Do I give the med or hold?

[spectrabrite]

I work in LTC, my resident is given gabapentin (time release capsule) along with a lot of other tablets. This resident chews all meds and will not listen that gabapentin states "swallow whole, do not chew, or crush". I see all the other nurses give this med and not worry about this.

[SL2014]

And morte, levothyroxine is almost exclusively a QAM drug, so it will only be given before breakfast. Other drugs that designate "on an empty stomach" means 30 minutes before and 2 hours after food.

[SL2014]

And a final note, if you ask a lot of these people, when they are at home they take their synthroid before breakfast... It's a point that is emphasized by primary care. That being said if a person is at your facility and you are improperly giving their synthroid with breakfast and they go home and take it the way it should be, now their dose will likely need adjustment. Not only does this recommendation improve absorbtion but (assuming everyone follows the same rules) ensures the absorbed dose is consistent despite setting.

[spectrabrite, LVN]

all the orders we get state time except for prn meds. Must just be my facilities policy with the docs.

Last time I checked doctors done order meds for a specific time lol the order is written "levothyroxine xmcg PO QAM" sometimes with "ac" after QAM... The time listed on the mars is not the physican's order, it's the time as chosen by the person who transposes meds to mars... VERY rarely does a doc ask for a med to be given at a specific time....

[BrandonLPN, LPN]

A few points: a) our breakfast is at 730. b) the doctor explicitly changed the med time to first shift, to avoid third shift having to wake people up so early c) in my facility, and many others, nobody is going home. They are here till they die. d) the third shift nurse has upwards of 80 residents some shifts so popping in 30 minutes before breakfast is not as easy as you suggest. It can not be done by any human on the planet. She would have to start giving them at 5 am or earlier.

[morte, LPN, LVN]

And morte, levothyroxine is almost exclusively a QAM drug, so it will only be given before breakfast. Other drugs that designate "on an empty stomach" means 30 minutes before and 2 hours after food.

there in lies the key, in the real world things are not ALWAYS optimal. and AM goes until 12N. Had to change a patient's time to 10 am because she wouldn't take it at 6. It was aborbed quite well, her TSH went from 9 to 1.

[morte, LPN, LVN]

I am with you brandon. Reality can be daunting, but must be dealt with.

A few points: a) our breakfast is at 730. b) the doctor explicitly changed the med time to first shift, to avoid third shift having to wake people up so early c) in my facility, and many others, nobody is going home. They are here till they die. d) the third shift nurse has upwards of 80 residents some shifts so popping in 30 minutes before breakfast is not as easy as you suggest. It can not be done by any human on the planet. She would have to start giving them at 5 am or earlier.

[spectrabrite, LVN]

A few points: a) our breakfast is at 730. b) the doctor explicitly changed the med time to first shift, to avoid third shift having to wake people up so early c) in my facility, and many others, nobody is going home. They are here till they die. d) the third shift nurse has upwards of 80 residents some shifts so popping in 30 minutes before breakfast is not as easy as you suggest. It can not be done by any human on the planet. She would have to start giving them at 5 am or earlier.

Our third shift has 146 residents, there are 2 seatings for all meals, there all here till they die but we manage to wake and give as directed no problem. 56 of our residents are a locked dementia unit third shift covers both sides.

[morte, LPN, LVN]

and you point is?....

Our third shift has 146 residents, there are 2 seatings for all meals, there all here till they die but we manage to wake and give as directed no problem. 56 of our residents are a locked dementia unit third shift covers both sides.