Medication tidbits an ER nurse should always know - page 4
by RNstdntSVSU 36,650 Views | 68 Comments
Hi all...I am currently doing an externship in the ER and even though I can't administer medications, I've picked up on a lot of important facts you have to remember about certain medications from watching my preceptor. Things... Read More
- 0Dec 16, '12 by hodgieRNBe weary of giving clonidine to lethargic pts. It will causes sleepiness. Clonidine is sometimes used as a sleeping pill for sleep disorder, ADHD, or insomnia. Had a pt that was prescribed catapress TID and no one could figre out why he was basically obtunded. A CAT scan, MRI, and Neuro consult later, the clonidine was stopped and he became awake enough for neuro to sign off.
- 1Dec 22, '12 by whichone'spinkI've learnt that Dilaudid is an insidious drug. Dilaudid can accumulate in the system and the effects can linger on, well after the pain has gone away. I had a little old lady who got Dilaudid and afterwards could no longer maintain her O2 sats on room air. Granted she had a very high fever, possible pneumonia as well, but I think the Dilaudid made her hypoxic. She remained hypoxic for 3 hours after the Dilaudid.
I also know of a case of a patient who was admitted for pancreatitis. He was getting Dilaudid at a regular interval and was tolerating it well. Until all of a sudden, he went into respiratory, and later cardiac arrest. The Dilaudid accumulated in the system and then it caught up with the patient.
- 0Dec 23, '12 by Esme12 Senior ModeratorQuote from momo72The spelling of meds corrrectly is a pet peeve......I'm sorry Rocepherine/Ceftriaxone.If IV Rocepine is pushed too fast (should be super slow ,10 minutes) the patient WILL vomit! Thankfully I learned this after another nurse gave it too fast !
- 0Dec 23, '12 by whichone'spinkQuote from momo72I always put IV Rocephin on a pump, and give it over 30 minutes. Pharmacy says to give it over 15 minutes, but 30 minutes is safer. Also, I no longer hang piggybacks (antibiotics and non-antibiotics) without a pump. I once gave a piggyback with Thorazine too fast (part of a migraine cocktail) and I snowed the patient. Not doing that again.If IV Rocepine is pushed too fast (should be super slow ,10 minutes) the patient WILL vomit! Thankfully I learned this after another nurse gave it too fast !Michele RN
- 4Dec 23, '12 by FlorenceNtheMachineQuote from Esme12Isn't the brand name Rocephin? Meds are really tough to get right! I used to mumble the names in the pharmacy, but the pharmacist used to make me pronounce them correctly before he'd respond! Haha
The spelling of meds corrrectly is a pet peeve......I'm sorry Rocepherine/Ceftriaxone.
- 2Dec 23, '12 by SionainnRNQuote from LAMtheRNThat's funny about the tetanus shot, I usually give it in the dominant arm because the more you move it right away the less painful and swelling it seems to have, in my experience. I also let the pt know why I'm doing it that way so they can move it a bit more to help the medicine absorb throughout the muscle.I'm adding to some previous comments----any IV steroid CAN cause that burning sensation in the groin....old school nurses call it the Burning Bush.....LOL. Push slowly with a 10 cc flush to minimize this. I give most IMs in the ventrogluteal site as opposed to arm or buttocks. ALWAYS change the needle after drawing up IM med. This minimizes the pain. I know this from personal experience as Toradol is the only thing I take for migraine. I've actually had it administered during an ER shift and been able to get up and work 10 min later, no headache and no pain at site. For tetanus I use a small usually 5/8 needle, ask the patient which is their dominant arm, and use the other, and tell them it will be sore 2-3 days and this is normal. Don't forget to provide a strainer and explain its use to a kidney stone pt, and tell them the pain meds will NOT completely dissipate pain until it passes.