Published Mar 1, 2004
I was recently caring for an elderly confused patient. He had some po medications we needed to get down him, and he kept spitting them back at us. We tried everything, including dissolving them in applesauce and ice cream, but nothing would work. Well, eventually he cooperated, but what should I have done differently? Are there any techniques or advice you have for me? Your responses would be appreciated.
why are you writing so big? and what was the med that was so important?
traumaRUs, MSN, APRN
I would have probably stopped the first time he refused, called the MD and see if they could be obtained in a liquid form. Is confusion the norm for this pt? If this was something new, I would also inform the doctor of this and refrain from giving po meds. Good luck...
Stop arguing with the patient, try again in 30 minutes after he calms down. Confused patients can be so frustrating...I agree with traumaRUs, was confusion the norm? How had other shifts been giving the meds. If there is family around have them help you talk to the patient.
The way I give meds to pts. like that is to dissolve or crush the med and put it in the smallest amount of pudding/applesauce/yogurt (whatever the pt. will prefer) that you can. That way, you're done with one spoonful. Keep the pts. favorite drink with a straw close at hand as well to wash it down.
It also depends on where you were caring for this patient..If this is LTC some patients really respond to certain staff members.I don't care how confused you think they are they still often recognize familiar faces.Sometimes there is nothing you can do...Hopefully other nurses have discovered tricks to deal with each pt and write it in the care plan or on the MAR...I had a gal that took a peppermint patty with her meds every am....If you are having problems in acute care you can always call the regular caregivers for some insight...Simply re-approaching is often very effective.The more you cajole the more uptight you both get....Walk away-come back 20 or 30 mins later and greet the person with a big smile and act like it is a whole new day...Works like a charm....
It is usually a good idea to avoid a battle of wills with confused patients. Or with any other kinds of patients, for that matter.
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