Drug Cards

[Diva0082]

I have pt with SBO, his only meds are phenergan, morphine sulfate IV PRN, and D5 1/2NS & 20mEq KCL IV 1000ml. Pt.'s K level is normal so I was wondering if this maybe was an IVPB for morphine. If I dont know then I get sent home in the morning, so any help would be great!!!

[APBT mom, LPN, RN]

I don't understand what you're asking. Do you have any more info about the patient.

SBO-?

[Daytonite, BSN, RN]

Most likely the phenergan and morphine are being given as direct IV pushes through the IV line since this patient has a small bowel obstruction and is probably in a lot of pain. Look up the uses for both so you know why they are being given.

The potassium level is being watched because when a patient has a bowel obstruction fluids tend to accumulate behind the bowel obstruction and are considered to be "lost" fluids because they are not in the vascular circulation. When the obstruction is finally relieved those fluids will be eliminated through the GI tract rather than reabsorbed back into the body. Fluids in the intestine are usually rich in potassium.

The D51/2NS is a maintanance IV fluid. Here is a chart of commonly used IV fluids. You can see from the chart what the uses of the various IV fluids are for

[attach]5949[/attach] Commonly Used IV Solutions

[al7139, ASN, RN]

The pt with a SBO would be NPO. There would also be vomiting associated with an obstruction. With the diagnosis and the vomiting, the pt would be at risk for severe electrolyte imbalances, especially hypokalemia. The choice of D5 1/2 NS with 20K would be to ensure that the pt maintains correct electrolyte balance, while the dextrose would provide nutritional support while NPO.

Hope this helps.

Amy