Did You Know?
allnurses is the largest community for nurses on the web. We now have over 388,174 members! Join today to network with other nurses, laugh, share, and much more.
| Advertisement Sponsored Links | | | | No. 32 | 
Nov 07, 2009, 11:33 AM
 Re: Pushing Dilaudid?
If it is ordered as an IVP and you give it in a 50mL bag of NS and administer as an IVPB then that is a med error. Is it one that will cause harm...no...but an error none the less. Also agree with not leaving a narc hanging unattended with a patient.
I also agree that the original poster was not interested in what other people had to say on the subject and only was looking for people to justify their actions...sorry you did not find it...you are wrong...we are right...the end.
 | | No. 33 |
Nov 07, 2009, 11:46 AM
Re: Pushing Dilaudid?
What JRD2002 said...if the MD orders Dilaudid IVP & you choose to hang a piggyback, you have changed the route of administration.
You can avoid a high & not change the route. Dilute it in 10mg saline & push it slow, over 5-10 minutes. That way, you are administering the med as ordered, the pain-relief seeking patient is getting treated, and the narc-seeking patient isn't getting a high.
| | No. 34 |
Nov 07, 2009, 11:52 AM
Updated
Nov 07, 2009 at 12:02 PM by c0ntagion
Re: Pushing Dilaudid? Originally Posted by chacmool  Yes of course I leave the room. I don't see how it would be an issue as it is in a bag so the patient isn't going to take it. It's not like a PCA where there's a huge syringe full of narcotic so we have to lock it. Even if they were to take the bag down what would they do with 50cc of fluids mixed with dilaudid? Drink it?
This is a bad, bad, bad, idea... would you leave 2 Percocet sitting on your patient's bedside table when anyone from staff to a family member (even a child) could come in and pick it up? If you're giving a pain med, the patient probably knows that's what you've hung as he/she has just requested pain medicine.
I never leave narcotics unsecured anywhere.
...and what about the patients who are getting it every hour or two? If you're continually putting it in 50 ml of saline, the patient could have an extra 600 ml of fluid in one 12 hour shift. In my area of practice, you've just gone half way through their daily fluid restriction! http://www.umm.edu/altmed/drugs/hydr...one-065100.htm
"I.V.: For IVP, must be given slowly over 2-3 minutes"
If you're that worried about it, just dilute it in a few mls of saline and put it in a 10 ml syringe on a Bard pump.
| | No. 35 |
Nov 07, 2009, 02:48 PM
Re: Pushing Dilaudid? Originally Posted by rnmi2004 What JRD2002 said...if the MD orders Dilaudid IVP & you choose to hang a piggyback, you have changed the route of administration.
You can avoid a high & not change the route. Dilute it in 10mg saline & push it slow, over 5-10 minutes. That way, you are administering the med as ordered, the pain-relief seeking patient is getting treated, and the narc-seeking patient isn't getting a high.
nope, still IV
| | No. 37 |
Nov 07, 2009, 06:01 PM
Re: Pushing Dilaudid?
Whats so wrong with pushing the Dilaudid? What you can do is, set it up, start pushing it a little,, then take care of other stuff with the patient, , like a small reassessment, or give them a tissue.. then push a little more,, You can incorporate pushing the IV with other tasks that you need to get done in this room, as long as you don't step too far away from their arm. Depending on whether this is someone you think MIGHT grab the syringe and push really fast (these people are rare).. Most people will lay there and let you push it in slowly and you're getting other tasks done,, great time management.
Forget the bag,, unless it is ordered or it is facility policy and pharmacy sent it to you in a bag.
| | No. 39 |
Nov 14, 2009, 09:58 AM
Re: Pushing Dilaudid?
studies show "drug seekers" are not always addicts; some portray addict like behavior only because their pain is not relieved. This study was also extended to "doctor shopping" and they found some were just in pain wanting to get out of pain. I leave the assumptions aside and push whatever is order to be pushed, hang whatever is supposed to be hanged.
Hopefully the doc has educated themselves on pain control and addictive behavior. I will not label a patient as "an addict" or "drug seeking" because anyone would seek drugs if in pain.
Pushing narcs is no big deal if you're experienced doing so. If they've had the amount before, I push it faster since I know that will help their pain, make them feel better and give me more time to deal with others if the patient is feeling better.
|
| 336 members
3,106 guests 3,442
| 1 | | | 12 | | | 2 | | | 9 | | | 17 | | | 11 | | | 14 | | | 16 | | | 37 | | | 14 | | | 20 | | | 23 | | | 19 | | | 24 | | | 10 | |
|
Happy Nursing ALL!!
Nursing News