I have also wondered about this. What I do (not saying it's correct):
If the patient is on it every four hours (as needed) I don't generally get a whole set of vitals, I just put the pulse ox on them and leave it there for about 15 minutes to make sure they don't quit breathing. As for diluting the medications that is a big no no no no no no. At least to the patients ( go figure ). However, on our emar morphine is now coming up with a note to dilute it and push it slowly over 5 minutes. But there's not a note to dilute the dilaudid. That'd be sort of alterting the medication.
But there's not a note to dilute the dilaudid. That'd be sort of alterting the medication.
Our eMAR & my drug book indicate that dilaudid can be diluted with NS which I pretty much always do; otherwise, how can you push it slow? Only time I don't is if I can push it higher on the line & let the drip flush it through. Had a pt a few nights ago request that I not push it via the IV port, but directly into the catheter "so that it gets there quicker". She was not happy when I did so, but diluted it in 4 ml NS, pushed slowly & then reattached her NS drip rather than giving a quick flush. She stated that she didn't get that "burning" in her chest like she normally does & didn't like it when I told her that having that happen wasn't a good thing!