Nurse knowledge and Ibuprofen vs. Tylenol

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roser13, ASN, RN

6,504 Posts

Specializes in Med/Surg, Ortho, ASC.
If you have any stories to share of a time where your knowledge or experience proved to be extremely important in a certain situation, feel free to enlighten us.
Only Every.Single.Day.

Meriwhen, ASN, BSN, MSN, RN

4 Articles; 7,907 Posts

Specializes in Psych ICU, addictions.

To answer your subject title: ibuprofen can affect the kidneys more.

And for the rest of your post: if you are not sure what a drug does, look it up in a reference (drug guide, pharmacy textbook). Ask the prescriber or pharmacist. Call the manufacturer if you need to.

Don't give a medication you're not familiar with, and then try to plead ignorance as your excuse should something happen. The fact is that if you (the nurse) administer a medication to the patient and something happens to the patient, YOU can also held liable along with the prescriber/pharmacist/everyone else.

No, you can't predict every single adverse reaction--that's impossible. But you should know as much as you can about what you are administering to avoid the major/common/likely ones. And if you don't know it, find out.

And last, if you are seeking medical and/or legal advice, then your primary care provider and/or lawyer are the ones you need to be talking to, as we at AN are not allowed to give either per the TOS.

Hope this helps.

double_minority

101 Posts

Still puzzled about why this very 1st time poster is asking us this????? -__-

nurseprnRN, BSN, RN

1 Article; 5,115 Posts

"If you have any stories to share of a time where your knowledge or experience proved to be extremely important in a certain situation, feel free to enlighten us."

---is this a joke?

I dunno, I think anyone who's been a nurse for awhile and has a certain level of expertise has had moments like this.

I was precepting a new nurse in the CVICU and able to show her what a brand new pneumothorax looks like when she couldn't tell why he suddenly looked awful, and that lateralized chest pain wasn't the same thing as his sternotomy pain.

I was able to get an insurance adjuster pay the wife of one of my work comp patients what she was earning in a paper bag plant (ten bucks an hour) to stay home and take care of him (bilateral bad hand injuries and he didn't want a stranger CNA doing his personal care, unzipping him in the bathroom, wiping his butt, and feeding him) and get her FMLA so she didn't lose her job while she did it. The insurance company saved a bundle (an agency would have charged $25/hour to send a CNA), the couple was happy, and it made a big difference.

Coming in to be in charge one morning I recognized an ET tube slipped down a right mainstem and pulled it back stat- it had been like that all night and the novice night charge didn't recognize what the vent popping off all the time and the patient trying to cough after every breath could mean and didn't check bilat breath sounds-- and when I pulled it back she said, "You can't do that, you have to call the pulmonologist!" Wrong-o.

Once I came in and found a breakfast tray untouched and the patient sleeping. Alas, he was a diabetic and rather than let him sleep in and have a more quiet morning, his nurse ought to have checked his blood sugar. I did, and it was.... 27. Stat D50 there :).

Recognized a few incipient compartment syndromes before anyone else. Recognized a post-endarterectomy stroke once or twice. Recognized a thyroid storm once. Did a lot of critical care transports where it was ... me.

But you know, none of these -- and there were so many more-- were really exceptional. They were what nurses DO. Or ought to. We make a difference because of our experience and education.

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I am curious. If an RN was not sure whether it was Ibuprofen or Tylenol which affected the kidneys more, would that worry you?

If you have any stories to share of a time where your knowledge or experience proved to be extremely important in a certain situation, feel free to enlighten us.

Welcome to AN! The largest online nursing community!

A simple Google search can answer your question...about ibuprofen and the kidney but it is impossible to tell whether it is right or wrong in any given situation without know the patient and details....for there are many benefit versus risk scenarios in medicine..

A nurses knowledge and experience assists her every day in all situations......I would love you enlighten all of you if you could share with us your thoughts. We will help with homework but we need to know what your input/thought are first.....

If this is not a homework question.....and is more personal.......as per the Terms of Service we cannot give medical/legal advice.

So....begin the conversation.....we will participate.

dudette10, MSN, RN

3,530 Posts

Specializes in Med/Surg, Academics.
I was able to get an insurance adjuster pay the wife of one of my work comp patients what she was earning in a paper bag plant (ten bucks an hour) to stay home and take care of him (bilateral bad hand injuries and he didn't want a stranger CNA doing his personal care, unzipping him in the bathroom, wiping his butt, and feeding him) and get her FMLA so she didn't lose her job while she did it. The insurance company saved a bundle (an agency would have charged $25/hour to send a CNA), the couple was happy, and it made a big difference.
This is advocacy above and beyond. Kudos to you!A question though. Where was the social worker in this scenario?

amoLucia

7,736 Posts

Specializes in retired LTC.
I am curious. If an RN was not sure whether it was Ibuprofen or Tylenol which affected the kidneys more, would that worry you?

If you have any stories to share of a time where your knowledge or experience proved to be extremely important in a certain situation, feel free to enlighten us.

How about hepatotoxicity? Carbontetrachloride and ???
Specializes in Cardiac.

It would concern me if the patient was on dialysis or had poor kidney or liver functions. Still wondering why you are asking?

tyvin, BSN, RN

1,620 Posts

Specializes in Hospice / Psych / RNAC.

What...I think this could be an interesting thread. Not only are these types of threads interesting and sometimes funny but they teach.

The winner of the my stories of things I've observed RNs doing during work is my famous wound change story. You would think that it would have been while I was working but it happened while I was actually a patient.

It began when the nurse came to change my wound vac dressing which was a deep lateral left knee wound from an infected surgical scar. They did the dressing post surgery and it had been on for 5 days. When the RN took off the clear film she then positioned her hand at the top of the sponge and it looked as if she was positioning her hand to a good grip as she was going to just rip it off...WAIT!; what are you doing I said calmly as I guided her hand away from my knee.

She explained to me that her theory was to just rip it off so it wouldn't hurt as much similar to ripping off a band-aid...she actually said that. I asked her how many wound vac dressings had she changed. Her answer was shocking; she had changed many and no one had complained. Obviously she hadn't changed one on an RN.

I instructed her to get sterile saline and then I would show her how it's done. It took us a little over 20 minutes to soak the sponge out because of the depth of the wound. If she would have ripped it out the resulting damage of the wound bed would have been very bloody (not to mention the pain I would have experienced). It did hurt, but not as much as it could have. I made her promise to use sterile saline in the future when warranted.

I did go to the DON and tell her what happened. I felt I had to. The DON assured me that the nurse wouldn't be punished for it but educated. If a hospital is doing wound vac dressings I believe all the RNs need to know how to change them under various situations. I know that many of those types of dressings are not deep but the majority of them are that I've seen.

It's astounding how many little things RNs need to experience to learn. There are many trial and error types of learning going on. An RN can't know everything when they first start but need help from experienced nurses to learn. :)

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