- 0Feb 23, '07 by FairlythereThe other day I had a patient who's prn order was Vistaril 25mg IV. It was given diluted in the IV tubing and shortly after was followed with a bolus of NS (for low urine output) so Im sure it was cleaned out of the vein rather quickly.
Later research shows this drug is only to be given IM as it is torturous to veins. I was horrified and will call the pharmacy to see if they need to change this.
Aside from that, I have read the main concern is that it causes most problems if accidently arterial or if the vein is punctured and thus can cause hemolysis or necrosis. Used to be it was given IV regularly from what I read but due to the risks, it is usually given IM now.
Should I write myself up for not catching this and do you think the patient is at risk for the side effects if it was flushed so well through a patent IV line?
Thanks for your help. I realize it is not the pharmacy or even the doc responsible as I should have researched the suggested route, but I had no clue as most of our drugs in this class (antihistamine/anti-emetic) are delivered IV.
Ready for my thrashing-suggestions. Go easy on me, Im already beating myself up severely as a relatively new nurse. :trout:
- 0Feb 23, '07 by ritarunningfeetIt is IM for the reasons of necrosis and irritation to the vein, alot of docs don't catch it that it should only be given IM as well. Phenergan may someday end up the same way because of the necrosis and irritation it can cause, it can still be given IV though just dilute it really well.
- 0Feb 23, '07 by ginger58I realize it is not the pharmacy or even the doc responsible as I should have researched the suggested route, but I had no clue as most of our drugs in this class (antihistamine/anti-emetic) are delivered IV.
No, no and no. Everyone is responsible! You're a new grad. Docs don't always know as much as they should about drugs but Pharmacists spent many years learning about drugs, and this isn't a new one.
I can tell you from having Vistaril IM pre-op my hip hurt for a year from that injection. No one will ever give that to me again! That stuff is painful.
Chin up, carry on and this may not be the first error the docs/Pharmacy make. Best wishes.
- 0Feb 23, '07 by GingerSueI can only speak re: what my current pharmacology textbook says - in several different areas of the book - vistaril is given either PO or IM, it is irritating
if the doctor ordered it IV, and the pharmacy supplied it labelled for IV, and you gave it IV, then all three are part of the mistake, but you should have caught it before giving it.
- 0Feb 24, '07 by jimthorpI actually have someone that begs for her Vistaril IM for her anxiety induced nausea. Funny thing is, it starts working the minute I tell her I'll go get the stuff...even before I inject it. Same with her anxiety induced cough and Robitussin DM.Last edit by jimthorp on Feb 24, '07