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Nurses in the telemetry or step-down units of the hospital are primarily concerned with a patient's heart rhythm. Nurses on this unit are not only certified in BLS (CPR), but also ACLS (Advanced Cardiac Life Support) and can effectively run a code blue without the presence of a physician. Nurses must be able to differentiate between different heart rhythms and understand what specific areas of the heart are doing based on those rhythms and alter the patient's drug therapy accordingly. Close monitoring of patients on high-risk intravenous medications is required. The nurse must be able to interpret lab values and integrate those values with the patient's illness. The relationship between the physician and the nurse on this unit must be one of utmost trust as frequently an acute change occurs, and the nurse must have the faith in his or her ability to advocate promptly and accurately for the patient.

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