Doubts as a new grad med-surg nurse

Aliakey · Jan 22, 2013

1. why are pts prescribed nexium to take even if they don't have GERD or acid reflux? I know pts that are on many meds are given it to decrease irritation in the stomach. But what about a young person in their 20s? Can being on antibiotics cause irritation in the stomach even if they are IV?

The antiulcer drugs (in this case, Nexium [esomeprazole], a histamine2 blocker) are used prophylactically to prevent the formation of stress ulcers that can occur during hospitalization, after major surgery/trauma, and after other forms of insult to the body. It follows the old advice that an ounce of prevention is worth a pound of cure.

If the 20 year old is receiving antibiotic therapy, there still exists additional stress to his/her body. May not be as obvious as a person with severe burn trauma, but it is significant and best to nip the potential problem in the bud.

2. Should you remove an old iv before starting a new one?

If the existing IV was still patent, I wouldn't remove it first, personally. Think of it this way: Is there any harm in leaving the old IV catheter in there for another two minutes to ensure you have another dependable intravenous access in place before its removal? Don't let Murphy's Law bite ya' in the backside by removing the only access you have... patients can go downhill at any time, any place.

HyperSaurus, RN, BSN · Jan 23, 2013

Nexium is not a histamine 2 blocker--those would be zantac, pepcid, tagamet, ect. Nexium, as well as prevacid, prilosec, aciphex, and protonix, are all proton pump inhibitors. Both H2 blockers and PPIs reduce the amount of stomach acid produced (H2 blockers indirectly, and ppis right at the source), there-by reducing the amount of gastric irritation. You can frequently see them ordered for GI bleeds, post surgery to possibly prevent indigestion, among things.

I agree with Aliakey, if the old IV is still patent, I certainly wouldn't remove it before ensuring you have another access available :)

Aliakey · Jan 23, 2013

I stand corrected... Thank you for correcting me on Nexium. Next thing ya know, I'll be referring to chocolate as an anti-depressant.... Oh, wait... Hmmm

Music in My Heart · Jan 23, 2013

Next thing ya know, I'll be referring to chocolate as an anti-depressant.... Oh, wait... Hmmm

Hmm, I thought it was an antipsychotic. Pretty sure on this one.

nightowlRN89 · Jan 30, 2013

Oh interesting. Thank you for your responses! I really appreciate it.

evolvingrn, BSN, RN · Jan 31, 2013

always leave a patent iv in until you have a new one :) they aren't always easy to place, you would rather have an old one in then none at all.