IV Pepcid (Dumb Student Nurse Question)

Bipley · Nov 9, 2005

Hi, this is my first semester in med/surg, so bear with me.
I shadowed an ICU nurse last week. She had me give Pepcid via IV Push instead of with a slow infusing device. She said, "If you want to run around, find an extension set, set up the infusor, you can, but it's an H2 blocker, what's the point?" Since I didn't have the keys and the knowledge to independently get the proper equipment, I followed her lead, which seemed to indicate that only an anal idiot would bother with such things.
Can anyone tell me why an order would be written for a slow infusion of Pepcid? Is it irritating to the veins?
Thanks in advance for any help you can give!

Any chance it was Protonix vs. Pepcid?

BirdFeederLady · Nov 9, 2005

Q from Bipley: "Any chance it was Protonix vs. Pepcid?"

No, in fact it said "famotidine" on the syringe label.

JentheRN05, RN · Nov 9, 2005

I just looked it up. Reason for slow is:

Rapid admission may cause hypotension, decrease doses in renal impaired-renal disease patients

That's the only thing I could find.

Now Phenergan - That is bad for veins! Burns severely and thats after 1:1 dilution! I HATE giving phenergan!

P_RN, ADN, RN · Nov 9, 2005

First NO question is ever stupid. And NO Student Nurse is Stupid...them's fighting words.

However, what was the written order? Students need to follow the rules while students.

No matter how nice, experienced etc.that ICU RN was the "do as I DO and not as I say DO" doesn't cut it while you are in school.

Let us know what you find out OK?

BirdFeederLady · Nov 10, 2005

In response to P_RN's query,

"However, what was the written order? Students need to follow the rules while students":

I've had one day of exposure to the ICU, and another day in the ED. I will be now be spending 5 days with an instructor on a med/surg floor. So I will have no opportunity to see the order again. I was doing my best not to slow the nurse down, who wasn't thrilled with my presence. (She had no idea she'd be working with me until I arrived, and exclaimed "Great!" (sarcastically) upon finding out I was assigned to her.)

That said, I do hear your warning about "following the rules." Having read many of the posts about being "guests," what is a tactful way to follow the order (which I believe was to use a slow infusion pump) while maximizing the opportunity to get "hands on" that this nurse was graciously giving me?

gizelda196 · Nov 10, 2005

I worked at a Hospital where pepcid was given slow IVP (over 3 min). It was policy. It was packaged by Pharmacy in 10cc syringes .At that hospital we also gave cefazolin and ceftriaxone like that.

nursem2 · Nov 10, 2005

rapid iv push can cause hypotension and dysrhythmias. NOT a dumb student nurse question!!! keep asking!

Bipley · Nov 10, 2005

I just looked it up. Reason for slow is:
Rapid admission may cause hypotension, decrease doses in renal impaired-renal disease patients
That's the only thing I could find.
Now Phenergan - That is bad for veins! Burns severely and thats after 1:1 dilution! I HATE giving phenergan!

Same with Benadryl. I dilute them both down a great deal.

BirdFeederLady · Nov 10, 2005

Thanks for your kind replies, all. I'm learning about IV Pepcid and more!

DeLySh · Nov 10, 2005

I have also seen this done but had a different question. Mine is, if you are giving a pt PO meds, why do you give Pepcid IV instead of PO? I understand if you don't give any PO meds but ...

Thanks for indulging me.

DeLySh

BirdFeederLady · Nov 10, 2005

"why do you give Pepcid IV instead of PO?"

My patient was NPO at the time . . .