursefriendly.com/nursing/clinical.cases/080199.htm

July 11, 1999: Nursing Home Rehabilitation Stay Proves Terminal. Was Quality of Care Given An Issue?
Nursing homes are frequently a patient's destination for rehabilitation following surgery.  Common conditions fitting this bill include large bone fractures, hip replacements and stroke. Following these acute episodes, the patients are too unstable to go home and not "sick" enough to have their hospital stays reimbursed by insurance companies.  The purpose of admission to a nursing home is to help the patient regain lost function, strength and health.  In this case, the patient would remain in the Nursing Home till her death of complications.
Lloyd v. County of Du Page, 707 NE.2d 1252 - IL (1999)
http://www.nursefriendly.com/nursing/clinical.cases/071199.htm

June 6, 1999: Emergency Department Nurse Verbally Abused, Physician History Well Documented
Official tolerance for verbal abuse and sexual harassment is approaching zero.  It is clear that both are still prevalent in healthcare settings today.  Enforcing and reporting instances of abuse are critical to an end being put to the situation.  In this case, a physician had a "history" of verbal abuse in the facility involved.  It was the documentation of previous events that made formal action and administration of a suspension feasible.
Gordon v. Lewiston Hospital, 714 A.2d 539 – PA (1998)
http://www.nursefriendly.com/nursing/clinical.cases/060699.htm

Resource Link Sections:

Clinical Charting and Documentation, Nurses Notes:
http://www.nursefriendly.com/nursing/directpatientcare/clinical.documentation.nurses.notes.htm

Courtroom Directory (National):
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Direct Patient Care Links :
http://www.nursefriendly.com/nursing/linksections/directpatientcarelinks.htm

Emergency Department Nursing:
http://www.nursefriendly.com/emergency/

Intravenous Therapy: Certified Registered Nurse Infusion (CRNI), Conscious Sedation, Heparin Administration, Commercial Infusion Pumps, Home Infusion, IV Fluids, Intravenous Therapy Humor, Nursing Consultants, Nursing Societies, PICC Lines, Professional Associations, Starting An Intravenous IV Line, Venepuncture, Steroid Therapy
http://www.nursefriendly.com/intravenous/

Medical Legal Consulting Nurse Entrepreneurs:
http://www.nursefriendly.com/nursing/ymedlegal.htm

Reflex Sympathetic Dystrophy Syndrome (RSDS), Neurological Disorders, Chronic Pain:
http://www.nursefriendly.com/rsds/

References:

1. NLRR 8 (January 2000)

2. Satarawala, Rebecca . “Confronting the Legal perils of I.V. Therapy.” Nursing2000 August 2000. Retrieved January 23rd, 2002 from the World Wide Web: http://www.springnet.com/ce/p008b.htm

3. National Institute of Neurological Disorders and Stroke, Public Domain. NINDS Reflex Sympathetic Dystrophy Syndrome Information Page. Retrieved January 23rd from the World Wide Web: http://www.ninds.nih.gov/disorders/reflex_sympathetic_dystrophy/reflex_sympathetic_dystrophy.htm

Tuesday, August 16, 2011

#Nurse Practitioners (#Cardiac) To Follow (@HEARTSTRONG1) on #Twitter

HEARTSTRONG1

HEARTSTRONG1

@HEARTSTRONG1 New Jersey
Nurse Practitioner specializing in health & wellness, interested in Fitness, Marketing, Speaking, Publishing

 

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HEARTSTRONG1

 

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HEARTSTRONG1

 

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HEARTSTRONG1

 

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HEARTSTRONG1

 

amednews: Revealing their medical errors: Why three doctors went public :: Aug. 15, 2011 ... American Medical News

In September 2010, Kimberly Hiatt made a medical error. The critical care nurse at Seattle Children's Hospital miscalculated and gave a fragile 8-month-old baby 1.4 grams of calcium chloride, 10 times the correct dose of 140 milligrams.

The mistake contributed to the death of the child and led to Hiatt's firing and an investigation by the state's nursing commission. In April 2011, devastated by the loss of her job and an infant patient, Hiatt committed suicide.

Hiatt, who had worked as a nurse for more than two decades, was another in a long line of "second victims" of medical error, the term used in medical literature to describe physicians and other health professionals who often feel guilty and depressed after adverse events. Many physicians and other health professionals hold themselves to a standard of perfection, and when things go wrong, they feel alone.

Please click on the "VIA" link to read the full article.

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

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http://www.nursinghumor.com

After Breast Cancer: A New Normal or a New Perspective?

Every Monday night at 9pm EST there's a terrific chat on Twitter about “the intersection of breast cancer and all things social media” (#BCSM). If you've never used Twitter, it limits users to 140 characters, including blank spaces, which forces you to make your thoughts concise and to the point. Perhaps the best thing about Twitter is that it allows you to have dialogs with people from all over the world, people you wouldn’t ordinarily meet.

For those of you who wonder if anything meaningful can come from writing a sentence or two, here’s a sampling of last Monday night’s Twitter chat about “finding our new normal after breast cancer treatment.” Participants in this conversation are listed below.

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For Health Information you can use, Follow, Connect, Like us on (Most Invites Accepted):
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Facebook:
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Nursing Entrepreneurs, Nurses In Business
http://nursingentrepreneurs.ning.com/

StumbleUpon,
http://www.nursefriendly.com/stumbleupon
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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

http://www.4nursing.com
http://www.inspirationalnursing.com
http://www.legalnursingconsultant.com
http://www.nursefriendly.com
http://www.nursingcasestudy.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com
http://www.nursinghumor.com

Friday, August 12, 2011

#Nurses To Follow: #Nurse Barb (@NurseBarbDehn) on @Twitter, Picks by @nursefriendly #nursefriendly #hcsm #rnchat

Nurse Barb

Nurse Barb

@NurseBarbDehn Silicon Valley
Barb is an award winning author and TV health expert, who posts on NurseBarb.com

 

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Jenny Carrick
  by NurseBarbDehn

 

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abc7newsBayArea
  by NurseBarbDehn

 

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Nurse Barb

 

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Nurse Barb