Changing medication Forms - page 2

by cfaith

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Can/should a RN change a mediction form without an MD order. ex MAR reads: ASA 325mg PO every am (one 325mg tablet). the nurse med room nurses crushs the med or change it to a BC powder without an MD order. How do you... Read More


  1. 0
    This the only statement from this states parctice act...
    "Implementing the treatment and pharmaceutical regimen prescribed by
    any person authorized by State law to prescribe the regimen."

    I'm seeking information as to when a nurse (RN &/or LPN) might change this "prescribed regimen" without consulting the person ordering it....
    So for all I have is what are the facilities policy.. looks like we need to write some ??????
    Thanks for everyones input.
  2. 1
    Quote from cfaith
    If MAR says tablet can I change to liquid or a powder?
    If it gum can I change it to lozenger?

    If it says suppository can I change it to solution and give as an enema???

    Those type of changes? Not the route ....
    Sorry, but this is kinda a pet peeve of mine. The word (at least in the US) is lozenge. Hearing "lozenger" gives me shivers. I don't know why it bothers me so much...it just does.

    Anyway, I would call the doc on the suppository vs. enema one. There might be a reason why a doc would not want a volume of liquid instilled into someones rectum.

    As for crushing a pill--there is no reason this can't be done unless it is something that cannot be crushed (like a SR tab).
    cfaith likes this.
  3. 4
    When I have a patient ordered oral potassium who can't swallow pills, I call the pharmacy and have them send liquid KCl instead, no doctor involved. Usually though the doctors don't specify "tablets", rather just the dose PO, so as long as what I'm giving is the correct PO dose, the form shouldn't matter.
    psu_213, PediLove2147, hiddencatRN, and 1 other like this.
  4. 1
    Quote from SaoirseRN
    When I have a patient ordered oral potassium who can't swallow pills, I call the pharmacy and have them send liquid KCl instead, no doctor involved. Usually though the doctors don't specify "tablets", rather just the dose PO, so as long as what I'm giving is the correct PO dose, the form shouldn't matter.
    Exactly what I was going to say... I was thinking the oral potassium as an example too...
    cfaith likes this.
  5. 2
    Quote from SaoirseRN
    When I have a patient ordered oral potassium who can't swallow pills, I call the pharmacy and have them send liquid KCl instead, no doctor involved. Usually though the doctors don't specify "tablets", rather just the dose PO, so as long as what I'm giving is the correct PO dose, the form shouldn't matter.
    Me too. Most of our patients are on potassium replacement protocols that specify either oral or IV. I can order liquid or tablet under the protocol.
    cfaith and psu_213 like this.
  6. 1
    If it is going to cost more, you may need a doc's order, esp. LTC
    Quote from SaoirseRN
    When I have a patient ordered oral potassium who can't swallow pills, I call the pharmacy and have them send liquid KCl instead, no doctor involved. Usually though the doctors don't specify "tablets", rather just the dose PO, so as long as what I'm giving is the correct PO dose, the form shouldn't matter.
    cfaith likes this.
  7. 1
    Quote from morte
    If it is going to cost more, you may need a doc's order, esp. LTC
    In Canada, so maybe that's the difference but it has never been a problem. I just tell pharmacy that the patient cannot swallow whole pills and ask for the liquid, and that is what they will send.
    cfaith likes this.


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