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Curious - Absolute No-No's



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  #1  
Old Dec 06, 2007, 09:49 AM
Drysolong (Female)
Senior Member
Join Date: May 2004
Curious - Absolute No-No's

Hi: I hope to get a lot of input from this question. As experienced nurses, what are some things especially related to medication administration, but anything else, that you would classify in red for a nurse to never, ever do? Also, what have been the consequences of nurses doing these things? Thanks, in advance!!!

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  #2  
Old Dec 06, 2007, 09:56 AM
TheCommuter's Avatar
TheCommuter (Female)
Palm tree lover
Join Date: Feb 2005
Re: Absolute No-No's

Giving antihypertensive meds without first obtaining the patient's blood pressure is rather dangerous. The consequences to doing this should be obvious.

Failing to routinely obtain temperatures on a patient on antibiotic therapy is unwise. After all, an infectious process is still occurring if the temp is 104 degrees, but how do we know the temp is elevated if we never monitor it?

Administering rapid-acting insulin to diabetics is unwise when we're unsure if they're going to eat anything. I've seen too many people with hypoglycemic reactions and bottomed-out blood glucose readings because somebody gave 15 units of Humalog a whopping 90 minutes before lunch time.

Giving crushed meds through a PICC line is an absolute NO! Yes, I've seen someone do this before.

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  #3  
Old Dec 06, 2007, 09:56 AM
Registered User
Join Date: Sep 2006
Re: Absolute No-No's

Giving Potassum directly into an IV - instant cardiac arrest...not good!

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  #4  
Old Dec 06, 2007, 10:04 AM
Registered User
Join Date: Jan 2006
Re: Absolute No-No's

Faxing a lab result for a PT INR rather than calling a physician. Giving coumadin for weeks without getting a PT INR as ordered. Giving coumadin too early or too late. Not taking seriously that the effect of medications being used inappropriately can result in a patient's death!

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  #5  
Old Dec 06, 2007, 10:05 AM
Registered User
Join Date: Sep 2006
Re: Absolute No-No's

This is what I meant to say regarding consequences:

"Administration of concentrated potassium injection can be fatal. Parenteral potassium chloride solutions must be well diluted, thoroughly mixed and administrered by slow i.v. infusion. Pain at the injection site and phlebitis may occur. Extravasation is to be avoided"

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  #6  
Old Dec 06, 2007, 10:07 AM
Emmanuel Goldstein's Avatar
Oh Goody!
Join Date: May 2007
Re: Absolute No-No's

Originally Posted by Drysolong View Post
Hi: I hope to get a lot of input from this question. As experienced nurses, what are some things especially related to medication administration, but anything else, that you would classify in red for a nurse to never, ever do? Also, what have been the consequences of nurses doing these things? Thanks, in advance!!!
There are many things you should and shouldn't do when administering medications. But the two most important IMO is to know what you're giving--- not just blindly follow an order, and never ever attempt to cover up an error.

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  #7  
Old Dec 06, 2007, 10:17 AM
motorcycle mama (Female)
Registered User
Join Date: May 2004
Re: Absolute No-No's

Recently, a nurse highlighted PM meds on the MARS to help distinguish which meds were to be given on what shift.

It caused confusion with a lot of nurses. I know I was looking for a DC order.

We flogged her good.

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  #8  
Old Dec 06, 2007, 10:32 AM
Spidey's mom's Avatar
SAHM wannabe
Join Date: Dec 2002
Re: Absolute No-No's

Never give a med you didn't draw up or retrieve. (Except in a trauma or code when a pharmacist is drawing up meds).

steph

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Old Dec 06, 2007, 10:38 AM
VivaLasViejas's Avatar
Proud Army Mom
Join Date: Sep 2002
Re: Absolute No-No's

There is NO "5-second rule" in medication administration. If you drop a pill on the floor---GET A NEW PILL.

I don't even take pills that fall on the floor in my own home. Blech!

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  #10  
Old Dec 06, 2007, 10:50 AM
TRC
Registered User
Join Date: Sep 2004
Re: Absolute No-No's

I worked in the ER. You should never ever let a seizure pt get up and walk to the bathroom(until theyve received their bolus)...even if they do say they're fine. I hated seeing other nurses letting their pts walk to the bathroom. We had one pt seize in the bathroom and the door was locked. Had to wait on security.
Also remember that many meds that can be given through a central port cannot be given peripherally at the same concentration.

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