[candyndel]

No- its very different than dobutamine...its a synthetic peptide, not an inotrope!! Also, the hypotension almost always occurs within the first 4 hours and the pt shouldnt be on it for more than 24 hours. There really should be an automatic stop on it (24 hours) so it doesnt get abused. The nurse should assess the pt's status and not just hang another bag! When you have pts on it for too long, the pharmacy is going to outrule it and pts that really need it wont be able to get it!!



QUOTE=staceylynn]Natrecor is ok to use on a tele unit. It not much different then dobutamine. The only problem is that it can cause hypotension, which usually occurs after 24 hr. But if you take on this drug, they'll keep adding more drugs![/quote]

[rwall]

Originally Posted by DutchgirlRN

I work on a Med/Surg/Telemetry floor and our ratio is 6:1 . We have Natrecor gtts frequently. We are not allowed to initiate the gtt nor bolus the gtt, that has to be done in CCU. Once they've been on the gtt for 4 hours they can come to the floor. The vital signs are Q 4 hours. So far no problems. I appreciate all the information. I am going to pass it on to my nurse manager. Merry Christmas !!

Do you happen to have this Policy written? If you do, I would be interested in seeing it. That would be helpful.

[candyndel]

Sure. email me and i'll send u a copy

Originally Posted by rwall

Do you happen to have this Policy written? If you do, I would be interested in seeing it. That would be helpful.

[PrncessK]

Originally Posted by DutchgirlRN

I work on a Med/Surg/Telemetry floor and our ratio is 6:1 . We have Natrecor gtts frequently. We are not allowed to initiate the gtt nor bolus the gtt, that has to be done in CCU. Once they've been on the gtt for 4 hours they can come to the floor. The vital signs are Q 4 hours. So far no problems. I appreciate all the information. I am going to pass it on to my nurse manager. Merry Christmas !!

I work on a 32 bed Tele unit and we have patients on Natrecor all the time. We do the bolus and do the drips and our policy is the standard vitals q4h.

[ageless]

Use cautiously in ESRD patients. According to them it is ineffective. Our nephrologists hate it and cancel the order written by another physician everytime.

[Pill Hoarding Hussy]

Originally Posted by maryangel

I work in a 33 bed telemetry unit, "stable" tele. The only drips we use are Dobutamine, Heparin, Cardizem. The physicians have decided to use Natrecor to treat CHF instead of Dobutamine. Currently if a patient is on this drip, they have to be in the unit for frequent vital signs, closer monitoring, etc. Our cardiologists want us to give the drip on our floor. Our nurse/pt. ratio is 1:5 or 6 on days and 1:8 or 9 on nights. Has anyone used this drug on their unit? and if so, do you think the ratio we have would be acceptable? Thanks for any input.

i work on a step down (before that a 32 bed "stable" tele floor) both floors have1:4 on days, step down has 1:4 or 1:5 nocs floor has 1:6-7 on nocs. majority of natrecor pts go to step down. q 15 min vitals while initiating the gtt, or increasing the dosage- then decreasing to q1 hr, q4. it's your nursing judgement about how the pt is tolerating the gtt. if they're hypotensive we may add dopa to the mix, depends on the pt' baseline sbp and how low nursing and the med team is comfortable allowing the pt to drift/if they are diuresing, etc. 1:6 sounds like a lot to handle with a pt of the intensity the usually requires this gtt.

[Pill Hoarding Hussy]

Originally Posted by candyndel

No- its very different than dobutamine...its a synthetic peptide, not an inotrope!! Also, the hypotension almost always occurs within the first 4 hours and the pt shouldnt be on it for more than 24 hours. There really should be an automatic stop on it (24 hours) so it doesnt get abused. The nurse should assess the pt's status and not just hang another bag! When you have pts on it for too long, the pharmacy is going to outrule it and pts that really need it wont be able to get it!!

what is the reationale for pts only being on natrecor for 24 hrs? yes, the oder does expire, but that does not necessarily mean that they don't have any more fluid to pull off. we routinely have pts on this gtt for 3 or so days... and it works for those who come 15 lbs over dry wgt.


QUOTE=staceylynn]Natrecor is ok to use on a tele unit. It not much different then dobutamine. The only problem is that it can cause hypotension, which usually occurs after 24 hr. But if you take on this drug, they'll keep adding more drugs!

[/quote]

[hui126]

Originally Posted by maryangel

I work in a 33 bed telemetry unit, "stable" tele. The only drips we use are Dobutamine, Heparin, Cardizem. The physicians have decided to use Natrecor to treat CHF instead of Dobutamine. Currently if a patient is on this drip, they have to be in the unit for frequent vital signs, closer monitoring, etc. Our cardiologists want us to give the drip on our floor. Our nurse/pt. ratio is 1:5 or 6 on days and 1:8 or 9 on nights. Has anyone used this drug on their unit? and if so, do you think the ratio we have would be acceptable? Thanks for any input.

i've used natrecor on the floor before. if the patient is stable and has been on the drip for awhile, you just have to make sure that you have another bag ready when the first one runs out, take frequency vitals. sometimes it's tricky if you have to start the drip, it's more tricky because of the loading dose and frequency vitals - then I would question the nurse to patient ratio. Hope this helps.

[snakeRN]

i work in a ccu and most of the time Natrecor infusions are done on the telemetry floors. However, with this drug, there does need to be and increase in the frequecey of the patients vital signs, as this drug can cause marked hypotension. The drug is an excellent choice for the CHF patient cause it increases the output of the heart, thereby reducing fluid buildup in the lungs. Hope this helps......Snake

[schroeders_piano]

Originally Posted by candyndel

Natrecor is perfectly fine for tele as well as M/S. It is now being used in CHF clinics for outpatients, as well. It doesnt require a monitor b/c it rarely causes arrhythmias (unlike dobutamine).

[/quote]

Natrecor doesn'ts casue arrhythmias but it can cause a substantial drop in heart rate. My facility requires q 15 minute vitals and constant telemetry monitoring for any patient on Natrecor. I have seen patient who have been on the drip for 2 hours with no problem and then suddenly the patient's blood pressure has taken a dramatic nose dive down. It is a very serious drug that requires frequent monitoring and assessment.


Schroeder