This is going to be a question/rant. I had a patient the other day (I work in Tele) with a heart rate sustaining in the 130's-140's and the attending cardiologist was VERY rude to me after I questioned him regarding his prescription for PRN Adenocard.
First of all, the order read "Adenocard, 6-12 mg, PRN systolic BP >150." That's it. No parameters, no frequency, nothing. I am a relatively new nurse, and was confused about the range "6-12." Did he mean 6 or 12 mg? Between 6 and 12 mg? If it was between, didn't that mean I would be technically prescribing the med? And how would I know when to give which amount?
When I approached my charge nurse to see if she could advise, she gasped and said "Never, NEVER push this medication on this unit without the MD present at bedside. You could put the patient into cardiac arrest." I guess this is because Adenocard momentarily stops the heart before 'resetting' it. So then pharmacy calls and asks me about me order, and at that point I just figured it would be best to ask the MD, who was still on the floor at that point.
I brought the copy of the order to him and asked him to clarify, and his response was "I don't see where the confusion is." I explained my question and he stated, VERY rudely, "Well, MOST nurses know what that means." I was livid! First of all, I am a new nurse (been on the floor about 5 months, 1 1/2 on my own), and second, his order was very unclear!
What have been your experiences with Adenocard? Do you IVP it on your floors? Does the MD need to be present? Thanks for all replies