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Discussion

another pharm question

Sorry, I have another question! The reason I am not sure of this is because, I haven't yet entered the clinical scene and have no idea how to go about. Our instructor never discussed situations like these either. Please tell me why and how you decide for these type of questions. Thanks a lot!

Nurse is preparing to administer a calcium blocker, a loop diuretic and a beta blocker to a client diagnosed with arterial hypertension. Which action should the nurse implement first?

a) Hold the meds and notify the physician regarding meds.

b) check the client's bp

c) contact pharmacist to discuss the meds

d) double check the physician's order

I am confused between a and d. Both are similar in a way and I was thinking because of "should implement first", I should go with d.

2. Everywhere I checked for Vasopressin it shows nasal spray or injection. In one of the questions it asked for Vasopressin tannate oil and what instruction should the nurse teach?

-The choices where sleep with head of the bed elevated (did not come across this anywhere).

-Use a tuberculin syringe to administer(I thot this choice makes sense, as the dosage is very small).

-admin meds in evening(no specific time was mentioned but said can be given upto three times/day).

-alternate nares when taking the meds(makes sense if it is nasal spray, to avoid ulcers).

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  • Expert

nurse is preparing to administer a calcium blocker, a loop diuretic and a beta blocker to a client diagnosed with arterial hypertension. which action should the nurse implement first?

a) hold the meds and notify the physician regarding meds.

b) check the client's bp

c) contact pharmacist to discuss the meds

d) double check the physician's order

i'd pick "b". i would always check a patient's blood pressure before giving 3 blood pressure medications together even though each of these work by a different mechanism of action

everywhere i checked for vasopressin it shows nasal spray or injection. in one of the questions it asked for vasopressin tannate oil and what instruction should the nurse teach?

-the choices where sleep with head of the bed elevated (did not come across this anywhere).

-use a tuberculin syringe to administer(i thought this choice makes sense, as the dosage is very small).

-admin meds in evening(no specific time was mentioned but said can be given up to three times/day).

-alternate nares when taking the meds(makes sense if it is nasal spray, to avoid ulcers).

it's most likely the last choice because the nasal form causes irritation of the nasal mucosa.

  • Author

But Daytonite, for the 2nd question they are asking Vasopressin tannate oil. I thot oils are always injection. Am I wrong? If I'm then I agree the last one has to be the choice.

Thanks as always!

But Daytonite, for the 2nd question they are asking Vasopressin tannate oil. I thot oils are always injection. Am I wrong? If I'm then I agree the last one has to be the choice.

Thanks as always!

vasopressin tannate (aka pitressin tannate) is always injectable...

i believe the correct answer is drawing it up w/tb syringe...

although i am a bit confused about the following link.

it is all about the various forms of ddavp.

if you scroll down to #4 under DDAVP Rhinal Tube, it states:

..."If difficulty is experienced in filling the tube, a diabetic or tuberculin syringe may be used to draw up the dose and load the tube".

but that statement references the intranasal route.

i read about DDAVP Injections, but didn't see any nsg considerations.

let's hope the link works...

http://www.fda.gov/cder/foi/label/2007/017922s038,018938s027,019955s013lbl.pdf

leslie

  • Expert

Am I wrong, but vasopressin tannate in oil is not approved for use in humans?

Am I wrong, but vasopressin tannate in oil is not approved for use in humans?

there were a couple of links that stated it had been discontinued...

but not all said that.

even more, one link said to never give it iv.

yet other links stated sc, im or iv.

so who knows?

that's why i got the most current link i could find, from the fda.

leslie

  • Author

earle58 thanks a lot for the help. I was confused for the same reason and I was also wondering if it is usual for instructors to ask questions which are controversial/ debatable.

Not to add to the confusion, but I just came across this in my med-surg book. It says that if vasopressin tannate in oil is given IM it should be administered in the evening so that maximum results are obtained during sleep. (Page 1148 in Brunner and Suddarth's)

Good luck!

  • Author

llinipeds thanks! Wow! it is a new twist. Now I am wondering which one is the right answer:)

the question for the oil says, "which should the nurse teach" not what the nurse should do. I am interpreting this as teach the patient.

So unless its normal for patients to give themselves this medication by needle, it can't be that.

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