What is "stacking"?

  1. 0 Can anyone please tell me what "stacking" is? I am a new nurse and 1st heard the term this weekend in regards to a patient who was on hospice and had been prescribed both morphine and hydrocodone. Thanks!
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  3. Visit  whisperinrain} profile page

    About whisperinrain

    Joined Sep '09; Posts: 8; Likes: 5.

    12 Comments so far...

  4. Visit  brownbook} profile page
    0
    Hi, I have no idea. However as an old nurse the best thing I have learned is it is ok to say, "I don't know." When you hear terms, medications, procedures, etc., and you can't remember what it means or have never heard of it ASK. I ask patients what such and such meds is for (who can remember every medication!) I ask patients what their disease is, yesterday I had a patient with Sorjerns (sp) disease. It wasn't why she was in the hospital, she was having a minor procedure done. Of course you hopefully aren't asking some basic questions, how do I take a blood pressure, what is a heart rate, etc. And of course have reference books handy to look things up. But you won't find "stacking" in any medical reference book!!!!!
  5. Visit  tewdles} profile page
    0
    I don't know what stacking is. When we are using multiple meds to treat a symptom in hospice we call it polypharmacy in my neck of the woods.
  6. Visit  mcknis} profile page
    0
    I have heard of stacking related to taking steroids. It is the idea that taking more than one dose at a time (stacking doses) produces better gains or effects than taking one steroid dose, or one steroid, alone. I haven't heard of "stacking" in regards to prescribed medications, but we do frequently talk about giving an Ativan/Phenergan/Benadryl/etc "chaser." It does make sense though when discussing Morphine and Vicodin, that "stacking" these two medications will provide better immediate pain control than just taking either one alone.
  7. Visit  studentNURSEwyo} profile page
    0
    To the best of my knowledge "stacking" means alternating between these two drugs. First take hydrocodone, then the next dose should be morphine, etc. They both treat pain in different ways, so it is believed to be more effective in pain management. We used this term in school when we were learning about arthritis, and how beneficial it is to "stack" Tylenol and Motrin - not taking at the same time, but alternating doses.
  8. Visit  tewdles} profile page
    0
    Quote from studentNURSEwyo
    To the best of my knowledge "stacking" means alternating between these two drugs. First take hydrocodone, then the next dose should be morphine, etc. They both treat pain in different ways, so it is believed to be more effective in pain management. We used this term in school when we were learning about arthritis, and how beneficial it is to "stack" Tylenol and Motrin - not taking at the same time, but alternating doses.
    we call this practice alternating...for obvious reasons and it leaves little question as to what the plan involves.
  9. Visit  chelynn} profile page
    0
    The only time I have heard this term is in regards to men tx. The doc ordered albuterol and ipratroprium. Administer one amp of one then one amp of the other right after the first.
  10. Visit  ShonaRN0522} profile page
    0
    I have heard of stacking. We refer to it with neb txs. For example, if someone comes in with a severe asthma attack, the ERP may order 3 neb txs "stacked" which means one right after the other. I don't know what "stacked means" in your situation though.
  11. Visit  Bug Out} profile page
    1
    Quote from whisperinrain
    Can anyone please tell me what "stacking" is? I am a new nurse and 1st heard the term this weekend in regards to a patient who was on hospice and had been prescribed both morphine and hydrocodone. Thanks!
    The hospice Nurses at my facility often recommend "stacking" pain meds and the term can be used to describe an entire host of meds but is most commonly used in pain management. Think of the patients who take two different kinds of HTN meds, a beta blocker and an ACE inhibitor. Why not just increase one and get rid of the other?

    Basically...you know how you give a pain med, lets say q4hrs and the med works the first 2 hours but really tapers out the last 2? Well you give a second different pain med 2 hrs after administering the first pain med to bridge out the last half of the first med. Each of the meds covers the downtime of the other achieving maximum effectiveness.

    You use two different meds to treat one thing, in that case pain. The two meds work independently but handle the same issue. Seperate they are only somewhat effective, used in combo the sum of their effects is greater than on their own.
    TiffanyRN!! likes this.
  12. Visit  fiveofpeep} profile page
    0
    my step dad has stage IV cancer and they use the term "stacking" to refer to the confusion he gets when too many narcotics build up and his crappy liver doesnt metabolize them so he gets "stacked up" with narcs
  13. Visit  smiles04} profile page
    0
    I am a med surg ortho RN and I would say it could mean two things - one alternating and two which I think it is- is stacking one on top of the other. One -hydrocodone is medium acting 4-6 hrs and morphine is shorter acting couple hrs or longer depending on how given. You can give morphine in pill and that could last 8 hrs and then hydrocodone for breakthru pain or visa versa. If in hospice its probably morphine and then hydrocodone additionally if needed. If its a med surg patient with mild to mod pain then hydrocdn given and morphine as a prn if really bad pain flares up. got it. Remember it is never wrong to ask it is wrong NOT TO!! smile 04
  14. Visit  DJMLPN} profile page
    0
    I've always used the term 'stairstepping' in terms of alternating 2 different pain medications. Have never heard of 'stacking'; will ask some other nurses at work today.
  15. Visit  mwk80} profile page
    0
    i am doing rn-bsn and our instructor happen do give us this link. http://nursingworld.org/mainmenucate...rk-of-rns.aspx
    stacking is the invisible, decision-making work of rns about the what, how, and when of delivering nursing care to an assigned group of patients (ebright et al., 2003).

    i hope it helps.


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