Crushing K-Dur

Antikigirl, ASN, RN · Jun 13, 2006

Oh boy have I seen this one a million times! I worked ALF and most of my folks were on this and couldn't even swallow a lasix pill! UHG!!!!!!! I had to spend sooooo much time calling or faxing docs to please change it to a more PO friendly or totally different route!

I would have called the MD first before giving to change it to a reasonable form if possible (and with KCl you can). Considering this patient is NPO...ummmm I kinda would check with the MD for all the meds that are listed as PO and let them know which is crushable or not so I save time not having to call again!

Nurses in my med surge unit (including me) have substituted the power form mixed in water given slowly via the NG or J/G tubes and flushed well with MD permission. There is also a liquid form. If one has an IV...that is a way to go also. Most tube feedings have KCl in them so some docs will be willing to forgo the oral KCl and just retest the blood to see if that is working (not that people on tube feedings don't get a ton of bloodwork anyway..LOL!).

As far as it 'not being her probelm'...um yes it is! A route of a medication that isn't working for a patient or contraindicated is a responsiblity of us all! The MD must be told, and not to mention she disobeyed a no crush rule which is very dangerous and she could be held accountable for that...maybe then she would realize..it is her problem!!!

Marie_LPN, RN, LPN, RN · Jun 13, 2006

NURSE A: "I know but that's what the doctor ordered, so that's what I gave. It's not my problem."

Good Lord, it WILL be. :uhoh3:

TazziRN, RN · Jun 13, 2006

And that is a scary nurse!!!

Marie_LPN, RN, LPN, RN · Jun 13, 2006

If the doctor order the pt. to be shoved out the window, is she going to do that too??

leslie :-D · Jun 13, 2006

isn't k-dur that God-awful, fat yellow EC pill?????

Marie_LPN, RN, LPN, RN · Jun 13, 2006

It's also a giant white pill that can be easily confused for a suppository.

leslie :-D · Jun 13, 2006

It's also a giant white pill that can be easily confused for a suppository.

i think i know what you're talking about.

doesn't that pill easily crumble?

and wouldn't that be crushable?

i'm thinking of the yellow pillow that's enteric-coated, which should be obvious to any nurse that it's non-crushable.

and this nurse worked in icu?????

Marie_LPN, RN, LPN, RN · Jun 13, 2006

No, this one's EC and also plainly says on the bottle "do not crush".

chadash · Jun 13, 2006

If the doctor order the pt. to be shoved out the window, is she going to do that too??

I just love your posts~

not now, RN · Jun 13, 2006

i think i know what you're talking about.
doesn't that pill easily crumble?
and wouldn't that be crushable?
i'm thinking of the yellow pillow that's enteric-coated, which should be obvious to any nurse that it's non-crushable.
and this nurse worked in icu?????

I know what pill you're talking about. Many of my confused geriatric residents would try to bite it regardless of how many times I asked them to "Please don't bite this pill..." and it would crumble in thier mouth. Then they would spit it out. Frustrating to say the least. We could often get the order changed to two 10meq instead of one 20meq which is slightly easier to swallow. Or liquid which from what I gather doesn't taste very well. I'd usually say "Take it like a shot of whiskey and here's your apple juice chaser." Or just mix it with juice and make sure they drank the entire thing.

I believe powder or liquid KCL is it's not sustained release like the pills are. But if the nurse is crushing pills, neither are they. If the patient is recieving bolus NG feeding the KCL liquid has to be timed to right before the feeding since the liquid can cause GI irritation.

Either way the nurse should have asked to have the order changed.

My question is: What do you do when you notify the MD the med is not crushable and he still wants it given?

sabRN2b05, BSN, RN · Jun 14, 2006

I just love your posts~

I agree! Marie, you just tell it like it is!!! My kind of girl!!