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Discussion

Dilaudid

I am a junior in nursing school and will not cover medications in depth until my fall semester. I work as a Tech at an acute care nursing facility and the other day my patient was asking for his pain medication. The nurse (an LPN) said she had to go find Alisha (an RN)....the RN came in to give him his medication which was Dilaudid IV. Why did the LPN need an RN to give this medication for her. Are there restrictions on meds that Lpn's can give. Im very curious.

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In many places, only RNs can give IV meds.

In some states LPNs are not allowed to give IV medications due to license restrictions (in other states, they must pass an IV certification course first). It sounds like this is the case in your facility.

  • Experts

In some states I believe you need to hold a valid RN license to pass medications.

Yes. In California, an LVN cannot give ANY IV medications, including IVPBs and IV push meds, and an RN must do it. As an RN, I can tell you: it sucks. RNs are technically responsible for the outcome of care for an LVN's patient if they pass meds. It scares me. I wish they could pass their own meds.

Even in states where LPN's can give IV meds.... I think dilaudid is (and if not, should be) one of a list that they cannot push. Patient's can go bad quickly with dilaudid. Strong young men's sats can drop 10 min after the push.

In PA its because it is supposed to be a timed pushed.

Dilaudid (Hydromorphone) is a strong narcotic stronger than morphine. 1 mg of dilaudid is equal to about 7 mg of morphine. It could be LPN not allowed to push narcotics. Dilaudid can lower blood pressure and needs careful monitoring also should be pushed slow over 2 min.

In some states LPNs can give IV meds but as far as I know they are not to give IV PUSH medications especially something like Dilaudid.

  • Author

Ok thanks everyone. Now I know.

Thanks for reemphasizing this, guys! Sometimes it feels that we give dilaudid so often that we forget how dangerous this stuff can be!

In many states LPNs with IV certification can give IV push meds, *including* dilaudid. It varies by state.

In my state, when I was an LPN, I could give meds such as IV lasix, fentanyl, dilaudid, all abx, and I could titrate heparin and insulin. I could not, however, given IV pepcid. WTH.

It is out of the scope of practice for LVN to administer IV drugs, unless the LVN Iis IV certified. At least in Cali this is. This actually is NCLEX question.

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