potassium

cindyRN 2006 · Nov 9, 2005

Bipley You are the type of teacher I admire, You realize that every question is an opportunity for you to teach and expand. Thank-you.

Nursie pooh, you are right many of us me included have had a long hard road. Do Not think for one moment you have paved the road for me. You have not. I have worked my way through school and have paved my own road because unfortunatley I have had to deal with several nurses like you who like to bring students down, Don't worry I 'm probably not going to take your job, Not today anyway. You can relax if that is what your problem is with students.

As I read your hostility I realize you either need to research the following quote or remove it from your posts..."An expert at anything was once a beginner." - Dr. Pat Benner, Nursing Theorist, & Kenya, LPN

Bipley · Nov 9, 2005

Bipley You are the type of teacher I admire, You realize that every question is an opportunity for you to teach and expand. Thank-you.
Nursie pooh, you are right many of us me included have had a long hard road. Do Not think for one moment you have paved the road for me. You have not. I have worked my way through school and have paved my own road because unfortunatley I have had to deal with several nurses like you who like to bring students down, Don't worry I 'm probably not going to take your job, Not today anyway. You can relax if that is what your problem is with students.
As I read your hostility I realize you either need to research the following quote or remove it from your posts..."An expert at anything was once a beginner." - Dr. Pat Benner, Nursing Theorist, & Kenya, LPN

With all due respect CindyRN 2006, you are still a student since it is not 2006. I answered your question, you have not answered mine.

I asked two, actually.

The answers are.... ?????

cindyRN 2006 · Nov 9, 2005

O.k . Here we go, You would not have the GI upset as severe if given IV or IM,the reason why (I think) is because when you take a Po med like Toradol it sits in the stomach and as it travels through the bowel it "eats" away at it. Thus causing the N/V/D. If the PO med was enteric coated it would not cause erosion of the stomach lining but would still cause some GI distress.

As far as the meds go that can cause N/V/D Is just about all PO meds like antihypertensives, antirheumatics, antiinnfectives, NSAIDS (big time), but the one that surprises me the most are the proton pump inhibitors like prevacid.

I hope this is what you were asking, Thanks for the challenge. I needed the distraction from my finals I have next week. LOL

Bipley · Nov 9, 2005

O.k . Here we go, You would not have the GI upset as severe if given IV or IM,the reason why (I think) is because when you take a Po med like Toradol it sits in the stomach and as it travels through the bowel it "eats" away at it. Thus causing the N/V/D. If the PO med was enteric coated it would not cause erosion of the stomach lining but would still cause some GI distress.
As far as the meds go that can cause N/V/D Is just about all PO meds like antihypertensives, antirheumatics, antiinnfectives, NSAIDS (big time), but the one that surprises me the most are the proton pump inhibitors like prevacid.
I hope this is what you were asking, Thanks for the challenge. I needed the distraction from my finals I have next week. LOL

So tell me, would you give an ER pt with a GI bleed (unknown location) with pain IV Toradol, IV MS04, or PO Tylenol? It's a trick question, btw.

SFCardiacRN · Nov 9, 2005

What was the question? I forgot.

cindyRN 2006 · Nov 9, 2005

None listed I would give a NSAID but I would give it with cytotec (if the PT. was not pregnant) IF that is not what you are asking then I would rest the bowel and only give IV or IM.

thanks

Bipley · Nov 9, 2005

What was the question? I forgot.

If a drug such as Toradol causes GI upset if given PO, will giving it IM or IV cause the same problems, and which classes of drugs cause GI upset.

It's a test for the newbie students. :chuckle

Bipley · Nov 9, 2005

None listed I would give a NSAID but I would give it with cytotec (if the PT. was not pregnant) IF that is not what you are asking then I would rest the bowel and only give IV or IM.
thanks

Really? Which NSAIDs would you give?

Keep in mind, drugs like Toradol *can* cause (not necessarily DO cause) the same exact problems given IV as IM. Long term it's even worse.

ALL drugs can cause GI distress, anything can. A placebo can. We are all different and respond to drugs differently. There isn't a drug on the market that hasn't caused someone GI problems.

Back to my question:

>>So tell me, would you give an ER pt with a GI bleed (unknown location) with pain IV Toradol, IV MS04, or PO Tylenol? It's a trick question, btw.

What is your reasoning for not giving IV Toradol, IV MS04, or PO Tylenol in an ER pt w/pain, with a GI bleed, somewhere?

cindyRN 2006 · Nov 9, 2005

would an answer like, I havn't seen a doctors order yet be acceptable? I don't know let me ponder and maybe research this one. What is initially coming to mind is that toradol is for used for pain only on a short term basis, mgso4 is going to draw fluid into the colon and I need this pt. to reset his bowels and the tylenol I don't want to give because it can also irritate the bowel.

Do I need to research more or is my first instrict close?

Bipley · Nov 9, 2005

would an answer like, I havn't seen a doctors order yet be acceptable? I don't know let me ponder and maybe research this one. What is initially coming to mind is that toradol is for used for pain only on a short term basis, mgso4 is going to draw fluid into the colon and I need this pt. to reset his bowels and the tylenol I don't want to give because it can also irritate the bowel.
Do I need to research more or is my first instrict close?

The patient already has a GI Bleed, giving Toradol (a drug that causes mega GI problems for many people) to a person with an existing GI problem is not wise. Yes, Toradol is used for pain but that is what we are treating, a GI bleed with pain. MS04 isn't good for GI problems, what if the guy is obstructed? MS04 is really the last narcotic you'd want to use (fluid and motility) although many docs still use it anyway, and in an ED setting with a person who has GI problems, gut pain, etc., they wouldn't likely be getting anything PO.

BTW.. Toradol IS used on a short term basis, GREAT job!

You done goodly. :)

cindyRN 2006 · Nov 9, 2005

Thanks again for the challenge, My college needs instructors like you.

Bipley · Nov 9, 2005

Thanks again for the challenge, My college needs instructors like you.

I've had quite a few students that would disagree! :) I still teach PRN at an allied health college but even those guys don't like me. They tend to like me a lot better after finals and they are done with my classes once and for all.

Go figure. :chuckle