Advice needed on first oral med pass

APBT mom, LPN, RN · Feb 11, 2008

Just make sure that you DON'T touch the pills (no no in my program), that you check the arm band and have the patient tell you their name and dob, that you have something for the patient to drink it down with, wear gloves because some meds can be absorbed through the skin, know what assessment's you need to do before you give the meds (bp, pulse, resp, pain), know what labs you need to look monitor and if the patients has them what there value was compared to the norm, do any med calcs BEFORE the instructor comes to watch, what the med is, how it works, allergies, what you need to look for in regards to a reaction (drug guides usually have importans S/E in red or underlined with red being more important), and if giving an injection get the proper size syringe and needle, ask the patient where they would like it or if it is a med that needs to be rotated ask where they had the last injection.

You might be a little uneasy because it's the first time and I know it looks like a lot that you need to know but just make a cheat sheet and bring it in with you so when the instructor asks a question if you didn't remember it you can look down and give it to her. And if at anytime she asks you something that you don't know tell her you'll let her know as soon as your done, look it up, and give it to her.

4x4country · Feb 11, 2008

just make sure that you don't touch the pills (no no in my program), that you check the arm band and have the patient tell you their name and dob, that you have something for the patient to drink it down with, wear gloves because some meds can be absorbed through the skin, know what assessment's you need to do before you give the meds (bp, pulse, resp, pain), know what labs you need to look monitor and if the patients has them what there value was compared to the norm, do any med calcs before the instructor comes to watch, what the med is, how it works, allergies, what you need to look for in regards to a reaction (drug guides usually have importans s/e in red or underlined with red being more important), and if giving an injection get the proper size syringe and needle, ask the patient where they would like it or if it is a med that needs to be rotated ask where they had the last injection.
you might be a little uneasy because it's the first time and i know it looks like a lot that you need to know but just make a cheat sheet and bring it in with you so when the instructor asks a question if you didn't remember it you can look down and give it to her. and if at anytime she asks you something that you don't know tell her you'll let her know as soon as your done, look it up, and give it to her.

:yeah: :yeah: :yeah: :yeah: good review. :yeah: :yeah: :yeah: :yeah: :yeah: :yeah: :yeah: :yeah:

question: what if you pass three-four pts meds, and only have a hour or less to look everything up? are there secret usual meds to write down in the back of your little notepad to always have? i havent had my first med pass yet, will in a few weeks.

APBT mom, LPN, RN · Feb 12, 2008

:yeah::yeah: good review. :yeah::yeah::yeah::yeah:
question: what if you pass three-four pts meds, and only have a hour or less to look everything up? are there secret usual meds to write down in the back of your little notepad to always have? i havent had my first med pass yet, will in a few weeks.

i forogt to attach my med pass sheet. it has boxes for everything and i usually just write the pts vs on the bottom.

it usually takes me an half an hour to do two pts so and hour for three or four should be enough time. what i do is either print a copy of the mar or jump on the computer and go to the mar first. then i'll look up the meds that i have to give first and go back before the others are due if i run out of time. some of the meds have the same interventions and such. ex. every insulin is the same on everything except the units the patient is to recieve. then i'll do one patient first and go through the others and re write the info if the have the same drugs on that pts med pass sheet. then i do the next and repeat for the other pts i have left until i'm done. the more you do this the more you'll start remembering what you have to do before you give the med.

you'll see a lot of patients with the same meds ex. lots of lovenox, anti ulcer meds, insulins. so what i do is i have a clipboard that i got from wally world that opens and i would keep my med pass sheets in it (i made a pocket on the part that opens) and when i had a med pour i would pull them out and just copy the info from my old sheets to my new ones. i would also cross out doubles so i could skim over the sheets quicker.

one of the students tabbed her drug guide with the name of every drug she gave during med pour (because of them being so repeatative) so when she looked them up it was quicker than finding it in the index and then looking up the page.

don't worry about any meds you can't give (no rt or iv pushes if you aren't allowed to give or prn unless it's a pain med and i would usually go and ask my pt if they were in any pain before i looked up my drugs and check to see if they had received it recently if not i wouldn't look it up).

if any of the meds that you have to give need to be cut make sure you know where a pill cutter is (some units don't have them on the floor or they've grown legs and walked). it's the most annoying thing and the nurses will tell you just to use a pair of scissors (no!!). if you have thefunds you can just buy one for yourself and keep it with your clinical stuff (wally world has a cool one for around $4).

also if your using davis and you have to give predinisone it's in the book under predinisolone don't ask me why it's not listed in the index but the info's on that page.

this is the stupid one to remember. if the meds come in those bubble wrappers before you give them figure out how you open them. some of them look like you have to peel the paper off but you really push it through. i don't know how many times i've tried to peel the paper off of one for a good three mins before i got frustrated and pushed the pill and saw that it pops through. you start getting flustered even if you've done everything right just because you can't get the dang pill out.

good luck. it's more nerve racking than anything but you'll do fine.

MED PASS.doc

carolinapooh, BSN, RN · Feb 13, 2008

Trivia: Prednisolone is the activated form of prednisone; it's also what your liver makes out of prednisone. The two drugs are considered interchangeable and you'll see them both used.

I second what Tampagirl said and my own :twocents: : have alcohol swabs in your pocket for injections (I always carried a handful in my pocket when I was in school, along with three or four flushes for IVs), and always remember to have something for the patient to drink!

Also - as you work on various floors, you will see after just a few patients that some drugs are "common" or "popular" on the floor. For example, EVERYBODY, it seems, at Duke Med gets Protonix/pantoprazole. Many of the cardiac patients on one of my early floors took a beta-blocker (the -olols), and most of them were on some sort of a statin. The heart failure folks all took powerful diuretics. It only took about a week (two shifts) to mentally file those drugs away.

When I was a pharmacy tech, I used to keep a running list of "common" drugs that I'd fill. After just a short time, I knew all eighty of them on my list. (Eventually the list topped out at about 150.) Seriously - it doesn't take long. Tape a piece of paper to your clipboard and as you start to repeatedly see drugs, write the name brand and generic name on the paper. If you consult this list whenever you look up a drug, you may find that you start to visually associate the name with the necessary information. I'm very visual myself, and if you are as well, this might be a good tip. If not, maybe it will help someone else!

carolinapooh, BSN, RN · Feb 13, 2008

This is the stupid one to remember. If the meds come in those bubble wrappers before you give them figure out how you open them. Some of them look like you have to peel the paper off but you really push it through. I don't know how many times I've tried to peel the paper off of one for a good three mins before I got frustrated and pushed the pill and saw that it pops through. You start getting flustered even if you've done everything right just because you can't get the dang pill out.
Good luck. It's more nerve racking than anything but you'll do fine.

Once I was trying to push a pill out through the foil, and it FLEW across the patient's room! I totally know the feeling! So aim down and for the cup and be careful. :specs:

Freedom42 · Feb 13, 2008

:yeah::yeah: good review. :yeah::yeah::yeah::yeah:
question: what if you pass three-four pts meds, and only have a hour or less to look everything up? are there secret usual meds to write down in the back of your little notepad to always have? i havent had my first med pass yet, will in a few weeks.

we get our patient assignments the day before clinical. by the time clinical starts at 6:45 a.m., we are expected to have an index card made for every drug we will administer. the card must include classification, dose ranges, contraindications, adverse effects, nursing implications. by the time you're done filling out those cards (last week, my patient had 26 oral meds), you don't need them any more. you've memorized everything. then we're quizzed on the floor. the instructor also listens to the description we give the patient. what i've found nerve-wracking is getting everything done in time to get enough sleep the night before.