Extended Release

[ohbet]

I was recently floated to another floor a few times this week.There are two patients there with alzheimers. I witnessed both these residents chewing their meds after I had given the meds in pudding whole. The trouble is both of them have cardiac meds that are extended release and these meds shouldnt be crused or CHEWED.

I told the HN and the Dr. that they have ER BP meds and chew them.The Dr. changed the dosagage,the meds and the times.

Two nurses on the following shift to issue with the new order saying the residents have been on the previous order for years and its never been a problem for the residents and if you give the patient water right away then they wont chew,they will swallow the meds.

Whos right? Should the meds have been changed or just leave the order as it was and give water right away?

[Genista, BSN, RN]

Sounds like you didn't know that the pts needed water after taking the pills in pudding. How were you supposed to know this little "trick?" ESP perhaps? As a float to the floor, why wasn't this communicated to you in report or written on pt's kardex? How are you to know. You were responsible and took action on what you saw as a problem. The important thing is that they get the meds in the correct dosage & concentration needed for therapeutic tx. Don't loose sleep over it. You did the right thing given the knowledge you had, and what you observed.