Changing medication Forms

  1. 0 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 feel about this?
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  3. Visit  cfaith} profile page

    About cfaith

    cfaith has '26' year(s) of experience and specializes in 'Addiction'. From 'North Carolina'; Joined Feb '11; Posts: 55; Likes: 19.

    16 Comments so far...

  4. Visit  NicuGal} profile page
    1
    I guess it would depend on the situation....we crush to put in a suspension solution or water to give to our kids because it doesn't come any other way. Is it a person who can't swallow pills? But you also have to be aware that certain things can NOT be crushed.
    cfaith likes this.
  5. Visit  hiddencatRN} profile page
    3
    Changing the form is going from IV to PO or subq. Crush a PO tablet and it's still going in PO, right? As long as you're working with something that is safe being crushed I see no issue here.
    psu_213, bebbercorn, and cfaith like this.
  6. Visit  classicdame} profile page
    0
    what do you mean by "form"?

    If you mean route, then yes, you need an MD order to change the route

    If you mean paperwork, then no, as long as the route is the same
  7. Visit  cfaith} profile page
    0
    Quote from classicdame
    what do you mean by "form"?

    If you mean route, then yes, you need an MD order to change the route

    If you mean paperwork, then no, as long as the route is the same
    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 ....
  8. Visit  RNewbie} profile page
    0
    Quote from cfaith

    If it says suppository can I change it to solution and give as an enema???
    Do you mind giving an example of this?
  9. Visit  morte} profile page
    1
    Sign....is this home work?
    Hygiene Queen likes this.
  10. Visit  classicdame} profile page
    1
    I think the person to ask is your risk manager or Educator, if you are in a facility. If this is homework, I would lean towards ALWAYS following orders to the letter. You can learn in practice what the law is for your area and what the practice is in your facility.
    cfaith likes this.
  11. Visit  cfaith} profile page
    0
    no not homework, not anymore. I'm waiting to hear from my practice board. just taking the temp on here. I am the Clinical Improvement specialist/Educator for my facility Great minds think a like!
  12. Visit  cfaith} profile page
    0
    Steriod suppository
    , nurse gave steriod enema as replacement as it was available.
  13. Visit  cfaith} profile page
    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.
  14. Visit  psu_213} profile page
    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.
  15. Visit  SaoirseRN} profile page
    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.


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