Ok Friends....need a bit of colaboration here.....how do you understand the giving of digitalis.....?
I have seen so many different "ways" if giving it/understanding it....that I just wonder what others think/do......
I am perserving my opinion......Thanks!!!!
Jun 15, '04
Quote from llg2700
I do those things too for sure.....wondering about the timing...dose...getting docs to order dig levels.....do you have p&p for holding.....do you call doc if you hold....how long do you hold it?...for a day?.....until next dose due?...do you check pulse later in the day and give it then if apical pulse is >60......
I work in CCU and it is on our standing orders to start dig (125 mcg Q4 hours x4 then daily PO) for post open heart surgery for frequent pacs/bursts afib....we can also use cardizem depending on rate, etc. We only start it if patient has not been digitilized previously....
As for the "chronic" use...We don't have any standing orders for holding, we don't call the docs for holding it (unless there is a major issue), if I the patient's heart rate is in the 60s and they take it every day and their heart rate is always in the 60s or high 50s and it wasn't part of the reason for their stay, I would give it, but I would have to look at the whole situation and what else was going on...If I did hold it and the heart rate spiked up in the afternoon, I would probably give it late and document--
If I did hold the med, I would document that and they reassess the next day and discuss it with the doc when he came by...again it depends on the patient, what they are in the hospital for, if the dig is part of the problem or part of their daily regimen and not part of their problem...it seems that most of our patients that are on it take in every morning...if they are on dig prior to admit they have a level done on admit...and usually every couple of days after that, or more often if necessary (they are out of our unit by that time so I am not 100% sure what the protocols are for that). Each situation is a case by case basis, as I am sure that you know.
Last edit by zambezi on Jun 15, '04