Crushing K-Dur

[Zee_RN]

OVERHEARD:

NURSE A: "I just gave him his K-Dur." (Pt. is intubated with dobhoff in place with tube feedings.)

NURSE B: "We can't crush K-Dur."

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

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Personally, this frightens me. I do not, will not, crush a sustained release med just because the doctor wasn't smart enough to realize he was ordering it for a patient on tube feeds.

[Spritenurse1210, BSN, RN]

what do you do if they order a non-crushable med?

[Spritenurse1210, BSN, RN]

*thud*

*Fans*

[MiRnSoon]

I currently work as a Pharmacy tech at an inpatient hospital in the Metro-Detroit area and if an order for k-dur git/ng/j-tube etc is ordered the Rph changes it to K-lor(powder)...after reading this thread I asked one of our Pharmacists the other day if dissolving K-dur was an acceptable preparation and he said yes, since it only dissolves the coating. What I can't understand is why an RN would dismiss resposibility in such a way... I wouldn't want to be her patient.

[lindarn54455]

Oh My ! You are a scary nurse! I can't believe you gave that without verifying this order with the MD? This is your responsibility!! You are the patients advocate! You have a license to know these things! Doctors are human and can make mistakes and we as registered nurses need to be aware of these things for our patients sake! How would you like to be this patient and just have the nurse say - "it's not my problem: and something happend to you because of this attitude. Please go back to school for reeducation! It will do you and your pts some good!

[NRSKarenRN, BSN, RN]

Summing up lessons learned here:

a. Whenever administering meds via GT/ PEG think twice about any med needing to be crushed to be administered.

b. Consult with pharmacist to see it liquid preparation available--sometimes pharmacy misses pt with tube feed.

c. Document in notes pharmacy conversation and reason given crushed pills and doctor notified.

d. Med unfamiliar and need to give via tube feed, no pharmacist: consult drug guide.

e. Crush meds dissolve better in warm (not hot) water. Swish in cup while pouring down tube to prevent pill fragments remaining bottom of med cup. Place more water in med cup to get remaining med if particles still seen, pour down tube syringe then flush with minimum 30-50cc H20 to prevent tube from clogging.

[nightingale, RN]

Just a question to through out there (not to change the subject) but have you ever tasted that stuff? It is so bitter! I try to get the capsule crystals to miss with pudding.